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Pharmacy500 On-Site Pharmacy Management Outsourcing Report 2025

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APR 2025

SUPPLY CHAIN TEARDOWN

ON-SITE PHARMACY

MANAGEMENT

OUTSOURCING

Alexa DiLuca

Marketing Manager

Michael McEwen

Pharmacy500 Market Analyst

michael.mcewen@rxinsider.com

Gregory Cianfarani, RPh

Founder & CEO

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

Report Lead

Jeff Rackliff

A 2025 Breakdown On-Site Pharmacy Management

Outsourcing Companies and Trends

Table of Contents

• Introduction .................................................... 2-3

• Executive Snapshot ..........................................4

• On-Site Pharmacy Management Outsourcing

Overview ..................................................... 5-6

• On-Site Pharmacy Management Outsourcing

Pharmacy500 Companies ...........................7

• Companies by Region & Practice Setting.....8

• Notable M&A & Consolidation ........................9

• On-Site Pharmacy Management Outsourcing

Product Matrix .............................................10

• Conferences, Trade Shows & Meetings .....11

• References .................................................12-13

• Pharmacy500 Companies ......................14-17

The objective of this report is to educate Pharmacy500

professionals, pharmacy leadership, and other stakeholders on

the companies, services, and benefits relating to on-site pharmacy

management outsourcing.

Pharmacy500 companies

provide outsourced

management services

2,600+

U.S. Hospitals were

participating in the 340B

program as of 2023

1,000+

Managed outsourced

pharmacies in the U.S.

1,850+

Pharmacies with

specialty accreditation

27%

of U.S. specialty

pharmacies are in

hospital/health systems

6,093

Hospitals in the U.S.

as of 2025

40.9% of all retail pharmacies participate in a 340B program (2022).

Source: RXinsider

Source: Drug Channels

Institute

Source: RXinsider

Source: Drug Channels

Institute

Source: American Hospital

Association

EXECUTIVE SNAPSHOT

ON-SITE PHARMACY

MANAGEMENT

OUTSOURCING

Source: US Government

Accountability

Source: JAMA Network

On-Site Pharmacy Management

Outsourcing Overview

On-site management outsourcing refers to delegating the management

and operational responsibilities of a hospital’s pharmacy department to

an external organization or service provider with expertise in pharmacy

management. This arrangement allows hospitals to leverage specialized

knowledge, optimize operations, and focus on patient care while ensuring

regulatory compliance and cost ef�ciency.

1. Operational Oversight:

• The outsourcing provider assumes responsibility for the day-to-day operations of the hospital pharmacy. This includes

staf�ng, work�ow optimization, inventory management, and procurement of medications.

2. StafÏng Solutions:

• Recruitment, training, and management of pharmacy staff are handled by the outsourced provider.

• Ensures adequate staf�ng levels and addresses labor shortages or turnover issues.

3. Compliance and Risk Management:

• The provider ensures adherence to regulatory standards set by bodies such as The Joint Commission, state boards of

pharmacy, and the Drug Enforcement Administration (DEA).

• Implements risk management strategies to minimize medication errors and ensure safe medication practices.

4. Technology Integration:

• Deployment and management of pharmacy management systems and automated dispensing technologies.

• Ensures ef�cient medication distribution, real-time inventory tracking, and compliance with electronic health record

(EHR) integration.

5. Clinical Services Enhancement:

• Improves the delivery of clinical pharmacy services, such as medication therapy management (MTM), patient

counseling, and pharmacovigilance.

• Promotes interdisciplinary collaboration with healthcare teams to optimize patient outcomes.

6. Inventory and Cost Management:

• Implements strategies to manage inventory effectively, reduce waste, and control medication costs.

• Negotiates with suppliers to secure better pricing and terms for the hospital.

7. Performance Metrics and Reporting:

• Tracks key performance indicators (KPIs) such as medication error rates, turnaround times, and budget adherence.

• Provides detailed reports to hospital leadership for transparency and decision-making.

Key Components of On-Site Pharmacy

Management Outsourcing

U.S. Hospitals with Outsourced

Pharmacy Management

U.S. Hospitals with Specialty

Pharmacy Accreditation

U.S. Hospitals Participating in the

340B Program

16%

Outsourced Phamacy

Management

84%

In House

43%

340B

57%

No 340B

Source: RXinsider

92%

No Specialty Pharmacy

Accreditation

Specialty Pharmacy

Accreditation

Pharmacy500 On-Site Pharmacy Management

Outsourcing Companies

The “Pharmacy500” are 500 businesses and associations that signi�cantly

impacted the business operations of dispensing pharmacies in the U.S. over

the previous year. The 11 companies listed below are the companies within

the 2025 Pharmacy500 that make up the on-site pharmacy management

outsourcing supply chain category. For Pharmacy500 criteria and details,

please visit RXinsider.com/Pharmacy500.

Companies by Location

The following shows the most common practice settings for on-site

pharmacy management outsourcing.

Practice Setting Breakout

NUCLEAR

MANAGED CARE / PBM

HOME INFUSION / COMPOUNDING

LONG TERM CARE

SPECIALTY

HOSPITAL / HEALTH SYSTEM

COMMUNITY / RETAIL

2025

McKesson Corporation Announced Launch

of Specialty and Infusion for Health Systems

ProxsysRx Announced Strategic Combination

With Maxor National Pharmacy Services 2024

CPS Solutions, LLC Announced Acquisition

of Trellis Rx, LLC, Offering End-To-End Suite

of Products and Solutions Across Inpatient,

Outpatient & Specialty Pharmacy

Cardinal Health Acquired Advanced

Diabetes Supply Group

Cardinal Health Acquired Majority

Stake in GI Alliance

Cardinal Health Acquired Integrated

Oncology Network

2023

CarepathRx and Evernorth Health

Services Partnered to Enhance

Specialty Care for Patients

Elevance Health Acquired CarepathRx’s

Specialty Pharmacy Subsidiary BioPlus 2022

Walgreens Took Full Ownership of

Shields Health Solutions

Notable M&A & Consolidation

On-Site Pharmacy Management Outsourcing

Services Matrix

340B Program Management

Pharmacy Leadership

Full-service staf�ng

Cardinal Health successfully

managed 75 340B pharmacies

and we’ve implemented dozens