Specialty Distributors Continue To Provide Effective Delivery and Value to the U.S. Healthcare Ecosystem

November 14, 2023

New benchmarking data released by the HDA Research Foundation showcase the continued value of HDA specialty distributors to the U.S. healthcare ecosystem. As illustrated in the 15th edition of Specialty Pharmaceutical Distribution Facts Figures and Trends, the average specialty distributor delivered medicines to treat chronic, complex or rare diseases to 51,469 unique ship-to points in 2022.

“The HDA Foundation’s latest Specialty Pharmaceutical Distribution Facts Figures and Trends quantifies the many ways specialty distributors serve as vital partners within an evolving healthcare ecosystem,” said Perry Fri, Executive Vice President of Industry Relations, Membership and Education, HDA; and COO, HDA Research Foundation. “The industry does this by achieving impressive service levels and efficient delivery, ultimately ensuring providers have the necessary medicines and support to keep their patients healthy.”

The primary research in this report includes survey data from the corporate level of HDA specialty distributor member companies. Those companies reported sales of $1 billion or more for fiscal year 2022, whose average gross specialty sales were $38.9 billion and distribute specialty pharmaceutical products nationally. Secondary research from leading healthcare organizations complements primary findings.

As highlighted in the latest edition:

  • On a typical business day, each specialty distributor handled an average of 4,200 daily orders, achieved fill rates of 99.5 percent and delivered within 1.5 days of order receipt.

  • Specialty distributors reported having agreements in place with an average of 222 manufacturer suppliers, up from 203 in 2021.

  • Independent, physician-owned clinics remain the most significant type of ship-to points with more than 17,000 outlets on average, followed by hospitals and hospital-owned clinics, retail pharmacies and specialty pharmacies.

  • About 1.5 percent of specialty pharmaceutical product units were returned, and the average annual value of these returns was approximately $152 million.

  • Approximately 46 percent of warehoused products required refrigerated storage in 2022, while 7 percent were required to be frozen.

  • Distributors continued to embrace sustainable practices by reusing packing materials, with 67 percent opting to reuse insulated boxes and ice packs and 33 percent reusing refrigerated boxes.

  • In 2022, distributors reported that they carried a weighted average of 23.2 days of inventory, showing an increase of 1.8 days from the previous year.

Increased specialty drug spending was driven primarily by sales in the immunology and oncology therapeutic areas. According to IQVIA, immunology sales grew $17 billion in 2022, contributing nearly half the $35 billion in overall specialty drug sales growth. Over the past five years, immunology sales have grown consistently, achieving an 18.7 percent CAGR between 2018 and 2022. Immunologic drugs accounted for a 34 percent market share of U.S. specialty pharmaceutical sales, surpassing oncology products for the third consecutive year. Oncology drugs, meanwhile, grew to $9 billion, a 28 percent market share.

The 2023 edition of Specialty Pharmaceutical Distribution Facts Figures and Trends is available as a complimentary download from The publication is supported by gold sponsors Eisai, Inc., and Genentech, A Member of the Roche Group; silver sponsors Regeneron and Takeda Pharmaceuticals U.S.A., Inc.; and bronze sponsor Johnson & Johnson Health Care Systems Inc.

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