MAY 2025
PRACTICE SETTING TEARDOWN
SPECIALTY PHARMACY
©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
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
Emma Cidade
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
A 2025 Breakdown of the Specialty Pharmacy
Practice Setting
Table of Contents
• Introduction .............................................................2-3
• Specialty Pharmacy Overview .................................4
• Executive Snapshot ....................................................5
• Companies by Region & Company Size ................6
• Practice Setting Crossover ........................................7
• Supply Chain Crossover ............................................8
• Conferences, Trade Shows & Meetings ...........9-11
• Market Trends .................................................... 12-13
• Career Center ........................................................... 14
• References .......................................................... 15-17
• Pharmacy500 Companies ............................... 18-21
The objective of this report is to educate Pharmacy500 The
objective of this report is to educate Pharmacy500 professionals,
pharmacy leadership, and key stakeholders on critical trends
shaping the specialty pharmacy practice setting.
This report provides a focused analysis of Pharmacy500
companies that significantly impact specialty pharmacies,
spanning the entire pharmacy supply chain - including specialty
distributors, delivery services, patient engagement platforms,
adherence technologies, and specialty pharmacy software
vendors.
This report includes a detailed overview of the supply chain
categories
represented,
highlights
Pharmacy500
company
participation at major industry conferences such as NASP and the
Asembia’s AXS25 Summit, and identifies organizations hosting
user conferences in 2025.
Specialty Pharmacy Overview
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
A specialty pharmacy is a type of pharmacy that provides medications and support
services for patients with complex, chronic, or rare medical conditions that require
specialized treatment. These medications, often biologics, injectables, or high-cost
therapies, typically require special handling, administration, or monitoring. Specialty
pharmacies focus on managing these complex therapies by offering personalized
care, education, and clinical management to optimize treatment outcomes,
improve medication adherence, and ensure safe and effective use.
Specialty pharmacies are often tightly integrated into larger healthcare systems,
including hospital networks, health insurance companies, and pharmacy
benefit managers (PBMs). They usually have specialized staff, including clinical
pharmacists, nurses, and patient care coordinators, who work directly with patients
to manage complex conditions and therapies. Specialty pharmacies can be open to
the public or closed to the public.
1. Dispensing Specialized Medications:
Specialty pharmacies dispense medications that are often high-cost, require special storage conditions (e.g., refrigeration), or must
be administered in a specific way (e.g., injectables, infusion therapies). These may include biologics, biosimilars, chemotherapy drugs,
and medications for conditions like cancer, HIV/AIDS, rheumatoid arthritis, and multiple sclerosis.
2. Patient Education and Counseling:
Offering comprehensive patient education on medication use, side effects, injection techniques, administration schedules, and
managing potential drug interactions. This service is designed to ensure patients are fully informed and confident in managing their
therapies.
3. Care Coordination:
Collaborating with healthcare providers, insurance companies, and other healthcare professionals to ensure seamless care. This
may include coordinating medication refills, managing prior authorizations, arranging for in-home infusions, and helping to navigate
insurance or reimbursement issues.
4. Adherence Monitoring and Support:
Implementing programs to improve medication adherence, including regular follow-up calls, medication reminders, and personalized
care plans. Specialty pharmacies often provide dedicated support teams, including pharmacists and nurses, to monitor patient
progress and encourage consistent therapy adherence.
5. Clinical Management:
Offering clinical management services such as medication therapy management (MTM) to assess the effectiveness of therapies,
monitor for side effects, and adjust treatment regimens. This may include monitoring lab values or conducting assessments to
ensure optimal patient outcomes.
6. Risk Management:
Specialty pharmacies are often involved in managing the risks associated with high-cost, high-risk medications, such as providing
support for managing side effects, tracking adverse reactions, and ensuring compliance with safety protocols.
7. Insurance and Reimbursement Assistance:
Helping patients navigate insurance issues, including obtaining prior authorization for treatments, coordinating with payers for
reimbursement, and assisting with financial assistance programs when medications are not fully covered.
