Specialty Pharmacy Market - Global Industry Size, Share, Trends, Competition, Opportunity and Forecast, Segmented By Ownership (Standalone, Hospital-Based, Others), By Therapy Area (Cancer, Rheumatoid Arthritis, Hemophilia, Hepatitis C, Multiple Sclerosis, Others), By Region 2021-2031F

Forecast Period	2027-2031
Market Size (2025)	USD 128.41 Billion
CAGR (2026-2031)	7.01%
Fastest Growing Segment	Hospital-based
Largest Market	North America
Market Size (2031)	USD 192.82 Billion

Market Overview

The Global Specialty Pharmacy Market will grow from USD 128.41 Billion in 2025 to USD 192.82 Billion by 2031 at a 7.01% CAGR. The Global Specialty Pharmacy Market involves the distribution and management of high-cost, high-touch medication therapies designed for patients with complex, chronic, or rare conditions requiring distinct handling and administration. Growth in this sector is primarily driven by the rising prevalence of chronic diseases, aging global demographics, and an expanding pharmaceutical pipeline focused on biologics and orphan drugs. These fundamental drivers necessitate the specialized clinical management and supply chain capabilities inherent to specialty pharmacy models to ensure patient adherence and safety.

Despite this upward trajectory, the market encounters substantial challenges regarding the high cost of therapy and rigorous reimbursement protocols which can restrict patient access. The financial magnitude of these therapies creates significant pressure on payers and health systems, intensifying the need for effective cost-management strategies. According to the Academy of Managed Care Pharmacy, in 2024, specialty medicines accounted for 51% of total pharmacy spending, a statistic that highlights the critical economic impact and management difficulties associated with these essential treatments.

Key Market Drivers

Accelerated innovation in biologics and gene therapies stands as a primary engine for the Global Specialty Pharmacy Market, radically shifting the treatment landscape for complex and rare diseases. This driver is characterized by a robust pipeline of high-value treatments that require the distinct cold-chain logistics, patient support services, and clinical expertise central to specialty pharmacy operations. The focus on orphan drugs has particularly intensified, ensuring that niche patient populations receive targeted therapies that were previously unavailable or strictly limited. According to the FDA, January 2025, in the '2024 New Drug Therapy Approvals' report, the agency approved 50 novel drugs in 2024, with therapies designated for rare diseases accounting for over 50% of these approvals. This influx of specialized products necessitates advanced care management models, thereby reinforcing the essential role of specialty pharmacies in delivering these life-altering regimens safely and effectively.

Simultaneously, the proliferation of biosimilars following patent expirations is reshaping market dynamics by offering cost-effective alternatives to established biologic brands. As major blockbuster biologics lose market exclusivity, payers and health systems are aggressively promoting biosimilar adoption to mitigate the escalating financial burden of specialty care while maintaining high standards of treatment. This transition not only reduces per-unit expenditure but also expands patient access to critical therapies by lowering economic barriers. According to the Association for Accessible Medicines, September 2025, in the '2025 U.S. Generic & Biosimilar Medicines Savings Report', biosimilars generated $20.2 billion in savings for the U.S. healthcare system in 2024. Despite these cost-saving measures, the aggregate demand for complex medications continues to drive significant market expansion. According to the American Society of Health-System Pharmacists, in 2025, overall pharmaceutical expenditures in the U.S. grew by 10.2% in 2024, reaching a total of $805.9 billion.

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Key Market Challenges

The high cost of therapy and rigorous reimbursement protocols present a significant barrier to the expansion of the Global Specialty Pharmacy Market. Payers and insurance providers frequently implement strict utilization management strategies to control these escalating expenses. These measures often include complex prior authorization requirements and step therapy protocols which create administrative burdens and delay treatment initiation. Consequently, patient access is restricted and medication adherence rates may decline, directly reducing the volume of dispensed prescriptions and limiting revenue generation for specialty pharmacies.

This financial pressure forces health systems to limit formulary inclusions and negotiate aggressive pricing models, which hampers market fluidity. According to the American Society of Health-System Pharmacists, in 2024, drug expenditures for clinics increased by 14.6 percent compared to the previous year, a surge driven primarily by high-cost specialty agents. This substantial economic burden necessitates tighter budget controls from payers, creating a restrictive environment where market growth is tempered by the financial inability of the healthcare infrastructure to absorb the rapid introduction of expensive new therapies.

Key Market Trends

The increasing vertical integration of payers, pharmacy benefit managers (PBMs), and specialty pharmacies is fundamentally restructuring market control and patient access mechanisms. Major health insurers are aggressively consolidating their operations to capture the full economic value of high-cost specialty therapies, effectively steering prescription volumes toward their own affiliated dispensing channels. This structural shift allows vertically integrated entities to tighten formulary management and retain higher margins, creating significant barriers for independent and hospital-owned pharmacies attempting to compete for limited distribution drugs. According to Becker's Hospital Review, June 2025, in the 'Top 15 specialty pharmacies by 2024 revenue' article, the three largest specialty pharmacies, all owned by vertically integrated PBM organizations, accounted for two-thirds of specialty prescription revenue in 2024.

