MAR 2025
PRACTICE SETTING TEARDOWN
HOSPITAL /
HEALTH SYSTEM
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
Alexa DiLuca
Marketing Manager
Michael McEwen
Pharmacy500 Market Analyst
michael.mcewen@rxinsider.com
Gregory Cianfarani, RPh
Founder & CEO
Report Lead
Lexi Cianfarani
MEET THE
MARKET INTELLIGENCE TEAM
About RXinsider
Founded in 1999, RXinsider is a pharmacist-founded marketing/
communications (MARCOM) and market intelligence (INTEL) company
focused on pharmacy operations and the companies supporting
dispensing pharmacies. Through our publications, digital platforms,
market research, and training resources, RXinsider educates pharmacy
management and industry professionals on the products, services,
and trends that impact pharmacy operations across the supply chain.
RXinsider’s Market Intelligence (INTEL) Group performs market research
on the pharmacy operations supply chain and the Pharmacy500
companies. Through our weekly reports, digital awareness, and online
training, the INTEL Group educates Pharmacy500 professionals and
pharmacy management on the products and services impacting
pharmacy operations.
Jeff Rackliff
Pharmacy500 Market Analyst
jeff.rackliff@rxinsider.com
Emma Cidade
Pharmacy500 Market Analyst
emma.cidade@rxinsider.com
Lexi Cianfarani
Pharmacy500 Market Analyst
lexi.cianfarani@rxinsider.com
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
A 2025 Breakdown of the
Hospital / Health System
Practice Setting
The objective of this report is to educate Pharmacy500
professionals, pharmacy leadership, and other stakeholders on
key trends within the hospital / health system practice setting.
The following report provides an analysis of the Pharmacy500
companies that significantly impact dispensing pharmacies within
the hospital / health system practice setting.
This report includes a detailed supply chain category and attended
conference breakdown on the hospital and health system focused
companies. Our research examines key trends within the hospital
pharmacy practice setting identified from the 2024 annual ASHP
Midyear meeting, as well as which companies are holding user
conferences for 2025. The 23 recent M&A and consolidation
activities, along with company sizes, have also been identified.
The report concludes with a snapshot of the publicly traded
Pharmacy500 companies and their stock performance for the
trailing four quarters.
Table of Contents
• Introduction .............................................................2-3
• Hospital / Health System Overview ....................4-5
• Companies by Region & Company Size ................6
• Practice Setting Crossover ........................................7
• Notable M&A & Consolidation .................................8
• Supply Chain Crossover ............................................9
• Conferences, Trade Shows & Meetings ........ 10-13
• Market Trends .................................................... 14-15
• Public Stocks ............................................................ 16
• Career Center ........................................................... 17
• References .......................................................... 18-19
• Pharmacy500 Companies ............................... 20-23
Hospital / Health System Overview
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
A hospital (health system) pharmacy is responsible for procuring,
preparing, dispensing, and managing medications for patients admitted
to the hospital (in-patients) and in certain cases, patients in the local
community (out-patients). The hospital pharmacy staff ensures the six
rights (the right patient, medication, indication, dose, time, and route).
Hospital pharmacies also provide services like drug therapy management,
clinical consultation, and patient education to optimize therapeutic
outcomes.
Hospital pharmacies typically consist of a team of pharmacists, pharmacy
technicians, and pharmacy interns who work closely with doctors,
nurses, and other healthcare providers. The team often includes clinical
pharmacists who specialize in particular areas (e.g., oncology, pediatrics,
or critical care) and medication safety officers who focus on minimizing
medication errors and improving patient outcomes. In-patient hospital
pharmacies are closed to the public (closed-door pharmacy), while an out-
patient pharmacy in a hospital is open to the public and operates similarly
to a retail/community pharmacy.
1. Medication Procurement and Inventory Management:
Ensuring the hospital is stocked with all necessary medications and pharmaceutical supplies.
2. Medication Dispensing:
Preparing and dispensing medications based on prescriptions written by physicians and other healthcare providers. This includes
both standard oral medications and specialized preparations like intravenous fluids, chemotherapeutic agents, and parenteral
nutrition.
3. Clinical Consultation and Drug Information:
Providing clinical expertise to healthcare providers on the safe and effective use of medications, including identifying drug
interactions, recommending alternative treatments, and adjusting doses based on patient conditions (e.g., renal function, age,
comorbidities).
4. Compounding:
Preparing customized medications, particularly when commercially available products do not meet specific patient needs (e.g.,
compounded chemotherapy drugs, pain management injections).
