Over time, the specialty pharmacy provider (SPP) market has evolved from a relatively concentrated distribution channel into a diverse ecosystem of organizations with distinct capabilities, expertise, and stakeholder relationships. HIRC’s report, Specialty Pharmacy Providers: Market Landscape Trends and Strategic Imperatives, examines the latest market dynamics, trends, and strategic priorities across the channel. The report addresses the following questions:

• How has the market evolved in share, total number accredited specialty pharmacies operating, and composition by ownership type?
• What notable market trends are impacting the specialty pharmacy channel in 2026?
• What are the latest trends in specialty drug dispensing and distribution (e.g., limited distribution, white bagging)?
• What do SPPs describe as their most urgent strategic imperatives for 2026?
• What differences in capabilities, priorities, and service models emerge across SPP ownership types?
• How common is it for various SPP services to be provided as a core service vs. at an additional cost to manufacturers?

Key Finding: As the specialty pharmacy channel continues to diversify, manufacturers have access to a broader range of capabilities, expertise, and partnership models that can be aligned to the unique needs of individual therapies and patient populations.

Pulse on the Market Environment from the SPP Lens. Given the rapidly evolving health care market environment, HIRC asked for specialty pharmacy perceptions of nine unique market trends. SPPs broadly perceive distribution, pricing, and regulatory-related changes as threats to traditional business models, while viewing AI, real-world evidence, and high-complexity specialty therapies as key enablers of future growth and competitive differentiation. Perceptions vary by ownership model.

Comprehensive View of the Specialty Pharmacy Channel. This new resource provides a comprehensive view of the specialty pharmacy channel, helping manufacturers better understand specialty pharmacy perspectives, evolving market dynamics, and the diverse capabilities that exist across the ecosystem. These insights provide valuable context for evaluating partnership approaches and supporting informed decision-making in an increasingly complex healthcare environment.

While specialty pharmacies tend to offer similar core services, competitive differentiation is emerging through ownership-specific strengths, with PBM/health plan-owned SPPs leveraging payer alignment and scale, independent SPPs emphasizing unique capabilities and/or specialization, and health system-owned SPPs differentiating through provider integration and continuity of care.

Profiles of Key Specialty Pharmacy Organizations. The full report includes in-depth profiles of the following largest specialty pharmacies in market share:

Dispensing trends, service offerings, and strategic imperatives are also segmented by the following three SPP ownership types (1) PBM/Health Plan-owned Specialty Pharmacies (n=8), (2) Independent/Other Specialty Pharmacies (e.g., Retail, Wholesaler-owned) (n=17, and (3) Health System-owned Specialty Pharmacies (n=21).

Research Methodology and Report Availability. In March & April, HIRC surveyed 46 specialty pharmacy provider executives, representing a variety of ownership types. In addition to extensive secondary research, online surveys and follow-up telephone interviews were used to gather information. The report, Specialty Pharmacy Providers: Market Landscape Trends and Strategic Imperatives, is part of the Specialty Pharmaceuticals Service, and is now available to subscribers at www.hirc.com.