A relatively few large, multinational firms comprise the bulk of the brand pharmaceutical manufacturing industry today. The 10 largest pharmaceutical corporations, as measured by U.S. sales, accounted for almost 60% of total U.S. sales of pharmaceuticals in 2004 (IMS Health, 2005).
The wholesale distribution industry is also closely held, having consolidated in the past 30 years, from approximately 200 distributors in 1975, to fewer than 50 in 2000. In 2004, the top three wholesale distributors accounted for almost 90% of the wholesale market.
The retail pharmacy landscape has changed from the traditional apothecary and drugstore model of decades ago. In 2004, drug store chains filled 41.2% of prescriptions, mail-order pharmacies 18.7%, other pharmacies 18.3%, supermarket pharmacies 12.3%, and mass merchants 9.6% (National Association of Chain Drug Stores, 2004).
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