5. Patient Safety and Monitoring:
Ensuring that medication use is safe, effective, and tailored to the individual needs of patients. This includes checking for adverse
drug reactions (ADRs), therapeutic drug monitoring, and assessing for drug-drug interactions.
6. Education and Training:
Educating healthcare providers, patients, and caregivers about the proper use of medications, potential side effects, and the
importance of adherence to prescribed regimens.
7. Regulatory Compliance:
Ensuring that the pharmacy department follows all relevant federal and state regulations, including those related to controlled
substances, proper storage conditions, and the handling of hazardous medications.
Key Functions & Characteristics
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
34%
of Pharmacists work in
hospitals (approx. 115,000)
$1.5 T
Total combined expenses for
all U.S. hospitals in 2024
6,093
Hospitals in the U.S. as of 2025
920,531
Total beds in the all U.S. hospitals
271
Drug shortages as of
December 2024
PRACTICE
SETTING
SNAPSHOT
60,000
Pharmacists, student pharmacists,
and pharmacy technicians represented
by ASHP
The first hospital pharmacy was established in 1752.
References: American Hospital Association, American Journal of Hospital Pharmacy, Data USA, and ASHP
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
21%
NORTHEAST
MIDWEST
Companies by Region
The Pharmacy500 companies range in
sizes. There are 121 small companies
with less than 50 employees, 87
medium-sized companies with 51 to 200
employees, 69 large companies with 201
to 1,000 employees, and 60 very large
organizations with more than 1,000
employees.
WEST 16%
SOUTH
34%
1,000+ EMPLOYEES
201-1,000 EMPLOYEES
51-200 EMPLOYEES
1-50 EMPLOYEES
121
87
60
69
Companies by Size
INTERNATIONAL
3%
26%
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
The following chart breaks down the
number of Pharmacy500 hospital / health
system companies that crossover to
additional pharmacy practice settings.
Practice Setting Crossover
187
147
126123
MANAGED CARE / PBM
NUCLEAR
LONG TERM CARE
SPECIALTY
HOME INFUSION & COMPOUNDING
COMMUNITY / RETAIL
14
12
Notable M&A & Consolidation
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
Q1 2025
RxStrategies, Hudson Headwaters 340B, and
RPH Innovations Merge to Form Pillr Health
Nuvem Acquires Louvir
Pharma Logistics Acquires
Rx Reverse Distributors
Avel eCare Acquires Amwell Psychiatric Care
Bluesight Acquires Protenus.
Q4 2024
CORE Higher Education Group
Merges with PeopleGrove
Amsino Acquires MedXL Inc.
Cardinal Health Acquires Both GI Alliance
& Advanced Diabetes Group
Ecolab Acquires Barclay Water Management
Kewaunee Scientific Corporation Acquires NuAire
WM Acquires Stericycle
Bluesight Acquires Sectyr
Bureau Veritas Acquires Aligned Incentives
U.S. Pharmacopeia Acquires Stratix Labs
Q3 2024
Fagron Acquires RideDose 503B
Cardinal Health Acquires Integrated
Oncology Network
Eurofins Acquires Infinity Laboratories
ASP Global Acquires RD Plastics Company
BD acquires Critical Care from
Edwards Lifesciences
Scriptology Acquires RxLive
ExactCare and Tabula Rasa HealthCare
Merge as AnewHealth
Q1 2024
Innovaccer Acquires Pharmacy Quality Solutions
Modular Devices Merges with Flow
Cleanrooms and Technical Air Products
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
Automation & Robotics
• Automated Dispensing Cabinets (ADCs)
• Med Carts, Computer Carts, COWs
• Pharmacy Fulfillment Robots
• Material Transport Delivery, Pneumatic Tubes
• Smart Pumps & Infusion Pumps
• Tablet & Capsule Counters
Compounding
• Closed System Drug-Transfer Devices (CSTDs)
• Sterile Compounding Automation, IV Automation
• USP <795> Non-Sterile Resources, Compliance,
Technology
• USP <797> & <800> Sterile Resources, Compliance,
Technology
Contamination Control
• Cleanrooms, Gloveboxes, Hoods, Isolators
• Cleanroom Supplies, Disposables, Sterilization
• Environmental Monitoring & Compliance
• Quality Control, Lab Testing Services
Delivery & Shipping
• Cold Chain Management & Supplies
• Courier, Delivery, Last-Mile Services
Distribution
