Specialty Distributors Navigated Pandemic’s First Year To Reliably Deliver Lifesaving Medications

December 16, 2021

ARLINGTON, Va. — Data published today by the Healthcare Distribution Alliance (HDA) Research Foundation indicate HDA-member specialty distributors adapted to ensure reliable delivery of complex medications during the first year of the COVID-19 response. As reported in the 2021 edition of Specialty Pharmaceutical Distribution Facts, Figures and Trends, individual specialty distributors serve as a critical nexus between 191 manufacturers and a record-high 50,000 healthcare provider ship-to points.

Products in the autoimmune/inflammatory category saw a 2.5-percentage-point increase to reach 11.6 percent of all specialty distributor sales (from 9.1 percent in 2019); this was due to a range of factors, including the experimental use of these drugs to treat coronavirus. However, oncology products still account for the highest sales volume among specialty distributors, at 51.6 percent on average (though down slightly from 52.2 percent in 2019).

Now in its 13th year, Specialty Pharmaceutical Distribution provides benchmarking trends and metrics for the 2020 fiscal year. As defined by the Foundation, specialty pharmaceuticals treat chronic, complex and rare diseases while meeting several criteria related to the distribution, care, delivery or cost of the medicines. These medicines typically require special handling (such as cold chain storage and distribution), and are administered by healthcare professionals, among other unique characteristics. Currently, the specialty segment comprises 49 percent ($263 billion) of the total pharmaceutical market according to IQVIA.

Primary data are based on a survey of HDA-member specialty distributors with sales greater than $1 billion; respondents averaged gross specialty sales of $27.5 billion and delivered to all 50 states last year. Secondary research from governmental and healthcare organizations complements survey data. Of note, the publication includes follow-up interviews with respondents to provide additional commentary on how COVID-19 affected operations, as well as expanded sections on biosimilars and payer dynamics.

“The latest Specialty Pharmaceutical Distribution book offers insights into specialty distributor operations given the shifting demand and use of healthcare services in 2020,” said Perry Fri, Executive Vice President of Industry Relations, Membership and Education, HDA; and COO of the HDA Research Foundation. “Though there were challenges, distributors adjusted to manage them, and this unique segment fulfilled its important responsibility of delivering these complex medications, safely and reliably, to thousands of providers.”

Among the metrics reported in the new edition:

  • The segment achieved high service levels for customers in 2020, with a 99.9 percent average fill rate. Specialty distributors delivered within 1.6 days of a placed order, and delivery was typically completed in 18.3 hours.
  • The average specialty distributor processed nearly 4,500 orders daily, with nearly 6,200 lines picked each business day (2.8 lines per order).
  • Specialty distributors reported carrying approximately 20.7 days of inventory. A typical warehouse averages 399,750 square feet, with more than half of that space equipped to store refrigerated or frozen products.
  • All respondents report using technologies like electronic data interchange and track-and-trace technologies to add efficiencies to their operations. Specialty distributors note “automating services,” “managing operations” and “increasing productivity” as the top three reasons for adopting new technologies.
  • Specialty distributors report offering dozens of professional services to help providers support patients, as well as marketing services beyond their central distribution functions.  

Specialty Pharmaceutical Distribution was made possible by gold sponsor Genentech, A Member of The Roche Group; silver sponsors Amneal Pharmaceuticals, Regeneron Healthcare Solutions and Takeda Pharmaceuticals U.S.A., Inc.; as well as bronze sponsors Cardinal Health, Inc., Pharmacy First and Reliance Wholesale Inc. The publication is available as a complimentary download


The HDA Research Foundation is the 501(c)(3) nonprofit charitable organization of the Healthcare Distribution Alliance (HDA). The Foundation serves as the thought leader in driving research, education and discussion for all healthcare supply chain stakeholders, enabling the industry's ability to deliver efficient, safe and secure patient access to medicines and medical products. Learn more at