In A Lesson from McKesson: How Specialty Pharmacy Growth Is Hurting Wholesalers, I explained the challenges to wholesalers' profits from the growth of patient-administered specialty pharmacy drugs.
Today, I provide a complementary look at the changing customer mix of wholesalers’ specialty distribution businesses for provider-administered drugs.
As you will see below, the latest data show that specialty distributors’ revenues from independent physician offices and clinics have eroded significantly. These customers now account for less than half of specialty distributors' business.
This change mirrors the ongoing disruption of the buy-and-bill market, where higher-cost hospital outpatient settings have been crowding out lower-cost physician offices.
The evolution of buy-and-bill has been generally negative for wholesaler profits, though the public companies have been relatively silent on the implications. It’s another aspect of the specialty boom that may prove not to be relaxing times for the wholesale distribution channel.
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