• 340B Solutions, 340B Management Systems
• DSCSA Solutions
• GPOs, Buying Groups, COOPs
• Pharmacy Supplies
• Returns, Reverse Distribution
• Wholesalers & Distributors
Facilities
• Design, Fixtures, Engineering
• Pharmacy Refrigeration & Cold Storage
• Pharmacy Security, Medication Storage, Carousels
• Temperature Monitoring (Wireless)
• Waste Management & Destruction
Finance
• Financing, Banking, Business Loans
• Insurance (Business, Liability, Malpractice)
• Mergers, Acquisitions, Buying-Selling, Franchising
• PSAOs, Revenue Cycle Management, Reconciliation
• Worker’s Comp, Claims, PA Management, Adjudication
Manufacturing
• 503B Outsourcing Facilities, Compounding Services
• Contract Manufacturing, Drug Shortage Mitigation
• Generics, Brand Name, Biotech
• Injectables
Merchandising
• DME, Devices
• OTC Products, Vitamins, Supplements, Merchandise
Patient Care
• Adherence, Compliance, Remote Monitoring, Med Sync
• Assistance Programs, Loyalty Resources, Discount
Cards
• Diabetic Care
• Medication Therapy Management (MTM)
• Patient Communication, Outreach, Engagement
• Personalized Wellness, Point-of-Care Services
Professional Development
• Associations, Trade Organizations
• Conferences, Trade Shows, Expos, Summits
• Continuing Education, Training
• Degree Programs, Masters, Post-Secondary
• Jobs, Careers
Professional Services
• Accounting & Legal Services
• Accreditation, Certification, Compliance
• Audit Support
• Consulting (Health Systems & Infusion)
• Consulting (Retail/Community & Specialty)
• Marketing Services
• On-Site Pharmacy Management Outsourcing
• Staffing Services, Recruiting Agencies
• Telepharmacy, Remote Order Entry
Software
• Business Management, Operations, ERP
• Clinical Monitoring, Surveillance, Insights
• Controlled Substance Reporting, Ordering
• Decision Support, Point of Care Reference, Dosing, DUR
• Drug Diversion Monitoring, Diversion Prevention
• eMAR, EMR, EHR, Bedside Verification
• Error Prevention, Drug Validation
• Formulary Management
• IV Workflow Management
• Long-Term Care Operation Management
• Medication Inventory Management & Procurement
• Pharmacy Management Systems, Workflow
• Stewardship Resources (Antibiotic, Opioid...)
Unit Dose
• Outsourced Packaging & Repackaging Services
• Multi-Dose Packaging Resources, Supplies
• Single-Dose Packaging Resources, Supplies
Workflow
• IVR / Interactive Voice Response Systems
• POS / Point of Sale Systems
• Printers, Barcode Printing
• Will-Call & Kiosk Prescription Management
Pharmacy Supply Chain Categories
The following charts represent the
market presence of hospital / health-
system companies that cross into the
88 supply chain categories.
TOP FIVE SUPPLY CHAIN CATEGORIES
56
Compounding:
USP <797> & <800> Sterile
Resources, Compliance,
& Technology
25
Contamination Control:
Cleanrooms & Gloveboxes
& Hoods & Isolators
39
Contamination Control:
Cleanroom Supplies,
Disposables, Sterilization
32
Distribution:
340B Solutions & 340B
Management Systems
34
Software:
Medication Inventory
Management
& Procurement
Supply Chain Crossover
The following charts represent the
market presence of hospital / health-
system companies that cross into the
88 supply chain categories.
TOP FIVE SUPPLY CHAIN CATEGORIES
56
Compounding:
USP <797> & <800> Sterile
Resources, Compliance,
& Technology
25
Contamination Control:
Cleanrooms & Gloveboxes
& Hoods & Isolators
39
Contamination Control:
Cleanroom Supplies,
Disposables, Sterilization
32
Distribution:
340B Solutions & 340B
Management Systems
34
Software:
Medication Inventory
Management
& Procurement
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
10
Conferences, Trade Shows & Meetings
The following identifies the top 16 national
pharmacy conferences at which hospital
/ health system companies exhibited
in 2024.
152
66
54
45
39
36
29
25
18
13
11
13
The following Pharmacy500 hospital / health system
companies that attended one or both of the ASHP annual
conferences.
ASHP Midyear vs. Pharmacy Futures
16
30
49
(PHARMACY
FUTURES)
(WINTER)
ASHP Midyear
(MIDYEAR)
ASHP Pharmacy
Futures
152
49
45