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Major US Pharmaceutical Wholesalers Expand Market Control Through Strategic Practice Management Acquisitions

24 days ago3 min read
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Key Insights

  • The three largest US pharmaceutical wholesalers—Cardinal Health, Cencora, and McKesson—are leveraging vertical integration to expand their influence beyond traditional drug distribution into the buy-and-bill market.

  • These companies have strengthened their positions by acquiring stakes in practice management firms through private equity roll-up activities, enhancing their control over provider-administered drug channels.

  • The strategic acquisitions are creating new implications for biosimilar market access and adoption within the buy-and-bill segment.

The three largest pharmaceutical wholesalers in the United States—Cardinal Health, Cencora, and McKesson—are fundamentally reshaping the pharmaceutical distribution landscape through strategic vertical integration initiatives that extend their influence far beyond traditional drug distribution channels.
These industry giants have significantly strengthened their positions in the buy-and-bill market for provider-administered drugs by pursuing aggressive integration strategies with downstream customers and acquiring ownership stakes in practice management companies. This strategic shift represents a major evolution in how pharmaceutical products reach healthcare providers and patients.

Strategic Acquisitions Drive Market Expansion

Recent analysis reveals that pharmaceutical wholesalers are increasingly leveraging private equity roll-up activities to acquire ownership stakes in practice management firms that support healthcare providers. This approach enables these companies to gain unprecedented control over aspects of the supply chain while positioning themselves strategically within the healthcare delivery ecosystem.
The acquisitions provide these wholesalers with enhanced capabilities to manage provider-administered biosimilars within the buy-and-bill market, creating new dynamics in how these cost-effective treatment options reach patients. By integrating with practice management companies, the wholesalers can influence treatment decisions and drug selection processes at the provider level.

Impact on Biosimilar Market Access

The vertical integration efforts are creating significant implications for biosimilar market access and adoption. As wholesalers gain greater control over provider-administered drug channels, they are positioned to influence which biosimilar products are made available to healthcare providers and how they are integrated into treatment protocols.
This enhanced control over the supply chain allows wholesalers to offer strategic advantages in managing provider-administered biosimilars, potentially affecting competition and pricing dynamics within this critical segment of the pharmaceutical market. The integration creates new pathways for biosimilars to reach patients while also establishing new gatekeeping mechanisms.

Transforming Traditional Business Models

These developments underscore how vertical integration is fundamentally transforming traditional business models within the pharmaceutical industry. The strategic approach is creating new opportunities within the healthcare sector while reshaping market dynamics that have governed pharmaceutical distribution for decades.
The findings highlight the evolving pharmaceutical landscape and demonstrate how major wholesalers are adapting to changing market conditions by expanding their influence throughout the healthcare delivery chain. This transformation affects not only how drugs are distributed but also how treatment decisions are made at the provider level.
The strategic initiatives by Cardinal Health, Cencora, and McKesson represent a significant shift in pharmaceutical distribution that will likely influence industry practices and market access strategies for years to come.
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