Perspectives

Health Delivered, Explained: Supporting Independent Pharmacists Behind the Counter

October 27, 2026

“Health Delivered, Explained” answers common questions about pharmaceutical distributors and their role in delivering medicines to patients who need them.  

In this installment, we explore how distributors support the business of running an independent pharmacy, from technology and contracting to administrative support, through Pharmacy Services Administrative Organizations, or PSAOs.  

How do distributors support pharmacies beyond delivering medicines? 

Distributors support nearly 20,000 independent pharmacies across the country, many of them small businesses that may be the primary source of care in their communities. Beyond reliable delivery, distributors provide the tools these pharmacies need to run efficiently, including ordering and inventory technology, business consulting and franchising programs. When the pharmacy owner is also the pharmacist, manager and bookkeeper, that support makes a real difference. It helps keep the doors open and the pharmacist's attention where it belongs: on patients. 

What is a PSAO, and why does my pharmacist use one? 

Pharmacy Services Administrative Organizations, or PSAOs, handle the behind-the-scenes administrative work that comes with running an independent pharmacy. PSAOs help manage pharmacists’ working relationships with payers and PBMs, providing support related to contracting, claims, reimbursement and audits.  

By combining resources and expertise across pharmacies, PSAOs play an important role in helping independent and community pharmacies remain viable as they navigate increasing pressure from PBMs and a complex healthcare market. Pharmacies voluntarily choose whether to work with a PSAO, typically for a fixed monthly fee of around $200 that is not tied to drug prices or volume.

PSAOs support approximately 83 percent of independent pharmacies nationwide; some are affiliated with distributors, while others are independent. Distributor-affiliated PSAOs are separate legal entities that operate independently. 

Learn more about how PSAOs support independent pharmacies by visiting HDA’s PSAO page and the PSAO Coalition’s website.  

Have a question about healthcare distribution? Watch this space — we'll tackle more in the next installment.