8. Compounding:
Some specialty pharmacies may also compound medications to meet specific patient needs, such as customized doses or
formulations.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
75%
of approximately 7,000 new
drug development were
represented by specialty
drugs in 2024.
55%
of total pharmacy spending
in 2024 was accounted for
specialty medications.
3,200
Specialty pharmacies in the U.S.
as of December 2024 (approx.).
3,000
Individual members, including pharmacists
represented by NASP.
55%
of net spending was accounted
from specialty medications
in March 2022.
SPECIALTY
PRACTICE
SETTING
SNAPSHOT
50
novel drugs approved in 2024 by the
FDA’s Center for Drug Evaluation and
Research (CDER).
Asembia founded one of the leading group purchasing
organizations (GPOs) in 2005.
Source: De�nitive Healthcare
Source: NASP
Source: IQVIA
Source: NASP
Source: IQVIA
Source: FDA
Source: Asembia
52%
of total drug spending is from specialty
pharmacy spending, up from 40% in 2020.
Source: IQVIA
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
26%
NORTHEAST
MIDWEST
Pharmacy500 Companies by Region
The Pharmacy500 companies serving
specialty pharmacies range in size. There
are 56 small companies with less than 50
employees, 45 medium-sized companies
with 51 to 200 employees, 40 large
companies with 201 to 1,000 employees,
and 28 very large organizations with more
than 1,000 employees.
WEST 15%
SOUTH
34%
Companies by Size
INTERNATIONAL
1%
24%
1,000+ EMPLOYEES
201-1,000 EMPLOYEES
51-200 EMPLOYEES
1-50 EMPLOYEES
28
40
56
45
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
The following chart breaks down the
number
of
Pharmacy500
specialty
pharmacy companies that crossover to
additional pharmacy practice settings.
Pharmacy500 Practice Setting Crossover
129
126
89
72
MANAGED CARE / PBM
NUCLEAR
HOME INFUSION & COMPOUNDING
LONG TERM CARE
HOSPITAL / HEALTH SYSTEM
COMMUNITY / RETAIL
12
12
©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 Work�ow Management
• Long-Term Care Operation Management
• Medication Inventory Management & Procurement
• Pharmacy Management Systems, Work�ow
• Stewardship Resources (Antibiotic, Opioid...)
Unit Dose
• Outsourced Packaging & Repackaging Services
• Multi-Dose Packaging Resources, Supplies
• Single-Dose Packaging Resources, Supplies
Work�ow
• IVR / Interactive Voice Response Systems
• POS / Point of Sale Systems
• Printers, Barcode Printing
• Will-Call & Kiosk Prescription Management
Pharmacy Supply Chain Categories
TOP FIVE SUPPLY CHAIN CATEGORIES
17
Compounding: USP <797> &
<800> Sterile Resources &
Compliance & Technology
12
Finance: PSAOs & Revenue
Cycle Management &
Reconciliation
17
Finance: Worker’s Comp & Claims
& PA Management & Adjudication
15
Patient Care: Patient
Communication &
Outreach & Engagement
Supply Chain Crossover
TOP FIVE SUPPLY CHAIN CATEGORIES
The
following
chart
represents
the market presence of specialty
pharmacy companies that cross into
the 88 supply chain categories.
13
Delivery & Shipping:
Courier & Delivery & Last-
Mile Services
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
Conferences, Trade Shows & Meetings
The following identifies the top 16
national pharmacy conferences
at which Pharmacy500 specialty
pharmacy
companies
exhibited
in the past year.
62
48
42
37
34
26
18
17
16
14
10
10
The
following
Pharmacy500
specialty
pharmacy
companies that attended one or both of NASP and
Asembia annual conferences.