Simultaneously, the rapid integration of artificial intelligence is revolutionizing workflow optimization and medication adherence protocols within the specialty pharmacy sector. Stakeholders are deploying advanced algorithms to automate complex administrative tasks such as prior authorization and benefits verification, which traditionally cause significant delays in therapy initiation. These AI-driven systems not only reduce operational bottlenecks but also enable predictive analytics to identify patients at risk of non-adherence, allowing for proactive clinical interventions. According to the Journal of Managed Care & Specialty Pharmacy, January 2025, in the 'Emerging trends in information technology: Perspectives on the 2024 AMCP Foundation Survey' article, 92% of managed care respondents anticipate that AI will be incorporated into more than half of all prior authorization reviews within the next five years.

Segmental Insights

The hospital-based segment represents the fastest-growing category within the global specialty pharmacy market due to the rising adoption of integrated care models by health systems. Hospitals are increasingly establishing in-house specialty pharmacies to maintain continuity of care for patients with complex chronic conditions such as cancer and autoimmune diseases. This approach allows medical facilities to monitor medication adherence directly and manage potential side effects more effectively than external providers. Additionally, keeping these services internal enables hospitals to streamline operations and capture revenue associated with high-value drug therapies, further incentivizing the expansion of this segment.

Regional Insights

North America currently maintains a dominant position in the Global Specialty Pharmacy Market due to the high prevalence of chronic diseases and a well-established healthcare infrastructure. The region benefits from extensive research and development activities that drive the rapid commercialization of complex therapeutics. Furthermore, supportive initiatives by regulatory bodies like the U.S. Food and Drug Administration streamline the approval process for new specialty drugs, enhancing patient access to necessary treatments. Favorable reimbursement frameworks and the presence of major industry players in the United States further solidify this regional leadership.

Recent Developments

• In April 2025, Mark Cuban Cost Plus Drug Company formed a strategic partnership with Morris & Dickson, a specialty pharmaceutical distributor, to improve access to injectable medications and streamline procurement processes. This collaboration aims to ensure a steady supply of rare injectable drugs while making them more affordable for healthcare providers by combining Cost Plus Drugs’ transparent pricing model with the distributor's extensive logistics capabilities. The partnership specifically targets the mitigation of drug shortages and reduces pricing barriers for acute care providers and healthcare organizations.
• In October 2024, CarelonRx, a subsidiary of Elevance Health, completed the acquisition of the specialty pharmacy business of The Kroger Co. This transaction, which was originally announced in March 2024, transferred Kroger’s specialty pharmacy operations to CarelonRx, allowing the latter to expand its reach in serving patients with complex and chronic conditions such as rheumatoid arthritis and multiple sclerosis. The deal did not include Kroger’s in-store retail pharmacies or its clinic business, enabling the grocer to focus on its core retail and healthcare operations while bolstering CarelonRx’s infusion and mail-order specialty capabilities.
• In August 2024, Walgreens formally launched Walgreens Specialty Pharmacy, a new business unit integrating its existing AllianceRx Walgreens Pharmacy with its community-based specialty pharmacies. This strategic move created a $24 billion entity capable of offering comprehensive care for complex conditions, including a dedicated gene and cell services pharmacy and innovation center in Pittsburgh. The launch aimed to expand the company's role in the specialty market by providing a holistic care model that leverages its nationwide pharmacy network and clinical expertise to support patients, payers, and pharmaceutical partners.
• In June 2024, Evernorth Health Services made a biosimilar for the biologic drug Humira available to eligible patients of its specialty pharmacy, Accredo, at no out-of-pocket cost. This initiative was part of a broader strategy to improve affordability and access to essential treatments for inflammatory conditions by leveraging Evernorth's supply chain and clinical capabilities. Produced for the company's private label distributor, Quallent Pharmaceuticals, the high- and low-concentration interchangeable biosimilar was introduced to drive significant savings for plan sponsors and patients amid the growing competition in the specialty drug market.

Key Market Players

• CVS Health Corporation
• Walgreens Boots Alliance, Inc.
• Express Scripts Holding Company
• UnitedHealth Group Incorporated
• Humana Inc.
• BioScrip, Inc.
• Diplomat Pharmacy, Inc.
• Accredo Health Group, Inc.
• Curant Health
• Avella Specialty Pharmacy

By Ownership	By Therapy Area	By Region
Standalone Hospital-Based Others	Cancer Rheumatoid Arthritis Hemophilia Hepatitis C Multiple Sclerosis Others	North America Europe Asia Pacific South America Middle East & Africa

Report Scope:

In this report, the Global Specialty Pharmacy Market has been segmented into the following categories, in addition to the industry trends which have also been detailed below:

• Specialty Pharmacy Market, By Ownership:

• Standalone
• Hospital-Based
• Others

• Specialty Pharmacy Market, By Therapy Area:

• Cancer
• Rheumatoid Arthritis
• Hemophilia
• Hepatitis C
• Multiple Sclerosis
• Others

• Specialty Pharmacy Market, By Region:

• North America
• United States
• Canada
• Mexico
• Europe
• France
• United Kingdom
• Italy
• Germany
• Spain
• Asia Pacific
• China
• India
• Japan
• Australia
• South Korea
• South America
• Brazil
• Argentina
• Colombia
• Middle East & Africa
• South Africa
• Saudi Arabia
• UAE