KANSAS CITY, Mo. – The 2026 NCPA Digest, sponsored by Cardinal Health, was released Sunday as part of the National Community Pharmacists Association’s Annual Convention, being held Oct. 3-6 in Kansas City. The NCPA Digest, which provides an annual overview of independent community pharmacy, found that the industry represents nearly 37 percent of all retail pharmacies in the United States. It continues to be true that no single pharmacy chain has more stores than all independents combined.
“Independent pharmacies continue to be resilient and providing health care services to people in communities large and small despite being faced with financial headwinds and ongoing challenges from anti-competitive PBM practices,” said NCPA CEO B. Douglas Hoey. “They’re offering personalized and high-quality care that makes a difference in the daily lives of their patients. As the Digest shows, they’re increasingly integral to the infrastructure of American health care. The stronger independent community and long-term care pharmacies are, the stronger our health care system and population will be.”
The 2026 NCPA Digest underscores the importance of pharmacy locations as health care destinations above and beyond providing accessible prescription medications. In 2025, 91 percent of respondents provided flu immunizations, and most offer at least one other vaccine for protection against respiratory infections, zoster, traveler’s infections, and more; 81 percent offered medication therapy management; 62 percent performed blood pressure monitoring; 55 percent offered services for LTC patients; and 48 percent offered compounding. From a philanthropic standpoint, 66 percent of independent community pharmacy owners donated to at least five local organizations in 2025, with 69 percent donating more than $3,000 annually to support community organizations.
Additional highlights from the NCPA Digest covering the independent community pharmacy marketplace include:
- The estimated number of independent community pharmacies in 2026 is 18,988, essentially unchanged from the 18,960 locations reported in 2025.
- Independent pharmacy represented a $103 billion marketplace in 2025, with over 96 percent of sales for independents derived from the prescription department.
- In 2025, the average prescription volume was 65,795 prescriptions per store, compared to 67,601 in 2024.
- Eighty-one percent of prescriptions at independent pharmacies are filled with a generic drug.
- Government programs account for nearly half of all prescriptions sold in independent community pharmacies, meaning that the reimbursement strategies of government programs significantly affect the financial viability of independent community pharmacy.
- This year, the Digest adds a new primary type of pharmacy operation: retail-LTC combo. Thirty-four percent of independent pharmacies report being this primary type of operation, with a majority (56 percent) categorizing themselves as a full-line retail pharmacy.
- Today, the CPESN® USA national network of clinically integrated pharmacies includes 44 local networks across 47 states and Washington, D.C., along with four specialized national networks, all working to advance value-based care.