NASP vs. Asembia
15
21
41
(PHARMACY
FUTURES)
(WINTER)
NASP
(MIDYEAR)
Asembia
21
20
21
(SUMMER)
©2025 RXinsider | RXinsider Market Intelligence Group | 2025
10
340B Health | 340B Coalition Summer
Conference
340B Health | 340B Coalition Winter
Conference
Washington, DC
San Diego, CA
JUL 21-23
FEB 24-26
1,500+
2,000+
50+
60
50+
30+
Hospital / Health
System
Membership
AACP | INitiate Interim Meeting
ACCP | Pharmacy Education Conference
Houston, TX
Chicago, IL
FEB 15-17
JUL 19-22
300+
2,500+
<10
60+
20+
150+
Academia
Membership
AAP | Annual Conference
Austin, TX
APR 10-12
Undisclosed
55+
<10
Community/Retail
Membership
ACA | Annual Conference & Expo
Memphis, TN
SEPT 25-27
Undisclosed
10
10+
Home Infusion &
Compounding
Membership
ACCP | Annual Meeting
Minneapolis, MN
OCT 18-21
1,500+
Undisclosed
100+
Hospital / Health
System
Membership
ACHC | ACHCU Academy
Houston, TX
MAR 3-5
Undisclosed
30+
70+
Various
Users/Customers
ACVP | Veterinary Pharmacy Conference
Fort Worth, TX
JUL 24-26
80+
10
10
Community/Retail
Membership
AMCP | Annual Conference
AMCP | Nexus
Houston, TX
National Harbor, MD
MAR 31-APR 3
OCT 27-30
4,000+
2,500+
70+
40+
30+
30+
Managed Care/
PBM
Membership
American Pharmacies | APEX
San Antonio, TX
JUN 19-21
200+
40+
<10
Community/Retail
Users/Customers
APC | Compounders on Capitol Hill
APC | Owner Summit
Washington, DC
Destin, FL
SEPT 16-17
MAR 14-16
150+
160+
30+
40+
10+
10+
Home Infusion &
Compounding
Membership
APCI | Annual Convention and Stockholders
Meeting
Nashville, TN
MAR 20-23
200+
20+
20+
Community/Retail
Membership
APhA | Annual Meeting & Expo
Nashville, TN
MAR 21-24
4,000+
100+
160+
Various
Membership
ASCP | Annual Meeting & Exhibition
San Diego, CA
OCT 23-26
1,000+
60+
50+
Long Term Care
Membership
Asembia | AXS Summit
Las Vegas, NV
APR 27-
MAY 1
8,000+
170+
70+
Specialty
Users/
Customers
ASHP | Midyear
ASHP | Pharmacy Futures
Las Vegas, NV
Charlotte, NC
DEC 7-11
JUN 7-11
20,000+
1,500+
340+
90+
200+
20+
Hospital / Health
System
Membership
Cardinal Health | RBC
Denver, CO
JUL 9-12
4,500+
200+
30+
Community/Retail
Users/Customers
Cencora | ThoughtSpot
Las Vegas, NV
JUL 16-19
3,500+
500+
20+
Various
Users/Customers
CORE Higher Education Group | Annual
Summit
Providence, RI
SEPT 29 - OCT 1
50+
<10
Academia
Users/Customers
DiversifyRx | Pharmacy Profit Summit
Dallas, TX
MAR 23-24
350+
100+
10+
Community/Retail
Users/Customers
Epic | UGM 2025
Epic | XGM 2025
Verona, WI
AUG 18-21
APR 28 - MAY 8
Undisclosed
10+
20+
Hospital / Health
System
Users/Customers
Epicor | Insights
Las Vegas, NV
MAY 5-8
3,000+
Undisclosed
40+
Community/Retail
Users/Customers
GeriMed | Annual Conference
Marco Island, FL
NOV 7-8
Undisclosed
Undisclosed
Undisclosed
Long Term Care
Users/Customers
HCP | Fall Hospital Pharmacy Conference
HCP | Spring Hospital Pharmacy Conference
Chicago, IL
New Orleans, LA
SEPT 29 - OCT 1
APR 14-16
Undisclosed
Undisclosed
Undisclosed
Hospital / Health
System
Users/Customers
Pharmacy500 Conferences
ATTENDEES
(Approx.)
EXHIBITORS
(Approx.)
EDUCATION
SESSIONS
(Approx.)
LOCATION
DATE
ATTENDEE
TYPE
SETTING
FOCUS