New NCPA Digest offers updated outlook for indie pharmacies

KANSAS CITY, Mo. – Independent community pharmacies represent nearly 37% of all retail pharmacies in the United States, according to the 2026 NCPA Digest, which was released as part of the National Community Pharmacists Association’s Annual Convention, Oct. 3-6 in Kansas City, Mo.

The NCPA points out that it continues to be true that no single pharmacy has more stores than all independent pharmacies 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, pharmacist, MBA. “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.”

Other data points from the digest, which was sponsored by Cardinal Health:

• 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 more than 96% 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.
• 81% 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%) categorizing themselves as a full-line retail pharmacy.

To compare this year’s digest to last year’s, go here.