HDA Factbook: Rx Sales Through Traditional Healthcare Distributors Increase

October 12, 2023

New data released by the HDA Research Foundation reveal that total prescription sales through traditional pharmaceutical distribution jumped 15.5 percent in 2022 to reach $666 billion. As highlighted in the 94th Edition HDA Factbook, an estimated 95 percent of all pharmaceutical sales move through the traditional distribution channel. Moreover, distributors are operating on the lowest margins in the study’s history — in 2022, the industry’s net profit margin after taxes was 0.4 percent.

Prescription drugs make up the majority (98.1 percent) of distributors' sales, split among sales of brand-name drugs (51.4 percent), branded specialty (35.5 percent), generic drugs (6.7 percent), biosimilar products (3.9 percent) and generic specialty (0.7 percent). Chain drug stores (46 percent) remain distributors' largest customer segment, followed by hospitals and HMOs (14.3 percent) and independent pharmacies (12.5 percent).

View an executive summary and infographic of key HDA Factbook data for the 2022 operating year.

“The data reflected in the HDA Factbook illustrate the operational efficiencies behind delivering 10 million medicines and healthcare products each day to hundreds of thousands of pharmacies, providers and ultimately patients,” said Perry Fri, Executive Vice President of Industry Relations, Membership and Education; and COO, HDA Research Foundation. “While the industry is not immune to certain economic realities like higher U.S. inflation rates and product supply challenges, distributors have remained resilient and continue to be a critical partner across the healthcare supply chain.”

Published annually since 1929, the HDA Factbook is based on surveys collected at the corporate level of HDA traditional distributor member companies with annual sales greater than $1 billion. Secondary data from leading healthcare industry organizations complement original data to illustrate overall distributor demographics as well as trends in operations, information technology, market characteristics, customers and product mix, among other sections.

As reported within the new Factbook:

  • Each traditional distribution center processed 4,600 orders each business day, and these orders averaged 11 invoice lines and 22 units;
  • Distributors worked with an average of 1,520 manufacturers in 2022, up from 1,350 in 2021;
  • Inventory management remained a bright spot for healthcare distributors, with companies holding inventory for just 24 days in 2022 (the shortest holding period in the study’s history);
  • From 2021 to 2022, sales of biosimilar drugs rose significantly from 0.7 percent to 3.9 percent. Brand name, specialty drugs also experienced a large jump in sales, from 33.5 percent to 35.5 percent. However, sales of brand name drugs fell from 55.3 percent in 2021 to 51.4 percent in 2022;
  • Distributors filled 86 percent of invoice lines for their “raw orders” in 2022. The cited reasons for unfilled orders were the manufacturers being unable to ship (69 percent) and distributors being out of stock (31 percent); and,
  • The continued investments in automation and other process improvements allowed for productivity gains. The portion of distribution companies using automated methods continued to climb (66 percent), and nearly half of the invoice lines were picked by automated methods in 2022.

The 94th Edition HDA Factbook: The Facts, Figures and Trends in Healthcare (2023–2024) is available as a complimentary download from The publication was made possible through the support of gold sponsors Apotex Corp., Real Value Rx; silver sponsor IQVIA; and bronze sponsors Ascend Laboratories, KeySource, Pharmacy First and Teva Pharmaceuticals.

The Healthcare Distribution Alliance (HDA) represents primary pharmaceutical distributors — the vital link between the nation’s pharmaceutical manufacturers and pharmacies, hospitals, long-term care facilities, clinics and others nationwide. Since 1876, HDA has helped members navigate regulations and innovations to get the right medicines to the right patients at the right time, safely and efficiently. The HDA Research Foundation, HDA’s nonprofit charitable foundation, serves the healthcare industry by providing research and education focused on priority healthcare supply chain issues.

The HDA Research Foundation is the 501(c)(3) non-profit 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