A Legacy Beyond the Numbers
Ahead of the 2026 CEO Roundtable Fundraiser in November, the HDA Research Foundation is looking back on a busy few months, including the June presentation of the Nexus Award for Lifetime Achievement. In this special installment of HDA Perspectives, we profile our 2026 winner, Al Paonessa.
This past June, on a stage in San Diego, Albert “Al” Paonessa accepted the Nexus Award for Lifetime Achievement, the healthcare distribution industry’s highest individual honor, presented by the Healthcare Distribution Alliance Research Foundation. For Paonessa, the moment closed a loop that started two decades earlier, when he watched friend and colleague Mike Baker receive the same award. At that time, Paonessa had told himself it would never be him on stage.
Ask anyone who’s worked alongside Paonessa what the award is really recognizing, and the financial metrics associated with his ability to successfully grow two companies — striking as they are — aren’t usually where they start. They start instead with a promise.
This promise to respect the people around him shaped who he became. When a private equity group flew him to New York in 2016 to discuss taking over KeySource, a family-run distributor, Paonessa laid out his terms before he’d agree to anything: If the business grew to the point that an employee’s role became too big for them, he would find that person another role in the organization. Those employees had helped build the company, and he wanted to recognize their contribution as it grew. He asked the investors to support that commitment, and they agreed.
It’s this same instinct that shaped the kind of leader Paonessa became: one who built companies not by outworking and outsmarting the competition alone, but by trusting the people who did it with him.
A Career He Never Planned
Paonessa didn’t set out to build a $2 billion distribution company. He set out to be a golf pro.
Paonessa grew up playing golf and continued at Bowling Green State University, where he studied communications, with a minor in sales and marketing. It was practical enough to fall back on but really just a means to an end. What he wanted was to teach golf at a country club. For five or seven years after college, that’s exactly what he did. “It really wasn’t very lucrative, though,” he says now.
Around that time, his father — a pharmacist who’d sold his own pharmacy to Rite Aid — was approached by a group of sales representatives from another generic pharmaceutical distributor who wanted to start their own company, and they needed a pharmacist on staff. In 1986, Paonessa’s father, along with a bookkeeper, a stock person, and three additional staff members, formed VIP Pharmaceuticals.
Paonessa joined the family business in 1991. His father ran the place the way he ran everything: old-school, demanding, unmoved by anything he didn’t personally understand. “His idea of IT was if he didn’t understand it, we didn’t need it,” Paonessa says. When VIP needed to modernize its systems, nobody was going to hire an outsider to do it. So Paonessa taught himself.
He learned to program on an AS/400 — the same machines behind bank mainframes and grocery store inventory systems in that era — and figured it out well enough to rebuild VIP’s software from the inside. It wasn’t glamorous and it wasn’t golf, but it turned out to be the education that mattered.
Learning the Business from the Inside Out
VIP was eventually sold to Andrx, the pharmaceutical company that also owned Anda (a distributor), in 2000. For the first two years, Paonessa split his time, commuting back and forth for Anda while running VIP, which had grown into a $100 million business by then. Then Anda asked him to come south and run IT.
The AS/400 knowledge came in handy sooner than he expected. Ahead of Y2K, Paonessa had purchased the same software Anda was already using to modernize VIP’s systems, betting correctly that a sale to Anda was on the horizon. The move gave him a head start once the acquisition closed, since he already knew the system inside and out. It was one of the reasons, he suspects, that Anda brought him to Florida to head up IT in the first place.
He ran IT for about two years, then was promoted to senior vice president of sales. Sixteen months later, Anda’s president left abruptly for a job outside the industry, and the company had to decide who would replace him. They picked Paonessa.
Paonessa’s first move as president was to restructure the company around three pillars: purchasing, sales and pricing. It was the beginning of an operating style that would define the rest of his career — bring the right people into a room, let them argue it out and trust them to land somewhere better than he could have alone.
Betting on What Was Possible
Watson (which later changed its name to Actavis and then Allergan) acquired Andrx, including its Anda distribution business, in 2006. When Paul Bisaro became Watson’s CEO the following year, he sat down with Paonessa to ask what the business needed to grow. Paonessa gave him two answers: a bigger vault for controlled substances at the Ohio facility and a new distribution center in Memphis, Tennessee, that could move 60,000 packages a day. Bisaro was skeptical, because nobody in the industry was doing that volume. Anda did it anyway. “We were reaching as high as 45,000 packages in a single day and growing to 65,000 ship-to locations across the country,” Paonessa says. By the time Paonessa retired as president in 2015, Anda’s sales had grown from $700 million to more than $2 billion.
Much of that growth came from being first. “We were the first ones to use internet and order straight from Palm Pilots,” he explains. Anda also ran events pairing pharmacy chains with vendors, brokering deals at golf outings and stepping back once the relationships were made. But Paonessa is quick to credit the people who built those systems with him rather than the systems themselves. He’s said more than once that he was never the smartest guy in the room. He just made sure he surrounded himself with people who made each other better.
After 10 years at Anda, Paonessa retired, but retirement didn’t take. He spent a couple of years opening restaurants with his wife, JoAnne, and their son, Michael, in the small village of Lewiston, New York. Then, in 2016, a private equity group asked him to run KeySource, a family-run distributor out of Cincinnati. KeySource reminded him of VIP, because it was the same size and had the same structure and feel. He told the private equity group he’d grow the business, and KeySource grew four times over with his leadership. He still serves as chairman of the board at KeySource.
The Measure That Matters
Long before Paonessa got into pharmaceutical distribution, a pastor at a church he attended in Fort Lauderdale, Florida, told him something that stuck with him for years: “Your dreams are what you’re meant to be. What you are is what you settled for.” At the time, he thought she was talking about his dream of playing in the PGA Tour. Standing on stage to receive the Nexus Award three decades later, he connected those words to the career he’d built and the people he’d helped along the way.
It’s a fitting realization for someone who built two companies less by building systems than by building people. Standing at the podium, Paonessa said as much outright. “I’ve been blessed with so many people that saw more in me than I ever saw in myself,” he told the room. “This industry gave me more than a career. It gave me friendships and mentors, it gave me purpose, but more importantly, it gave me the privilege to work alongside the finest people I could ever hope to know.”
Ask him what he wants his legacy to be, and he doesn’t reach for the growth numbers. It’s the kind of thing Paonessa is uncomfortable taking credit for. JoAnne has spent years nudging him to introduce himself as the man who ran a $2 billion pharmaceutical distribution company, rather than a man who simply works for one. He still won’t say it that way. “I cared more about everybody else than myself. I never yelled at anybody. I never treated anybody wrong,” he said.
Outside of work, he’s still on a golf course as often as he can manage — he plays competitively in senior events — and still cooks for anyone who’ll show up, a habit that started with posting recipes on Facebook and seeing who came by to try them. Between the two companies, two restaurants and grandkids he and JoAnne split their time visiting in Florida and New York, his life has mimicked his own ethos to build something, then take care of the people building it with you.
“I can’t wait to stand with you guys in the future,” Paonessa said, looking at past winners on the Nexus stage. “This is such an extraordinary honor,” he closed, “And I’m so grateful.”
For more information on our awards programs, visit HDA.org/industry-recognition.
HDA recently spoke with previous Nexus Award winners for their perspectives on this career achievement award. Watch our new video, “Nobody Thinks It Is Them” to hear their thoughts: