Pharmacies. - National Association of Chain Drug Stores€¦ · Between 2016 and 2017, retail sales in traditional drug stores fell 0.1%, with prescription sales decreasing 3.8%

1NACDS CHAIN MEMBER FACT BOOK, 2018-2019

Pharmacies. The Face of Neighborhood Healthcare.

Pharmacies are the face of neighborhood healthcare. They also contribute to overall community health, which includes the well-being of patients, economic vitality, and good jobs. Traditional drug stores, supermarkets, and mass merchants, as well as suppliers of products sold in the pharmacy and front-end departments, contribute valuably to each of these attributes.

The data in this report quantify many important aspects of the industry’s value, in the front end and pharmacy alike.

Enhancing Healthcare through the Value of PharmacyImproving healthcare quality, access and affordability will remain a focus of public policy into the future. One of the ways that pharmacies can help to improve patient care and reduce healthcare costs is through enhancement of medication adherence, which refers to patients’ correct use of their medications.

Pharmacists are an accessible healthcare resource – readily available to patients and underutilized in the healthcare system. Pharmacists are capable of providing much more in the way of services than they currently do, but roadblocks in the form of coordination of care, acceptance by the healthcare system of an expanded role, and payment for services continue to hinder this expanded role. NACDS research on pharmacists supports an expanded role for community retail pharmacy in the United States.

3NACDS CHAIN MEMBER FACT BOOK, 2018-2019 TABLE OF CONTENTS

Table of Contents List of Figures and Tables ................................................................................................4

Introduction Community Pharmacy in America: The Story Behind the Face of Neighborhood Healthcare ............................................6

Section 1: Background and Basic DataDefining Community Pharmacy and the Chain Pharmacy Industry ........................................8

Manufacturers’ Sales of Prescription Drugs ......................................................................................................................9

Community Retail Pharmacy Stores: Where, What Kind, and How Many ....................................................................10

Community Retail Pharmacy Store Characteristics .........................................................................................................14

State by State Information ................................................................................................................................................16

Number of Stores ..............................................................................................................................................................16

Tax Estimate Breakdown by State ....................................................................................................................................21

Top Chain Pharmacy Companies .....................................................................................................................................26

Industry Consolidation: Mergers and Acquisitions .........................................................................................................28

Section 2: Financial Information/Non-Prescription SalesGeneral Financial Information by Type of Store..............................................................................................................33

Inventory/Sales Ratios .......................................................................................................................................................39

Technology .........................................................................................................................................................................42

Employees .........................................................................................................................................................................42

Non-Prescription Sales ......................................................................................................................................................45

Section 3: The PharmacyAmericans Trust Community Pharmacists .......................................................................................................................51

Pharmacist Employment Figures ......................................................................................................................................52

Pharmacist Employment by Practice Setting ..................................................................................................................54

Retail Pharmacy Sales and Prescriptions .........................................................................................................................55

Prescriptions by Method of Payment and Geography ...................................................................................................57

Prescription Drug Prices and Brand/Generic Mix ...........................................................................................................58

Inflation ...............................................................................................................................................................................59

Revenue from a Prescription .............................................................................................................................................60

Profile of the Pharmacy Consumer ...................................................................................................................................61

Source of Payment.............................................................................................................................................................62

Top Prescription Products .................................................................................................................................................62

Demographics and Prescription Utilization .....................................................................................................................66

4 TABLE OF CONTENTS NACDS CHAIN MEMBER FACT BOOK, 2018-2019

List of Figures and TablesFIGURESFigure 1 Manufacturer Sales of Prescription Drugs, $452.6 Billion, 2017 ....................................................................9

Figure 2 Retail Pharmacy Prescription Drug Sales, $386 Billion, by Type of Store, 2017 .........................................10

Figure 3 Community Retail Pharmacy Outlets by Type of Store, 2007-2017 .............................................................11

Figure 4 Community Retail Pharmacy Outlets, by Location, 2017 .............................................................................12

Figure 5 Retail Inventories, Sales, and Retail Inventory/Sales Ratio, 1992-2017 .......................................................39

Figure 6 Traditional Chain Drug Store Merchandise Mix, 2017 .................................................................................46

Figure 7 Prescriptions, by Type of Store, 2007-2017 ...................................................................................................56

Figure 8 Retail Prescription Dollar Sales, by Type of Store, 2007-2017 .....................................................................56

Figure 9 Prescription Drug Consumer Price Index vs. Consumer Price Index for all Items .....................................60

Figure 10 Where Revenue from a Prescription Goes, 2017 ..........................................................................................60

TABLES

Table 1. Community Retail Pharmacy Outlets by Type of Store, 2007-2017 .............................................................10

Table 2. Type of Store and Store Characteristics, 2017 ..............................................................................................14

Table 3. Urban/Rural Breakdown of Retail Community Pharmacies, 2017 ...............................................................15

Table 4. Average Distance to Nearest Pharmacy, by Core Based Statistical Area (CBSA) Status, 2017 ................15

Table 5. Traditional Chain Drug Stores: State by State Estimates of Number of Stores, Sales, Employment, Payroll, and Taxes Paid, 2017 .......................................................................................17

Table 6. Independent Drug Stores: State by State Estimates of Number of Stores, Sales, Employment, Payroll, and Taxes Paid, 2017 .......................................................................................18

Table 7. Supermarkets with Pharmacies: State by State Estimates of Number of Stores, Sales, Employment, Payroll, and Taxes Paid, 2017 ..................................................................................................19

Table 8. Mass Merchants with Pharmacies: State by State Estimates of Number of Stores, Sales, Employment, Payroll, and Taxes Paid, 2017 ..................................................................................................20

Table 9. Estimated Sales, by Tax Category and Type of Store, 2017 ........................................................................21

Table 10. Traditional Chain Drug Stores: State by State Estimates of Taxes Paid by Category, 2017 ......................22

Table 11. Independent Drug Stores: State by State Estimates of Taxes Paid by Category, 2017 ............................23

Table 12. Supermarkets with Pharmacies: State by State Estimates of Taxes Paid by Category, 2017 ....................24

Table 13. Mass Merchants with Pharmacy: State by State Estimates of Taxes Paid by Category, 2017 ...................25

Table 14. Top Chain Retail Pharmacy Companies, by Pharmacy Sales, 2017 .............................................................26

Table 15. Top Chain Retail Pharmacy Companies, by Number of Pharmacies, 2017 ................................................27

Table 16. Top Chain Retail Pharmacy Companies, by Prescription Share, 2017 ........................................................27

Table 17. Recent Mergers, Acquisitions, and Transfers of Store Ownership ..............................................................28

Table 18. Financials by Industry for Publicly Held Companies, 2017 ..........................................................................34

Table 19. Estimated Per Capita Sales, By North American Industrial Classification System (NAICS) Code for Drug Stores, Grocery Stores, and Mass Merchants, 2007-2017 ....................................38

Table 20. Retail Sales, Retail Purchases, Gross Margin, and Gross Margin as Percent of Sales, 1992-2016 ............40

Table 21. E-Commerce for Retail Pharmacy Product Lines, 2005-2016 ......................................................................42

Table 22. State by State Estimates of Wages per Employee, by Type of Store, 2017 ...............................................43

Table 23. Employment by Occupation for Drug Stores, Supermarkets, and Department Stores, 2017 ..................44

5NACDS CHAIN MEMBER FACT BOOK, 2018-2019 TABLE OF CONTENTS

Table 24. Total Sales, Front-End Sales, HBA Sales, and OTC Sales, by Category of Store, 2017 ............................46

Table 25. Rx to OTC Switch Products, 1995-2018 .........................................................................................................47

Table 26. Top HBA/OTC Categories, by Type of Store, 2018 ......................................................................................49

Table 27. Growth by Department for Traditional Drug Stores, 2017 ...........................................................................49

Table 28. Growth by Department for Supermarkets, 2017 ..........................................................................................50

Table 29. Growth by Department for Other Retailers, 2017 ........................................................................................50

Table 30. Honesty and Ethical Ratings of People in Different Professions, 2017 Gallup Poll ...................................51

Table 31. Licensed Pharmacists and Pharmacist Jobs, by State, 2017 ........................................................................53

Table 32. Employment of Pharmacists by Practice Setting, Mean and Median Hourly Wage, 2017 .......................54

Table 33. Retail Pharmacy Sales and Prescriptions, by Type of Store, 2007-2017 ......................................................55

Table 34. Prescriptions, by State and Source of Payment, 2017 ..................................................................................57

Table 35. Prescription Drug Prices and Brand/Generic Mix, 1990-2017 .....................................................................59

Table 36. Profile of the Pharmacy Consumer, 2016 .......................................................................................................61

Table 37. Retail Prescriptions by Source of Payment, 1990-2017 ................................................................................62

Table 38. Top 100 Prescription Products, by Number of Prescriptions Dispensed, 2017 ..........................................63

Table 39. Top 100 Prescription Products, by Dollar Spending, 2017 ...........................................................................64

Table 40. Top 10 Products Filled by Mail Order, by Number of Prescriptions Dispensed, 2017 ..............................65

Table 41. Top 10 Products Filled by Mail Order, by Dollars Spent, 2017 ....................................................................65

Table 42. Top Therapeutic Classes, by Number of Prescriptions, 2017 ......................................................................65

Table 43. Prescriptions Mentions at Outpatient Physician Office Visits, by Age and Sex, 2015 ...............................66

Table 44. Prescription Mentions at Outpatient Physician Office Visits, by Age and Race, 2015 ..............................67

Table 45. Number of Prescription Mentions per Physician Office Visit, by Type of Payment, 2015 .........................67

Table 46. Number of Prescription Mentions per Physician Office Visit, by Major Reason for Visit, 2015 ................68

Table 47. Prescription Utilization by Age and Sex, 2016 ..............................................................................................68

Table 48. Percent of Population and Prescriptions Accounted for by People Taking Chronic Medications ...........69

Table 49. Prescription Utilization by Age and Income Group, Prescriptions Filled at Retail Pharmacies, 2016 ..................................................................................................................................69

Table 50. Prescription Utilization by Age and Primary Payment Type, Prescriptions Filled at Retail Pharmacies, 2016 ..................................................................................................................................70

Table 51. Average Annual Prescription Drug Spending by Patients with Given Diagnosis, 2015 ............................71

Table 52. Top Products Taken by Patients with Top Diagnoses, 2015 .........................................................................72

6 INTRODUCTION NACDS CHAIN MEMBER FACT BOOK, 2018-2019

Introduction This resource is provided for the use of NACDS chain members. NACDS has collected statistics that provide background and serve as a basis for comparison of operational performance for chain pharmacy companies. This resource provides information on the chain pharmacy industry, as well as on community retail pharmacy in general.

Community Pharmacy in America: The Story Behind the Face of Neighborhood HealthcareCommunity retail pharmacy is essential to the healthcare delivery system. Its convenience, pharmacist consultations, and ability to help patients take their medications as prescribed and prevent other health problems deliver remarkable value.

For most Americans, the community retail pharmacy is their community health resource center, offering easy, convenient access to a trusted health professional. Indeed, pharmacists are among America’s most trusted professionals who, working in alliance with other healthcare providers, play a pivotal role in monitoring and maintaining patient health.

Today, over three out of every four patients who visit a doctor leave with a prescription. As medical science advances and doctors rely more and more on drug therapy, outpatient prescription drug use is now at an all-time high. In 2017, 4.1 billion prescriptions were filled in retail pharmacies – a 15.4% increase since 2007.

Chain pharmacy represents the largest component of pharmacy practice, comprising over 24,000 traditional chain drug stores and an additional 16,000 pharmacies within supermarkets and mass merchant stores. The chain drug industry has more than 157,000 pharmacist positions and more than 250,000 pharmacy technician positions, and fills more than 73% of prescriptions dispensed annually in the United States.

7NACDS CHAIN MEMBER FACT BOOK, 2018-2019 INTRODUCTION

Between 2016 and 2017, retail sales in traditional drug stores fell 0.1%, with prescription sales decreasing 3.8%. Overall, the retail prescription market reached $386 billion in 2017, and chain pharmacies accounted for about 48% of retail prescription dollars ($196 billion).

This thriving business has also secured pharmacies’ place as valuable economic and business resources in their communities. In 2017, community retail pharmacies and their associated retail stores employed nearly 2.85 million people and generated sales of over $800 million.

The chain pharmacy industry is growing in other ways as well. The pharmacist’s role has grown and evolved over the years to become more inclusive of patients’ healthcare needs as a whole. Patients can now look to their pharmacy as a total healthcare provider, and today’s pharmacists play an important role in improving patient outcomes.

Pharmacists help patients with healthcare advice and guidance on their general prescription or over-the-counter medication information. Pharmacists are often on the front lines to guide patients through their evolving healthcare needs. Much of a pharmacist’s time is spent interacting with patients, identifying possible drug interactions, and advising how best to use an over-the-counter medication.

In the age of convenience – with 24-hour and drive-through pharmacies – pharmacists understand the need for timely and effective prescription and healthcare information. Pharmacists seek money-saving alternatives for their patients such as offering generic substitutions or discussing the availability of various prescription drug coverage plans.

Today’s pharmacies offer a variety of healthcare screenings and programs for a wide range of ailments and illnesses so that patients may maintain a healthy lifestyle. Pharmacies are creating, or partnering with, centers and clinics where patients can obtain information on asthma and diabetes as well as take screening tests for blood pressure, cholesterol, and osteoporosis, or receive flu shots. Often the centers and clinics are staffed by a nurse, resident, or clinical pharmacist practitioner. Several health policy visionaries have cited these venues as potential solutions to more costly options in healthcare delivery, and the future of these clinics and centers is at the heart of strategic discussions within companies and from an industry-wide perspective.

The chain pharmacy industry looks forward to promoting the safe use of medications and providing patients with the medications they need with the help of local community retail pharmacists they know and trust.

SECTION ONE | BACKGROUND AND BASIC DATA NACDS CHAIN MEMBER FACT BOOK, 2018-20198

1Background and Basic DataThe chain pharmacy industry is part of a highly competitive environment commonly referred to as community retail pharmacy. Retail pharmacies sell prescription drugs, over-the-

counter medications, and a wide range of other products directly to consumers. Community retail pharmacy is generally defined to include

retail stores accessible to the general public in a specific location on a walk-in basis. This includes all community retail stores with a pharmacy, and excludes mail order, hospitals, long-term care, physicians’ offices, and clinics.

Stores must have pharmacy sales to be considered part of community retail pharmacy. However, they do not need to be traditional drug stores. Retail community pharmacies may operate within supermarkets, mass merchant or discount stores, or even convenience stores. This section provides background information on typical stores such as average sales, employment,

store size, asset value, and inventories. Using the information provided, one can answer questions such as:

• What percentage of sales comes from the pharmacy as opposed to the rest of the store?

• How many people does a typical store employ?

Defining Community Pharmacy and the Chain Pharmacy IndustryFor purposes of this reference book, a chain pharmacy company is defined as one that operates four or more pharmacies open to the general public. These pharmacies include traditional drug store formats as well as pharmacies located in supermarkets and mass merchant or discount stores.

Only traditional drug stores are identified by chain or independent status. Supermarkets and mass merchants may also be either independent or chain, but the vast majority are chains and for the purposes of this document they are generally counted as chain pharmacies.

NACDS CHAIN MEMBER FACT BOOK, 2018-2019 SECTION ONE | BACKGROUND AND BASIC DATA 9

Manufacturers’ Sales of Prescription DrugsIn 2017, manufacturers’ sales of prescription drugs reached $452.6 billion, a 1.4% increase from 2016. These prescription drugs reach consumers in a variety of ways: some are distributed through hospitals, long-term care facilities, or home healthcare providers; some are dispensed to patients at clinics, HMOs, or physicians’ offices. A growing share of prescriptions is purchased through mail-order pharmacies. Community retail pharmacies have lost market share, but still account for a majority of prescription drug sales.

Figure 1 provides a breakdown of manufacturers’ prescription drug sales by type of pharmacy.

Source: IQVIA

Manufacturer Sales of Prescription Drugs, $452.6 Billion, 2017FIGURE 1

HMOS 1.1%

CHAIN DRUGSTORES 24.1%

OTHER 0.3%

INDEPENDENT DRUGSTORES 10.9%

MASS MERCHANTS 4.9%

SUPERMARKETS 5.8%

HOME HEALTH CARE 0.9%

LONG-TERM CARE 3.7%

CLINICS 15.6%

HOSPITALS 8.1%

MAIL ORDER 24.1%

Community retail pharmacies and mail-order pharmacies, combined, accounted for $318.7 billion of the $452.6 billion in manufacturer sales in 2017. Chain pharmacies are the largest segment of retail pharmacy. Figure 2 breaks down retail pharmacy prescription drug sales by type of store. Sales by chain pharmacies, including traditional chain drug stores, mass merchants, and supermarkets, account for about 48% of retail pharmacy sales, measured in total dollars. Mail-order pharmacy sales are over 33% of all retail dollar sales.


DRUG STORES – INDEPENDENT 15.6%

DRUG STORES – CHAIN 36.0%

Source: IQVIA and NACDS Economics Department

Retail Pharmacy Prescription Drug Sales, $386 Billion, by Type of Store, 2017FIGURE 2

MAIL ORDER 15.6%

SUPERMARKET 8.2%

MASS MERCHANDISE 6.6%

Community Retail Pharmacy Stores: Where, What Kind, and How ManyCommunity retail pharmacy is comprised of many different types of stores. Table 1 and Figure 3 present trends in total store counts for traditional drug stores, supermarkets, and mass merchants from 2007–2017. The number of community retail pharmacies decreased overall during this period, from over 60,000 to under 59,000. The average number of prescriptions per pharmacy has increased from about 57,400 in 2007 to about 69,700 in 2017.

TABLE 1. COMMUNITY RETAIL PHARMACY OUTLETS BY TYPE OF STORE, 2007-2017

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Total Stores 60,568 59,604 60,393 61,036 61,743 61,091 59,705 59,953 62,098 61,780 58,947

Traditional Drug Stores 43,326 42,408 43,059 43,430 43,465 43,433 42,066 42,116 43,810 45,097 42,935

Chain 21,721 22,090 22,267 22,595 22,828 22,437 22,362 21,454 22,931 24,971 24,168

Independent 21,605 20,318 20,792 20,835 20,637 20,996 19,704 20,662 20,879 20,126 18,767

Mass Merch. 7,504 8,081 8,137 8,273 8,893 8,538 8,558 8,817 9,066 7,339 6,986

Supermarket 9,738 9,115 9,197 9,333 9,385 9,120 9,081 9,020 9,222 9,344 9,026

Source: NACDS estimates based on IQVIA and NCPDP data.


Community Retail Pharmacy Outlets by Type of Store, 2007-2017FIGURE 3

■ INDEPENDENT DRUG STORES■ MASS MERCHANTS■ SUPERMARKETS■ CHAIN DRUG STORES

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 20170

5000

10000

15000

20000

25000

The overall number of community pharmacies decreased slightly in 2017. Continued consolidation has reduced the total number of retail pharmacies to just under 62,000.

Community retail pharmacies are integral parts of communities all across the United States. Figure 4 shows the numbers of different types of community retail pharmacies in each state, the District of Columbia, and several U.S. territories.


Community Retail Pharmacy Outlets, by Location, 2017FIGURE 4


Alaska19154116

California1746442631

2,383

Hawaii70202591

Texas1,185631831

1,616

Washington172124319415

Oregon83121163193

Montana82384231

North Dakota720042

South Dakota71331847

Nebraska1587446117

Kansas2059282139

Oklahoma37214023

204

Wyoming32312813

Colorado129125255243

New Mexico595752103

Utah1318716296

Nevada4359100182

Idaho83508155

Arizona150150257456


Community Retail Pharmacy Outlets, by Location, 2017FIGURE 4


Florida1,1254098691,733

Georgia580268412760

DC3441981

South Carolina294145161417

North Carolina665246211

867

Michigan841278170935

West Virginia1985347201

Virginia320177

300694

Pennsylvania815200414

1,159New Jersey

71695251816

New York21881463031,707

Maine682570121

Louisiana37219193

352

Minnesota176126145478

Wisconsin21619982

452

Vermont257

2377

New Hampshire233243151

Massachusetts12656149722

Connecticut11642120358

Rhode Island21917

137

Mississippi28919237161

Alabama559175120391

Tennessee421231246519

Kentucky477133109314

Ohio4492373331,037

Illinois4452533031028

Indiana192181172584

Iowa20895138171

Missouri379172168424

Arkansas33217471121

Delaware361224126

Maryland34676

246487

Guam8140

Northern Marianas1000

Puerto Rico634550

144

Virgin Islands9201


Community Retail Pharmacy Store CharacteristicsWhat does a typical community retail pharmacy look like? What are the broad defining characteristics that differentiate a supermarket from a mass merchant or a traditional chain drug store? Naturally, one obvious difference is the

range of non-pharmacy products. But the physical and financial characteristics of stores are different, too. Table 2 shows some of the distinctive characteristics of drug stores, supermarkets, and mass merchants.

TABLE 2. TYPE OF STORE AND STORE CHARACTERISTICS, 2017

Store Characteristic Traditional Drug Store

Traditional Chain Drug Store Independent Drug Store Supermarket with

PharmacyMass Merchant with

Pharmacy

Number of Employees1 479,135 380,880 98,255 1,078,666 1,389,541

Number of Employees per Store2 11.2 15.8 5.3 119.5 198.9

Total Sales3 $272,109,000 $204,081,750 $68,027,250 $274,207,845 $323,530,021

Total Pharmacy Sales4 $199,260,000 $138,967,674 $60,292,326 $31,790,499 $25,326,000

Average Annual Sales5 $6,367,506 $8,444,296 $3,664,077 $30,379,775 $46,311,197

Average Annual Pharmacy Sales6 $4,662,798 $5,750,069 $3,247,459 $3,522,103 $3,625,251

Percent Pharmacy Sales7 73.23% 68.09% 88.63% 11.59% 7.83%

Number of Stores8 42,734 24,168 18,566 9,026 6,986

1. Source: United States Bureau of Labor Statistics, Quarterly Census of Employment and Wages and NACDS Estimates.2. Source: Number of employees divided by number of stores.3. Source: United States Department of Commerce, Retail Sales Data.4. Source: IQVIA Manufacturer Sales plus Retail Margin.5. Source: Total sales divided by number of stores.6. Source: Pharmacy sales divided by number of stores.7. Source: Pharmacy sales divided by total sales.8. Source: IQVIA, United States Bureau of Labor Statistics, Quarterly Census of Employment and Wages, NCPDP, and NACDS Estimates.

Traditional chain drug stores tend to be much larger than independent drug stores. As a result, non-pharmacy sales account for a larger percentage of overall sales in traditional chain drug stores. Note that the percentage of pharmacy sales for traditional chain drug stores includes sales by those companies outside of the traditional store (e.g., specialty pharmacy and mail-order sales). Pharmacy sales are a much smaller share of overall sales in supermarket and mass merchant stores, reflecting far larger stores with less focus on the pharmacy itself. In contrast, pharmacy sales account for over 88% of total sales at independent pharmacies.

The community retail pharmacy industry is geographically diverse. Most stores (92.1%) are located in Core Based Statistical Areas (CBSAs). Core Based Statistical Area is the official term for a functional region based around an urban center with a population of at least 10,000. Chain drug stores are more concentrated in urban areas (94.6%). Independent pharmacies are more common in rural areas, but 86.6% are still located in CBSAs.

Table 3 shows the urban–rural breakdown of chain and independent pharmacies. Note that we use CBSA status as a proxy for urban/suburban and rural areas. It is important to recognize that some areas within a CBSA may be considered rural by other definitions.


TABLE 3. URBAN/RURAL BREAKDOWN OF RETAIL COMMUNITY PHARMACIES, 2017

CBSA Non-CBSA Total

Independent 16,076 2,483 18,559

Mass Merchant 6,219 767 6,986

Supermarket 8,659 374 9,033

Traditional Chain 23,131 1,037 24,168

54,085 4,661 58,746

Independents as % of total stores: 29.7% 53.3% 31.6%

Chains as % of total stores: 70.3% 46.7% 68.4%

% of Independents in CBSAs: 86.6%

% of Chains in CBSAs: 94.6%

Overall: 92.1%

Source: NCPDP Pharmacy File, July 2017, and NACDS Economics Dept.

Nearly all Americans (91.7%) live within 5 miles of a community retail pharmacy. The average distance to a community retail pharmacy within a CBSA is 1.4 miles. Outside of CBSAs, the average distance to a community retail pharmacy is 6.3 miles.

Over a third of the rural population (36.4%) has to travel at least 5 miles to get to a retail pharmacy, where only 6.2% of the population within CBSAs has to travel at least 5 miles to a pharmacy. If the sample is limited to people for whom the

nearest pharmacy is at least 5 miles away, the average distance to a pharmacy for people within a CBSA jumps to nearly 8 miles. For people outside of a CBSA and at least 5 miles away, the average distance to a pharmacy is 10.3 miles. The estimated population that has to travel at least 5 miles to a pharmacy is 27 million people.

Note that all distances are measured as the crow flies (in a straight line). Actual travel distance may be longer depending on available transportation routes.

TABLE 4. AVERAGE DISTANCE TO NEAREST PHARMACY, BY CORE BASED STATISTICAL AREA (CBSA) STATUS, 2017

Location Average Distance Population

Within CBSAs 1.43 302,219,979

Outside CBSAs 6.31 23,499,199

Within CBSAs, Distance > 5 miles 7.97 18,649,100

Outside CBSAs, Distance > 5 Miles 10.27 8,546,213

Overall 1.75

Source: NCPDP Pharmacy File, ArcGIS Census Tract Files, and NACDS Economics Department.Core Based Statistical Area is the official term for a functional region based around an urban center of at least 10,000 people, based on standards published by the Office of Management and Budget (OMB) in 2000.


State by State InformationThe composition of community pharmacy varies considerably from state to state. This section presents general information on sales, employment, payroll, and total taxes paid.

Tables 5–8 present this information for traditional chain drug stores, independent drug stores, supermarkets, and mass merchants, respectively.

Number of StoresThe total number of traditional drug stores, mass merchants, and supermarkets per state was estimated using the U.S. Bureau of Labor Statistics Quarterly Census of Employment and Wages for 2017. These totals were reconciled with state by state totals for 2017 from the list of pharmacy licenses published by NCPDP.

For traditional drug stores, the estimated state total was further broken down into chain and independent stores using the NCPDP pharmacy list from July 2017. In these tables, franchise operations are included as independent drug stores. The states with the largest number of traditional chain drug stores are California, Florida, New York, Texas, and Pennsylvania.

For mass merchants and supermarkets, the state total consists of only those stores that have pharmacies. These were estimated using Quarterly Census of Employment and Wages data adjusted proportionally to match NCPDP’s state totals and CSGIS totals for consistency.

Estimated Dollar Sales: Estimated dollar sales by state were calculated based on estimated payroll, and used the state ratio of payroll to sales for drug stores. This ratio is based on total payroll as a percentage of actual traditional drug store sales for 2017 of $272.1 billion. Dollar sales were broken down between chain drug stores and independents using a ratio of 3:1, the approximate ratio of average store sales between chains and independents.

For mass merchants and supermarkets, estimated dollar sales were based on payroll using payroll-to-sales ratio for each state for mass merchants and for supermarkets from the Economic Census, and payroll from the Quarterly Census of Employment and Wages. Dollar sales for mass merchants and supermarkets with pharmacies were based on sales ratios of stores with pharmacies and without pharmacies.

Estimated Sales per Store: Total estimated sales for the state divided by the total number of stores. All other per store statistics are based on totals divided by number of stores.

Number Employed During Year: Forecasted estimate based on Quarterly Census of Employment and Wages data.

Estimated Payroll: Estimate based on Quarterly Census of Employment and Wages data.

Estimated Taxes Paid: Based on the numbers presented in Tables 10–13.


TABLE 5. TRADITIONAL CHAIN DRUG STORES: STATE BY STATE ESTIMATES OF NUMBER OF STORES, SALES, EMPLOYMENT, PAYROLL, AND TAXES PAID, 2017

State Number of Stores

Estimated Dollar Sales

(000)

Estimated Sales Per

Store (000)

Number Employed

During Year

Estimated Payroll (000)

Estimated Payroll Per Store (000)

Estimated Taxes Paid

(000)

Estimated Taxes Paid per

Store (000)

Alabama 391 $3,133,837 $8,015 6,032 $247,426 $633 $149,866 $383 Alaska 16 $173,246 $10,828 395 $18,952 $1,184 $2,990 $187 Arizona 456 $3,864,036 $8,474 6,458 $301,359 $661 $115,497 $253 Arkansas 121 $1,278,566 $10,567 2,472 $101,299 $837 $43,054 $356 California 2,383 $21,875,734 $9,180 38,433 $1,841,923 $773 $772,186 $324 Colorado 243 $2,831,371 $11,652 4,696 $236,604 $974 $65,061 $268 Connecticut 358 $3,095,684 $8,647 5,183 $200,024 $559 $100,941 $282 DC 81 $670,803 $8,282 1,116 $43,579 $538 $18,490 $228 Delaware 126 $884,148 $7,017 1,570 $59,286 $471 $15,075 $120 Florida 1,733 $11,790,914 $6,804 24,231 $971,316 $560 $320,738 $185 Georgia 760 $4,986,347 $6,561 10,870 $429,951 $566 $131,078 $172 Hawaii 91 $1,181,869 $12,988 2,012 $76,749 $843 $34,282 $377 Idaho 55 $454,295 $8,260 1,043 $41,359 $752 $16,261 $296 Illinois 1,028 $8,065,507 $7,846 16,327 $723,749 $704 $298,960 $291 Indiana 584 $4,190,941 $7,176 9,092 $345,966 $592 $141,739 $243 Iowa 171 $1,388,371 $8,119 3,223 $116,321 $680 $46,121 $270 Kansas 139 $1,177,282 $8,470 2,558 $96,841 $697 $42,722 $307 Kentucky 314 $3,436,406 $10,944 6,857 $276,596 $881 $107,369 $342 Louisiana 352 $3,028,103 $8,603 5,584 $221,635 $630 $88,976 $253 Maine 121 $1,099,110 $9,084 1,959 $82,321 $680 $33,994 $281 Maryland 487 $4,284,923 $8,799 7,034 $297,260 $610 $120,063 $247 Massachusetts 722 $6,347,283 $8,791 10,984 $445,688 $617 $206,397 $286 Michigan 935 $7,200,344 $7,701 14,159 $597,916 $639 $225,234 $241 Minnesota 478 $3,575,622 $7,480 6,960 $298,940 $625 $107,925 $226 Mississippi 161 $1,488,074 $9,243 2,922 $120,206 $747 $56,814 $353 Missouri 424 $3,700,683 $8,728 7,241 $290,684 $686 $102,534 $242 Montana 31 $255,481 $8,241 537 $21,635 $698 $4,197 $135 Nebraska 117 $1,032,075 $8,821 2,243 $82,302 $703 $31,582 $270 Nevada 182 $1,178,469 $6,475 2,253 $91,557 $503 $37,145 $204 New Hampshire 151 $1,027,163 $6,802 1,907 $78,732 $521 $17,360 $115 New Jersey 816 $9,300,215 $11,397 14,647 $615,451 $754 $273,341 $335 New Mexico 103 $777,497 $7,549 1,651 $62,880 $610 $22,595 $219 New York 1,707 $20,910,700 $12,250 32,273 $1,308,968 $767 $495,664 $290 North Carolina 867 $7,685,611 $8,865 15,258 $596,320 $688 $208,748 $241 North Dakota 42 $493,917 $11,760 829 $36,605 $872 $13,909 $331 Ohio 1,037 $7,392,115 $7,128 15,799 $581,045 $560 $231,776 $224 Oklahoma 204 $1,995,734 $9,783 3,618 $148,107 $726 $60,883 $298 Oregon 193 $1,544,602 $8,003 3,013 $118,257 $613 $25,785 $134 Pennsylvania 1,159 $9,427,761 $8,134 18,427 $689,983 $595 $269,708 $233 Rhode Island 137 $1,341,130 $9,789 2,232 $97,110 $709 $45,689 $333 South Carolina 417 $2,801,225 $6,718 5,262 $211,468 $507 $86,765 $208 South Dakota 47 $362,326 $7,709 808 $30,367 $646 $10,378 $221 Tennessee 519 $4,623,217 $8,908 8,483 $369,649 $712 $172,468 $332 Texas 1,616 $12,404,690 $7,676 23,013 $991,052 $613 $353,547 $219 Utah 96 $849,869 $8,853 1,838 $71,747 $747 $27,924 $291 Vermont 77 $631,472 $8,201 1,264 $50,518 $656 $17,765 $231 Virginia 694 $4,530,445 $6,528 8,964 $341,285 $492 $125,717 $181 Washington 415 $3,404,356 $8,203 6,566 $294,309 $709 $104,201 $251 West Virginia 201 $1,630,391 $8,111 3,269 $127,444 $634 $51,255 $255 Wisconsin 452 $3,150,439 $6,970 7,063 $257,031 $569 $92,643 $205 Wyoming 13 $127,351 $9,796 253 $10,759 $828 $3,095 $238 Total 24,023 $204,081,750 $8,495 380,880 $15,768,527 $656 $6,148,510 $256


TABLE 6. INDEPENDENT DRUG STORES: STATE BY STATE ESTIMATES OF NUMBER OF STORES, SALES, EMPLOYMENT, PAYROLL, AND TAXES PAID, 2017



(000)

Estimated Sales Per Store

(000)

Number Employed

During Year




(000)


Store (000)

Alabama 559 $1,760,773 $3,150 2,875 $117,912 $211 $70,043 $125 Alaska 19 $82,547 $4,345 156 $7,502 $395 $1,434 $75 Arizona 150 $671,395 $4,476 708 $33,044 $220 $14,927 $100 Arkansas 332 $1,310,798 $3,948 2,261 $92,648 $279 $31,256 $94 California 1,746 $6,915,154 $3,961 9,386 $449,853 $258 $175,782 $101 Colorado 129 $693,541 $5,376 831 $41,868 $325 $13,211 $102 Connecticut 116 $532,515 $4,591 560 $21,604 $186 $12,733 $110 DC 34 $138,033 $4,060 156 $6,097 $179 $2,947 $87 Delaware 36 $140,148 $3,893 150 $5,646 $157 $2,399 $67 Florida 1,125 $3,379,984 $3,004 5,243 $210,181 $187 $70,231 $62 Georgia 580 $1,629,805 $2,810 2,765 $109,373 $189 $34,133 $59 Hawaii 70 $388,829 $5,555 516 $19,679 $281 $8,114 $116 Idaho 83 $267,971 $3,229 525 $20,805 $251 $6,334 $76 Illinois 445 $1,696,986 $3,813 2,356 $104,432 $235 $53,293 $120 Indiana 192 $727,931 $3,791 996 $37,914 $197 $17,644 $92 Iowa 208 $675,655 $3,248 1,307 $47,163 $227 $16,963 $82 Kansas 205 $680,208 $3,318 1,257 $47,607 $232 $15,714 $77 Kentucky 477 $2,039,144 $4,275 3,472 $140,060 $294 $47,095 $99 Louisiana 372 $1,303,281 $3,503 1,967 $78,076 $210 $29,501 $79 Maine 68 $281,286 $4,137 367 $15,421 $227 $6,595 $97 Maryland 346 $1,320,943 $3,818 1,666 $70,398 $203 $28,489 $82 Massachusetts 126 $757,254 $6,010 639 $25,926 $206 $18,092 $144 Michigan 841 $2,699,511 $3,210 4,245 $179,268 $213 $62,531 $74 Minnesota 176 $670,770 $3,811 854 $36,690 $208 $15,248 $87 Mississippi 289 $1,027,786 $3,556 1,748 $71,924 $249 $24,625 $85 Missouri 379 $1,380,135 $3,642 2,158 $86,611 $229 $29,242 $77 Montana 82 $253,036 $3,086 473 $19,076 $233 $4,204 $51 Nebraska 158 $551,044 $3,488 1,010 $37,048 $234 $12,767 $81 Nevada 43 $166,253 $3,866 177 $7,210 $168 $3,678 $86 New Hampshire 23 $114,505 $4,978 97 $3,997 $174 $1,933 $84 New Jersey 716 $3,414,594 $4,769 4,284 $180,009 $251 $75,911 $106 New Mexico 59 $201,947 $3,423 315 $12,006 $203 $4,466 $76 New York 2,188 $10,658,497 $4,871 13,789 $559,270 $256 $207,065 $95 North Carolina 665 $2,522,514 $3,793 3,901 $152,462 $229 $52,299 $79 North Dakota 72 $327,078 $4,543 473 $20,917 $291 $6,995 $97 Ohio 449 $1,555,566 $3,465 2,280 $83,860 $187 $36,601 $82 Oklahoma 372 $1,398,471 $3,759 2,199 $90,026 $242 $29,945 $80 Oregon 83 $323,445 $3,897 432 $16,952 $204 $5,428 $65 Pennsylvania 815 $2,882,163 $3,536 4,319 $161,730 $198 $63,873 $78 Rhode Island 21 $149,962 $7,141 114 $4,962 $236 $3,658 $174 South Carolina 294 $858,184 $2,919 1,237 $49,698 $169 $19,623 $67 South Dakota 71 $213,920 $3,013 407 $15,291 $215 $4,189 $59 Tennessee 421 $1,589,388 $3,775 2,294 $99,950 $237 $38,789 $92 Texas 1,185 $3,923,889 $3,311 5,625 $242,243 $204 $85,522 $72 Utah 131 $458,003 $3,496 836 $32,635 $249 $10,433 $80 Vermont 25 $108,770 $4,351 137 $5,467 $219 $2,351 $94 Virginia 320 $998,279 $3,120 1,378 $52,455 $164 $20,345 $64 Washington 172 $694,166 $4,036 907 $40,660 $236 $15,084 $88 West Virginia 198 $660,470 $3,336 1,073 $41,847 $211 $15,399 $78 Wisconsin 216 $712,837 $3,300 1,125 $40,943 $190 $16,129 $75 Wyoming 32 $117,887 $3,684 208 $8,828 $276 $2,233 $70 Total 17,914 $68,027,250 $3,797 98,255 $4,057,248 $226 $1,547,499 $86


TABLE 7. SUPERMARKETS WITH PHARMACIES: STATE BY STATE ESTIMATES OF NUMBER OF STORES, SALES, EMPLOYMENT, PAYROLL, AND TAXES PAID, 2017



(000)

Estimated Sales Per

Store (000)

Number Employed

During Year




(000)


Store (000)

Alabama 120 $2,503,612 $20,863 11,764 $247,712 $2,064 $183,486 $1,529 Alaska 41 $1,022,237 $24,933 3,329 $93,647 $2,284 $17,653 $431 Arizona 257 $13,244,027 $51,533 47,054 $1,315,819 $5,120 $306,163 $1,191 Arkansas 71 $1,386,144 $19,523 6,252 $133,881 $1,886 $55,602 $783 California 631 $18,734,070 $29,689 62,924 $1,913,218 $3,032 $599,522 $950 Colorado 255 $12,482,874 $48,952 39,391 $1,184,426 $4,645 $239,188 $938 Connecticut 120 $3,407,352 $28,395 12,856 $354,687 $2,956 $97,897 $816 DC 19 $422,771 $22,251 1,602 $49,818 $2,622 $11,878 $625 Delaware 24 $607,473 $25,311 2,673 $62,515 $2,605 $10,392 $433 Florida 869 $23,493,148 $27,035 111,856 $2,606,629 $3,000 $605,391 $697 Georgia 412 $11,580,854 $28,109 51,593 $1,134,458 $2,754 $260,608 $633 Hawaii 25 $842,122 $33,685 2,740 $82,528 $3,301 $46,415 $1,857 Idaho 81 $3,030,543 $37,414 9,392 $277,636 $3,428 $216,083 $2,668 Illinois 303 $7,349,745 $24,257 28,133 $639,286 $2,110 $276,880 $914 Indiana 172 $3,650,512 $21,224 16,956 $360,178 $2,094 $104,991 $610 Iowa 138 $3,536,138 $25,624 19,097 $383,050 $2,776 $101,503 $736 Kansas 82 $2,556,891 $31,182 10,360 $211,743 $2,582 $197,465 $2,408 Kentucky 109 $2,892,886 $26,540 10,855 $227,712 $2,089 $79,721 $731 Louisiana 93 $1,632,068 $17,549 7,706 $165,202 $1,776 $44,142 $475 Maine 70 $1,858,130 $26,545 7,537 $172,252 $2,461 $49,721 $710 Maryland 246 $7,243,352 $29,445 27,026 $754,542 $3,067 $195,666 $795 Massachusetts 149 $6,296,552 $42,259 28,092 $692,477 $4,647 $180,613 $1,212 Michigan 170 $3,671,905 $21,599 15,273 $362,379 $2,132 $103,586 $609 Minnesota 145 $4,194,125 $28,925 19,834 $448,770 $3,095 $125,644 $867 Mississippi 37 $773,196 $20,897 3,595 $69,013 $1,865 $65,104 $1,760 Missouri 168 $3,968,882 $23,624 18,310 $402,733 $2,397 $132,684 $790 Montana 42 $991,681 $23,611 3,907 $96,210 $2,291 $16,317 $388 Nebraska 46 $1,088,818 $23,670 5,524 $107,572 $2,339 $30,184 $656 Nevada 100 $4,712,393 $47,124 16,573 $472,899 $4,729 $110,257 $1,103 New Hampshire 43 $1,939,483 $45,104 9,019 $180,649 $4,201 $32,893 $765 New Jersey 251 $5,440,550 $21,675 20,384 $562,967 $2,243 $165,710 $660 New Mexico 52 $1,673,691 $32,186 6,976 $175,786 $3,381 $41,573 $799 New York 303 $3,395,734 $11,207 13,741 $342,983 $1,132 $85,622 $283 North Carolina 211 $5,595,119 $26,517 24,019 $473,725 $2,245 $137,941 $654 North Dakota 0 Ohio 333 $9,408,817 $28,255 36,696 $829,859 $2,492 $256,733 $771 Oklahoma 23 $492,490 $21,413 2,141 $47,011 $2,044 $29,871 $1,299 Oregon 163 $5,295,486 $32,488 19,723 $529,684 $3,250 $88,495 $543 Pennsylvania 414 $10,695,211 $25,834 47,906 $1,048,620 $2,533 $304,363 $735 Rhode Island 17 $489,085 $28,770 2,051 $50,926 $2,996 $15,070 $886 South Carolina 161 $3,087,513 $19,177 13,319 $275,728 $1,713 $56,303 $350 South Dakota 18 $407,730 $22,652 2,077 $40,847 $2,269 $23,672 $1,315 Tennessee 246 $7,793,024 $31,679 30,179 $643,893 $2,617 $513,409 $2,087 Texas 831 $38,468,400 $46,292 133,454 $3,467,459 $4,173 $834,831 $1,005 Utah 162 $5,781,461 $35,688 23,673 $556,819 $3,437 $261,730 $1,616 Vermont 23 $495,387 $21,539 2,117 $49,550 $2,154 $14,398 $626 Virginia 300 $10,008,446 $33,361 38,115 $930,236 $3,101 $442,891 $1,476 Washington 319 $10,148,364 $31,813 33,023 $997,948 $3,128 $251,068 $787 West Virginia 47 $1,054,259 $22,431 3,911 $86,771 $1,846 $29,164 $621 Wisconsin 82 $2,446,128 $29,831 10,690 $217,872 $2,657 $66,201 $807 Wyoming 28 $916,969 $32,749 3,248 $90,142 $3,219 $16,464 $588 Total 9,022 $274,207,845 $30,393 1,078,666 $26,622,472 $2,951 $8,133,160 $901


TABLE 8. MASS MERCHANTS WITH PHARMACIES: STATE BY STATE ESTIMATES OF NUMBER OF STORES, SALES, EMPLOYMENT, PAYROLL, AND TAXES PAID, 2017



(000)

Estimated Sales Per

Store (000)

Number Employed

During Year




(000)


Store (000)

Alabama 175 $7,479,615 $42,741 33,291 $703,313 $4,019 $1,174,207 $6,710 Alaska 15 $5,830,399 $388,693 2,476 $63,787 $4,252 $37,632 $2,509 Arizona 150 $5,036,308 $33,575 30,559 $627,323 $4,182 $743,355 $4,956 Arkansas 174 $12,798,466 $73,554 31,455 $621,791 $3,574 $1,562,097 $8,978 California 442 $14,189,582 $32,103 98,849 $2,512,754 $5,685 $3,802,246 $8,602 Colorado 125 $5,873,697 $46,990 27,050 $661,780 $5,294 $503,463 $4,028 Connecticut 42 $576,975 $13,738 7,623 $204,762 $4,875 $264,635 $6,301 DC 4 N/A N/A N/A N/A N/A N/A N/A Delaware 12 $600,610 $50,051 2,287 $48,431 $4,036 $18,289 $1,524 Florida 409 $21,403,892 $52,332 86,002 $2,062,567 $5,043 $3,762,299 $9,199 Georgia 268 $13,077,547 $48,797 50,322 $1,078,969 $4,026 $1,458,560 $5,442 Hawaii 20 $546,903 $27,345 4,820 $164,654 $8,233 $211,921 $10,596 Idaho 50 $1,706,965 $34,139 9,916 $238,618 $4,772 $362,864 $7,257 Illinois 253 $10,505,595 $41,524 54,016 $1,296,653 $5,125 $2,611,261 $10,321 Indiana 181 $14,304,847 $79,032 39,469 $814,346 $4,499 $1,703,922 $9,414 Iowa 95 $2,417,861 $25,451 17,311 $310,311 $3,266 $410,362 $4,320 Kansas 92 $3,911,744 $42,519 16,914 $326,589 $3,550 $750,931 $8,162 Kentucky 133 $5,677,896 $42,691 24,957 $472,750 $3,555 $613,436 $4,612 Louisiana 191 $7,433,005 $38,916 33,573 $605,253 $3,169 $718,666 $3,763 Maine 25 $512,844 $20,514 4,640 $87,889 $3,516 $115,254 $4,610 Maryland 76 $1,667,271 $21,938 17,127 $424,297 $5,583 $552,767 $7,273 Massachusetts 56 $1,090,887 $19,480 10,346 $276,928 $4,945 $519,262 $9,273 Michigan 278 $25,906,778 $93,190 53,816 $1,223,735 $4,402 $2,374,522 $8,541 Minnesota 126 $5,970,177 $47,382 26,010 $628,572 $4,989 $1,250,754 $9,927 Mississippi 192 $7,586,112 $39,511 34,655 $625,179 $3,256 $1,119,588 $5,831 Missouri 172 $10,589,651 $61,568 32,268 $591,680 $3,440 $848,587 $4,934 Montana 38 $720,147 $18,951 6,666 $131,528 $3,461 $47,647 $1,254 Nebraska 74 $2,221,852 $30,025 13,570 $241,099 $3,258 $296,240 $4,003 Nevada 59 $2,255,881 $38,235 11,798 $251,779 $4,267 $475,999 $8,068 New Hampshire 32 $688,659 $21,521 6,364 $127,675 $3,990 $48,600 $1,519 New Jersey 95 $1,213,478 $12,773 15,935 $467,590 $4,922 $627,288 $6,603 New Mexico 57 $2,153,792 $37,786 10,354 $197,064 $3,457 $302,740 $5,311 New York 146 $4,202,185 $28,782 32,731 $896,884 $6,143 $812,732 $5,567 North Carolina 246 $11,312,174 $45,984 49,253 $1,091,623 $4,437 $1,228,461 $4,994 North Dakota 0 Ohio 237 $8,911,530 $37,601 49,237 $1,079,768 $4,556 $1,262,608 $5,327 Oklahoma 140 $7,416,050 $52,972 24,682 $469,107 $3,351 $855,471 $6,111 Oregon 121 $6,596,193 $54,514 26,627 $703,977 $5,818 $250,400 $2,069 Pennsylvania 200 $3,631,605 $18,158 39,826 $755,694 $3,778 $966,625 $4,833 Rhode Island 9 $126,248 $14,028 1,814 $37,087 $4,121 $52,730 $5,859 South Carolina 145 $5,661,987 $39,048 26,837 $499,146 $3,442 $678,360 $4,678 South Dakota 33 $752,388 $22,800 5,973 $114,771 $3,478 $154,479 $4,681 Tennessee 231 $5,116,942 $22,151 46,675 $1,053,750 $4,562 $1,802,980 $7,805 Texas 631 $41,830,138 $66,292 130,306 $3,171,436 $5,026 $5,931,287 $9,400 Utah 87 $5,349,061 $61,483 17,177 $410,324 $4,716 $550,608 $6,329 Vermont 7 N/A N/A N/A N/A N/A N/A N/A Virginia 177 $5,344,957 $30,197 34,389 $684,206 $3,866 $867,050 $4,899 Washington 124 $10,339,835 $83,386 29,400 $919,775 $7,418 $1,062,910 $8,572 West Virginia 53 $1,538,368 $29,026 10,223 $204,170 $3,852 $262,439 $4,952 Wisconsin 199 $8,506,033 $42,744 43,191 $938,971 $4,718 $1,467,816 $7,376 Wyoming 31 $775,695 $25,022 5,088 $101,253 $3,266 $128,616 $4,149 Total 6,928 $323,360,826 $46,674 1,387,867 $31,221,605 $4,507 $47,624,964 $6,874


TABLE 9. ESTIMATED SALES, BY TAX CATEGORY AND TYPE OF STORE, 2017

Prescriptions Food Health and Beauty Aids OTCsGeneral Merchandise (includes Health and

Beauty Aids and OTCs)

Chain Drug Stores 68.09% 6.7% 5.05% 6.57% 25.16%

Independent Drug Stores 88.63% N/A 1.44% 3.74% 11.37%

Mass Merchants 3.16% 26.1% 4.89% 3.05% 70.72%

Supermarkets 11.59% 74.68% 2.18% 2.26% 13.72%

Chain Drug Stores $138,967,674 $13,775,433 $10,314,220 $13,409,081 $51,338,643

Independent Drug Stores $60,292,326 N/A $978,967 $2,545,428 $7,734,924

Mass Merchants $25,326,000 $77,688,658 $14,552,631 $9,061,484 $220,515,363

Supermarkets $31,790,499 $204,786,130 $5,985,740 $6,194,099 $37,631,216

Source: ACNielsen, U.S. Department of Commerce Bureau of Economic Analysis, NACDS Economics Department.

Tax Estimate Breakdown by StateTaxes paid vary by state. 2017 tax rates, along with estimated sales by category from the previous section, were used to develop estimates of taxes paid by category. The estimates are presented in Tables 10–13.

Number of Stores: Estimated as described in the previous section.

Estimated Taxes Paid: Total of state income tax, sales tax, real estate tax, unemployment insurance, and federal income tax. This total does not include alcoholic beverage taxes, motor fuel sales taxes, tobacco sales taxes, other selective sales taxes, and does not include license fees of any kind.

Estimated Taxes Paid by Store: Equals estimated taxes paid divided by the number of stores.

Estimated State Income Tax: Equals state corporate income tax rate times earnings before interest and taxes (EBIT). EBIT is estimated as 4% of total sales.

Estimated Sales Tax: Sales tax estimates were calculated by multiplying estimated category sales by their respective sales tax rate. The estimated category sales for each type of retail outlet are shown in Table 9 above.

Estimated Real Estate Tax: Estimated at an average of $1,000 per store and distributed proportionally by sales.

State Unemployment Insurance: Estimated at 0.7% of payroll.

Federal Income Tax: Federal income tax was calculated by multiplying EBIT by 35%, the approximate corporate income tax rate for 2017 for chain drug stores.

Total Taxes Collected by State: Reference information taken from the U.S. Bureau of the Census. More than $865 billion in taxes was collected by the states in 2016. Six states (California, Texas, Florida, Ohio, and Illinois) accounted for over 38% of the business taxes paid by traditional chain drug stores.

Estimated 2017 State Taxes Paid: Total estimated taxes paid minus federal income tax.


TABLE 10. TRADITIONAL CHAIN DRUG STORES: STATE BY STATE ESTIMATES OF TAXES PAID BY CATEGORY, 2017



(000)

Estimated Taxes Paid per Store

(000)

Estimated State Income

Tax (000’s)

Estimated Sales Tax (000’s)

Estimated Real Estate Tax (000’s)

State Unemploy-

ment Insurance

(000’s)

Federal Income Tax

(000’s)

Total Taxes Collected by State, 2016

(000’s)

Estimated 2016 State Taxes Paid

(000’s)

Alabama 391 $149,866 $383 $65,184 $39,995 $391 $422 $43,874 $9,919,794 $105,992 Alaska 16 $2,990 $187 $521 $0 $16 $28 $2,425 $1,042,164 $565 Arizona 456 $115,497 $253 $6,059 $54,434 $456 $452 $54,096 $14,676,375 $61,401 Arkansas 121 $43,054 $356 $2,659 $22,201 $121 $173 $17,900 $9,452,883 $25,154 California 2,383 $772,186 $324 $61,882 $398,971 $2,383 $2,690 $306,260 $155,231,252 $465,926 Colorado 243 $65,061 $268 $4,195 $20,655 $243 $329 $39,639 $12,795,318 $25,422 Connecticut 358 $100,941 $282 $7,430 $49,450 $358 $363 $43,340 $15,244,947 $57,601 DC 81 $18,490 $228 $1,771 $7,169 $81 $78 $9,391 $7,404,521 $9,099 Delaware 126 $15,075 $120 $2,461 $0 $126 $110 $12,378 $3,522,301 $2,697 Florida 1,733 $320,738 $185 $20,752 $131,484 $1,733 $1,696 $165,073 $37,640,420 $155,665 Georgia 760 $131,078 $172 $9,574 $50,174 $760 $761 $69,809 $21,454,446 $61,269 Hawaii 91 $34,282 $377 $2,420 $15,083 $91 $141 $16,546 $6,919,035 $17,736 Idaho 55 $16,261 $296 $1,076 $8,697 $55 $73 $6,360 $4,209,514 $9,901 Illinois 1,028 $298,960 $291 $24,519 $159,353 $1,028 $1,143 $112,917 $38,907,220 $186,043 Indiana 584 $141,739 $243 $8,047 $73,799 $584 $636 $58,673 $17,587,958 $83,066 Iowa 171 $46,121 $270 $5,331 $20,955 $171 $226 $19,437 $9,558,563 $26,683 Kansas 139 $42,722 $307 $1,507 $24,415 $139 $179 $16,482 $8,058,949 $26,240 Kentucky 314 $107,369 $342 $6,598 $51,868 $314 $480 $48,110 $11,778,866 $59,259 Louisiana 352 $88,976 $253 $7,752 $38,087 $352 $391 $42,393 $9,309,673 $46,582 Maine 121 $33,994 $281 $3,141 $15,207 $121 $137 $15,388 $4,130,242 $18,606 Maryland 487 $120,063 $247 $11,312 $47,782 $487 $492 $59,989 $20,894,199 $60,074 Massachusetts 722 $206,397 $286 $16,249 $99,795 $722 $769 $88,862 $27,283,005 $117,535 Michigan 935 $225,234 $241 $13,825 $108,679 $935 $991 $100,805 $27,436,607 $124,430 Minnesota 478 $107,925 $226 $11,213 $45,688 $478 $487 $50,059 $25,189,128 $57,866 Mississippi 161 $56,814 $353 $2,381 $33,235 $161 $205 $20,833 $7,660,391 $35,981 Missouri 424 $102,534 $242 $7,401 $42,392 $424 $507 $51,810 $12,245,169 $50,724 Montana 31 $4,197 $135 $552 $0 $31 $38 $3,577 $2,627,943 $620 Nebraska 117 $31,582 $270 $2,579 $14,280 $117 $157 $14,449 $5,117,133 $17,133 Nevada 182 $37,145 $204 $0 $20,307 $182 $158 $16,499 $8,025,046 $20,647 New Hampshire 151 $17,360 $115 $2,695 $0 $151 $133 $14,380 $2,641,946 $2,980 New Jersey 816 $273,341 $335 $26,785 $114,512 $816 $1,025 $130,203 $31,546,720 $143,138 New Mexico 103 $22,595 $219 $1,468 $10,024 $103 $116 $10,885 $5,462,107 $11,710 New York 1,707 $495,664 $290 $43,494 $155,454 $1,707 $2,259 $292,750 $81,353,963 $202,914 North Carolina 867 $208,748 $241 $7,378 $91,836 $867 $1,068 $107,599 $26,201,576 $101,149 North Dakota 42 $13,909 $331 $681 $6,212 $42 $58 $6,915 $3,709,105 $6,994 Ohio 1,037 $231,776 $224 $19,219 $106,924 $1,037 $1,106 $103,490 $28,694,883 $128,287 Oklahoma 204 $60,883 $298 $3,832 $28,654 $204 $253 $27,940 $8,491,187 $32,943 Oregon 193 $25,785 $134 $3,756 $0 $193 $211 $21,624 $11,043,311 $4,160 Pennsylvania 1,159 $269,708 $233 $30,139 $105,132 $1,159 $1,290 $131,989 $37,394,589 $137,719 Rhode Island 137 $45,689 $333 $3,004 $23,616 $137 $156 $18,776 $3,265,727 $26,914 South Carolina 417 $86,765 $208 $4,482 $42,280 $417 $368 $39,217 $9,551,052 $47,548 South Dakota 47 $10,378 $221 $0 $5,202 $47 $57 $5,073 $1,747,550 $5,306 Tennessee 519 $172,468 $332 $9,616 $97,014 $519 $594 $64,725 $13,386,169 $107,743 Texas 1,616 $353,547 $219 $32,562 $144,092 $1,616 $1,611 $173,666 $52,132,817 $179,881 Utah 96 $27,924 $291 $1,360 $14,442 $96 $129 $11,898 $7,082,961 $16,026 Vermont 77 $17,765 $231 $1,718 $7,042 $77 $88 $8,841 $3,085,865 $8,925 Virginia 694 $125,717 $181 $8,698 $52,271 $694 $627 $63,426 $21,219,757 $62,291 Washington 415 $104,201 $251 $0 $55,666 $415 $460 $47,661 $22,280,088 $56,540 West Virginia 201 $51,255 $255 $3,391 $24,608 $201 $229 $22,825 $5,127,970 $28,429 Wisconsin 452 $92,643 $205 $7,964 $39,626 $452 $494 $44,106 $17,607,733 $48,537 Wyoming 13 $3,095 $238 $0 $1,281 $13 $18 $1,783 $1,913,607 $1,312 Total 24,023 $6,148,510 $256 $520,635 $2,720,046 $24,023 $26,662 $2,857,145 $930,263,745 $3,291,366


TABLE 11. INDEPENDENT DRUG STORES: STATE BY STATE ESTIMATES OF TAXES PAID BY CATEGORY, 2017



(000)


(000)


Tax (000’s)



State Unemploy-

ment Insurance

(000’s)

Federal Income Tax

(000’s)


(000’s)


(000)

Alabama 559 $70,043 $125 $36,624 $8,008 $559 $201 $24,651 $9,919,794 $45,393 Alaska 19 $1,434 $75 $248 $0 $19 $11 $1,156 $1,042,164 $278 Arizona 150 $14,927 $100 $1,053 $4,275 $150 $50 $9,400 $14,676,375 $5,527 Arkansas 332 $31,256 $94 $2,726 $9,688 $332 $158 $18,351 $9,452,883 $12,904 California 1,746 $175,782 $101 $19,562 $57,005 $1,746 $657 $96,812 $155,231,252 $78,970 Colorado 129 $13,211 $102 $1,028 $2,287 $129 $58 $9,710 $12,795,318 $3,502 Connecticut 116 $12,733 $110 $1,278 $3,845 $116 $39 $7,455 $15,244,947 $5,278 DC 34 $2,947 $87 $364 $605 $34 $11 $1,932 $7,404,521 $1,015 Delaware 36 $2,399 $67 $390 $0 $36 $10 $1,962 $3,522,301 $437 Florida 1,125 $70,231 $62 $5,949 $15,471 $1,125 $367 $47,320 $37,640,420 $22,911 Georgia 580 $34,133 $59 $3,129 $7,413 $580 $194 $22,817 $21,454,446 $11,315 Hawaii 70 $8,114 $116 $796 $1,768 $70 $36 $5,444 $6,919,035 $2,671 Idaho 83 $6,334 $76 $635 $1,828 $83 $37 $3,752 $4,209,514 $2,582 Illinois 445 $53,293 $120 $5,159 $23,766 $445 $165 $23,758 $38,907,220 $29,535 Indiana 192 $17,644 $92 $1,398 $5,794 $192 $70 $10,191 $17,587,958 $7,453 Iowa 208 $16,963 $82 $2,595 $4,609 $208 $91 $9,459 $9,558,563 $7,503 Kansas 205 $15,714 $77 $871 $5,027 $205 $88 $9,523 $8,058,949 $6,191 Kentucky 477 $47,095 $99 $3,915 $13,911 $477 $243 $28,548 $11,778,866 $18,547 Louisiana 372 $29,501 $79 $3,336 $7,409 $372 $138 $18,246 $9,309,673 $11,255 Maine 68 $6,595 $97 $804 $1,759 $68 $26 $3,938 $4,130,242 $2,657 Maryland 346 $28,489 $82 $3,487 $6,046 $346 $117 $18,493 $20,894,199 $9,996 Massachusetts 126 $18,092 $144 $1,939 $5,381 $126 $45 $10,602 $27,283,005 $7,491 Michigan 841 $62,531 $74 $5,183 $18,417 $841 $297 $37,793 $27,436,607 $24,738 Minnesota 176 $15,248 $87 $2,104 $3,518 $176 $60 $9,391 $25,189,128 $5,857 Mississippi 289 $24,625 $85 $1,644 $8,180 $289 $122 $14,389 $7,660,391 $10,236 Missouri 379 $29,242 $77 $2,760 $6,630 $379 $151 $19,322 $12,245,169 $9,920 Montana 82 $4,204 $51 $547 $0 $82 $33 $3,543 $2,627,943 $662 Nebraska 158 $12,767 $81 $1,377 $3,446 $158 $71 $7,715 $5,117,133 $5,052 Nevada 43 $3,678 $86 $0 $1,295 $43 $12 $2,328 $8,025,046 $1,350 New Hampshire 23 $1,933 $84 $300 $0 $23 $7 $1,603 $2,641,946 $330 New Jersey 716 $75,911 $106 $9,834 $17,257 $716 $300 $47,804 $31,546,720 $28,107 New Mexico 59 $4,466 $76 $381 $1,177 $59 $22 $2,827 $5,462,107 $1,639 New York 2,188 $207,065 $95 $22,170 $32,524 $2,188 $965 $149,219 $81,353,963 $57,846 North Carolina 665 $52,299 $79 $2,422 $13,624 $665 $273 $35,315 $26,201,576 $16,984 North Dakota 72 $6,995 $97 $451 $1,859 $72 $33 $4,579 $3,709,105 $2,416 Ohio 449 $36,601 $82 $4,044 $10,170 $449 $160 $21,778 $28,694,883 $14,823 Oklahoma 372 $29,945 $80 $2,685 $7,155 $372 $154 $19,579 $8,491,187 $10,366 Oregon 83 $5,428 $65 $787 $0 $83 $30 $4,528 $11,043,311 $900 Pennsylvania 815 $63,873 $78 $9,214 $13,192 $815 $302 $40,350 $37,394,589 $23,523 Rhode Island 21 $3,658 $174 $336 $1,194 $21 $8 $2,099 $3,265,727 $1,558 South Carolina 294 $19,623 $67 $1,373 $5,855 $294 $87 $12,015 $9,551,052 $7,608 South Dakota 71 $4,189 $59 $0 $1,095 $71 $28 $2,995 $1,747,550 $1,194 Tennessee 421 $38,789 $92 $3,306 $12,650 $421 $161 $22,251 $13,386,169 $16,538 Texas 1,185 $85,522 $72 $10,300 $18,709 $1,185 $394 $54,934 $52,132,817 $30,587 Utah 131 $10,433 $80 $733 $3,099 $131 $59 $6,412 $7,082,961 $4,021 Vermont 25 $2,351 $94 $296 $498 $25 $10 $1,523 $3,085,865 $828 Virginia 320 $20,345 $64 $1,917 $4,036 $320 $96 $13,976 $21,219,757 $6,369 Washington 172 $15,084 $88 $0 $5,130 $172 $63 $9,718 $22,280,088 $5,366 West Virginia 198 $15,399 $78 $1,374 $4,506 $198 $75 $9,247 $5,127,970 $6,153 Wisconsin 216 $16,129 $75 $1,802 $4,053 $216 $79 $9,980 $17,607,733 $6,149 Wyoming 32 $2,233 $70 $0 $536 $32 $15 $1,650 $1,913,607 $583 Total 17,914 $1,547,499 $86 $184,624 $385,701 $17,914 $6,878 $952,381 $930,263,745 $595,117


TABLE 12. SUPERMARKETS WITH PHARMACIES: STATE BY STATE ESTIMATES OF TAXES PAID BY CATEGORY, 2017



(000)


(000)


Tax (000’s)



State Unemploy-

ment Insurance

(000’s)

Federal Income Tax

(000’s)


(000’s)


(000)

Alabama 120 $183,486 $1,529 $52,075 $95,489 $48 $823 $35,051 $9,919,794 $148,435 Alaska 41 $17,653 $431 $3,075 $0 $34 $233 $14,311 $1,042,164 $3,342 Arizona 257 $306,163 $1,191 $20,767 $96,463 $223 $3,294 $185,416 $14,676,375 $120,747 Arkansas 71 $55,602 $783 $2,883 $32,848 $27 $438 $19,406 $9,452,883 $36,196 California 631 $599,522 $950 $52,995 $279,712 $134 $4,405 $262,277 $155,231,252 $337,245 Colorado 255 $239,188 $938 $18,495 $42,930 $246 $2,757 $174,760 $12,795,318 $64,428 Connecticut 120 $97,897 $816 $8,178 $41,074 $42 $900 $47,703 $15,244,947 $50,194 DC 19 N/A N/A N/A N/A N/A N/A N/A $7,404,521 N/ADelaware 24 $10,392 $433 $1,691 $0 $9 $187 $8,505 $3,522,301 $1,887 Florida 869 $605,391 $697 $41,348 $226,787 $522 $7,830 $328,904 $37,640,420 $276,487 Georgia 412 $260,608 $633 $22,235 $72,365 $264 $3,612 $162,132 $21,454,446 $98,476 Hawaii 25 $46,415 $1,857 $1,725 $32,702 $6 $192 $11,790 $6,919,035 $34,625 Idaho 81 $216,083 $2,668 $7,176 $165,760 $62 $657 $42,428 $4,209,514 $173,655 Illinois 303 $276,880 $914 $22,343 $149,584 $87 $1,969 $102,896 $38,907,220 $173,984 Indiana 172 $104,991 $610 $7,009 $45,610 $77 $1,187 $51,107 $17,587,958 $53,883 Iowa 138 $101,503 $736 $13,579 $37,014 $67 $1,337 $49,506 $9,558,563 $51,997 Kansas 82 $197,465 $2,408 $3,273 $157,634 $36 $725 $35,796 $8,058,949 $161,669 Kentucky 109 $79,721 $731 $5,554 $32,868 $39 $760 $40,500 $11,778,866 $39,221 Louisiana 93 $44,142 $475 $4,178 $16,554 $22 $539 $22,849 $9,309,673 $21,294 Maine 70 $49,721 $710 $5,310 $17,836 $34 $528 $26,014 $4,130,242 $23,707 Maryland 246 $195,666 $795 $19,122 $73,113 $132 $1,892 $101,407 $20,894,199 $94,259 Massachusetts 149 $180,613 $1,212 $16,119 $74,322 $54 $1,966 $88,152 $27,283,005 $92,461 Michigan 170 $103,586 $609 $7,050 $44,015 $45 $1,069 $51,407 $27,436,607 $52,179 Minnesota 145 $125,644 $867 $13,153 $52,324 $61 $1,388 $58,718 $25,189,128 $66,927 Mississippi 37 $65,104 $1,760 $1,237 $52,783 $8 $252 $10,825 $7,660,391 $54,279 Missouri 168 $132,684 $790 $7,938 $67,829 $71 $1,282 $55,564 $12,245,169 $77,120 Montana 42 $16,317 $388 $2,142 $0 $18 $273 $13,884 $2,627,943 $2,433 Nebraska 46 $30,184 $656 $2,721 $11,820 $13 $387 $15,243 $5,117,133 $14,941 Nevada 100 $110,257 $1,103 $0 $43,040 $84 $1,160 $65,973 $8,025,046 $44,284 New Hampshire 43 $32,893 $765 $5,089 $0 $20 $631 $27,153 $2,641,946 $5,740 New Jersey 251 $165,710 $660 $15,669 $72,382 $64 $1,427 $76,168 $31,546,720 $89,542 New Mexico 52 $41,573 $799 $3,160 $14,465 $28 $488 $23,432 $5,462,107 $18,141 New York 303 $85,622 $283 $7,063 $30,032 $25 $962 $47,540 $81,353,963 $38,082 North Carolina 211 $137,941 $654 $5,371 $52,496 $60 $1,681 $78,332 $26,201,576 $59,609 North Dakota 0 $3,709,105 Ohio 333 $256,733 $771 $24,463 $97,835 $143 $2,569 $131,723 $28,694,883 $125,010 Oklahoma 23 $29,871 $1,299 $946 $21,878 $3 $150 $6,895 $8,491,187 $22,976 Oregon 163 $88,495 $543 $12,879 $0 $99 $1,381 $74,137 $11,043,311 $14,359 Pennsylvania 414 $304,363 $735 $34,190 $116,914 $173 $3,353 $149,733 $37,394,589 $154,630 Rhode Island 17 $15,070 $886 $1,096 $6,980 $4 $144 $6,847 $3,265,727 $8,223 South Carolina 161 $56,303 $350 $4,940 $7,151 $54 $932 $43,225 $9,551,052 $13,078 South Dakota 18 $23,672 $1,315 $0 $17,814 $5 $145 $5,708 $1,747,550 $17,964 Tennessee 246 $513,409 $2,087 $16,209 $385,830 $155 $2,113 $109,102 $13,386,169 $404,307 Texas 831 $834,831 $1,005 $100,980 $185,393 $559 $9,342 $538,558 $52,132,817 $296,273 Utah 162 $261,730 $1,616 $9,250 $169,708 $175 $1,657 $80,940 $7,082,961 $180,790 Vermont 23 N/A N/A N/A N/A N/A N/A N/A $3,085,865 N/AVirginia 300 $442,891 $1,476 $19,216 $280,722 $166 $2,668 $140,118 $21,219,757 $302,773 Washington 319 $251,068 $787 $0 $106,489 $190 $2,312 $142,077 $22,280,088 $108,991 West Virginia 47 $29,164 $621 $2,193 $11,921 $17 $274 $14,760 $5,127,970 $14,405 Wisconsin 82 $66,201 $807 $6,184 $25,005 $18 $748 $34,246 $17,607,733 $31,956 Wyoming 28 $16,464 $588 $0 $3,376 $22 $227 $12,838 $1,913,607 $3,626 Total 9,022 $8,133,160 $901 $634,732 $3,579,553 $4,459 $75,507 $3,838,910 $930,263,745 $4,294,251


TABLE 13. MASS MERCHANTS WITH PHARMACY: STATE BY STATE ESTIMATES OF TAXES PAID BY CATEGORY, 2017



(000)


(000)


Tax (000’s)



State Unemploy-

ment Insurance

(000’s)

Federal Income Tax

(000’s)


(000’s)


(000)

Alabama 175 $1,174,207 $6,710 $337,372 $607,117 $311 $2,330 $227,077 $9,919,794 $947,130 Alaska 15 $37,632 $2,509 $6,624 $0 $6 $173 $30,828 $1,042,164 $6,803 Arizona 150 $743,355 $4,956 $20,892 $533,562 $227 $2,139 $186,535 $14,676,375 $556,820 Arkansas 174 $1,562,097 $8,978 $51,817 $1,158,878 $431 $2,202 $348,770 $9,452,883 $1,213,328 California 442 $3,802,246 $8,602 $154,821 $2,873,504 $777 $6,919 $766,224 $155,231,252 $3,036,022 Colorado 125 $503,463 $4,028 $20,498 $287,219 $165 $1,893 $193,687 $12,795,318 $309,776 Connecticut 42 $264,635 $6,301 $9,986 $195,790 $73 $534 $58,252 $15,244,947 $206,383 DC 4 N/A N/A N/A N/A N/A N/A N/A $7,404,521 N/ADelaware 12 $18,289 $1,524 $3,006 $0 $8 $160 $15,115 $3,522,301 $3,174 Florida 409 $3,762,299 $9,199 $114,414 $2,731,251 $502 $6,020 $910,112 $37,640,420 $2,852,187 Georgia 268 $1,458,560 $5,442 $62,692 $934,837 $377 $3,523 $457,131 $21,454,446 $1,001,429 Hawaii 20 $211,921 $10,596 $7,844 $150,078 $37 $337 $53,624 $6,919,035 $158,296 Idaho 50 $362,864 $7,257 $11,626 $281,731 $80 $694 $68,733 $4,209,514 $294,131 Illinois 253 $2,611,261 $10,321 $123,959 $1,912,292 $364 $3,781 $570,864 $38,907,220 $2,040,397 Indiana 181 $1,703,922 $9,414 $50,107 $1,285,451 $237 $2,763 $365,364 $17,587,958 $1,338,558 Iowa 95 $410,362 $4,320 $25,832 $288,989 $148 $1,212 $94,181 $9,558,563 $316,181 Kansas 92 $750,931 $8,162 $12,464 $600,807 $149 $1,184 $136,327 $8,058,949 $614,604 Kentucky 133 $613,436 $4,612 $20,259 $443,519 $187 $1,747 $147,723 $11,778,866 $465,713 Louisiana 191 $718,666 $3,763 $36,167 $482,001 $360 $2,350 $197,789 $9,309,673 $520,877 Maine 25 $115,254 $4,610 $5,748 $80,987 $35 $325 $28,159 $4,130,242 $87,095 Maryland 76 $552,767 $7,273 $24,570 $396,583 $117 $1,199 $130,298 $20,894,199 $422,470 Massachusetts 56 $519,262 $9,273 $21,010 $382,551 $76 $724 $114,901 $27,283,005 $404,361 Michigan 278 $2,374,522 $8,541 $78,513 $1,719,421 $331 $3,767 $572,490 $27,436,607 $1,802,032 Minnesota 126 $1,250,754 $9,927 $60,137 $920,153 $175 $1,821 $268,468 $25,189,128 $982,286 Mississippi 192 $1,119,588 $5,831 $23,385 $888,539 $621 $2,426 $204,617 $7,660,391 $914,971 Missouri 172 $848,587 $4,934 $34,718 $568,384 $196 $2,259 $243,029 $12,245,169 $605,558 Montana 38 $47,647 $1,254 $6,294 $0 $88 $467 $40,797 $2,627,943 $6,849 Nebraska 74 $296,240 $4,003 $13,402 $206,677 $135 $950 $75,076 $5,117,133 $221,164 Nevada 59 $475,999 $8,068 $0 $369,972 $101 $826 $105,099 $8,025,046 $370,899 New Hampshire 32 $48,600 $1,519 $7,594 $0 $47 $445 $40,514 $2,641,946 $8,086 New Jersey 95 $627,288 $6,603 $28,057 $461,564 $163 $1,115 $136,389 $31,546,720 $490,900 New Mexico 57 $302,740 $5,311 $10,858 $210,550 $89 $725 $80,518 $5,462,107 $222,222 New York 146 $812,732 $5,567 $37,777 $518,242 $149 $2,291 $254,272 $81,353,963 $558,460 North Carolina 246 $1,228,461 $4,994 $24,117 $848,853 $339 $3,448 $351,705 $26,201,576 $876,756 North Dakota 0 $3,709,105 Ohio 237 $1,262,608 $5,327 $56,413 $898,697 $291 $3,447 $303,761 $28,694,883 $958,847 Oklahoma 140 $855,471 $6,111 $28,267 $619,128 $233 $1,728 $206,116 $8,491,187 $649,356 Oregon 121 $250,400 $2,069 $36,756 $0 $193 $1,864 $211,587 $11,043,311 $38,813 Pennsylvania 200 $966,625 $4,833 $51,767 $685,060 $305 $2,788 $226,706 $37,394,589 $739,919 Rhode Island 9 $52,730 $5,859 $1,725 $40,083 $12 $127 $10,783 $3,265,727 $41,947 South Carolina 145 $678,360 $4,678 $18,676 $494,181 $207 $1,879 $163,417 $9,551,052 $514,943 South Dakota 33 $154,479 $4,681 $0 $116,121 $70 $418 $37,870 $1,747,550 $116,609 Tennessee 231 $1,802,980 $7,805 $48,044 $1,427,650 $645 $3,267 $323,373 $13,386,169 $1,479,607 Texas 631 $5,931,287 $9,400 $261,274 $4,266,546 $883 $9,121 $1,393,463 $52,132,817 $4,537,824 Utah 87 $550,608 $6,329 $13,690 $415,814 $114 $1,202 $119,787 $7,082,961 $430,820 Vermont 7 N/A N/A N/A N/A N/A N/A N/A $3,085,865 N/AVirginia 177 $867,050 $4,899 $28,174 $630,818 $211 $2,407 $205,439 $21,219,757 $661,611 Washington 124 $1,062,910 $8,572 $0 $815,283 $119 $2,058 $245,449 $22,280,088 $817,461 West Virginia 53 $262,439 $4,952 $9,271 $189,954 $97 $716 $62,401 $5,127,970 $200,038 Wisconsin 199 $1,467,816 $7,376 $71,233 $998,640 $430 $3,023 $394,489 $17,607,733 $1,073,327 Wyoming 31 $128,616 $4,149 $0 $85,580 $88 $356 $42,592 $1,913,607 $86,024 Total 6,928 $47,624,964 $6,874 $2,071,853 $34,023,057 $11,001 $97,151 $11,421,901 $930,263,745 $36,203,062


Top Chain Pharmacy CompaniesAlthough many people think of chain pharmacy as traditional drug stores, a list of the top chain pharmacy companies illustrates how diverse the retail pharmacy environment is. Tables 14 and 15 show the top chain pharmacy companies by

pharmacy sales and by number of pharmacies in 2017.

The top companies by prescription share are shown in Table 16.

TABLE 14. TOP CHAIN RETAIL PHARMACY COMPANIES, BY PHARMACY SALES, 2017

Rank Company Pharmacy Sales (in millions)

Total Sales (in millions)

1 Walgreens Boots Alliance Inc. 60,352.9 87,468.0

2 CVS Health 59,586.7 79,449.0

3 Walmart Stores Inc.1 18,470.0 318,477.0

4 Rite Aid Corporation 14,187.6 21,529.0

5 The Kroger Co. 9,800.9 115,302.3

6 Albertsons LLC 4,895.4 59,924.6

7 Ahold Delhaize2 2,918.5 29,511.4

8 Safeway Inc. 2,867.5 37,000.0

9 Publix Super Markets Inc. 2,246.3 34,558.3

10 Costco Wholesale Corp. 1,892.6 126,172.0

11 Medicine Shoppe International Inc. 1,710.0 1,800.0

12 H-E-B 1,582.6 21,100.7

13 Hy-Vee Inc. 1,189.8 9,915.0

14 Fred’s Inc. 1,067.0 2,125.4

15 Genoa, a QoL Healthcare Company 1,029.0 1,050.0

16 Wegmans Food Markets Inc. 891.5 8,490.0

17 Giant Eagle Inc. 866.5 10,315.2

18 Fred Meyer Stores Inc. 661.3 9,870.0

19 Southeastern Grocers 658.5 10,975.8

20 Kinney Drugs 648.8 865.0

21 ShopKo Stores Operating Co. LLC 646.0 3,400.0

22 Winn-Dixie Stores Inc. 513.8 7,340.0

23 Sears Holding Company 449.4 5,618.0

24 Wakefern Food 445.0 9,870.7

25 SUPERVALU INC. 382.2 3,822.4 1 U.S. stores division only reflects discount stores, supercenters, and neighborhood markets.2 Includes Giant Food, LLC, Giant Food Stores LLC, The Stop & Shop Supermarket Corporation, Food Lion, and Hannaford Bros. Co.Source: Chain Store Guide Information Services Directory of Drug Store and HBC Chains


TABLE 15. TOP CHAIN RETAIL PHARMACY COMPANIES, BY NUMBER OF PHARMACIES, 2017

Rank Company Name Stores Pharmacies Rank Company Name Stores Pharmacies

1 CVS Health 9,803 9,803 14 Kmart Corp. 432 367

2 Walgreens Boots Alliance Inc. 10,032 8,725 15 Fred’s Inc. 601 357

3 Walmart Stores Inc. 4,702 4,393 16 Winn-Dixie Stores Inc. 518 280

4 Rite Aid Corporation 2,548 2,548 17 ShopKo Stores Operating Co. LLC 381 273

5 The Kroger Co. 2,790 2,255 18 Hy-Vee Inc. 266 265

6 Albertsons LLC 2,318 1,775 19 Meijer Inc. 231 238

7 Publix Super Markets Inc. 1,185 1,040 20 Giant Eagle Inc. 434 210

8 Safeway Inc. 1,269 881 21 Ingles Markets Inc. 200 200

9 Ahold Delhaize 1,968 760 22 H-E-B 378 188

10 Costco Wholesale Corp. 746 673 23 Weis Markets Inc. 206 180

11 Medicine Shoppe International Inc. 416 416 24 Wakefern 198 175

12 Southeastern Grocers 582 400 25 Fred Meyer Stores Inc. 132 130

13 Genoa Healthcare 400 400

(1) U.S. stores division only reflects discount stores, supercenters, and neighborhood markets.Counts are for June 2017. (2) Includes Giant Food, LLC, Giant Food Stores LLC, The Stop & Shop Supermarket Corporation, Food Lion, and Hannaford Bros. Co.

TABLE 16. TOP CHAIN RETAIL PHARMACY COMPANIES, BY PRESCRIPTION SHARE, 2017

Rank Company Prescription Share Rank Company Prescription Share

1 CVS Health 21.9% 14 Giant Eagle Inc. 0.4%

2 Walgreens Boots Alliance Inc. 18.5% 15 Meijer Inc. 0.4%

3 Walmart Stores Inc. 6.6% 16 Sears Holding Company 0.4%

4 The Kroger Co. 4.0% 17 Hy-Vee Inc. 0.4%

5 Rite Aid Corporation 3.9% 18 Wegmans Food Markets Inc. 0.3%

6 Albertsons LLC 2.9% 19 Kinney Drugs 0.2%

7 Ahold Delhaize (1) 1.4% 20 Thrifty White Drug Stores Inc. 0.2%

8 Publix Super Markets Inc. 1.2% 21 Weis Markets Inc. 0.2%

9 Costco Wholesale Corp. 1.1% 22 Raley’s Family of Fine Stores 0.2%

10 H-E-B 0.7% 23 The Bartell Drug Company 0.1%

11 ShopKo Stores Operating Co. LLC 0.5% 24 Discount Drug Mart Inc. 0.1%

12 Medicine Shoppe International Inc. 0.4% 25 SUPERVALU INC. 0.1%

13 Fred’s Inc. 0.4%

Source: CSGIS Directory of Drugstore and HBC Chains, 2018, and NCPDP store database, July 2017.(1) Includes Giant Food, LLC, Giant Food Stores LLC, The Stop & Shop Supermarket Corporation, Food Lion, and Hannaford Bros. Co.


Industry Consolidation: Mergers and AcquisitionsThe retail pharmacy industry continues to consolidate. Companies also continue to acquire individual stores or groups of stores from competitors to expand or strengthen their market position.

Mergers are driven in part by the cost savings that can be found when different functions, such as distribution, purchasing, and management, are combined. Because integration may take some time, an acquisition that will eventually increase earnings of a company may temporarily reduce profits. Table 17 presents the most recent mergers and acquisitions in the chain drug industry.

TABLE 17. RECENT MERGERS, ACQUISITIONS, AND TRANSFERS OF STORE OWNERSHIP

Year Buying Company Acquisition # of pharmacies Notes

2018 Walgreens Rite Aid 1,651

2018 CVS Health EntrustRx 3 Fred’s specialty pharmacy business

2017 CVS Health Eaton Apothecary 3

2016 Ahold USA Delhaize America 183 Combined firm is Ahold Delhaize

2015 CVS Health Target ~1,600 pharmacies 80 clinics also be transferred.

2015 CVS Health Omnicare 135 Long term care and specialty pharmacies

2015 Rite Aid Corporation EnvisionRx Pharmacy benefit management company

2015 Albertsons LLC Safeway 1,079

2014 CVS Caremark Navarro Discount Pharmacies 33

2014 CVS Caremark Coram LLC 85 Specialty pharmacy chain

2014 The Kroger Company Harris Teeter 147

2013 Giant Eagle Rx21 Specialty Pharmacy 1

2013 Bi-Lo Piggly Wiggly 5

2013 Ritzman Pharmacies Mast Pharmacy 5

2013 Walgreens Kerr Drug 76

2013 Bi-Lo Sweetbay Supermarkets, Harvey’s, Reids

165 stores, about 100

pharmaciesAcquired from Delhaize America

2013 Albertsons LLC SUPERVALU 877

2013 The Kroger Company Axium Pharmacy Holdings 1 Specialty pharmacy

2013 The Bartell Drug Company Everett Clinic 2

2012 Walgreens USA Drug 144

2012 Walgreens BioScrip 30

2012 Bi-Lo Winn-Dixie 480 Includes about 380 pharmacies

2011 Walgreens Morton Pharmacy 12

2011 Ritzman Pharmacies Buehler’s Fresh Food Markets 11

2011 Walgreens Carle RxExpress 10

2010 Walgreens Duane Reade 257 Includes corporate office and 2 distribution centers

2010 Walgreens Eaton Apothecary 12

2010 Walgreens Graymark Healthcare Inc. 18 ApothecaryRx pharmacies

2010 Walgreens USA Drug Pharmacy files from 17 Super D and Ike’s stores




2010 Walgreens Farmacias El Amal 3 3 stores plus files from 11 stores

2010 Walgreens Katz Group 25 Snyder Drug Stores in MN

2009 Walgreens Drug Fair 33 Walgreens purchased prescription files for 2 additional Drug Fair locations

2009 Southern Family Markets Bruno’s Supermarkets LLC 56 31 stores will continue to operate under Brunoís and Food World banners

2009 Walgreens Rite Aid 12 7 in CA, 5 in eastern ID

2008 CVS Caremark Longs Drug Stores 521 Includes RxAmerica pharmacy benefit management company

2008 The Kroger Company Farmer Jack (under A & P) 20 41 Farmer Jack sites bought by independent grocers; 2 warehouses and 25 stores for sale after July 2007

2008 Arcadia Resources, Inc. PrairieStone Pharmacy, LLC ~200 Management company that provides services to retail pharmacies

2008 Walgreens Farmacias El Amal 20 41 stores to continue operation under Farmacia El Amal

2008 Spartan Stores VG’s 32 17 supermarkets, 15 pharmacies

2008 Rite Aid Corporation Spartan’s Pharm Stores 12 2 other stores sold in a separate transaction

2008 Publix Super Markets, Inc. Albertsons LLC 49

2008 CVS Snyder’s 23 19 in MN, 4 in MT

2007 Rite Aid Corporation Brooks Eckerd 1,850

2007 Walgreens FamilyMeds 53 Asset purchase agreement 2/14/07

2006 Longs Drug Network Pharmaceuticals 21

2006 Walgreens Happy Harry’s 76

2006 CVS Albertson’s 703 Freestanding stores only

2006 SUPERVALU Albertson’s 1,124

2006 Cerberus Capital Management Albertson’s 655

2005 Rite Aid Corporation Shelly’s 5 2 stores converted to Rite Aid format, 3 to transfer pharmacy files

2005 Walgreens Medic 23

2005 Omnicare NeighborCare Inc. 30

2004 USA/Super D Med-X 22 Plus distribution center

2004 USA/Super D May’s Drug Stores 39

2004 CVS Eckerd Corp. 1,260

2004 Brooks Pharmacy Eckerd Corp. 1,540

2004 Brooks Pharmacy Pelton’s 3

2004 Albertson’s Shaw’s Supermarkets 202

2004 DrugMax FamilyMeds 82

2003 Medicine Shoppe International Medicap 179

2003 Walgreens Hi-School 17

2003 Inland Retail Real Estate Trust Eckerd Corp. 19 Acquisition of assets

2002 Brooks Pharmacy Albertsons Inc-New England Osco Drugstores 80 Acquisition of assets

2002 J M Smith Corp. CornerDrugstore.com (SymRx Inc) n/a Acquisition of assets

2002 Rite Aid CVS 11 4 stores in Flint, MI, 4 in Toledo, OH, 3 in Canton, OH

2002 CVS Rite Aid 15 9 stores in Columbus, OH, 6 stores in Cincinnati, OH

2002 Jean Coutu Grp/Brooks Pharmacy Osco Drugs 80

2001 Navarro Discount Drugs Fedco Drugs 4




2001 Aurora Pharmacy Copps Food Center 12

2001 Snyder’s Drug Stores (Katz Group)

Vix Deep Discount (div. of Drug Emporium) 12

2001 Snyder’s Drug Stores (Katz Group) F & M Super Drug Stores 12

2001 Snyder’s Drug Stores (Katz Group) Drug Emporium 70-80

2001 Big A Drug Stores Drug Emporium 15

2001 Eckerd Corp. (J. C. Penney Co., Inc.) Stewart-Wood Drug 1

2001 CVS Drug Emporium Asset purchase: inventory, prescription files. Drug Emporium closes 16 Georgia stores, 20 California stores

2001 Pathmark Stores Grand Union 6

2001 Snyder’s Drug Stores (Katz Group) Independents 6 6 total independent drug stores acquired

2001 Familymeds Integrated Pharmacy Solutions (subsid. of Aetna, US) 38

2001 Snyder’s Drug Stores (Katz Group) Drug Emporium 81

2001 Longs Drugs Stores Drug Emporium 2

2001 Big A Drug Stores’ Drug Emporium 15

2001 CVS Grand Union 10 Store leases acquired

2001 Snyder’s Drug Stores (Katz Group)

Park Pharmacy, Park Rapids, and Synder Drug 3 Purchase of 3 total independent stores

2000 Snyder’s Drug Stores (Katz Group) Tobin’s Drug Stores 2

2000 Snyder’s Drug Stores (Katz Group) The Family Pharmacy 1

2000 Snyder’s Drug Stores (Katz Group) Peterson Snyder’s Drug 1 Previously operated as a Snyder’s independent retailer

2000 CVS Stadtlander Pharmacy (div. of Bergen Brunswig Corp.)

Specialty pharmacy, part of which is a wholesaler/distributor; 3 walk-in pharmacies, 14 mail-distribution centers

2000 Duane Reade Value Drug 5

2000 Eckerd Corp. (J. C. Penney Co., Inc.) Greshamís (Chain) 7

2000 Snyder’s Drug Stores (Katz Group) Western Drug of Billings 7

2000 Longs Drugs Stores Rite Aid 31

2000 Park Pharmacy Corp. Dougherty’s Pharmacy Inc. 1

2000 Park Pharmacy Corp. MJN Enterprises Inc. 1

2000 Park Pharmacy Corp. Total Pharmacy Supply Inc. 1

2000 Kaire Holdings Inc. Classic Care Pharmacy 1

2000 Park Pharmacy Corp. Amedisys Infusion Pharmacy Operations

2000 CVS Corp. Thrifty Rexall Drugs 1

2000 Kerr CVS 3 2 stores to remain open, 1 pharmacy’s files to be transferred

2000 Kerr Eckerd 1 Store to be closed, pharmacy’s files to be transferred

1999 Medicap Pharmacies, Inc. Gollash Pharmacies, Inc.




1999 D.A.W. Eaton Apothecary (80% subsid. of Nyer Medical Group) 3

1999 Horizon Pharmacies, Inc. Save-More Drugs 1

1999 Horizon Pharmacies, Inc. Jones Low Priced Drugs 2

1999 Horizon Pharmacies, Inc. Fulton Drug 1 Mail-order and Internet pharmacy, Starscripts.

1999 Horizon Pharmacies, Inc.

Blake Pharmacy, Brennan Pharmacy Downtown, The Prescription Center, Sav-More Drugs, Inc., Stroncek Eagle Drug, Inc.

5 5 total independent pharmacies purchased

1999 Horizon Pharmacies, Inc. Fountainview Pharmacy 1

1999 Horizon Pharmacies, Inc. Jones Low Priced Drugs Inc. 2

1999 Fry’s Food Stores (Kroger) Smith’s Food and Drug Stores (Fred Meyer, Inc.) 37 FTC agreement: 2 Fry’s and 1 Smith’s to be sold

1999 Anchor Pharmacies indepedents 2

1999 Medicine Shoppe Pharmacies Food Lion 0 New or remodeled Food Lions in selected markets to become Medicine Shoppes

1999 Medicine Shoppe Pharmacies Kash n’ Karry (div. of Food Lion) 50 Existing pharmacies in Kash’s stores to become Medicine Shoppe franchises

1999 Melrose Trading Company Medicine Shoppe (India) 5 5 franchises

1999 Longs Drugs Stores Rite Aid 35 Of 35, 1 closed; original plan to purchase 38, lease 6

1999 Longs Drugs Stores Drug Emporium/Western Drug Distributors 20

1999 Drug Emporium Inc. Vix Stores 12

1999 Duane Reade Love’s (Chain) 6

1999 Duane Reade Love Stores 10

1999 Katz Group Snyder’s Drug Stores (Chain) 141

1999 Albertson’s American Drug Stores Co. (Chain) 1,558 As part of FTC agreement, Albertson’s has divested 144 stores

1999 Raley’s Albertson’s 27 Part of Albertson’s divestiture

1999 Certified Grocers of California, Ltd. Albertson’s 31 Part of Albertson’s divestiture

1999 Ralph’s Grocery Company (Subsid. of Kroger) Albertson’s 42 Stores included Alberston’s, Lucky, Super Saver, Monte Mart. 40

stores, 2 sites; part of Albertson’s divestiture

1999 Stater Brothers Markets Albertson’s 44 Stores included Alberston’s, Lucky. 43 stores, 1 site; part of Albertson’s divestiture

1999 Vons Companies, Inc. Albertson’s 5 4 stores, 1 site; part of Albertson’s divestiture

1999 Eckerd Corp. (J. C. Penney Co., Inc.) Genovese Drug Stores, Inc. (Chain) 141

1999 Phar-Mor, Inc. Pharmhouse Corp., Rx Place 32 Stores to operate as Phar-Mor, Pharmhouse, The Rx Place

1999 Rite Aid Corporation Edgehill Drugs Inc. 25

1999 Palm Beach Pharmacies FEDCO, Inc. (Florida) 20

1999 Drug Emporium Inc. Vix Deep Discount 12 Includes 11 Vix stores and 1 Vixís Herbs outlet; operated by Tops Markets Inc., div. of Ahold international

1999 Jean Coutu Group/Brooks Pharmacy City Drug Stores (Chain) 11 Of the 11 stores, 10 have pharmacies

1999 Eckerd Corporation The Chemist Shop 1

1999 Arrow Corp. KPC Medical Management 18 Pharmacies in clinics

1999 Arrow Pharmacy & Nutrition Centers (Arrow Corp.) Super Sav-On Drugs 18




1999 Arrow Pharmacy & Nutrition Centers (Arrow Corp.) Kaiser Permanente’s NE division 17

1999 Snyder’s Drug Stores (Chain) Unnamed independents 5 5 total independent pharmacies purchased

1999 Sav-Mor DrugsEfros Drugs, FRD Sav-Mor Pharmacy, Jan’s Discount Pharmacy, Proos Pharmacy and Robert’s Sav-Mor


1999 ICN Pharmaceuticals retail pharmacies 88

1999 Health Script Pharmacy Services Rx West, Inc. 1

1999 Power Cell Park Pharmacy 1

1999 CVS Century City Drug, Pace Blvd. City Drugs 2 2 total acquisitions

1998 Lewis Drugs/Sioux Valley Hospitals and Health System Family Drug Stores 11

1998 Albertson’s Buttrey Food and Drug Stores Co. 44 As part of the FTC agreement, Albertson’s divested 6 of its own stores and 9 Buttrey units for a net gain of 29

1998 CVS Arbor Drugs (Chain) 207

1998 Duane Reade Rock Bottom Stores 38

1998 Longs Drug Stores Western Drug Distributors 20 Drug Emporium of Washington & Oregon

1998 CVS Thriftway Pharmacy Associates 16

1998 NeighborCare Health Care Professionals 2

1998 Scottís Food Stores (div. of Supervalu) Keltsch Drug Stores (Chain) 14 Eleven freestanding units and 3 in-store pharmacies

1998 Horizon Pharmacies, Inc. Briargrove Pharmacy, Kirkwood Pharmacy, Interurban Pharmacy 3 Acquisition of an independent chain of three retail pharmacies in

Houston, TX

1998 Horizon Pharmacies, Inc. Holland Drug Store 2

1998 Horizon Pharmacies, Inc.

Barrett Drug, Belen Sav-on Drug, Conoly-Herry Drug, Inc., Drug Towne Pharmacy, Ernie’s Sav-on Drug, Highlands Ranch Pharmacy, R & R Professional Pharmacy, Inc., St. John’s Drug, Steelville Drug


1998 Raley’s Supermarket and Drug Centers Nob Hill Foods 27 To be operated as wholly-owned subsidiary with no name change

33NACDS CHAIN MEMBER FACT BOOK, 2018-2019 SECTION TWO | FINANCIAL INFORMATION/NON-PRESCRIPTION SALES

2Financial Information/Non-Prescription Sales

This section presents general information on community pharmacies. Included are:

• General financial information by type of store; • Warehousing and distribution; • Inventory/sales ratios; • Technology; • Internet sales; • Employee issues; and • Non-prescription sales.

General Financial Information by Type of StoreEvery type of community retail pharmacy invests resources into developing ideal physical location and appropriate inventory standards. Whether the chain store is a traditional chain drug store, a supermarket, or a mass merchant, capitalizing the return on this investment is a must. The following information is provided to evaluate investment returns for each type of store based on these measures:

• Profitability, valuation, operational, and financial ratios;

• per capita sales; and

• Gross margin.

34 SECTION TWO | FINANCIAL INFORMATION/NON-PRESCRIPTION SALES NACDS CHAIN MEMBER FACT BOOK, 2018-2019

The values in the following tables are best used as both an industry average and as comparative devices between different types of retail stores. Note the information on these measures is not available for particular chain stores, only for the

major industry groups to which the chain drug stores belong. Still, these data should provide a useful comparison for chain drug stores when assessing their own business performance.

TABLE 18. FINANCIALS BY INDUSTRY FOR PUBLICLY HELD COMPANIES, 2017

Industry Name Number of Firms

EBITDA/Sales

EBITDASG&A/Sales

After-tax Unadjusted Operating

Margin

Net Margin ROE ROC Price/BV PE Price/Sales EV/SalesAccounts

Receivable/Sales

Inventory/Sales

Accounts Payable/

Sales

Non-cash Working Capital/

Sales

Beta Expected Growth Net Margin Tax Rate

Pre-Tax Operating

Margin

Advertising 40 15.97% 28.31% 11.79% 5.45% -0.88% 77.57% 9.16 42.07 1.02 1.66 47.59% 4.92% 53.19% -1.65% 1.15 7.24% 5.45% 33.12% 12.40%Aerospace/Defense 87 13.47% 20.55% 10.36% 7.22% 29.03% 37.05% 6.43 45.24 1.84 2.09 18.74% 22.36% 10.04% 27.71% 1.08 11.46% 7.22% 29.56% 11.81%Air Transport 17 20.64% 24.40% 10.19% 7.03% 24.78% 13.50% 3.06 12.40 0.94 1.56 4.30% 2.46% 5.38% 1.19% 1.01 6.46% 7.03% 37.16% 12.84%Apparel 51 14.13% 52.78% 9.77% 3.43% 7.62% 14.18% 3.58 19.94 1.56 1.99 12.73% 19.61% 7.17% 25.76% 1.02 11.32% 3.43% 25.24% 10.94%Auto & Truck 18 10.25% 18.15% 3.61% 2.07% 8.64% 3.97% 2.05 15.03 0.52 1.22 6.37% 7.73% 14.14% -2.06% 1.20 18.35% 2.07% 31.05% 3.96%Auto Parts 62 11.05% 18.16% 8.27% 5.32% 24.14% 23.79% 2.92 23.32 0.82 0.98 17.07% 9.11% 15.18% 11.20% 1.04 12.64% 5.32% 12.10% 9.08%Bank (Money Center) 11 0.00% 51.03% 0.00% 26.03% 9.93% -0.01% 1.24 17.09 3.65 8.45 0.00% 0.46% N/A N/A 0.64 7.54% 26.03% 28.35% -0.07%Banks (Regional) 612 0.00% 50.10% 0.00% 23.82% 9.03% -0.03% 1.50 33.24 4.39 6.27 0.00% 1.92% N/A N/A 0.50 9.43% 23.82% 29.54% -0.16%Beverage (Alcoholic) 28 20.26% 44.64% 21.08% 21.18% 25.16% 24.32% 4.01 31.31 4.05 5.05 11.22% 18.55% 16.17% 16.51% 1.33 20.06% 21.18% 30.04% 23.41%Beverage (Soft) 35 22.71% 59.24% 17.96% 10.86% 28.39% 24.92% 9.95 28.28 3.57 4.20 11.39% 5.63% 21.60% -3.45% 0.70 10.77% 10.86% 26.55% 19.32%Broadcasting 27 28.92% 51.80% 19.28% 4.09% 18.11% 21.38% 7.34 31.34 1.44 2.83 22.97% 3.77% 3.09% 22.96% 1.12 7.59% 4.09% 33.53% 23.45%Brokerage & Investment Banking 42 0.38% 41.06% 0.29% 15.01% 11.41% 0.02% 1.56 31.77 2.48 6.75 159.43% 0.09% N/A N/A 1.24 11.70% 15.01% 28.42% 0.11%Building Materials 39 12.50% 28.81% 7.71% 6.30% 23.81% 18.27% 4.77 28.83 1.51 1.78 12.99% 11.45% 9.24% 15.60% 1.11 14.98% 6.30% 26.30% 10.31%Business & Consumer Services 169 13.05% 32.31% 9.03% 5.19% 18.32% 26.37% 4.95 59.52 1.59 1.94 19.68% 1.79% 6.36% 16.32% 1.17 12.94% 5.19% 33.10% 10.49%Cable TV 14 29.14% 54.92% 14.24% 7.88% 11.05% 12.72% 2.80 25.74 2.28 3.44 6.97% 0.21% 6.38% -1.12% 0.92 10.25% 7.88% 33.08% 18.25%Chemical (Basic) 38 13.41% 20.68% 9.83% 5.77% 18.60% 14.43% 3.47 28.39 1.32 1.76 14.90% 12.48% 9.17% 20.27% 1.20 14.14% 5.77% 15.16% 10.91%Chemical (Diversified) 7 15.45% 22.19% 10.61% 5.58% 14.20% 16.59% 1.74 281.02 2.43 2.90 20.03% 25.62% 17.39% 34.35% 2.03 18.82% 5.58% 22.18% 12.03%Chemical (Specialty) 99 18.20% 38.20% 11.96% 7.53% 17.00% 16.74% 4.15 145.32 2.25 2.79 17.45% 15.73% 12.07% 21.49% 1.11 12.34% 7.53% 23.09% 13.50%Coal & Related Energy 30 9.33% 14.93% 7.41% 12.62% N/A 8.53% 2.03 13.36 0.78 1.01 7.99% 6.17% 10.31% 4.34% 1.25 N/A 12.62% N/A 8.87%Computer Services 111 10.83% 25.55% 7.37% 5.93% 28.66% 27.96% 4.04 48.66 1.08 1.34 17.53% 5.73% 10.50% 12.65% 1.10 12.36% 5.93% 14.82% 8.30%Computers/Peripherals 58 24.14% 33.61% 18.81% 14.34% 28.55% 23.86% 5.42 26.11 2.69 3.03 9.07% 5.41% 20.37% -2.62% 1.01 15.79% 14.34% 23.91% 19.76%Construction Supplies 49 12.74% 22.23% 7.89% 4.78% 13.23% 10.59% 4.21 35.67 1.71 2.14 14.74% 16.92% 12.39% 15.83% 1.12 15.00% 4.78% 27.74% 9.62%Diversified 24 18.15% 25.32% 11.37% 8.54% 9.59% 10.98% 2.04 38.63 2.09 2.62 21.01% 11.67% 12.57% 14.41% 1.19 12.48% 8.54% 21.93% 12.95%Drugs (Biotechnology) 459 31.34% 57.53% 24.67% 12.57% 13.45% 11.60% 6.20 127.65 7.02 7.70 16.81% 7.58% 10.36% 14.85% 1.44 27.31% 12.57% 36.45% 24.92%Drugs (Pharmaceutical) 185 31.94% 59.76% 23.11% 14.05% 14.39% 17.68% 4.85 46.35 4.60 5.08 19.35% 13.90% 7.30% 22.58% 1.21 20.47% 14.05% 21.69% 23.63%Education 34 13.43% 44.65% 7.64% 1.38% 2.60% 11.47% 2.33 132.99 1.45 1.87 13.59% 1.85% 5.96% 10.56% 1.15 11.91% 1.38% 45.20% 8.17%Electrical Equipment 118 14.98% 34.96% 11.03% 6.21% 13.54% 21.88% 4.31 29.63 2.26 2.48 18.59% 13.47% 11.06% 19.90% 1.08 15.09% 6.21% 37.86% 11.89%Electronics (Consumer & Office) 24 -7.25% 17.19% -3.16% -10.63% -29.60% -5.54% 7.91 35.28 2.45 2.52 14.73% 16.65% 14.63% 19.76% 1.09 12.77% -10.63% N/A -3.36%Electronics (General) 167 13.60% 27.76% 8.55% 6.67% 11.30% 13.55% 3.04 56.36 2.00 2.12 15.61% 16.42% 13.60% 18.58% 0.94 17.82% 6.67% 28.86% 9.48%Engineering/Construction 49 5.63% 12.27% 3.53% 1.99% 7.71% 18.43% 2.08 28.75 0.58 0.69 22.57% 1.65% 9.14% 15.07% 1.27 12.30% 1.99% 35.38% 4.29%Entertainment 90 24.26% 40.76% 19.79% 11.50% 18.99% 31.11% 3.05 312.73 2.24 2.87 18.56% 3.83% 8.51% 10.59% 1.15 11.54% 11.50% 29.01% 20.72%Environmental & Waste Services 87 19.78% 32.71% 11.50% 4.41% 9.47% 21.28% 4.10 73.67 1.96 2.63 15.63% 1.21% 5.73% 10.13% 0.88 12.83% 4.41% 40.39% 12.54%Farming/Agriculture 34 7.18% 12.55% 4.03% 3.08% 12.10% 7.14% 2.42 22.90 0.70 1.02 7.37% 13.99% 11.11% 10.29% 0.74 15.33% 3.08% 28.27% 4.50%Financial Services (Non-bank & Insurance) 264 7.76% 37.90% 5.97% 26.46% -0.29% 0.21% 2.20 41.45 2.82 31.18 2696.24% 0.58% N/A N/A 0.61 11.62% 26.46% 33.18% 7.28%

Food Processing 87 17.09% 31.50% 11.96% 7.37% 11.54% 19.71% 2.88 36.08 1.88 2.42 8.02% 11.43% 10.41% 7.32% 0.68 9.46% 7.37% 29.04% 14.21%Food Wholesalers 15 4.15% 18.10% 2.58% 1.34% 16.64% 19.96% 5.00 50.79 0.39 0.53 6.78% 6.58% 6.63% 6.42% 1.79 8.70% 1.34% 34.09% 2.98%Furn/Home Furnishings 31 12.57% 28.94% 7.97% 5.89% 17.62% 17.56% 2.98 17.82 1.14 1.41 14.27% 16.42% 15.02% 12.87% 0.79 13.40% 5.89% 23.24% 9.42%Green & Renewable Energy 22 55.01% 70.52% 15.63% 1.27% 0.66% 1.94% 1.21 89.05 4.44 8.40 15.67% 1.07% 17.53% 9.67% 1.20 11.05% 1.27% N/A 11.76%Healthcare Products 251 21.04% 53.56% 14.43% 8.52% 9.51% 16.30% 4.04 161.11 4.35 4.79 17.26% 15.52% 7.35% 22.93% 0.94 16.55% 8.52% 17.88% 15.34%Healthcare Support Services 115 5.28% 13.40% 3.98% 2.58% 17.40% 50.54% 3.19 38.56 0.55 0.62 6.31% 3.89% 16.30% -6.15% 0.90 14.52% 2.58% 32.24% 4.68%Heathcare Information and Technology 112 18.91% 47.55% 12.81% 8.54% 10.80% 15.73% 4.05 174.42 4.29 4.95 20.70% 9.89% 7.60% 23.13% 0.98 15.21% 8.54% 19.52% 13.77%

Homebuilding 32 9.98% 20.20% 7.63% 5.98% 12.49% 9.31% 2.07 883.19 1.12 1.49 1.08% 82.30% 4.60% 78.80% 1.11 17.58% 5.98% 37.00% 10.11%Hospitals/Healthcare Facilities 35 14.72% 18.67% 8.24% 0.61% 8.21% 11.84% 3.82 58.93 0.49 1.32 14.17% 2.06% 5.29% 12.33% 1.18 6.50% 0.61% 50.10% 8.81%Hotel/Gaming 70 25.89% 44.27% 17.50% 8.25% 12.94% 11.33% 4.51 34.20 3.07 4.15 7.30% 3.50% 6.07% -1.45% 0.94 13.18% 8.25% 19.58% 19.60%




EBITDA/Sales

EBITDASG&A/Sales


Margin


Receivable/Sales

Inventory/Sales

Accounts Payable/

Sales


Sales


Pre-Tax Operating

Margin

Advertising 40 15.97% 28.31% 11.79% 5.45% -0.88% 77.57% 9.16 42.07 1.02 1.66 47.59% 4.92% 53.19% -1.65% 1.15 7.24% 5.45% 33.12% 12.40%Aerospace/Defense 87 13.47% 20.55% 10.36% 7.22% 29.03% 37.05% 6.43 45.24 1.84 2.09 18.74% 22.36% 10.04% 27.71% 1.08 11.46% 7.22% 29.56% 11.81%Air Transport 17 20.64% 24.40% 10.19% 7.03% 24.78% 13.50% 3.06 12.40 0.94 1.56 4.30% 2.46% 5.38% 1.19% 1.01 6.46% 7.03% 37.16% 12.84%Apparel 51 14.13% 52.78% 9.77% 3.43% 7.62% 14.18% 3.58 19.94 1.56 1.99 12.73% 19.61% 7.17% 25.76% 1.02 11.32% 3.43% 25.24% 10.94%Auto & Truck 18 10.25% 18.15% 3.61% 2.07% 8.64% 3.97% 2.05 15.03 0.52 1.22 6.37% 7.73% 14.14% -2.06% 1.20 18.35% 2.07% 31.05% 3.96%Auto Parts 62 11.05% 18.16% 8.27% 5.32% 24.14% 23.79% 2.92 23.32 0.82 0.98 17.07% 9.11% 15.18% 11.20% 1.04 12.64% 5.32% 12.10% 9.08%Bank (Money Center) 11 0.00% 51.03% 0.00% 26.03% 9.93% -0.01% 1.24 17.09 3.65 8.45 0.00% 0.46% N/A N/A 0.64 7.54% 26.03% 28.35% -0.07%Banks (Regional) 612 0.00% 50.10% 0.00% 23.82% 9.03% -0.03% 1.50 33.24 4.39 6.27 0.00% 1.92% N/A N/A 0.50 9.43% 23.82% 29.54% -0.16%Beverage (Alcoholic) 28 20.26% 44.64% 21.08% 21.18% 25.16% 24.32% 4.01 31.31 4.05 5.05 11.22% 18.55% 16.17% 16.51% 1.33 20.06% 21.18% 30.04% 23.41%Beverage (Soft) 35 22.71% 59.24% 17.96% 10.86% 28.39% 24.92% 9.95 28.28 3.57 4.20 11.39% 5.63% 21.60% -3.45% 0.70 10.77% 10.86% 26.55% 19.32%Broadcasting 27 28.92% 51.80% 19.28% 4.09% 18.11% 21.38% 7.34 31.34 1.44 2.83 22.97% 3.77% 3.09% 22.96% 1.12 7.59% 4.09% 33.53% 23.45%Brokerage & Investment Banking 42 0.38% 41.06% 0.29% 15.01% 11.41% 0.02% 1.56 31.77 2.48 6.75 159.43% 0.09% N/A N/A 1.24 11.70% 15.01% 28.42% 0.11%Building Materials 39 12.50% 28.81% 7.71% 6.30% 23.81% 18.27% 4.77 28.83 1.51 1.78 12.99% 11.45% 9.24% 15.60% 1.11 14.98% 6.30% 26.30% 10.31%Business & Consumer Services 169 13.05% 32.31% 9.03% 5.19% 18.32% 26.37% 4.95 59.52 1.59 1.94 19.68% 1.79% 6.36% 16.32% 1.17 12.94% 5.19% 33.10% 10.49%Cable TV 14 29.14% 54.92% 14.24% 7.88% 11.05% 12.72% 2.80 25.74 2.28 3.44 6.97% 0.21% 6.38% -1.12% 0.92 10.25% 7.88% 33.08% 18.25%Chemical (Basic) 38 13.41% 20.68% 9.83% 5.77% 18.60% 14.43% 3.47 28.39 1.32 1.76 14.90% 12.48% 9.17% 20.27% 1.20 14.14% 5.77% 15.16% 10.91%Chemical (Diversified) 7 15.45% 22.19% 10.61% 5.58% 14.20% 16.59% 1.74 281.02 2.43 2.90 20.03% 25.62% 17.39% 34.35% 2.03 18.82% 5.58% 22.18% 12.03%Chemical (Specialty) 99 18.20% 38.20% 11.96% 7.53% 17.00% 16.74% 4.15 145.32 2.25 2.79 17.45% 15.73% 12.07% 21.49% 1.11 12.34% 7.53% 23.09% 13.50%Coal & Related Energy 30 9.33% 14.93% 7.41% 12.62% N/A 8.53% 2.03 13.36 0.78 1.01 7.99% 6.17% 10.31% 4.34% 1.25 N/A 12.62% N/A 8.87%Computer Services 111 10.83% 25.55% 7.37% 5.93% 28.66% 27.96% 4.04 48.66 1.08 1.34 17.53% 5.73% 10.50% 12.65% 1.10 12.36% 5.93% 14.82% 8.30%Computers/Peripherals 58 24.14% 33.61% 18.81% 14.34% 28.55% 23.86% 5.42 26.11 2.69 3.03 9.07% 5.41% 20.37% -2.62% 1.01 15.79% 14.34% 23.91% 19.76%Construction Supplies 49 12.74% 22.23% 7.89% 4.78% 13.23% 10.59% 4.21 35.67 1.71 2.14 14.74% 16.92% 12.39% 15.83% 1.12 15.00% 4.78% 27.74% 9.62%Diversified 24 18.15% 25.32% 11.37% 8.54% 9.59% 10.98% 2.04 38.63 2.09 2.62 21.01% 11.67% 12.57% 14.41% 1.19 12.48% 8.54% 21.93% 12.95%Drugs (Biotechnology) 459 31.34% 57.53% 24.67% 12.57% 13.45% 11.60% 6.20 127.65 7.02 7.70 16.81% 7.58% 10.36% 14.85% 1.44 27.31% 12.57% 36.45% 24.92%Drugs (Pharmaceutical) 185 31.94% 59.76% 23.11% 14.05% 14.39% 17.68% 4.85 46.35 4.60 5.08 19.35% 13.90% 7.30% 22.58% 1.21 20.47% 14.05% 21.69% 23.63%Education 34 13.43% 44.65% 7.64% 1.38% 2.60% 11.47% 2.33 132.99 1.45 1.87 13.59% 1.85% 5.96% 10.56% 1.15 11.91% 1.38% 45.20% 8.17%Electrical Equipment 118 14.98% 34.96% 11.03% 6.21% 13.54% 21.88% 4.31 29.63 2.26 2.48 18.59% 13.47% 11.06% 19.90% 1.08 15.09% 6.21% 37.86% 11.89%Electronics (Consumer & Office) 24 -7.25% 17.19% -3.16% -10.63% -29.60% -5.54% 7.91 35.28 2.45 2.52 14.73% 16.65% 14.63% 19.76% 1.09 12.77% -10.63% N/A -3.36%Electronics (General) 167 13.60% 27.76% 8.55% 6.67% 11.30% 13.55% 3.04 56.36 2.00 2.12 15.61% 16.42% 13.60% 18.58% 0.94 17.82% 6.67% 28.86% 9.48%Engineering/Construction 49 5.63% 12.27% 3.53% 1.99% 7.71% 18.43% 2.08 28.75 0.58 0.69 22.57% 1.65% 9.14% 15.07% 1.27 12.30% 1.99% 35.38% 4.29%Entertainment 90 24.26% 40.76% 19.79% 11.50% 18.99% 31.11% 3.05 312.73 2.24 2.87 18.56% 3.83% 8.51% 10.59% 1.15 11.54% 11.50% 29.01% 20.72%Environmental & Waste Services 87 19.78% 32.71% 11.50% 4.41% 9.47% 21.28% 4.10 73.67 1.96 2.63 15.63% 1.21% 5.73% 10.13% 0.88 12.83% 4.41% 40.39% 12.54%Farming/Agriculture 34 7.18% 12.55% 4.03% 3.08% 12.10% 7.14% 2.42 22.90 0.70 1.02 7.37% 13.99% 11.11% 10.29% 0.74 15.33% 3.08% 28.27% 4.50%Financial Services (Non-bank & Insurance) 264 7.76% 37.90% 5.97% 26.46% -0.29% 0.21% 2.20 41.45 2.82 31.18 2696.24% 0.58% N/A N/A 0.61 11.62% 26.46% 33.18% 7.28%

Food Processing 87 17.09% 31.50% 11.96% 7.37% 11.54% 19.71% 2.88 36.08 1.88 2.42 8.02% 11.43% 10.41% 7.32% 0.68 9.46% 7.37% 29.04% 14.21%Food Wholesalers 15 4.15% 18.10% 2.58% 1.34% 16.64% 19.96% 5.00 50.79 0.39 0.53 6.78% 6.58% 6.63% 6.42% 1.79 8.70% 1.34% 34.09% 2.98%Furn/Home Furnishings 31 12.57% 28.94% 7.97% 5.89% 17.62% 17.56% 2.98 17.82 1.14 1.41 14.27% 16.42% 15.02% 12.87% 0.79 13.40% 5.89% 23.24% 9.42%Green & Renewable Energy 22 55.01% 70.52% 15.63% 1.27% 0.66% 1.94% 1.21 89.05 4.44 8.40 15.67% 1.07% 17.53% 9.67% 1.20 11.05% 1.27% N/A 11.76%Healthcare Products 251 21.04% 53.56% 14.43% 8.52% 9.51% 16.30% 4.04 161.11 4.35 4.79 17.26% 15.52% 7.35% 22.93% 0.94 16.55% 8.52% 17.88% 15.34%Healthcare Support Services 115 5.28% 13.40% 3.98% 2.58% 17.40% 50.54% 3.19 38.56 0.55 0.62 6.31% 3.89% 16.30% -6.15% 0.90 14.52% 2.58% 32.24% 4.68%Heathcare Information and Technology 112 18.91% 47.55% 12.81% 8.54% 10.80% 15.73% 4.05 174.42 4.29 4.95 20.70% 9.89% 7.60% 23.13% 0.98 15.21% 8.54% 19.52% 13.77%

Homebuilding 32 9.98% 20.20% 7.63% 5.98% 12.49% 9.31% 2.07 883.19 1.12 1.49 1.08% 82.30% 4.60% 78.80% 1.11 17.58% 5.98% 37.00% 10.11%Hospitals/Healthcare Facilities 35 14.72% 18.67% 8.24% 0.61% 8.21% 11.84% 3.82 58.93 0.49 1.32 14.17% 2.06% 5.29% 12.33% 1.18 6.50% 0.61% 50.10% 8.81%Hotel/Gaming 70 25.89% 44.27% 17.50% 8.25% 12.94% 11.33% 4.51 34.20 3.07 4.15 7.30% 3.50% 6.07% -1.45% 0.94 13.18% 8.25% 19.58% 19.60%

Profitability, valuation, operational, and financial ratios assist the investor in assessing the value of their investment. Retail drug stores (included in retail – special lines) has distinctive financial

performance measures, as shown in Table 18. Other industries are included for comparison purposes.




EBITDA/Sales

EBITDASG&A/Sales


Margin


Receivable/Sales

Inventory/Sales

Accounts Payable/

Sales


Sales


Pre-Tax Operating

Margin

Household Products 131 21.99% 54.16% 16.81% 13.90% 29.25% 29.52% 5.09 46.52 2.79 3.30 11.00% 10.96% 12.44% 10.46% 1.00 11.60% 13.90% 25.20% 18.24%Information Services 61 28.97% 49.78% 21.05% 13.39% 20.91% 33.51% 7.63 60.11 5.44 6.03 20.35% 0.31% 7.99% -5.15% 0.88 14.92% 13.39% 33.72% 25.32%Insurance (General) 21 12.66% 25.79% 4.29% 2.41% 1.97% 2.82% 1.19 34.97 1.38 1.84 21.35% 0.00% 94.66% -16.80% 0.78 10.46% 2.41% 4.81% 5.11%Insurance (Life) 25 8.65% 19.12% 6.93% 4.85% 4.17% 4.40% 1.04 152.83 1.06 1.45 15.73% 0.00% 21.85% 5.65% 1.01 7.82% 4.85% 17.84% 8.21%Insurance (Prop/Cas.) 50 12.09% 22.66% 7.50% 5.17% 7.29% 8.32% 1.70 120.04 1.25 1.52 19.44% 0.00% 84.05% -36.67% 0.84 11.56% 5.17% 37.22% 9.30%Investments & Asset Management 165 19.18% 51.39% 18.44% 22.54% 13.75% 9.89% 2.12 99.35 4.05 4.96 15.97% 0.02% N/A N/A 0.99 13.11% 22.54% 24.28% 19.95%Machinery 126 15.94% 35.61% 11.47% 8.27% 19.08% 25.89% 4.49 47.35 2.30 2.65 17.98% 15.58% 9.66% 22.98% 1.15 14.03% 8.27% 26.47% 13.60%Metals & Mining 102 19.51% 23.29% 17.52% 6.03% 10.78% 14.34% 2.93 28.08 2.09 2.54 8.67% 18.54% 12.06% 15.30% 1.10 30.62% 6.03% 46.08% 17.94%Office Equipment & Services 24 11.54% 35.67% 6.58% 2.25% 8.70% 17.72% 3.12 18.92 0.75 1.02 12.72% 10.39% 14.32% 8.21% 1.37 12.25% 2.25% 44.31% 8.56%Oil/Gas (Integrated) 5 11.05% 16.36% 2.46% 5.64% 5.90% 2.15% 1.81 45.20 1.82 2.07 11.56% 6.61% 14.48% 4.21% 1.37 25.77% 5.64% 18.22% 2.94%

Oil/Gas (Production and Exploration) 311 19.88% 32.18% -0.19% -6.62% -4.87% 0.09% 1.93 25.17 3.21 4.33 14.11% 2.40% 14.34% -1.75% 1.26 1.81% -6.62% N/A 0.26%

Oil/Gas Distribution 16 27.57% 34.75% 16.78% 2.04% 1.97% 6.13% 1.63 313.75 2.37 4.52 9.30% 3.13% 9.22% 4.24% 1.21 10.00% 2.04% 23.29% 17.80%Oilfield Svcs/Equip. 130 6.04% 10.48% 2.87% 0.73% 1.97% 6.42% 1.64 87.54 0.82 1.02 11.33% 9.89% 10.40% 9.77% 1.23 40.24% 0.73% 47.00% 3.23%Packaging & Container 25 14.45% 25.03% 7.64% 5.25% 20.54% 14.58% 3.88 51.42 1.13 1.65 13.43% 12.26% 14.01% 10.41% 0.74 9.31% 5.25% 27.47% 10.00%Paper/Forest Products 21 9.64% 19.47% 4.63% 2.26% 6.15% 8.48% 1.89 40.11 0.74 0.97 10.51% 13.01% 8.74% 13.99% 1.20 9.62% 2.26% 23.28% 5.43%Power 61 32.15% 34.52% 14.61% 13.93% 15.55% 6.43% 1.88 25.25 2.03 3.51 14.38% 6.51% 10.50% 7.32% 0.50 5.41% 13.93% 9.86% 17.94%Precious Metals 111 36.38% 44.47% 16.86% 3.55% 1.89% 7.53% 1.49 29.92 3.07 3.24 1.86% 18.61% 6.12% 13.56% 0.96 24.26% 3.55% 144.26% 17.38%Publishing & Newspapers 41 11.24% 37.42% 6.70% -1.18% -2.51% 13.48% 1.76 53.87 0.78 1.04 14.88% 4.51% 7.99% 11.34% 1.02 7.90% -1.18% 267.57% 7.43%R.E.I.T. 244 45.83% 54.53% 25.52% 24.44% 9.54% 3.08% 2.05 58.88 6.56 11.48 60.14% 0.47% 17.31% 46.35% 0.66 6.81% 24.44% N/A 22.31%Real Estate (Development) 20 26.87% 39.35% 13.24% 13.45% 4.62% 2.27% 1.60 20.24 5.62 7.42 19.59% 65.52% 5.52% 65.06% 0.75 N/A 13.45% 32.75% 11.59%Real Estate (General/Diversified) 10 17.30% 57.82% 12.68% 8.99% 4.17% 4.32% 1.25 216.85 5.82 6.20 8.38% 211.62% 28.92% 197.48% 0.75 N/A 8.99% 39.04% 14.64%Real Estate (Operations & Services) 60 10.41% 45.76% 6.86% 5.18% 15.06% 11.05% 3.06 486.19 1.44 1.99 16.18% 0.02% 8.11% 15.00% 1.02 13.63% 5.18% 30.49% 7.56%Recreation 70 16.51% 39.80% 9.80% 2.12% 5.26% 14.59% 4.12 27.16 1.63 2.02 15.31% 14.19% 8.51% 19.93% 0.85 12.23% 2.12% 58.64% 10.92%Reinsurance 3 11.43% 11.85% 6.54% 5.26% 6.05% 5.97% 1.13 11.75 1.04 1.23 17.72% 0.00% 29.40% 3.87% 0.52 8.75% 5.26% 23.14% 7.31%Restaurant/Dining 81 20.52% 29.25% 13.81% 9.98% 95.67% 17.01% 77.39 37.50 2.73 3.54 4.43% 2.44% 4.03% 0.97% 0.85 15.04% 9.98% 32.36% 14.55%Retail (Automotive) 25 7.18% 22.23% 4.84% 3.27% 34.26% 10.38% 5.22 14.30 0.54 0.95 2.87% 19.23% 9.08% 12.99% 1.01 16.63% 3.27% 34.49% 5.39%Retail (Building Supply) 8 13.33% 33.51% 10.23% 7.00% 91.26% 30.30% 32.98 46.86 1.76 2.05 1.29% 15.58% 10.34% 5.99% 0.86 20.46% 7.00% 36.59% 11.63%Retail (Distributors) 92 8.40% 27.09% 6.57% 3.93% 16.05% 13.18% 3.47 120.38 0.96 1.36 12.83% 13.65% 8.71% 17.16% 1.15 15.04% 3.93% 35.28% 7.97%Retail (General) 18 6.86% 27.24% 3.47% 2.32% 16.10% 11.90% 4.00 96.81 0.58 0.74 0.98% 12.31% 10.29% 2.24% 1.05 7.88% 2.32% 33.84% 4.21%

Retail (Grocery and Food) 14 4.91% 22.75% 2.09% 1.62% 24.43% 8.75% 3.30 28.23 0.22 0.41 1.45% 5.96% 5.51% 0.66% 0.71 7.90% 1.62% 33.13% 2.33%

Retail (Online) 61 8.43% 36.30% 3.60% 3.72% 18.72% 13.40% 9.37 73.27 3.32 3.58 7.38% 6.98% 13.84% -0.43% 1.18 20.77% 3.72% 17.83% 3.76%Retail (Special Lines) 106 8.57% 28.87% 4.88% 3.18% 16.59% 11.69% 3.43 43.48 0.64 0.94 4.29% 12.78% 8.22% 7.00% 1.11 11.59% 3.18% 34.47% 5.82%Rubber& Tires 4 17.17% 31.51% 9.05% 6.64% 21.44% 13.96% 1.55 13.28 0.55 0.92 17.64% 19.87% 16.10% 15.99% 0.95 9.50% 6.64% N/A 10.31%Semiconductor 72 31.03% 42.13% 22.93% 18.10% 19.87% 16.13% 3.94 49.82 4.17 4.35 12.88% 12.09% 6.71% 17.81% 1.17 15.68% 18.10% 20.14% 25.02%Semiconductor Equip 45 24.29% 34.30% 20.45% 18.74% 33.63% 29.06% 4.50 37.81 3.16 3.23 16.54% 16.52% 6.84% 23.10% 0.98 16.67% 18.74% 11.00% 22.55%Shipbuilding & Marine 9 13.54% 23.79% 5.40% -1.80% -1.88% 4.88% 1.47 18.23 1.59 2.29 14.89% 15.57% 8.96% 22.21% 1.34 13.50% -1.80% 378.18% 7.40%Shoe 11 14.39% 46.22% 9.80% 9.44% 25.32% 20.40% 6.85 95.38 2.56 2.68 11.30% 15.86% 6.99% 20.19% 0.88 12.39% 9.44% 13.83% 11.39%Software (Entertainment) 13 23.98% 50.76% 20.10% 15.97% 16.33% 27.79% 5.53 67.28 6.44 6.39 15.00% 0.90% 4.01% 20.73% 0.89 14.94% 15.97% 14.09% 20.57%Software (Internet) 305 26.20% 51.87% 23.98% 23.83% 18.52% 16.63% 4.97 205.58 7.95 8.04 13.83% 0.44% 2.87% 9.86% 1.20 27.74% 23.83% 4.66% 24.31%Software (System & Application) 255 25.94% 54.58% 18.41% 14.59% 17.08% 14.82% 6.60 209.66 6.62 7.27 14.68% 1.75% 4.63% 12.76% 1.09 17.06% 14.59% 16.95% 19.25%Steel 37 8.09% 15.13% 6.64% 3.51% 12.23% 15.67% 2.26 28.91 0.76 0.96 11.57% 17.70% 6.97% 21.05% 1.82 12.22% 3.51% 24.70% 7.29%Telecom (Wireless) 18 25.80% 54.41% 8.31% 1.01% 1.87% 5.43% 1.79 64.32 1.02 2.15 11.69% 2.36% 11.54% 3.08% 1.30 10.83% 1.01% 65.97% 8.77%Telecom. Equipment 104 23.73% 44.96% 16.73% 13.76% 15.31% 13.59% 3.22 114.62 3.09 3.48 18.16% 7.12% 5.89% 17.50% 1.03 14.42% 13.76% 15.61% 18.37%Telecom. Services 66 32.77% 55.18% 16.59% 8.38% 16.34% 15.97% 2.82 61.28 1.52 2.57 12.92% 0.50% 15.19% -2.89% 1.08 5.99% 8.38% 34.00% 17.58%Tobacco 24 41.43% 59.59% 38.32% 43.37% N/A 95.59% 78.25 29.52 5.84 6.63 9.08% 23.60% 4.75% 18.05% 1.26 10.33% 43.37% 31.57% 40.60%Transportation 18 11.38% 13.44% 6.14% 4.44% 28.97% 17.61% 7.26 82.37 1.22 1.54 13.30% 0.33% 5.65% 8.46% 0.95 15.49% 4.44% 33.62% 7.72%Transportation (Railroads) 8 41.59% 41.68% 26.27% 18.68% 17.41% 13.55% 4.19 27.22 4.46 5.40 8.46% 3.33% 8.01% 2.83% 1.01 10.56% 18.68% 37.53% 34.33%Trucking 30 14.34% 21.80% 5.53% 1.99% 7.87% 7.07% 3.33 29.95 1.09 1.79 13.33% 0.45% 6.88% 7.64% 1.20 21.01% 1.99% 44.09% 7.65%Utility (General) 18 30.01% 30.47% 13.48% 9.48% 9.95% 6.21% 2.15 27.54 2.24 3.73 11.95% 7.12% 8.72% 5.09% 0.29 5.50% 9.48% 31.12% 19.39%Utility (Water) 23 38.96% 47.83% 24.06% 12.96% 10.00% 6.53% 3.33 141.22 4.72 6.48 16.12% 2.81% 7.24% 9.89% 0.34 8.99% 12.96% 34.43% 28.31%Total Market 7247 15.02% 31.34% 9.59% 7.90% 13.63% 6.53% 3.02 71.28 2.05 3.10 51.08% 8.27% 84.35% -25.17% #N/A 13.60% 7.90% 26.06% 10.56%




EBITDA/Sales

EBITDASG&A/Sales


Margin


Receivable/Sales

Inventory/Sales

Accounts Payable/

Sales


Sales


Pre-Tax Operating

Margin

Household Products 131 21.99% 54.16% 16.81% 13.90% 29.25% 29.52% 5.09 46.52 2.79 3.30 11.00% 10.96% 12.44% 10.46% 1.00 11.60% 13.90% 25.20% 18.24%Information Services 61 28.97% 49.78% 21.05% 13.39% 20.91% 33.51% 7.63 60.11 5.44 6.03 20.35% 0.31% 7.99% -5.15% 0.88 14.92% 13.39% 33.72% 25.32%Insurance (General) 21 12.66% 25.79% 4.29% 2.41% 1.97% 2.82% 1.19 34.97 1.38 1.84 21.35% 0.00% 94.66% -16.80% 0.78 10.46% 2.41% 4.81% 5.11%Insurance (Life) 25 8.65% 19.12% 6.93% 4.85% 4.17% 4.40% 1.04 152.83 1.06 1.45 15.73% 0.00% 21.85% 5.65% 1.01 7.82% 4.85% 17.84% 8.21%Insurance (Prop/Cas.) 50 12.09% 22.66% 7.50% 5.17% 7.29% 8.32% 1.70 120.04 1.25 1.52 19.44% 0.00% 84.05% -36.67% 0.84 11.56% 5.17% 37.22% 9.30%Investments & Asset Management 165 19.18% 51.39% 18.44% 22.54% 13.75% 9.89% 2.12 99.35 4.05 4.96 15.97% 0.02% N/A N/A 0.99 13.11% 22.54% 24.28% 19.95%Machinery 126 15.94% 35.61% 11.47% 8.27% 19.08% 25.89% 4.49 47.35 2.30 2.65 17.98% 15.58% 9.66% 22.98% 1.15 14.03% 8.27% 26.47% 13.60%Metals & Mining 102 19.51% 23.29% 17.52% 6.03% 10.78% 14.34% 2.93 28.08 2.09 2.54 8.67% 18.54% 12.06% 15.30% 1.10 30.62% 6.03% 46.08% 17.94%Office Equipment & Services 24 11.54% 35.67% 6.58% 2.25% 8.70% 17.72% 3.12 18.92 0.75 1.02 12.72% 10.39% 14.32% 8.21% 1.37 12.25% 2.25% 44.31% 8.56%Oil/Gas (Integrated) 5 11.05% 16.36% 2.46% 5.64% 5.90% 2.15% 1.81 45.20 1.82 2.07 11.56% 6.61% 14.48% 4.21% 1.37 25.77% 5.64% 18.22% 2.94%

Oil/Gas (Production and Exploration) 311 19.88% 32.18% -0.19% -6.62% -4.87% 0.09% 1.93 25.17 3.21 4.33 14.11% 2.40% 14.34% -1.75% 1.26 1.81% -6.62% N/A 0.26%

Oil/Gas Distribution 16 27.57% 34.75% 16.78% 2.04% 1.97% 6.13% 1.63 313.75 2.37 4.52 9.30% 3.13% 9.22% 4.24% 1.21 10.00% 2.04% 23.29% 17.80%Oilfield Svcs/Equip. 130 6.04% 10.48% 2.87% 0.73% 1.97% 6.42% 1.64 87.54 0.82 1.02 11.33% 9.89% 10.40% 9.77% 1.23 40.24% 0.73% 47.00% 3.23%Packaging & Container 25 14.45% 25.03% 7.64% 5.25% 20.54% 14.58% 3.88 51.42 1.13 1.65 13.43% 12.26% 14.01% 10.41% 0.74 9.31% 5.25% 27.47% 10.00%Paper/Forest Products 21 9.64% 19.47% 4.63% 2.26% 6.15% 8.48% 1.89 40.11 0.74 0.97 10.51% 13.01% 8.74% 13.99% 1.20 9.62% 2.26% 23.28% 5.43%Power 61 32.15% 34.52% 14.61% 13.93% 15.55% 6.43% 1.88 25.25 2.03 3.51 14.38% 6.51% 10.50% 7.32% 0.50 5.41% 13.93% 9.86% 17.94%Precious Metals 111 36.38% 44.47% 16.86% 3.55% 1.89% 7.53% 1.49 29.92 3.07 3.24 1.86% 18.61% 6.12% 13.56% 0.96 24.26% 3.55% 144.26% 17.38%Publishing & Newspapers 41 11.24% 37.42% 6.70% -1.18% -2.51% 13.48% 1.76 53.87 0.78 1.04 14.88% 4.51% 7.99% 11.34% 1.02 7.90% -1.18% 267.57% 7.43%R.E.I.T. 244 45.83% 54.53% 25.52% 24.44% 9.54% 3.08% 2.05 58.88 6.56 11.48 60.14% 0.47% 17.31% 46.35% 0.66 6.81% 24.44% N/A 22.31%Real Estate (Development) 20 26.87% 39.35% 13.24% 13.45% 4.62% 2.27% 1.60 20.24 5.62 7.42 19.59% 65.52% 5.52% 65.06% 0.75 N/A 13.45% 32.75% 11.59%Real Estate (General/Diversified) 10 17.30% 57.82% 12.68% 8.99% 4.17% 4.32% 1.25 216.85 5.82 6.20 8.38% 211.62% 28.92% 197.48% 0.75 N/A 8.99% 39.04% 14.64%Real Estate (Operations & Services) 60 10.41% 45.76% 6.86% 5.18% 15.06% 11.05% 3.06 486.19 1.44 1.99 16.18% 0.02% 8.11% 15.00% 1.02 13.63% 5.18% 30.49% 7.56%Recreation 70 16.51% 39.80% 9.80% 2.12% 5.26% 14.59% 4.12 27.16 1.63 2.02 15.31% 14.19% 8.51% 19.93% 0.85 12.23% 2.12% 58.64% 10.92%Reinsurance 3 11.43% 11.85% 6.54% 5.26% 6.05% 5.97% 1.13 11.75 1.04 1.23 17.72% 0.00% 29.40% 3.87% 0.52 8.75% 5.26% 23.14% 7.31%Restaurant/Dining 81 20.52% 29.25% 13.81% 9.98% 95.67% 17.01% 77.39 37.50 2.73 3.54 4.43% 2.44% 4.03% 0.97% 0.85 15.04% 9.98% 32.36% 14.55%Retail (Automotive) 25 7.18% 22.23% 4.84% 3.27% 34.26% 10.38% 5.22 14.30 0.54 0.95 2.87% 19.23% 9.08% 12.99% 1.01 16.63% 3.27% 34.49% 5.39%Retail (Building Supply) 8 13.33% 33.51% 10.23% 7.00% 91.26% 30.30% 32.98 46.86 1.76 2.05 1.29% 15.58% 10.34% 5.99% 0.86 20.46% 7.00% 36.59% 11.63%Retail (Distributors) 92 8.40% 27.09% 6.57% 3.93% 16.05% 13.18% 3.47 120.38 0.96 1.36 12.83% 13.65% 8.71% 17.16% 1.15 15.04% 3.93% 35.28% 7.97%Retail (General) 18 6.86% 27.24% 3.47% 2.32% 16.10% 11.90% 4.00 96.81 0.58 0.74 0.98% 12.31% 10.29% 2.24% 1.05 7.88% 2.32% 33.84% 4.21%

Retail (Grocery and Food) 14 4.91% 22.75% 2.09% 1.62% 24.43% 8.75% 3.30 28.23 0.22 0.41 1.45% 5.96% 5.51% 0.66% 0.71 7.90% 1.62% 33.13% 2.33%

Retail (Online) 61 8.43% 36.30% 3.60% 3.72% 18.72% 13.40% 9.37 73.27 3.32 3.58 7.38% 6.98% 13.84% -0.43% 1.18 20.77% 3.72% 17.83% 3.76%Retail (Special Lines) 106 8.57% 28.87% 4.88% 3.18% 16.59% 11.69% 3.43 43.48 0.64 0.94 4.29% 12.78% 8.22% 7.00% 1.11 11.59% 3.18% 34.47% 5.82%Rubber& Tires 4 17.17% 31.51% 9.05% 6.64% 21.44% 13.96% 1.55 13.28 0.55 0.92 17.64% 19.87% 16.10% 15.99% 0.95 9.50% 6.64% N/A 10.31%Semiconductor 72 31.03% 42.13% 22.93% 18.10% 19.87% 16.13% 3.94 49.82 4.17 4.35 12.88% 12.09% 6.71% 17.81% 1.17 15.68% 18.10% 20.14% 25.02%Semiconductor Equip 45 24.29% 34.30% 20.45% 18.74% 33.63% 29.06% 4.50 37.81 3.16 3.23 16.54% 16.52% 6.84% 23.10% 0.98 16.67% 18.74% 11.00% 22.55%Shipbuilding & Marine 9 13.54% 23.79% 5.40% -1.80% -1.88% 4.88% 1.47 18.23 1.59 2.29 14.89% 15.57% 8.96% 22.21% 1.34 13.50% -1.80% 378.18% 7.40%Shoe 11 14.39% 46.22% 9.80% 9.44% 25.32% 20.40% 6.85 95.38 2.56 2.68 11.30% 15.86% 6.99% 20.19% 0.88 12.39% 9.44% 13.83% 11.39%Software (Entertainment) 13 23.98% 50.76% 20.10% 15.97% 16.33% 27.79% 5.53 67.28 6.44 6.39 15.00% 0.90% 4.01% 20.73% 0.89 14.94% 15.97% 14.09% 20.57%Software (Internet) 305 26.20% 51.87% 23.98% 23.83% 18.52% 16.63% 4.97 205.58 7.95 8.04 13.83% 0.44% 2.87% 9.86% 1.20 27.74% 23.83% 4.66% 24.31%Software (System & Application) 255 25.94% 54.58% 18.41% 14.59% 17.08% 14.82% 6.60 209.66 6.62 7.27 14.68% 1.75% 4.63% 12.76% 1.09 17.06% 14.59% 16.95% 19.25%Steel 37 8.09% 15.13% 6.64% 3.51% 12.23% 15.67% 2.26 28.91 0.76 0.96 11.57% 17.70% 6.97% 21.05% 1.82 12.22% 3.51% 24.70% 7.29%Telecom (Wireless) 18 25.80% 54.41% 8.31% 1.01% 1.87% 5.43% 1.79 64.32 1.02 2.15 11.69% 2.36% 11.54% 3.08% 1.30 10.83% 1.01% 65.97% 8.77%Telecom. Equipment 104 23.73% 44.96% 16.73% 13.76% 15.31% 13.59% 3.22 114.62 3.09 3.48 18.16% 7.12% 5.89% 17.50% 1.03 14.42% 13.76% 15.61% 18.37%Telecom. Services 66 32.77% 55.18% 16.59% 8.38% 16.34% 15.97% 2.82 61.28 1.52 2.57 12.92% 0.50% 15.19% -2.89% 1.08 5.99% 8.38% 34.00% 17.58%Tobacco 24 41.43% 59.59% 38.32% 43.37% N/A 95.59% 78.25 29.52 5.84 6.63 9.08% 23.60% 4.75% 18.05% 1.26 10.33% 43.37% 31.57% 40.60%Transportation 18 11.38% 13.44% 6.14% 4.44% 28.97% 17.61% 7.26 82.37 1.22 1.54 13.30% 0.33% 5.65% 8.46% 0.95 15.49% 4.44% 33.62% 7.72%Transportation (Railroads) 8 41.59% 41.68% 26.27% 18.68% 17.41% 13.55% 4.19 27.22 4.46 5.40 8.46% 3.33% 8.01% 2.83% 1.01 10.56% 18.68% 37.53% 34.33%Trucking 30 14.34% 21.80% 5.53% 1.99% 7.87% 7.07% 3.33 29.95 1.09 1.79 13.33% 0.45% 6.88% 7.64% 1.20 21.01% 1.99% 44.09% 7.65%Utility (General) 18 30.01% 30.47% 13.48% 9.48% 9.95% 6.21% 2.15 27.54 2.24 3.73 11.95% 7.12% 8.72% 5.09% 0.29 5.50% 9.48% 31.12% 19.39%Utility (Water) 23 38.96% 47.83% 24.06% 12.96% 10.00% 6.53% 3.33 141.22 4.72 6.48 16.12% 2.81% 7.24% 9.89% 0.34 8.99% 12.96% 34.43% 28.31%Total Market 7247 15.02% 31.34% 9.59% 7.90% 13.63% 6.53% 3.02 71.28 2.05 3.10 51.08% 8.27% 84.35% -25.17% #N/A 13.60% 7.90% 26.06% 10.56%


Per capita sales is a measure of how much an individual spends in a particular type of store. Table 19 shows that in 2017 the average consumer spent $835 in traditional drug stores. For a family of four this amount would have totaled $3,340. Similarly, the average spending per person in grocery stores was $1,968, or about $7,872 annually per four-member family. On a monthly basis, average per capita spending in a drug store is about $70 and in a food store is $164.

Per capita sales in drug stores increased about 25% from 2007 to 2017 at an average rate of 2.2% per year. Sales fell overall from 2016 to 2017, but the expanded market for specialty pharmacy is expected to drive sales over the

next several years. Per capita sales grew very slowly in supermarkets over the same period, increasing by 21% overall or about 1.9% per year. Mass merchants (including discount department stores, warehouse clubs, and superstores) experienced lower average growth than in previous years, suggesting that this market is reaching maturation. Per capita sales at these stores increased about 17% between 2007 and 2017, increasing by an average of about 1.6% per year. The average person now spends nearly as much per year in discount department stores, warehouse clubs, and superstores as in grocery stores, likely because of the increase in food offerings.

TABLE 19. ESTIMATED PER CAPITA SALES, BY NORTH AMERICAN INDUSTRIAL CLASSIFICATION SYSTEM (NAICS) CODE FOR DRUG STORES, GROCERY STORES, AND MASS MERCHANTS, 2007-2017

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Drug Stores (NAICS 44611) $671 $693 $708 $718 $742 $732 $745 $786 $821 $842 $835

Grocery Stores (NAICS 4451) $1,629 $1,681 $1,661 $1,683 $1,757 $1,795 $1,817 $1,882 $1,910 $1,939 $1,968

Discount Department Stores; Warehouse Clubs and Superstores (NAICS 452112 and 45291)

$1,671 $1,729 $1,715 $1,744 $1,795 $1,846 $1,870 $1,904 $1,919 $1,922 $1,959

Source: Annual Retail Trade Survey, U.S. Bureau of Census, and Department of Commerce retail sales data and Census Estimates.

Gross margin is the difference between the cost of goods and revenue received. Gross margin must cover the entire cost of running the business for a retail operation to be profitable. It is also a

measure of the value that a company adds with its services. Table 20 shows gross margins for several types of businesses that include retail pharmacies.


Across all retail businesses, gross margins have fluctuated over the period from 1992 to 2017. Drug store gross margins have been in the mid 20’s for this time period, with margins slightly higher over the last five years. Grocery store gross margins have consistently been between

24-28%. Discount department stores are currently operating with gross margins over 30%. Warehouse clubs and superstores have similar gross margins. For comparison, the average gross margin for mail-order and Internet retailers was about 40% in 2016.

Inventory/Sales RatiosInventory levels indicate how well a retailer is able to forecast demand, or the retailer’s ability to find the delicate balance between minimizing inventory investment and making sure there are sufficient goods on hand to service customer needs. Studying the relationship between sales and inventory is a good way to measure operational performance. Retail inventory/sales ratios are not available specifically for drug stores,

but inventory/sales ratios are available for the entire retail industry. In 2017, overall inventory/sales ratios increased slightly from 2016 levels, bucking the longer-term trend that is apparent in Figure 5. From 2007 to 2017, average inventory/sales ratios fell approximately 3.7%. Figure 5 shows inventory and sales levels as well as the inventory/sales ratio over time for retail trade.

Retail Inventories, Sales, and Retail Inventory/Sales Ratio, 1992-2017FIGURE 5

100,000

200,000

300,000

400,000

500,000

600,000

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

■ TOTAL RETAIL INVENTORIES■ TOTAL RETAIL SALES

RETAIL INVENTORY / SALES RATIOS

1.0

1.5

2.0


TABLE 20. RETAIL SALES, RETAIL PURCHASES, GROSS MARGIN, AND GROSS MARGIN AS PERCENT OF SALES, 1992-2016 (NUMBERS ARE AS REPORTED IN ANNUAL RETAIL TRADE SURVEY.)

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Drug Stores (NAICS 44611)

Retail Sales (000) $77,791 $79,707 $81,994 $85,840 $91,810 $98,823 $108,415 $121,282 $130,857 $141,772 $153,936 $165,524 $169,231 $179,170 $191,018 $202,284 $210,857 $217,260 $222,230 $231,249 $229,951 $235,548 $250,546 $263,468 $272,435

Retail Purchases (000) $57,963 $59,059 $61,222 $64,652 $68,878 $73,730 $80,580 $91,416 $97,656 $106,425 $113,641 $122,812 $126,299 $133,771 $142,546 $152,839 $159,504 $162,558 $165,225 $172,296 $168,830 $172,462 $183,553 $194,630 $201,990

Gross Margin (000) $19,828 $20,648 $20,772 $21,188 $22,932 $25,093 $27,835 $29,866 $33,201 $35,347 $40,295 $42,712 $42,932 $45,399 $48,472 $49,445 $51,353 $54,702 $57,005 $58,953 $61,121 $63,086 $66,993 $68,838 $70,445

Gross Margin as Percent of Sales 25.5% 25.9% 25.3% 24.7% 25.0% 25.4% 25.7% 24.6% 25.4% 24.9% 26.2% 25.8% 25.4% 25.3% 25.4% 24.4% 24.4% 25.2% 25.7% 25.5% 26.6% 26.8% 26.7% 26.1% 25.9%

Grocery Stores (NAICS 4451)

Retail Sales (000) $337,370 $341,318 $350,523 $356,409 $365,547 $372,570 $378,188 $394,250 $402,515 $418,127 $419,813 $427,987 $441,136 $457,667 $471,699 $491,360 $511,222 $510,033 $520,750 $547,476 $563,645 $574,547 $599,603 $613,225 $626,981


Gross Margin (000) $82,194 $83,221 $85,295 $89,648 $91,991 $94,694 $97,839 $104,537 $107,908 $117,151 $119,672 $123,335 $127,054 $130,671 $135,560 $140,383 $145,745 $143,089 $145,070 $150,794 $152,770 $153,577 $158,951 $164,987 $169,573


Discount Department Stores (NAICS 452112 )

Retail Sales (000) $93,871 $103,405 $111,793 $118,661 $121,936 $128,049 $131,411 $136,545 $139,637 $141,708 $137,545 $132,498 $134,154 $133,215 $135,470 $134,926 $128,991 $124,270 $120,564 $118,049 $114,506 $109,697 $107,678 $105,277 $100,282


Gross Margin (000) $20,916 $23,693 $23,824 $25,769 $26,033 $28,445 $37,451 $39,293 $42,046 $42,044 $39,860 $40,752 $43,473 $40,561 $41,721 $41,452 $40,163 $38,917 $37,731 $37,380 $35,168 $34,631 $35,021 $33,163 $35,098


Warehouse Clubs and Superstores (NAICS 45291)

Retail Sales (000) $70,787 $78,311 $86,245 $94,578 $103,102 $111,255 $127,791 $149,875 $171,753 $199,091 $225,777 $254,301 $281,691 $313,119 $341,101 $369,190 $396,805 $402,335 $419,002 $441,405 $465,000 $481,680 $499,095 $510,897 $521,150


Gross Margin (000) $36,474 $38,573 $37,814 $41,077 $44,453 $46,000 $44,440 $49,392 $54,517 $59,672 $66,594 $81,986 $87,069 $99,060 $103,305 $114,200 $120,728 $129,363 $135,573 $142,684 $147,152 $153,706 $164,715 $171,564 $176,681


Electronic Shopping and Mail Order (NAICS 4541)

Retail Sales (000) $35,210 $40,677 $47,037 $52,680 $61,106 $70,067 $80,297 $94,282 $113,790 $114,749 $122,214 $134,304 $154,157 $175,900 $202,251 $223,681 $229,242 $235,625 $263,488 $294,697 $328,655 $350,487 $386,065 $433,692 $490,857


Gross Margin (000) $15,922 $17,753 $20,192 $22,599 $25,922 $28,875 $32,019 $35,718 $43,051 $43,867 $47,766 $52,478 $58,867 $64,639 $75,877 $83,018 $84,400 $84,465 $94,157 $105,551 $121,577 $134,836 $152,151 $172,016 $197,539


All Retail Businesses, excluding motor vehicle and parts dealers.

Retail Sales (000) $1,392,838 $1,464,707 $1,564,090 $1,637,898 $1,734,039 $1,814,948 $1,893,346 $2,038,884 $2,187,065 $2,246,688 $2,309,741 $2,421,143 $2,606,676 $2,800,976 $2,971,576 $3,085,043 $3,149,450 $2,940,699 $3,075,135 $3,290,014 $3,415,735 $3,499,156 $3,618,589 $3,632,015 $3,722,711

Retail Purchases (000) $981,571 $1,032,690 $1,102,461 $1,148,666 $1,213,244 $1,267,733 $1,315,836 $1,419,221 $1,519,174 $1,555,185 $1,597,634 $1,657,753 $1,793,778 $1,937,488 $2,068,894 $2,154,074 $2,218,964 $2,048,604 $2,153,745 $2,324,971 $2,409,468 $2,452,290 $2,514,928 $2,476,790 $2,511,311

Gross Margin (000) $411,267 $432,017 $461,629 $489,232 $520,795 $547,215 $577,510 $619,663 $667,891 $691,503 $712,107 $763,390 $812,898 $863,488 $902,682 $930,969 $930,486 $892,095 $921,390 $965,043 $1,006,267 $1,046,866 $1,103,661 $1,155,225 $1,211,400


Source: U.S. Bureau of the Census Annual Retail Trade Survey


TABLE 20. RETAIL SALES, RETAIL PURCHASES, GROSS MARGIN, AND GROSS MARGIN AS PERCENT OF SALES, 1992-2016 (NUMBERS ARE AS REPORTED IN ANNUAL RETAIL TRADE SURVEY.)

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Drug Stores (NAICS 44611)

Retail Sales (000) $77,791 $79,707 $81,994 $85,840 $91,810 $98,823 $108,415 $121,282 $130,857 $141,772 $153,936 $165,524 $169,231 $179,170 $191,018 $202,284 $210,857 $217,260 $222,230 $231,249 $229,951 $235,548 $250,546 $263,468 $272,435


Gross Margin (000) $19,828 $20,648 $20,772 $21,188 $22,932 $25,093 $27,835 $29,866 $33,201 $35,347 $40,295 $42,712 $42,932 $45,399 $48,472 $49,445 $51,353 $54,702 $57,005 $58,953 $61,121 $63,086 $66,993 $68,838 $70,445


Grocery Stores (NAICS 4451)

Retail Sales (000) $337,370 $341,318 $350,523 $356,409 $365,547 $372,570 $378,188 $394,250 $402,515 $418,127 $419,813 $427,987 $441,136 $457,667 $471,699 $491,360 $511,222 $510,033 $520,750 $547,476 $563,645 $574,547 $599,603 $613,225 $626,981


Gross Margin (000) $82,194 $83,221 $85,295 $89,648 $91,991 $94,694 $97,839 $104,537 $107,908 $117,151 $119,672 $123,335 $127,054 $130,671 $135,560 $140,383 $145,745 $143,089 $145,070 $150,794 $152,770 $153,577 $158,951 $164,987 $169,573


Discount Department Stores (NAICS 452112 )

Retail Sales (000) $93,871 $103,405 $111,793 $118,661 $121,936 $128,049 $131,411 $136,545 $139,637 $141,708 $137,545 $132,498 $134,154 $133,215 $135,470 $134,926 $128,991 $124,270 $120,564 $118,049 $114,506 $109,697 $107,678 $105,277 $100,282


Gross Margin (000) $20,916 $23,693 $23,824 $25,769 $26,033 $28,445 $37,451 $39,293 $42,046 $42,044 $39,860 $40,752 $43,473 $40,561 $41,721 $41,452 $40,163 $38,917 $37,731 $37,380 $35,168 $34,631 $35,021 $33,163 $35,098


Warehouse Clubs and Superstores (NAICS 45291)

Retail Sales (000) $70,787 $78,311 $86,245 $94,578 $103,102 $111,255 $127,791 $149,875 $171,753 $199,091 $225,777 $254,301 $281,691 $313,119 $341,101 $369,190 $396,805 $402,335 $419,002 $441,405 $465,000 $481,680 $499,095 $510,897 $521,150


Gross Margin (000) $36,474 $38,573 $37,814 $41,077 $44,453 $46,000 $44,440 $49,392 $54,517 $59,672 $66,594 $81,986 $87,069 $99,060 $103,305 $114,200 $120,728 $129,363 $135,573 $142,684 $147,152 $153,706 $164,715 $171,564 $176,681


Electronic Shopping and Mail Order (NAICS 4541)

Retail Sales (000) $35,210 $40,677 $47,037 $52,680 $61,106 $70,067 $80,297 $94,282 $113,790 $114,749 $122,214 $134,304 $154,157 $175,900 $202,251 $223,681 $229,242 $235,625 $263,488 $294,697 $328,655 $350,487 $386,065 $433,692 $490,857


Gross Margin (000) $15,922 $17,753 $20,192 $22,599 $25,922 $28,875 $32,019 $35,718 $43,051 $43,867 $47,766 $52,478 $58,867 $64,639 $75,877 $83,018 $84,400 $84,465 $94,157 $105,551 $121,577 $134,836 $152,151 $172,016 $197,539


All Retail Businesses, excluding motor vehicle and parts dealers.

Retail Sales (000) $1,392,838 $1,464,707 $1,564,090 $1,637,898 $1,734,039 $1,814,948 $1,893,346 $2,038,884 $2,187,065 $2,246,688 $2,309,741 $2,421,143 $2,606,676 $2,800,976 $2,971,576 $3,085,043 $3,149,450 $2,940,699 $3,075,135 $3,290,014 $3,415,735 $3,499,156 $3,618,589 $3,632,015 $3,722,711

Retail Purchases (000) $981,571 $1,032,690 $1,102,461 $1,148,666 $1,213,244 $1,267,733 $1,315,836 $1,419,221 $1,519,174 $1,555,185 $1,597,634 $1,657,753 $1,793,778 $1,937,488 $2,068,894 $2,154,074 $2,218,964 $2,048,604 $2,153,745 $2,324,971 $2,409,468 $2,452,290 $2,514,928 $2,476,790 $2,511,311

Gross Margin (000) $411,267 $432,017 $461,629 $489,232 $520,795 $547,215 $577,510 $619,663 $667,891 $691,503 $712,107 $763,390 $812,898 $863,488 $902,682 $930,969 $930,486 $892,095 $921,390 $965,043 $1,006,267 $1,046,866 $1,103,661 $1,155,225 $1,211,400


Source: U.S. Bureau of the Census Annual Retail Trade Survey


TechnologyOnline pharmacy has demonstrated its convenience to a subset of customers, and the chain pharmacy industry has embraced the Internet and online sales as an extra service for their customers. However, online sales for

other retail pharmacy lines are also flourishing and compete with bricks and mortar stores. Nearly 23% of retail pharmacy product line sales occurred online as of 2016.

TABLE 21. E-COMMERCE FOR RETAIL PHARMACY PRODUCT LINES, 2005-2016 (DRUGS, HEALTH AIDS, AND BEAUTY AIDS)

Year Total Sales of Drugs, Health Aids, and Beauty Aids E-Commerce Percent

2016 129,459 29,692 22.9%

2015 116,187 24,226 20.9%

2014 93,586 19,112 20.4%

2013 91,447 17,451 19.1%

2012 91,108 14,602 16.0%

2011 82,737 11,889 14.4%

2010 75,527 10,983 14.5%

2009 69,295 8,880 12.8%

2008 64,839 7,593 11.7%

2007 61,861 6,472 10.5%

2006 63,305 5,415 8.6%

2005 49,811 4,269 8.6%

Source: U.S. Census Bureau, Annual Retail Trade Survey, http://www.census.gov/data/tables/2016/econ/e-stats/2016-e-stats.html

EmployeesPharmacy employee salaries vary by state and by the type of store they work in. Table 22 shows average wages by store type by state. The wages presented in Table 22 are for all employees, including pharmacists and part-time employees. These figures are helpful by representing the costs to the store for the average employee for the year. These figures are affected by labor turnover, the management/staff ratios, and the cost of living in the particular state. No data is

available for independent drug stores. Average wages reflect the mix of employees traditionally used in each type of community retail pharmacy. This number will go proportionally up or down based on the labor status of the staff included in the calculation. For example, more than 18% of employees in traditional drug stores are pharmacists, while less than 1% of all employees in supermarkets and mass merchants are pharmacists.


TABLE 22. STATE BY STATE ESTIMATES OF WAGES PER EMPLOYEE, BY TYPE OF STORE, 2017

State Traditional Drug Store

Supermarkets with Pharmacy

Mass Merchants with Pharmacy State Traditional Drug

StoreSupermarkets with Pharmacy

Mass Merchants with Pharmacy

Alabama $41,018.41 $21,057.34 $21,126.43 Montana $40,299.25 $24,624.08 $19,730.01

Alaska $48,021.83 $28,128.34 $25,764.94 Nebraska $36,695.08 $19,472.51 $17,766.62

Arizona $46,667.59 $27,964.26 $20,528.11 Nevada $40,636.94 $28,533.55 $21,341.51

Arkansas $40,979.05 $21,415.49 $19,767.93 New Hampshire $41,289.56 $20,030.35 $20,061.56

California $47,926.04 $30,405.01 $25,420.23 New Jersey $42,017.84 $27,617.56 $29,343.69

Colorado $50,383.00 $30,068.79 $24,465.48 New Mexico $38,084.63 $25,197.93 $19,033.40

Connecticut $38,589.98 $27,588.46 $26,862.54 New York $40,559.45 $24,961.32 $27,402.07

DC $39,038.20 $31,087.78 N/A North Carolina $39,083.00 $19,722.90 $22,163.77

Delaware $37,754.77 $23,390.01 $21,178.73 North Dakota $44,175.29 N/A N/A

Florida $40,085.65 $23,303.47 $23,982.72 Ohio $36,778.02 $22,614.20 $21,929.94

Georgia $39,555.58 $21,988.45 $21,441.21 Oklahoma $40,941.28 $21,957.09 $19,005.68

Hawaii $38,152.43 $30,120.51 $34,159.58 Oregon $39,247.02 $26,856.64 $26,438.35

Idaho $39,636.20 $29,562.00 $24,062.93 Pennsylvania $37,444.07 $21,889.31 $18,974.94

Illinois $44,327.53 $22,723.49 $24,004.95 Rhode Island $43,502.42 $24,831.84 $20,439.88

Indiana $38,050.53 $21,242.19 $20,632.70 South Carolina $40,189.46 $20,702.50 $18,598.87

Iowa $36,086.13 $20,058.61 $17,925.82 South Dakota $37,563.71 $19,670.61 $19,213.49

Kansas $37,859.24 $20,438.41 $19,308.59 Tennessee $43,576.13 $21,335.46 $22,576.48

Kentucky $40,339.17 $20,977.38 $18,942.83 Texas $43,064.45 $25,982.44 $24,338.32

Louisiana $39,690.94 $21,437.89 $18,028.19 Utah $39,037.13 $23,521.42 $23,887.99

Maine $42,015.49 $22,855.04 $18,939.52 Vermont $39,980.20 $23,408.06 N/A

Maryland $42,261.91 $27,918.70 $24,772.84 Virginia $38,074.15 $24,405.94 $19,895.83

Massachusetts $40,577.42 $24,650.55 $26,767.89 Washington $44,822.73 $30,219.39 $31,285.17

Michigan $42,228.65 $23,726.14 $22,739.13 West Virginia $38,987.01 $22,183.78 $19,971.41

Minnesota $42,949.05 $22,626.83 $24,166.91 Wisconsin $36,393.73 $20,380.32 $21,740.08

Mississippi $41,141.18 $19,197.25 $18,040.00 Wyoming $42,463.29 $27,754.49 $19,901.80

Missouri $40,142.82 $21,994.96 $18,336.52 Total $41,378.28 $22,502.41 $24,680.92

Source: Bureau of Labor Statistics Quarterly Census of Employment and Wages, 2017 and NACDS Economics Department.

Detailed statistics from 2017 are presented in Table 23. The three major store types – traditional drug store, mass merchant, and supermarket – all rely heavily on transaction-related personnel: clerical staff, cashiers, or stock clerks. Many are part-time employees, and some figures will

reflect this type of staffing. Approximately 50% of all employees in stores with pharmacies are in occupations related to transactions. Another 5% of drug store employees and more than 25% of supermarket and mass merchant employees are office and administrative support personnel.


TABLE 23. EMPLOYMENT BY OCCUPATION FOR DRUG STORES, SUPERMARKETS, AND DEPARTMENT STORES, 2017

Drug Stores Food and Beverage Stores1 General Merchandise Stores2

Code Occupation Employment As Percent of Total Employment As Percent

of Total Employment As Percent of Total

00-0000 Industry Total 728,700 100.00 2,926,580 100.00 3,220,360 100.00

11-0000 Management Occupations 16,520 2.27 46,750 1.60 39,690 1.23

11-1021 General and Operations Managers 13,390 1.84 35,820 1.22 32,620 1.01

13-0000 Business and Financial Operations Occupations 3,950 0.54 13,050 0.45 13,500 0.42

13-1020 Buyers and Purchasing Agents 630 0.09 6,020 0.21 2,470 0.08

13-2011 Accountants and Auditors 850 0.12 1,150 0.04 230 0.01

15-0000 Computer and Mathematical Occupations 910 0.12 1,500 0.05 700 0.02

27-0000 Arts, Design, Entertainment, Sports, and Media Occupations 440 0.06 8,920 0.30 22,580 0.70

27-1023 Floral Designers 6,730 0.23 780 0.02

27-1026 Merchandise Displayers and Window Trimmers 280 0.04 1,060 0.04 19,840 0.62

29-0000 Healthcare Practitioners and Technical Occupations 360,370 49.45 58,410 2.00 82,020 2.55

29-1051 Pharmacists 136,420 18.72 23,820 0.81 24,180 0.75

29-2052 Pharmacy Technicians 218,580 7.47 34,080 1.16 42,700 1.33

31-0000 Healthcare Support Occupations 24,540 3.37 3,210 0.11 3,440 0.11

31-9095 Pharmacy Aides 24,120 3.31 3,170 0.11 1,940 0.06

33-0000 Protective Service Occupations 960 0.13 4,280 0.15 38,820 1.21

33-9032 Security Guards 910 0.12 3,790 0.13 22,730 0.71

35-0000 Food Preparation and Serving Related Occupations 2,320 0.32 384,540 13.14 63,260 1.96

37-0000 Building and Grounds Cleaning and Maintenance Occupations 1,020 0.14 22,300 0.76 53,790 1.67

39-0000 Personal Care and Service Occupations 250 0.03 1,250 0.04 19,640 0.61

39-5010 Hairdressers, Hairstylists, and Cosmetologists ** ** 100 0.00 17,620 0.55

41-0000 Sales and Related Occupations 250,880 34.43 1,225,790 41.88 1,827,550 56.75

41-1011First-Line Supervisors/Managers of Retail Sales Workers

29,680 4.07 156,000 5.33 247,510 7.69

41-2011 Cashiers 184,380 25.30 916,540 31.32 702,660 21.82

41-2021 Counter and Rental Clerks 1,720 0.24 11,400 0.39 3,370 0.10

41-2031 Retail Salespersons 31,760 4.36 130,020 4.44 838,540 26.04

41-9011 Demonstrators and Product Promoters 240 0.03 4,090 0.14 4,280 0.13

43-0000 Office and Administrative Support Occupations 41,420 5.68 749,950 25.63 811,600 25.20

45-0000 Farming, Fishing, and Forestry Occupations 2,960 0.10

49-0000 Installation, Maintenance, and Repair Occupations 720 0.10 7,870 0.27 15,310 0.48

51-0000 Production Occupations 2,480 0.34 206,750 7.06 59,840 1.86


TABLE 23. EMPLOYMENT BY OCCUPATION FOR DRUG STORES, SUPERMARKETS, AND DEPARTMENT STORES, 2017

Drug Stores Food and Beverage Stores1 General Merchandise Stores2

Code Occupation Employment As Percent of Total Employment As Percent

of Total Employment As Percent of Total

51-3011 Bakers 48,460 1.66 21,170 0.66

51-3021 Butchers and Meat Cutters 105,310 3.60 7,830 0.24

53-0000 Transportation and Material Moving Occupations 21,320 2.93 188,780 6.45 168,320 5.23

53-3032 Truck Drivers, Heavy and Tractor-Trailer 1,540 0.05 750 0.02

53-3033 Truck Drivers, Light Or Delivery Services 18,610 2.55 7,770 0.27 2,000 0.06

53-7062 Laborers and Freight, Stock, and Material Movers, Hand 150 0.02 28,500 0.97 102,350 3.18

53-7064 Packers and Packagers, Hand 310 0.04 138,140 4.72 28,250 0.88

1 Includes supermarkets and specialty food stores.2 Includes department stores, warehouse clubs, and superstores.** = indicates that an employment estimate is not availableThese occupations are representative of those employed in the industries. Subcategories may not total because not all subcategories are shown.Source: Occupational Employment Survey, Bureau of Labor Statistics, May 2017.

Non-Prescription SalesMany stores have substantial non-prescription sales. These consist of various types of merchandise for each type of store, comprising a different percentage of sales in each. This section details dollar amounts and percentages of front-end sales by category. Additional information is available about the specific merchandise mix of traditional chain drug stores. This information is based on line-of-business census data, which collects specific information on sales by category for traditional drug stores.

Figure 6 shows the 2017 traditional chain drug store merchandise mix (by dollar sales). Prescription drugs continue to be the most important category, accounting for over 68% of sales. This percentage has dropped slightly for the past few years because of increased use of generic drugs and discount generic programs. Prescription sales are expected to increase overall primarily due to the increasing importance of specialty pharmacy. Many other categories contribute substantially to total sales in traditional chain drug stores. In particular, food sales have shown strong growth for the past few years.


Traditional Chain Drug Store Merchandise Mix, 2017FIGURE 6

PRESCRIPTIONS 68.1%

COSMETICS/FRAGRANCE 2.6%EDIBLE CONSUMABLES 8.3%

GENERAL MERCHANDISE 1.3%NONEDIBLE CONSUMABLES 3.6%

OFFICE/SCHOOL SUPPLIES 0.4%

OTC/HEALTH 9.6%

PERSONAL CARE 4.2%

Source: ACNielsen, IQVIA, NACDS Economics Department

Table 24 provides information on total sales, front-end sales, and health and beauty aid (HBA) sales by type of pharmacy. HBA sales tend to

be associated with pharmacy sales; stores with pharmacies have higher HBA sales than stores without.

TABLE 24. TOTAL SALES, FRONT-END SALES, HBA SALES, AND OTC SALES, BY CATEGORY OF STORE, 2017

Total Sales Pharmacy Sales

Front-End Sales HBA Sales* OTC Sales* OTC/HBA % OTC%

Drug Stores (NAICS 44611) $272,109 $199,260 $72,849 $11,293 $15,955 10.0% 5.9%

Traditional Chain Drug Stores $204,082 $138,968 $65,114

Independent Drug Stores $68,027 $60,292 $7,735

Grocery Stores (NAICS 4451) $641,042 $31,790 $609,252 $8,042 $8,321 2.6% 1.3%

Supermarkets with Pharmacy $274,208 $31,790 $242,417 $5,986 $6,194 4.4% 2.3%

Discount Department Stores (NAICS 452112 ), and Warehouse Clubs and Superstores (NAICS 45291) $638,169 $25,326 $612,843 $29,858 $18,591 7.6% 2.9%

Mass Merchants with Pharmacy $323,530 $25,326 $298,204 $14,553 $9,061 7.3% 2.8%

* HBA (health and beauty aids) is part of total front-end sales. Excludes OTC products.Source: U.S. Department of Commerce, IQVIA, ACNielsen, and NACDS Economics Department.

Many prescription products have been authorized for sale as over-the-counter (OTC) medications. The switch from prescription to OTC typically shifts purchases from third-party payers to

consumers, and returns pricing power to the retailer. A substantial number of products have switched since 1995 and are listed in Table 25.


TABLE 25. RX TO OTC SWITCH PRODUCTS, 1995-2018

Ingredient Adult Dosage Product Category Date of OTC Approval Product Examples

famotidine (NDA) 10 mg, up to 20 mg/day acid reducer 4/28/1995 Pepcid AC (J&J Merck)

ibuprofen suspension 100mg/5ml for pediatric use (NDA) 7.5 mg/kg up to 4 times a day internal analgesic/antipyretic 6/16/1995 Children’s Motrin (McNeil Consumer)

cimetidine (NDA) 200 mg up to twice per day acid reducer 6/19/1995 Tagamet HB (SmithKline)

ketoprofen (NDA) 12.5 mg every 4 to 6 hours internal analgesic 10/16/1995 Orudis KT (Whitehall-Robins), Actron (Bayer)

ranitidine (NDA) 75 mg up to twice per day acid reducer 12/19/1995 Zantac 75 (Warner Wellcome)

butoconazole nitrate (NDA) 2.0% cream and applicators (3 days) anticandidal 12/26/1995 Femstat 3 (Procter & Gamble)

minoxidil (NDA) 2.0% topical solution hair grower 2/9/1996 Rogaine (Pharmacia & Upjohn)

nicotine polacrilex (NDA) 2 mg and 4 mg gum smoking cessation 2/9/1996 Nicorette (SmithKline Beecham)

nizatidine (NDA) 75 mg up to twice daily acid reducer 5/9/1996 AXID AR (Whitehall-Robins Healthcare)

miconazole nitrate (NDA) 2.0% cream and 200-mg inserts anticandidal 4/16/1996 Monistat 3 (Ortho)

nicotine transdermal system (NDA) 15 mg patch smoking cessation 7/3/1996 Nicotrol (McNeil Consumer)

clotrimazole (NDA)* 1% cream & 200 mg inserts anticandidal 7/29/1996 Gyne-Lotrimin 3 (Schering-Plough)

nicotine transdermal system (NDA) 21, 14, & 7 mg patch smoking cessation 8/2/1996 Nicoderm CQ (SmithKline Beecham), Habitrol (Novartis) (Nov. 12, 1999)

bentoquatam (NDA)* 5% lotion poison ivy protection 8/26/1996 Ivy Block (EnviroDerm)

cromolyn sodium (NDA) 4% nasal solution allergy prevention & treatment 1/6/1997 Nasalcrom (McNeil Consumer)

tioconazole (NDA) 6.5% vaginal ointment anticandidal 2/11/1997 Vagistat-1 (Bristol-Myers Squibb), Monistat 1 (McNeil)

loperamide/simethicone (NDA)* 2 mg loperamide, 125 mg simethicone antidiarrheal/antigas 6/26/1997 Imodium Advanced (McNeil

Consumer)

triclosan (dentifrice) (NDA)* 0.30% triclosan/0.243% fluoride antigingivitis 7/11/1997 Total (Colgate-Palmolive)

ketoconazole (NDA) 1% shampoo dandruff shampoo 10/10/1997 Nizoral (Johnson & Johnson Consumer Products)

minoxidil (NDA)* 5.0% topical solution hair grower 11/17/1997 Rogaine Extra Strength for Men (Pharmacia & Upjohn)

aspirin /caffeine /acetaminophen(NDA)** 250 mg/65 mg/250 mg migraine 1/14/1998 Excedrin Migraine (Bristol-Myers

Squibb)

miconazole nitrate (NDA)* 4.0% cream anticandidal 3/30/1998 Monistat 3 (Advanced Care Products)

terbinafine hydrochloride (NDA) 1.0% cream antifungal 3/9/1999 Lamisil AT (Novartis)

cimetidine suspension (NDA)* Suspension acid reducer 7/9/1999 Tagamet HB 200 (SmithKline Beecham)

naproxen Na, pseudoephedrine HCl (NDA)*

220 mg naproxen Na, 120 mg pseudoephedrine HCl analgesic/decongestant 11/29/1999 Aleve Cold & Sinus (Bayer Consumer

Care)

ibuprofen (NDA)** 200 mg migraine 2/25/2000 Motrin Migraine Pain (McNeil Consumer Healthcare)

ibuprofen (NDA)** 200 mg migraine 3/16/2000 Advil Migraine Liqui-Gels (Whitehall-Robins)

docosanol (NDA)* 10% cream cold sore/fever blister 7/25/2000 Abreva Cream (Avanir Pharmaceuticals)

famotidine, calcium carbonate, magnesium hydroxide (NDA)*

10 mg famotidine, 800 mg calcium carbonate, 165 mg magnesium hydroxide

heartburn, acid indigestion 10/17/2000 Pepcid Complete (J&J/Merck)

butenafine hydrochloride (NDA) 1.0% cream athlete’s foot, jock itch, ringworm 12/7/2001 Lotrimin Ultra (Schering-Plough)

ibuprofen, pseudoephedrine HCl, suspension for pediatric use (NDA)*

100 mg ibuprofen, 15 mg pseudoephedrine HCl/5 ml; 5 or 10 ml up to 4 times a day

analgesic/decongestant 4/18/2002 Children’s Advil Cold (Wyeth)

guaifenesin extended-release tablet (NDA)

600 or 1200 mg once or twice a day expectorant 7/12/2002 Mucinex (Adams Respiratory

Therapeutics)


TABLE 25. RX TO OTC SWITCH PRODUCTS, 1995-2018

Ingredient Adult Dosage Product Category Date of OTC Approval Product Examples

nicotine polacrilex troche/lozenge (NDA)* 2 mg and 4 mg smoking cessation 10/31/2002 Commit (GlaxoSmithKline)

loratadine (NDA) 10 mg/day antihistamine 11/27/2002 Claritin Tablets, Claritin RediTabs, Claritin Syrup (Schering-Plough)

loratadine, pseudoephededrine sulfate (NDA)

10 mg loratadine, 240 mg pseudoephedrine sulfate daily antihistamine/decongestant 11/27/2002

Claritin-D 12 Hour Extended Release Tablets, Claritin-D 24 Hour Extended Release Tablets (Schering-Plough)

omeprazole magnesium 20 mg/day acid reducer to treat frequent heartburn 6/20/2003 Prilosec OTC (Procter & Gamble)

loratadine (NDA)** 10 mg/day hives relief 11/15/2003 Claritin hives relief (Schering-Plough)diphenhydramine citrate & ibuprofen (NDA)*; diphenhydramine HCl & ibuprofen potassium (NDA)*

400 mg ibuprofen and 78 mg diphenhydramine citrate or 50 mg diphenhydramine HCl at bedtime

analgesic sleep-aid 12/21/2005 Advil PM (Wyeth)

ecamsule (combined with avobenzone and octocrylene) (NDA)*

2% ecamsule; 2% avobenzone; 10% octocrylene sunscreen 7/21/2006 Anthelios SX (LíOreal)

levonorgestrel (NDA)Two 0.75-mg tablets, with the second one taken 12 hours after the first

contraceptive 8/24/2006 Plan B (Duramed)

polyethylene glycol 3350 (NDA) 17 g (scoopful) of powder per day in 8 oz of water laxative 10/6/2006 MiraLAX (Schering-Plough)

ketotifen (NDA) 0.025% ophthalmic solution antihistamine eye drops 10/19/2006 Zaditor (Novartis)orlistat (NDA) 60 mg; 180 mg daily maximum weight loss aid 2/7/2007 Alli (GlaxoSmithKline)cetirizine HCl & pseudoephedrine HCl (NDA)

5 mg cetirizine and 120 mg pseudoephedrine antihistamine/decongestant 11/9/2007 Zyrtec-D (McNeil)

cetirizine HCl (NDA)1 mg/ml (childrenís syrup), 5 mg and 10 mg (tablets and chewable tablets)

antihistamine, hives relief 11/16/2007 Zyrtec (McNeil)

lansoprazole (NDA) 15 mg/day acid reducer to treat frequent heartburn 5/18/2009 Prevacid 24 HR (Novartis)

levonorgestrel (NDA) 1.5 mg contraceptive 7/10/2009 Plan B One Step (Duramed)omeprazole and sodium bicarbonate (NDA)

20 mg omeprazole and 20 mg sodium bicarbonate

acid reducer to treat frequent heartburn 12/1/2009 Zegerid OTC (Schering-Plough)

ibuprofen and phenylephrine HCl (NDA) 200 mg ibuprofen and 10 mg phenylephrine HCl analgesic/decongestant 5/27/2010 Advil Congestion Relief (Pfizer)

fexofenadine hydrochloride (NDA) 30 mg; 60 mg; 180 mg; 30 mg/5 mL antihistamine 1/24/2011 Allegra (Chattem)

fexofenadine hydrochloride and pseudoephedrine HCl (NDA) 60 mg; 120 mg antihistamine/decongestant 1/24/2011 Allegra D 12-Hour (Chattem)

fexofenadine hydrochloride and pseudoephedrine HCl (NDA) 180 mg; 240 mg antihistamine/decongestant 1/24/2011 Allegra D 24-Hour (Chattem)

oxybutynin (NDA) 3.9 mg overactive bladder 1/25/2013 Oxytrol for Women (Merck)

triamcinolone acetonide (NDA) 55 mcg/spray, aqueous suspension intranasal steroid for allergic rhinitis 10/11/2013 Nasacort Allergy 24HR (Chattem)

esomeprazole magnesium (NDA) 20 mg/day acid reducer to treat frequent heartburn 3/28/2014 Nexium 24HR (Pfizer)

fluticasone propionate (NDA) 50 mcg/spray intranasal steroid for upper respiratory allergies 7/23/2014 Flonase Allergy Relief

(GlaxoSmithKline)budesonide (NDA) 32 mcg/spray intranasal steroid for allergic rhinitis 3/23/2015 Rhinocort Allergy Spray (McNeil)adapalene (sNDA) 0.1% gel, once daily acne 7/8/2016 Differin Gel (Galderma)

fluticasone furoate (sNDA) 27.5 mcg spray intranasal steroid for upper respiratory allergies 8/2/2016 Flonase Sensimist Allergy Relief

(GlaxoSmithKline)levocetirizine dihydrochloride (NDA) 5 mg antihistamine 1/31/2017 Xyzal Allergy 24HR (Chattem)

brimonidine tartrate (NDA) 0.025% ophthalmic solution relief of redness of the eye due to minor eye irritations 12/22/2017 Lumify (Bausch + Lomb)

+ FDA approval for OTC marketing is on an interim basis pending adoption of a Final Monograph.* New OTC NDA - Not previously Rx **New OTC indication, product previously OTCSource: Consumer Healthcare Products Association, www.chpa-info.org


Front-end sales differ markedly by type of store. All types of chain pharmacies carry health and beauty aids and OTC medicines, but the top categories are different by type of store. These

differences are illustrated in Table 26. As always, the subcategories with the highest growth rate tend to have low dollar volume with plenty of room for growth.

TABLE 26. TOP HBA/OTC CATEGORIES, BY TYPE OF STORE, 2018

Traditional Drug Store Supermarket Other Retailers

Category Sales (millions) Category Sales

(millions) Category Sales (millions)

1 Upper Respiratory Medicine $3,654 Vitamins and Supplements $2,092 Vitamins and Supplements $9,728

2 Vitamins And Supplements $2,845 Oral Hygiene $1,810 Upper Respiratory Medicine $8,647

3 Cosmetics $2,779 Upper Respiratory Medicine $1,693 Oral Hygiene $8,604

4 Oral Hygiene $1,896 Nutritional $1,332 Cosmetics $7,739

5 Pain Relief $1,699 Bar and Liquid Soap $1,124 Bar and Liquid Soap $5,063

6 First Aid $1,423 Shampoo and Conditioner $1,020 Pain Relief $5,028

7 Stomach Upper G.I. $1,377 Pain Relief $968 Shampoo and Conditioner $4,712

8 Facial Cleanser and Moisturizer $1,054 Disposable Diaper and Training Pant $846 Disposable Diaper and Training Pant $4,613

9 Shampoo and Conditioner $896 Stomach Upper G.I. $798 Stomach Upper G.I. $3,994

10 Feminine Hygiene $830 Cosmetics $742 Nutritional $3,779

Source: ACNielsen Strategic Planner Data 2018 and NACDS Economics Department

For each type of store, we are able to assess growth by department. Tables 27 through 29 show growth by department. For traditional drug

stores, which had been increasing food sales, 2017 saw a return to increase in health care sales.

TABLE 27. GROWTH BY DEPARTMENT FOR TRADITIONAL DRUG STORES, 2017

Dollar Sales (000) Growth Rate

Fresh Meat $72,716,394 5.1%

Delicatessen $75,355,840 2.9%

Health Care $15,268,466,679 0.7%

Frozen Foods $613,774,896 0.5%

Alcohol $3,002,150,037 -0.6%

Pet Care $395,334,754 -1.0%

Personal Care $8,368,474,322 -1.8%

Household Care $2,330,460,918 -2.1%

Tobacco $2,884,015,969 -2.7%

Grocery $8,899,079,873 -2.9%

Beauty Care $5,083,974,241 -4.0%

General Merchandise $2,303,612,927 -4.6%

Produce $51,117,684 -6.8%

Dairy $652,434,705 -7.7%

Bakery $167,998,645 -9.4%

Source: ACNielsen Strategic Planner Data, 2017


TABLE 28. GROWTH BY DEPARTMENT FOR SUPERMARKETS, 2017



Health Care $8,684,099 2.6%

Produce $21,509,845 2.3%

Alcohol $23,582,069 0.4%

Fresh Meat $15,628,001 -0.5%

Frozen Foods $30,697,834 -0.7%

Personal Care $8,336,930 -0.9%

Grocery $114,463,934 -1.6%

Pet Care $6,558,953 -1.7%

Beauty Care $1,941,172 -1.7%

Household Care $17,970,756 -1.9%

Bakery $14,516,776 -2.0%

Dairy $43,781,519 -2.8%

Tobacco $4,271,559 -2.8%

General Merchandise $4,593,885 -3.5%


TABLE 29. GROWTH BY DEPARTMENT FOR OTHER RETAILERS, 2017



Health Care $20,501,569 3.7%

Fresh Meat $9,776,715 3.3%

Produce $10,468,632 3.0%

Frozen Foods $21,467,860 2.7%

Tobacco $66,964,005 2.5%

Pet Care $13,596,095 2.2%

Alcohol $26,040,889 2.1%

Grocery $129,576,836 1.8%

Bakery $11,082,962 1.8%

Dairy $23,836,649 1.1%

Household Care $37,835,030 0.9%

Personal Care $26,307,021 0.1%

Beauty Care $9,233,356 -0.8%

General Merchandise $36,990,115 -3.8%


51NACDS CHAIN MEMBER FACT BOOK, 2018-2019 SECTION THREE | THE PHARMACY

3 The Pharmacy Americans Trust Community PharmacistsTable 30 illustrates that pharmacists are widely considered one of the most trusted healthcare resources available. These figures reflect a 2017 Gallup

poll on professional honesty and ethics in which pharmacists ranked very highly as one of the most trusted professional groups. Pharmacists have been

judged as very high or high by more than 60% of respondents for 30 continuous years in this poll.

TABLE 30. HONESTY AND ETHICAL RATINGS OF PEOPLE IN DIFFERENT PROFESSIONS, 2017 GALLUP POLL

% Very high/High % Average % Low/very low

Nurses 82 16 2

Military officers 71 24 3

Grade school teachers 66 27 5

Medical doctors 65 31 4

Pharmacists 62 32 6

Police officers 56 32 12

Day care providers 46 43 7

Judges 43 41 15

Clergy 42 41 13

Auto mechanics 32 53 14

Nursing home operators 26 48 22

Bankers 25 54 21

Newspaper reporters 25 39 35

Local officeholders 24 53 20

TV reporters 23 39 37

State officeholders 19 47 33

Lawyers 18 53 28

Business executives 16 54 28

Advertising practitioners 12 49 34

Members of Congress 11 29 60

Car salespeople 10 48 39

Lobbyists 8 31 58

Source: Gallup Poll, Honesty/Ethics in Professions, https://news.gallup.com/poll/224639/nurses-keep-healthy-lead-honest-ethical-profession.aspx

52 SECTION THREE | THE PHARMACY NACDS CHAIN MEMBER FACT BOOK, 2018-2019

Pharmacist Employment FiguresAll states and the District of Columbia require a license to practice pharmacy. Estimates of the current number of pharmacists vary. Pharmacists may be licensed and practice in multiple states, and therefore, the number of pharmacist licenses overestimates the actual number of pharmacists.

The Bureau of the Census estimates that there were 188,110 total pharmacist jobs in community retail pharmacy – both chain and independent pharmacies – in 2017.

Using data from the Bureau of Labor Statistics’ Occupational Employment Survey and the Current Population Survey (CPS), we projected the number of pharmacists currently employed in each state using total employment in the drug store industry and a pharmacist-to-total employment ratio. We assume that nearly all employee pharmacists work in chain companies, and that all or nearly all self-employed (proprietors) pharmacists work in independent pharmacies.

The National Association of Boards of Pharmacy (NABP) reports pharmacists licensed by states, pharmacists with in-state licenses, and occasionally the number of pharmacists employed in community retail pharmacy. We have included the number of licensed pharmacists by state for comparison purposes.

Table 31 shows the estimated number of licensed pharmacists overall, by state, as well as the estimated number of licensed pharmacists working in chain drug stores and independent drug stores, by state. California, Texas, New York, Florida, and Pennsylvania have the largest number of licensed pharmacists working in community retail pharmacy. These states also have the highest number of pharmacists working in chain pharmacies. New York has the largest number of licensed pharmacists working in independent drug stores, followed by California.

Alaska is the state with the smallest number of licensed pharmacists working in community retail pharmacy overall. Alaska has the fewest pharmacists working in both chain pharmacies and independent pharmacies.


TABLE 31. LICENSED PHARMACISTS AND PHARMACIST JOBS, BY STATE, 2017

State 2017 Estimated Licensed Chain Pharmacy Pharmacist Jobs Independent Drug Store Jobs 2017 Estimated Pharmacist Jobs in

Community Retail Pharmacy

Alabama 8,996 2,434 846 3,280 Alaska 1,083 244 28 272 Arizona 10,978 3,790 281 4,071 Arkansas 6,121 1,546 598 2,144 California 44,864 14,839 3,199 18,038 Colorado 8,411 2,925 258 3,183 Connecticut 5,545 1,550 148 1,698 DC 1,886 498 70 568 Delaware 2,208 557 53 610 Florida 34,316 10,686 1,704 12,390 Georgia 14,235 5,093 875 5,968 Hawaii 2,603 842 185 1,027 Idaho 2,399 710 135 845 Illinois 18,184 6,484 777 7,261 Indiana 11,190 3,511 307 3,818 Iowa 11,369 1,644 361 2,005 Kansas 5,864 1,431 400 1,831 Kentucky 9,554 2,140 783 2,923 Louisiana 8,655 2,156 538 2,694 Maine 2,047 687 92 779 Maryland 11,388 3,213 586 3,799 Massachusetts 12,580 4,705 273 4,978 Michigan 15,238 4,518 1,172 5,690 Minnesota 8,620 3,448 346 3,794 Mississippi 5,955 1,161 367 1,528 Missouri 10,894 3,021 639 3,660 Montana 2,205 547 172 719 Nebraska 5,158 1,148 326 1,474 Nevada 8,125 1,410 76 1,486 New Hampshire 2,572 625 27 652 New Jersey 16,684 4,535 1,192 5,727 New Mexico 2,944 837 99 936 New York 26,328 9,228 3,996 13,224 North Carolina 16,060 4,691 1,005 5,696 North Dakota 2,455 283 207 490 Ohio 20,146 6,866 818 7,684 Oklahoma 7,296 1,565 677 2,242 Oregon 7,776 2,272 169 2,441 Pennsylvania 23,089 6,884 1,350 8,234 Rhode Island 2,185 853 47 900 South Carolina 8,638 2,445 424 2,869 South Dakota 2,022 577 178 755 Tennessee 11,777 3,808 687 4,495 Texas 34,069 11,482 1,886 13,368 Utah 3,270 1,279 207 1,486 Vermont 1,103 352 35 387 Virginia 14,390 3,776 440 4,216 Washington 10,231 3,306 283 3,589 West Virginia 4,780 1,071 301 1,372 Wisconsin 5,834 2,892 364 3,256 Wyoming 1,383 259 49 308 Guam 107 18 12 30 Puerto Rico 5,340 517 703 1,220 Total 521,150 157,359 30,751 188,110 Source: Occupational Employment Survey, May 2018 and NACDS Economics Department.


Pharmacist Employment by Practice SettingUsing the occupational employment survey data from 2017, Table 32 was developed to show the numbers of pharmacists working in different practice settings. This table shows total employment figures and the percentage of employed pharmacists in different practice settings, along with the median and mean hourly wage at each setting. Wages do not include

overtime, holiday pay, severance, or other special categories such as merchandise discounts. In retail settings, the median wage is highest at mass merchants, followed by traditional chain drug stores and supermarkets. To some extent, this ranking may depend on the geographical distribution of the stores.

TABLE 32. EMPLOYMENT OF PHARMACISTS BY PRACTICE SETTING, MEAN AND MEDIAN HOURLY WAGE, 2017

Industry Total Employment Percent of Pharmacists Mean Hourly Wage Median Hourly

Wage

Professional and Commercial Equipment and Supplies Merchant Wholesalers 460 0.1% $59.49 $59.73

Merchant Wholesalers, Nondurable Goods 6,750 2.2% $57.70 $58.45

Wholesale Electronic Markets and Agents and Brokers 350 0.1% $56.15 $57.29

Food and Beverage Stores 23,820 7.7% $58.33 $60.51

Pharmacies and Drug Stores 136,420 44.1% $58.37 $59.46

General Merchandise Stores 24,180 7.8% $59.21 $61.83

Electronic Shopping and Mail-Order Houses 4,620 1.5% $58.18 $59.04

Management, Scientific, and Technical Consulting Services 810 0.3% $58.23 $57.99

Management of Companies and Enterprises 2,640 0.9% $59.43 $60.08

Colleges, Universities, and Professional Schools 1,750 0.6% $55.06 $57.08

Offices of Physicians 4,880 1.6% $62.42 $61.73

Outpatient Care Centers 4,360 1.4% $62.44 $64.52

Home Health Care Services 1,370 0.4% $57.55 $58.12

General Medical and Surgical Hospitals 74,060 23.9% $59.15 $60.16

Psychiatric and Substance Abuse Hospitals 1,110 0.4% $53.43 $54.98

Specialty (except Psychiatric and Substance Abuse) Hospitals 3,380 1.1% $58.84 $59.45

Nursing and Residential Care Facilities 560 0.2% $57.40 $58.17

Federal Executive Branch (OES Designation) 6,370 2.1% $52.30 $56.29

State Government, excluding schools and hospitals (OES Designation) 1,500 0.5% $52.70 $52.86

Local Government, excluding schools and hospitals (OES Designation) 1,030 0.3% $57.92 $58.25

Other Practice Settings 8,910 2.9% ** **

Total 309,330

In Community Retail Pharmacy 184,420 59.6%

Source: Occupational Employment Survey, May 2017**Unknown.


Retail Pharmacy Sales and PrescriptionsWhile front-end sales constitute a significant portion of sales for traditional chain drug stores, the pharmacy remains the core part of their business. Table 33 shows retail pharmacy sales and estimated prescriptions by type of store since 2007. Pharmacy sales for traditional chain drug stores fell 3.8%, and accounted for $139.0

billion in sales in 2017. Of the approximately 4 billion prescriptions dispensed in 2017, over 3 billion – or over 77% – were dispensed by chain pharmacies of all types.

Figures 7 and 8 show the trends in both retail pharmacy sales and prescriptions by type of store, from 2007 through 2017.

TABLE 33. RETAIL PHARMACY SALES AND PRESCRIPTIONS, BY TYPE OF STORE, 2007-2017

Pharmacy Sales (millions) 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

Total $249,248 $249,218 $260,590 $274,658 $285,450 $275,179 $288,816 $331,138 $372,512 $387,489 $386,138

Drug Stores $145,852 $144,515 $148,390 $151,372 $153,179 $145,487 $150,111 $170,280 $191,911 $203,285 $199,260

Chain $98,297 $98,935 $102,793 $104,994 $106,529 $101,029 $105,288 $118,879 $133,080 $142,871 $138,968

Independent $47,555 $45,580 $45,597 $46,378 $46,650 $44,458 $44,823 $51,401 $58,831 $60,414 $60,292

Mass Merchant $23,596 $24,160 $25,622 $26,553 $27,211 $28,447 $29,304 $30,244 $27,900 $25,700 $25,326

Supermarket $27,293 $25,169 $25,847 $25,980 $28,989 $28,745 $31,425 $32,400 $35,201 $33,861 $31,790

Mail Order $52,507 $55,374 $60,731 $70,753 $76,071 $72,500 $77,976 $98,214 $117,500 $124,643 $129,762

Prescriptions (millions)

Total 3,530 3,558 3,637 3,675 3,693 3,822 3,893 3,965 4,008 4,098 4,075

Drug Stores 2,405 2,416 2,486 2,517 2,542 2,600 2,698 2,800 2,858 2,973 2,922

Chain 1,652 1,677 1,755 1,787 1,816 1,879 1,979 2,075 2,133 2,241 2,184

Independent 753 739 731 730 726 721 719 725 725 732 738

Mass Merchant 390 400 402 406 409 439 442 433 421 372 414

Supermarket 478 481 487 488 482 521 520 520 525 564 565

Mail Order 257 261 262 264 260 262 233 212 204 189 174

Source: IQVIA and NACDS Economics Department.


FIGURE 7

0

1,000

2,000

3,000

4,000

5,000

■ TRADITIONAL CHAIN■ INDEPENDENT ■ MASS MERCHANT■ SUPERMARKET■ MAIL ORDER

Prescriptions, by Type of Store, 2007-2017 (In Millions)Source: IQVIA and NACDS Economics Department

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

FIGURE 8

■ TRADITIONAL CHAIN■ INDEPENDENT ■ MASS MERCHANT■ SUPERMARKET■ MAIL ORDER

Retail Prescription Dollar Sales, by Type of Store, 2007-2017 (In Millions)Source: IQVIA and NACDS Economics Department

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000


Prescriptions by Method of Payment and GeographyThere is substantial variation in the share of prescriptions paid by different sources from state to state. The highest share of cash prescriptions (7.6%) is found in Mississippi, while the lowest

is 2.9% in Iowa and Massachusetts. The highest share of fee-for-service Medicaid prescriptions is in Montana (17.4%), and the highest share of Medicare prescriptions is in Mississippi (33.9%).

TABLE 34. PRESCRIPTIONS, BY STATE AND SOURCE OF PAYMENT, 2017

Cash Cash Percent Medicaid Medicaid

PercentManaged Medicaid

Managed Medicaid Percent

Medicare Medicare Percent

Other Third Party

Other Third Party

PercentTotal

Alabama 4,812,077 5.9% 6,951,765 8.6% 270,056 0.3% 24,608,599 30.4% 44,268,492 54.7% 80,910,989

Alaska 192,349 3.7% 808,866 15.5% 65,125 1.2% 894,978 17.1% 3,267,480 62.5% 5,228,798

Arizona 2,376,571 3.3% 1,155,121 1.6% 13,118,857 18.2% 20,276,644 28.1% 35,343,194 48.9% 72,270,387

Arkansas 2,949,473 5.8% 4,595,691 9.1% 162,287 0.3% 16,227,542 32.2% 26,528,396 52.6% 50,463,389

California 12,604,871 3.8% 19,339,497 5.8% 45,710,488 13.7% 93,220,113 28.0% 162,164,881 48.7% 333,039,850

Colorado 1,610,410 3.5% 6,332,862 13.7% 1,156,231 2.5% 11,654,257 25.1% 25,629,660 55.3% 46,383,420

Connecticut 1,369,960 3.0% 7,664,746 16.8% 510,855 1.1% 11,757,668 25.8% 24,293,508 53.3% 45,596,737

Delaware 323,289 3.0% 121,438 1.1% 1,997,835 18.4% 2,959,653 27.2% 5,472,345 50.3% 10,874,560

District of Columbia 314,032 3.5% 1,040,997 11.8% 1,001,915 11.3% 1,404,572 15.9% 5,087,159 57.5% 8,848,675

Florida 16,545,280 6.5% 9,041,410 3.6% 19,007,356 7.5% 79,666,350 31.5% 128,818,366 50.9% 253,078,762

Georgia 7,847,596 5.8% 7,002,998 5.1% 8,843,109 6.5% 38,903,998 28.5% 73,707,099 54.1% 136,304,800

Hawaii 438,444 3.7% 196,103 1.7% 2,002,150 17.0% 2,923,993 24.9% 6,189,175 52.7% 11,749,865

Idaho 872,946 4.7% 1,809,064 9.8% 242,475 1.3% 5,391,291 29.3% 10,092,950 54.8% 18,408,726

Illinois 5,016,967 3.4% 9,270,580 6.3% 14,596,668 9.9% 38,302,785 26.1% 79,583,887 54.2% 146,770,887

Indiana 3,306,189 3.6% 2,667,574 2.9% 8,857,457 9.8% 24,856,150 27.4% 50,928,126 56.2% 90,615,496

Iowa 1,040,571 2.4% 484,489 1.1% 5,671,892 13.2% 14,235,473 33.1% 21,584,928 50.2% 43,017,353

Kansas 1,522,334 3.7% 798,691 1.9% 2,498,394 6.1% 12,035,856 29.2% 24,304,987 59.0% 41,160,262

Kentucky 2,885,134 3.3% 1,396,004 1.6% 19,014,654 21.7% 25,995,678 29.7% 38,226,684 43.7% 87,518,154

Louisiana 3,724,027 4.5% 1,899,571 2.3% 12,543,471 15.2% 23,955,197 29.0% 40,375,185 48.9% 82,497,451

Maine 726,432 4.5% 2,162,202 13.3% 118,173 0.7% 5,352,275 33.0% 7,862,244 48.5% 16,221,326

Maryland 2,261,470 3.5% 3,797,961 5.8% 6,825,778 10.5% 13,797,318 21.2% 38,537,975 59.1% 65,220,502

Massachusetts 2,166,593 2.4% 8,398,699 9.2% 9,574,593 10.5% 23,601,624 25.9% 47,228,931 51.9% 90,970,440

Michigan 4,995,003 3.6% 9,865,804 7.2% 14,113,230 10.2% 42,182,926 30.6% 66,760,844 48.4% 137,917,807

Minnesota 1,724,535 3.2% 2,048,579 3.8% 6,014,763 11.1% 16,116,324 29.6% 28,456,571 52.3% 54,360,772

Mississippi 3,648,082 7.6% 1,106,498 2.3% 2,809,445 5.8% 16,338,442 33.9% 24,306,548 50.4% 48,209,015

Missouri 4,026,854 4.6% 8,908,258 10.3% 705,451 0.8% 28,134,896 32.4% 44,951,329 51.8% 86,726,788

Montana 561,957 4.7% 2,093,525 17.4% 56,174 0.5% 3,595,148 29.8% 5,753,710 47.7% 12,060,514

Nebraska 745,602 2.9% 260,709 1.0% 2,014,425 7.9% 7,882,378 31.0% 14,503,162 57.1% 25,406,276

Nevada 1,215,254 3.9% 1,912,464 6.1% 2,434,309 7.7% 9,158,839 29.1% 16,755,360 53.2% 31,476,226

New Hampshire 590,611 3.7% 517,477 3.3% 871,163 5.5% 4,306,227 27.1% 9,620,364 60.5% 15,905,842

New Jersey 3,968,796 3.6% 1,645,382 1.5% 16,925,886 15.2% 28,325,240 25.5% 60,303,270 54.2% 111,168,574

New Mexico 809,185 3.8% 381,162 1.8% 4,387,124 20.8% 5,903,933 28.0% 9,581,071 45.5% 21,062,475


TABLE 34. PRESCRIPTIONS, BY STATE AND SOURCE OF PAYMENT, 2017

Cash Cash Percent Medicaid Medicaid

PercentManaged Medicaid

Managed Medicaid Percent

Medicare Medicare Percent

Other Third Party

Other Third Party

PercentTotal

New York 8,144,591 2.9% 6,350,128 2.3% 54,413,586 19.6% 75,532,401 27.2% 133,077,048 48.0% 277,517,754

North Carolina 7,016,120 5.1% 15,300,478 11.1% 730,996 0.5% 41,917,204 30.3% 73,379,653 53.0% 138,344,451

North Dakota 444,930 4.9% 823,155 9.1% 400,913 4.4% 3,001,683 33.0% 4,420,594 48.6% 9,091,275

Ohio 4,549,381 2.5% 3,860,784 2.2% 32,418,967 18.1% 50,374,152 28.2% 87,520,727 49.0% 178,724,011

Oklahoma 2,778,201 5.6% 5,150,040 10.4% 166,437 0.3% 14,787,068 29.7% 26,833,514 54.0% 49,715,260

Oregon 1,448,661 3.4% 1,737,578 4.1% 5,581,955 13.1% 12,949,774 30.4% 20,928,409 49.1% 42,646,377

Pennsylvania 5,863,382 3.1% 5,446,368 2.9% 24,031,511 12.7% 56,639,191 30.0% 97,010,376 51.3% 188,990,828

Rhode Island 430,570 2.5% 672,614 3.8% 3,329,591 19.0% 4,537,691 25.9% 8,552,114 48.8% 17,522,580

South Carolina 3,342,278 4.9% 3,192,148 4.6% 4,559,066 6.6% 19,705,341 28.7% 37,859,406 55.1% 68,658,239

South Dakota 553,971 5.3% 676,857 6.4% 218,926 2.1% 3,412,649 32.5% 5,631,578 53.7% 10,493,981

Tennessee 5,051,116 4.6% 1,430,796 1.3% 11,890,820 10.7% 34,981,450 31.6% 57,416,146 51.8% 110,770,328

Texas 16,325,965 5.3% 6,722,262 2.2% 27,072,457 8.7% 77,689,952 25.1% 182,196,037 58.8% 310,006,673

Utah 1,389,617 4.5% 1,027,975 3.4% 1,249,026 4.1% 6,169,182 20.1% 20,846,730 67.9% 30,682,530

Vermont 187,930 2.6% 1,207,797 16.8% 116,637 1.6% 2,200,358 30.7% 3,465,168 48.3% 7,177,890

Virginia 4,224,599 4.3% 2,921,386 2.9% 5,212,182 5.3% 25,313,730 25.5% 61,599,340 62.1% 99,271,237

Washington 2,091,231 2.9% 1,094,415 1.5% 10,199,683 14.0% 17,477,563 24.1% 41,766,381 57.5% 72,629,273

West Virginia 1,170,324 3.2% 4,411,824 12.2% 3,644,171 10.0% 11,072,122 30.5% 16,003,033 44.1% 36,301,474

Wisconsin 1,702,257 2.8% 8,686,537 14.3% 377,553 0.6% 18,187,333 30.0% 31,592,759 52.2% 60,546,439

Wyoming 289,052 4.9% 330,747 5.6% 96,611 1.6% 1,642,010 28.0% 3,514,286 59.8% 5,872,706

Puerto Rico 3,146,588 5.6% 243,662 0.4% 12,438,920 22.0% 28,070,955 49.6% 12,657,113 22.4% 56,557,238

Overall 163,908,018 4.0% 196,389,329 4.8% 409,736,266 10.1% 1,129,915,211 27.9% 2,090,586,894 51.6% 4,052,965,662

Source: Source PHASTÆ Prescription Monthly, data accessed 8/13/2018.

Prescription Drug Prices and Brand/Generic MixGeneric drug utilization has increased in recent years, and will likely continue to do so due to the implementation of the Medicare Part D drug benefit and the loss of patent protection for some blockbuster drugs. This increase continues to slow the overall growth of prescription drug prices, but is counteracted by increasing demand

driven by the aging of the population. Average prescription prices for brand and generic are available only through 2016. Table 35 shows the average prescription price since 1990 as well as the mix of utilization. As the table illustrates, generic drugs accounted for over 84% of prescriptions in 2017.


TABLE 35. PRESCRIPTION DRUG PRICES AND BRAND/GENERIC MIX, 1990-2017

Year Brand All Rx’s Generic Percent Brand Percent Generic

1990 $27.16 $22.06 $10.29 69.8% 30.2%

1991 $30.11 $23.87 $10.85 67.6% 32.4%

1992 $33.68 $26.33 $11.78 66.4% 33.6%

1993 $35.28 $26.99 $12.82 63.1% 36.9%

1994 $37.37 $28.37 $14.18 61.2% 38.8%

1995 $40.22 $30.01 $14.84 59.8% 40.2%

1996 $45.11 $32.86 $15.71 58.3% 41.7%

1997 $49.55 $35.72 $16.95 57.6% 42.4%

1998 $53.51 $38.43 $17.33 58.3% 41.7%

1999 $60.66 $42.42 $18.16 57.1% 42.9%

2000 $65.29 $45.79 $19.33 57.6% 42.4%

2001 $69.75 $50.06 $21.72 59.0% 41.0%

2002 $77.49 $55.37 $24.89 57.9% 42.1%

2003 $86.35 $57.37 $27.69 50.6% 49.4%

2004 $86.44 $66.20 $32.55 49.0% 51.0%

2005 $95.76 $68.93 $37.21 46.2% 53.8%

2006 $97.50 $71.13 $38.86 40.4% 59.6%

2007 $123.82 $70.61 $26.57 37.1% 62.9%

2008 $144.16 $70.03 $26.35 31.1% 68.9%

2009 $155.59 $71.65 $26.42 28.3% 71.7%

2010 $191.18 $74.74 $25.12 25.5% 74.5%

2011 $214.45 $77.30 $24.73 22.9% 77.1%

2012 $238.10 $72.00 $27.46 21.7% 78.3%

2013 $251.88 $74.19 $34.65 20.4% 79.6%

2014 $273.62 $83.52 $37.31 18.9% 81.1%

2015 $317.81 $92.94 $43.30 18.1% 81.8%

2016 $367.79 $94.56 $39.39 16.8% 83.2%

2017 $94.76 15.7% 84.3%

Source: IQVIA, Source Healthcare Analytics, PHAST ô Prescription Monthly, data drawn 8/9/17, Medical Expenditure Panel Survey 2004-2016, and NACDS Economics Department.

InflationThe rate of inflation in prescription drug prices at the manufacturer level was 2.8%, significantly higher than the general rate of inflation, which was 2.1% in 2017.

Figure 9 shows the increase in Consumer Price Index for all items (CPI-U), Consumer Price Index for Prescription Drugs, and increase in retail prescription drug expenditures from 1992–2017.


Revenue From a PrescriptionThe average retail pharmacy reimbursement across all payers in 2017 was $94.76 per prescription. Of this amount, about 86% ($81.12) represents the amount that the pharmacy pays to the manufacturer or a wholesaler to purchase the drug. The remaining 14% ($13.64) is used by

the pharmacy to pay for operating and overhead costs such as salaries, rent, utilities, computer systems, services of wholesalers, complying with state and federal regulations, and other expenses. From this amount, pharmacy retains a

net profit of about 2% ($2.20) per prescription.

FIGURE 9

Prescription Drug Consumer Price Index vs. Consumer Price Index for all ItemsSource: U.S. Bureau of the Census, Bureau of Labor Statistics, and IQVIA

-5

0

5

10

15

20

1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017

■ INCREASE IN RETAIL RX DRUG EXPENDITURES■ INCREASE IN CPI-RX DRUGS■ INCREASE IN CPI-U

MANUFACTURER S G & A

23.7%

Where Revenue from a Prescription Goes, 2017FIGURE 10

Source: IQVIA, NACDS Economics Department

RETAIL NET PROFIT 2.3%

MANUFACTURERCOST OF

MATERIALS 24.2%

MANUFACTURER S G & A

23.7%

RETAIL TAXES 2.4%RETAIL COST OF OPERATIONS 9.7%WHOLESALE NET PROFIT 1.3%WHOLESALE OPERATING COST AND TAXES 0.9%

MANUFACTURER NET PROFIT 11.7%

MANUFACTURER TAXES 8.4%

MANUFACTURER R & D 15.4%


Profile of the Pharmacy ConsumerWhile it is interesting to see how consumers have their prescriptions filled, it is also interesting to see what the typical pharmacy consumer looks

like. Table 36 shows demographics of pharmacy consumers.

TABLE 36. PROFILE OF THE PHARMACY CONSUMER, 2016

Age Group under 5 5-14 15-24 25-34 35-44 45-54 55-64 65-74 75+

sample size 1,163 2,187 1,891 2,184 2,344 2,870 3,054 2,192 1,719

estimated total 10,694,894 17,127,923 19,934,528 21,873,358 22,656,887 28,645,137 32,626,077 24,747,760 18,822,431

Gender

Male 54.0% 51.7% 39.8% 36.7% 39.6% 45.3% 45.9% 46.6% 41.8%

Female 46.0% 48.3% 60.2% 63.3% 60.4% 54.7% 54.1% 53.4% 58.2%

Ethnicity

White 76.3% 75.8% 80.0% 77.9% 78.4% 79.1% 80.5% 82.9% 86.7%

Black 11.5% 11.3% 10.5% 11.7% 11.8% 12.1% 12.1% 9.4% 8.0%

Hispanic 0.6% 1.0% 0.7% 0.8% 1.0% 0.9% 0.9% 0.6% 0.7%

Asian 4.2% 3.9% 3.0% 6.3% 6.2% 5.1% 4.2% 4.8% 3.8%

Other 7.3% 8.0% 5.8% 3.4% 2.5% 2.7% 2.3% 2.2% 0.8%

Ethnicity

Hispanic 23.8% 22.9% 16.9% 15.9% 16.5% 14.1% 9.4% 7.9% 7.5%

Marital Status

Married 5.3% 45.0% 63.4% 65.1% 66.3% 63.3% 47.0%

Widowed 0.0% 0.2% 0.6% 2.5% 5.1% 12.9% 38.3%

Divorced 0.0% 4.5% 12.1% 17.5% 17.8% 16.4% 10.1%

Separated 0.0% 2.4% 3.1% 2.6% 2.5% 1.9% 0.5%

Never Married 100.0% 100.0% 94.2%

Education

Master’s, Doctorate, or Professional Degree 11.5% 12.9% 13.4% 13.9% 11.8% 8.9%

Bachelor’s Degree 0.1% 8.6% 13.6% 10.4% 8.9% 11.8% 8.2%

Some College/Associate Degree 4.7% 29.9% 25.7% 21.3% 18.4% 19.0% 13.9%

High School Graduate 41.2% 43.9% 39.2% 45.7% 48.6% 43.9% 48.1%

Some High School or less 27.7% 5.8% 8.2% 8.8% 9.4% 13.0% 19.8%

Health Insurance

Any Private 56.4% 57.7% 70.5% 75.1% 76.9% 79.7% 77.9% 58.8% 50.5%

Public Only 40.9% 38.6% 25.1% 18.6% 15.9% 14.6% 16.9% 40.8% 49.2%

Uninsured 2.8% 3.7% 4.4% 6.3% 7.1% 5.7% 5.2% 0.3% 0.3%

Source: Medical Expenditure Panel Survey, 2016.


Source of PaymentJust as the method consumers use to fill and refill prescriptions varies, so too does the source of payment for those prescriptions, which are increasingly being made by third parties. Table 37 shows that the percentage of prescriptions paid for with cash has dropped from 63% in 1990 down to 4.1% in 2017. The share of Medicaid prescriptions dropped precipitously in 2006

with the implementation of the Medicare Part D prescription drug benefit, as dual eligibles were shifted to Medicare. This share has grown substantially since 2006 and is now at back up to 15.3% of all prescriptions. Medicaid prescriptions have increased as a share of the total due to expansions in coverage from the Affordable Care Act.

TABLE 37. RETAIL PRESCRIPTIONS BY SOURCE OF PAYMENT, 1990-2017

Medicaid Other Third Party

Medicare Part D Cash Medicaid Other Third

PartyMedicare

Part D Cash

1990 10.7% 26.1% 63.1% 2004 12.8% 73.8% 13.3%

1991 12.8% 28.0% 59.2% 2005 12.9% 75.1% 12.0%

1992 14.3% 30.1% 55.6% 2006 7.1% 82.7% 10.2%

1993 14.9% 34.7% 50.5% 2007 6.4% 83.4% 10.2%

1994 13.3% 42.0% 44.7% 2008 6.6% 83.0% 10.4%

1995 12.7% 49.1% 38.2% 2009 7.0% 82.3% 10.7%

1996 11.6% 55.0% 33.4% 2010 10.9% 59.4% 19.3% 10.5%

1997 11.1% 59.8% 29.1% 2011 10.9% 57.8% 21.3% 10.1%

1998 10.5% 64.8% 24.7% 2012 9.9% 59.5% 22.2% 8.5%

1999 10.8% 68.2% 21.0% 2013 10.7% 52.6% 28.3% 8.4%

2000 11.1% 70.4% 18.5% 2014 14.7% 45.6% 30.3% 9.4%

2001 11.0% 73.0% 16.0% 2015 14.2% 52.9% 27.6% 5.4%

2002 11.1% 74.5% 14.4% 2016 14.9% 52.3% 28.0% 4.8%

2003 11.7% 74.7% 13.7% 2017 15.3% 52.0% 28.6% 4.1%

Source: IQVIA through 2001, Wolters Kluwer Pharmaceutical Audit Suite for 2002-2010,Symphony Health Source PHASTÆ for 2011-2017.Beginning in 2010, Medicaid includes Managed Medicaid prescriptions.

Top Prescription ProductsTables 38 and 39 list the top prescription products by the number of prescriptions dispensed and by dollar volume at community retail pharmacies. Tables 40 and 41 show the top products for mail-order pharmacies. Only one of the top 10 mail-order products by prescriptions was brand in 2017.

In terms of spending, brands account for the majority of the top products. Of the top 20 products by spending for community retail pharmacy in 2017, only two were generic drugs. All of the top 10 products by spending for mail-order pharmacy were brands.


TABLE 38. TOP 100 PRESCRIPTION PRODUCTS, BY NUMBER OF PRESCRIPTIONS DISPENSED, 2017

Rank Product Brand/Generic Status Rank Product Brand/Generic Status

1 Atorvastatin Calcium G 51 Rosuvastatin Calcium G2 Lisinopril G 52 Ciprofloxacin HCl G3 Levothyroxine Sodium G 53 Potassium Chloride G4 Amlodipine Besylate G 54 Venlafaxine HCl ER G5 Hydrocodone-Acetaminophen G 55 Oxycodone HCl G6 Omeprazole G 56 Fluconazole G7 Metformin HCl G 57 Methylprednisolone G8 Gabapentin G 58 Metformin HCl ER G9 Amoxicillin G 59 Losartan-Hydrochlorothiazide G10 Simvastatin G 60 Naproxen G11 Losartan Potassium G 61 Triamcinolone Acetonide G12 Azithromycin G 62 Allopurinol G13 Sertraline HCl G 63 Warfarin Sodium G14 Hydrochlorothiazide G 64 Synthroid B15 Prednisone G 65 Quetiapine Fumarate G

16 Alprazolam G 66 Spironolactone G

17 Metoprolol Succinate G 67 Doxycycline Hyclate G

18 Montelukast Sodium G 68 Valacyclovir G

19 Fluticasone Propionate G 69 Diclofenac Sodium G

20 Tramadol HCl G 70 Albuterol Sulfate G

21 Metoprolol Tartrate G 71 Amitryptyline HCl G

22 Furosemide G 72 Lamotrigine G

23 Pantoprazole Sodium G 73 Clonidine HCl G

24 Escitalopram Oxalate G 74 Ondansetron ODT G

25 Ibuprofen G 75 Benzonatate G

26 Fluoxetine HCl G 76 Glimepiride G

27 Trazodone HCl G 77 Topiramate G

28 Oxycodone-Acetaminophen G 78 Paroxetine HCl G

29 Meloxicam G 79 Latanoprost G

30 Amoxicillin-Clavulanate Potassium G 80 Diazepam G

31 Citalopram Hydrobromide G 81 Vyvanse B

32 Zolpidem Tartrate G 82 Tizanidine HCl G

33 Cyclobenzaprine HCl G 83 Metronidazole G34 Clonazepam G 84 Fenofibrate G

35 Ventolin HFA B 85 Buspirone HCl G

36 Pravastatin Sodium G 86 Folic Acid G37 Vitamin D2 G 87 Estradiol G38 Lisinopril-Hydrochlorothiazide G 88 Cefdinir G

39 Proair HFA B 89 Glipizide G

40 Carvedilol G 90 Mupirocin G41 Tamsulosin HCl G 91 Ondansetron HCl G42 Duloxetine HCl G 92 Clindamycin HCl G

43 Cephalexin G 93 Alendronate Sodium G

44 Lorazepam G 94 IBU B45 Ranitidine HCl G 95 Dextroamphetamine-Amphetamine ER G46 Bupropion XL G 96 Valsartan G

47 Clopidogrel G 97 Levofloxacin G48 Atenolol G 98 Advair Diskus B

49 Sulfamethoxazole-Trimethoprim G 99 Triamterene Hydrochlorothiazide G50 Dextroamphetamine-Amphetamine G 100 Lyrica B

Source: Source Healthcare Analytics, PHASTÆ Prescription Monthly, data drawn 8/20/2018.


TABLE 39. TOP 100 PRESCRIPTION PRODUCTS, BY DOLLAR SPENDING, 2017

Rank Product Brand/Generic Rank Product Brand/Generic

1 Januvia B 51 Farxiga B2 Lyrica B 52 Atripla B3 Lantus Solostar B 53 Toujeo Solostar B4 Advair Diskus B 54 Dexilant B5 Eliquis B 55 Esomeprazole Magnesium G6 Xarelto B 56 Xifaxan B7 Vyvanse B 57 Linzess B8 Novolog Flexpen B 58 Duexis B9 Symbicort B 59 Duloxetine HCl G10 Victoza 3-Pak B 60 Oxycodone-Acetaminophen G11 Latuda B 61 Chantix B12 Levemir Flextouch B 62 Diclofenac Sodium G13 Trulicity B 63 Budesonide G14 Lantus B 64 Enoxaparin Sodium G15 Truvada B 65 Androgel B

16 Genvoya B 66 Myrbetriq B

17 Spiriva B 67 Tivicay B

18 Humalog Kwikpen U-100 B 68 Enbrel Sureclick B

19 Levothyroxine Sodium G 69 Pennsaid B

20 Methylphenidate ER G 70 Qvar B

21 Invokana B 71 Dextroamphetamine-Amphetamine G

22 Aripiprazole G 72 Creon B

23 Novolog B 73 Vesicare B

24 Humalog B 74 Adderall XR B

25 Humira Pen B 75 Vimpat B

26 Hydrocodone-Acetaminophen G 76 Amoxicillin-Clavulanate Potassium G

27 Metoprolol Succinate G 77 Tresiba Flextouch U-200 B

28 Atorvastatin Calcium G 78 Ezetimibe G

29 Suboxone B 79 Invega Sustenna B

30 Restasis B 80 Bystolic B

31 Cialis B 81 Premarin B

32 Triumeq B 82 Oxycodone HCl G

33 Harvoni B 83 Fluticasone Propionate G

34 Oxycontin B 84 Epinephrine G

35 Dextroamphetamine-Amphetamine ER G 85 Nuvaring B

36 Breo Ellipta B 86 Sensipar B37 Proair HFA B 87 Ranexa B38 Lidocaine G 88 Lialda B

39 Clobetasol Propionate G 89 Descovy B

40 Metformin HCl ER G 90 Combivent Respimat B41 Ventolin HFA B 91 Doxycycline Hyclate G42 Viagra B 92 Stribild B

43 Omeprazole G 93 Epclusa B

44 Gabapentin G 94 Novolog Mix 70-30 Flexpen B45 Tradjenta B 95 Pravastatin Sodium G46 Bupropion XL G 96 Synthroid B

47 Flovent HFA B 97 Celecoxib G48 Jardiance B 98 Nexium B

49 Janumet B 99 Azithromycin G50 Fenofibrate G 100 Potassium Chloride G



TABLE 40. TOP 10 PRODUCTS FILLED BY MAIL ORDER, BY NUMBER OF PRESCRIPTIONS DISPENSED, 2017

Rank Product Brand/Generic

1 Atorvastatin Calcium G

2 Lisinopril G

3 Amlodipine Besylate G

4 Simvastatin G

5 Omeprazole G

6 Synthroid B

7 Metformin HCl G

8 Levothyroxine Sodium G

9 Losartan Potassium G

10 Hydrochlorothiazide G


TABLE 41. TOP 10 PRODUCTS FILLED BY MAIL ORDER, BY DOLLARS SPENT, 2017

Rank Product Brand/Generic

1 Humira Pen B

2 Enbrel Sureclick B

3 Harvoni B

4 Copaxone B

5 Tecfidera B

6 Revlimid B

7 Stelara B

8 Epclusa B

9 Ibrance B

10 Humira B


Table 42 shows the top 20 therapeutic drug classes by prescriptions. In 2017, the top therapeutic drug class ranked by the number of prescriptions dispensed was vascular agents,

which includes ACE inhibitors and calcium channel blockers. Psychotherapeutics, including anti-psychotics and antidepressants, ranked second.

TABLE 42. TOP THERAPEUTIC CLASSES, BY NUMBER OF PRESCRIPTIONS, 2017

Rank Therapeutic Class Total Prescriptions Rank Therapeutic Class Total Prescriptions

1 Vascular Agents 0 11 Hormones 0

2 Psychotherapeutic Drugs 0 12 Thyroid Therapy 0

3 Anti-Infectives, Systemic 0 13 Diuretics and Aquaretics 0

4 Antihyperlipidemic Agents 0 14 Genitourinary 0

5 Respiratory Therapy 0 15 Contraceptives 0

6 Analgesics 0 16 Ophthalmic Preparations 0

7 Diabetes Therapy 0 17 Musculoskeletal 0

8 Neurological Disorders, Misc. 0 18 Hemostatic Modifiers 0

9 Gastrointestinal 0 19 Anti-Fungal Agents 0

10 Antiarthritics 0 20 Sedatives & Hypnotics 0



Demographics and Prescription UtilizationIdentifying which patient groups have the highest prescription drug utilization is important for many reasons. It helps manufacturers project prescription volume for particular drugs and also helps them identify specific marketing opportunities. Lastly, knowing which demographic uses which types of drugs helps insurers assess contracts, especially risk contracts.

The National Ambulatory Medical Care Survey (NAMCS) collects this information on an annual basis and publishes data relating to prescriptions written as a result of physician visits. Since these data are released two years after they are collected, the most recent information is from 2015.

Table 43 compares prescriptions mentioned at outpatient visits by age and sex in 2015. Females continue to get more prescriptions than males in almost every age group measured. Females account for nearly 60% of all drug mentions at physician visits. Overall, on an annual basis, an average female discusses 9.2 prescriptions with her physician and an average male discusses 7.1 prescriptions. Individuals age 75 and older discuss 25 prescriptions per year, more than double the number of those between the ages of 55 and 64.

Table 44 compares the average number of prescriptions mentioned at physician visits by age and race.

TABLE 43. PRESCRIPTIONS MENTIONS AT OUTPATIENT PHYSICIAN OFFICE VISITS, BY AGE AND SEX, 2015

Age Group Female Male Overall

<5 2.90 3.70 3.31

5-14 1.38 1.80 1.60

15-24 2.16 1.44 1.79

25-34 3.46 1.72 2.60

35-44 5.63 3.39 4.53

45-54 8.50 5.76 7.16

55-64 11.82 10.43 11.15

65-74 20.46 18.04 19.33

75+ 23.77 27.05 25.12

Overall Prescription Mentions 9.23 7.13

Total Physician Visits 585,795,029 405,013,456 990,808,485

Total Prescription Mentions 1,492,693,424 1,101,345,290 2,594,038,713

Percent 57.54% 42.46%

Source: National Ambulatory Medical Care Survey, 2015; NACDS Economics Dept.


TABLE 44. PRESCRIPTION MENTIONS AT OUTPATIENT PHYSICIAN OFFICE VISITS, BY AGE AND RACE, 2015

Age Group White Black* Other

<5 3.59 3.38 4.61

5-14 1.84 2.04 1.22

15-24 2.54 2.10 1.64

25-34 3.04 2.98 1.90

35-44 5.17 4.18 2.48

45-54 8.32 12.18 7.64

55-64 12.80 18.06 7.95

65-74 19.69 33.16 28.30

75+ 27.58 31.19 32.89

Total Physician Visits 537,151,193 95,184,507 60,937,339

Total Prescription Mentions 2,050,150,147 363,492,421 180,265,463

Percent 79.0% 14.0% 6.9%

Source: National Ambulatory Medical Care Survey, 2015.*Survey respondents were asked to identify themselves as white, black, Asian/Pacific Islander, or American Indian/Eskimo/Aleut.

The remaining utilization information provides indications about methods of payment. The number of prescription mentions from patients with private insurance was 38.3% in 2015. This means that over a third of all prescription drugs discussions are with private insurance patients. Half of prescription mentions come from Medicare or Medicaid patients.

A frequently asked question is the percentage of prescriptions written for chronic versus acute conditions. Table 46 shows that approximately 44% of prescription discussions are for routine chronic conditions. Preventive care accounts for about 14% of prescription mentions in physician visits.

TABLE 45. NUMBER OF PRESCRIPTION MENTIONS PER PHYSICIAN OFFICE VISIT, BY TYPE OF PAYMENT, 2015

Age Group Private Insurance, HMO Medicare Medicaid Self-Pay Other Total

<5 2.03 2.47 1.76

5-14 1.75 1.95 1.54

15-24 2.12 2.12 2.44 1.78

25-34 2.45 4.19 2.75 1.94 2.04

35-44 2.67 4.42 2.96 2.35 2.64

45-54 3.38 4.89 3.80 2.54 3.22

55-64 3.92 5.24 4.85 2.91 3.82

65-74 4.67 4.68 4.37 1.98 4.50

75+ 5.48 4.96 3.94 4.91

Total Physician Visits 308,453,087 208,548,274 87,347,417 35,102,455 51,792,470 691,243,705

Total Prescription Mentions 992,089,552 1,047,759,292 263,652,830 87,531,602 197,090,653 2,588,123,929

Percent 38.3% 40.5% 10.2% 3.4% 7.6% 100.0%

Source: National Ambulatory Medical Care Survey, 2015.


TABLE 46. NUMBER OF PRESCRIPTION MENTIONS PER PHYSICIAN OFFICE VISIT, BY MAJOR REASON FOR VISIT, 2015

New ProblemChronic

Problem, Routine

Chronic Problem, Flare-Up

Pre- or Post-Surgery or

IllnessPreventive Care Other Total

Prescriptions per Visit 2.2 3.5 3.2 2.6 1.8 1.2

Physician Visits 305,599,711 329,468,465 69,443,236 60,471,102 202,265,562 23,075,423 990,323,499

Prescriptions 666,385,757 1,150,918,901 220,379,926 159,782,470 367,865,627 28,040,269 2,593,372,952

Percentage 25.7% 44.4% 8.5% 6.2% 14.2% 1.1%

Source: National Ambulatory Medical Care Survey, 2015.

An additional source of information about prescription utilization is the Medical Expenditure Panel Survey (MEPS), conducted by the Agency for Healthcare Research and Quality. Data from MEPS are several years old, but it is the most comprehensive source of information on

healthcare expenditures currently available. Unlike the NAMCS data, which focus on discussion of medicines during office visits, MEPS data focus on prescriptions actually filled (as opposed to those discussed or written). These data confirm the patterns found in NAMCS data.

TABLE 47. PRESCRIPTION UTILIZATION BY AGE AND SEX, 2016

Prescriptions Filled at Retail Pharmacies

Age Group Male Female Overall

<5 2.47 1.60 2.06

5-14 2.50 2.02 2.26

15-24 1.86 3.66 2.74

25-34 3.05 5.97 4.54

35-44 5.17 8.71 6.97

45-54 9.50 12.78 11.17

55-64 16.72 20.39 18.63

65-74 24.94 27.29 26.20

75+ 28.90 30.76 29.99

Overall Retail Prescriptions 8.71 11.66 10.22

Total Prescriptions 1,358,189,446 1,896,045,806 3,254,235,252

Percent 41.74% 58.26%

Source: Medical Expenditure Panel Survey, 2016; NACDS Economics Dept.

Using MEPS data, it can be shown that users of chronic medications (defined as filled three or more times per year) account for a disproportionate number of total prescriptions

filled. In fact, only 7.0% of the U.S. population – those filling prescriptions for six or more chronic medications each year – accounts for 44.2% of total prescriptions.


TABLE 48. PERCENT OF POPULATION AND PRESCRIPTIONS ACCOUNTED FOR BY PEOPLE TAKING CHRONIC MEDICATIONS

Chronic Medications Only

Number of Chronic Medications Population Prescriptions Population Share Prescriptions per

YearPrescriptions per

Month Prescription Share

6+ 22,620,582 1,335,281,400 7.0% 59.0 4.9 44.2%

5+ 30,602,846 1,557,582,641 9.5% 50.9 4.2 51.5%

4+ 41,404,506 1,800,502,524 12.8% 43.5 3.6 59.6%

3+ 56,122,761 2,042,121,624 17.4% 36.4 3.0 67.6%

2+ 77,953,263 2,273,669,320 24.1% 29.2 2.4 75.2%

1+ 114,730,323 2,472,222,320 35.5% 21.5 1.8 81.8%

All Medications Filled by Population

6+ 22,620,582 1,507,966,383 7.0% 66.7 5.6 49.9%

5+ 30,602,846 1,779,413,548 9.5% 58.1 4.8 58.9%

4+ 41,404,506 2,079,745,286 12.8% 50.2 4.2 68.8%

3+ 56,122,761 2,389,890,078 17.4% 42.6 3.5 79.1%

2+ 77,953,263 2,710,460,100 24.1% 34.8 2.9 89.7%

1+ 114,730,323 3,022,692,558 35.5% 26.3 2.2 100.0%

Total 323,141,687 3,022,692,558 9.4 0.8

Source: Medical Expenditure Panel Survey, Prescribed Medicines File, 2016, and NACDS Economics Department.Chronic medications are defined as those filled more than three times per year.

More detailed analysis of MEPS data shows that prescription utilization increases with age and appears to decline with increases in income. For example, as shown in Table 49, in older age groups there is a relatively consistent decline in the number of prescriptions per year as income increases. In addition, there is a correlation between income and health. Generally, those

individuals in higher income groups have lower utilization of prescription drugs.

Source of payment is also important. Table 50 shows the number of prescriptions per year by primary expected source of payment. Cash customers spend less and get fewer prescriptions than either Medicaid or other third-party payment customers. They also (on average) spend less per prescription.

TABLE 49. PRESCRIPTION UTILIZATION BY AGE AND INCOME GROUP, PRESCRIPTIONS FILLED AT RETAIL PHARMACIES, 2016

Income Group

Age Group <$5,000 >=$5,000, <$10,000

>=$10,000, <$15,000

>=$15,000, <$20,000

>=$20,000, <$30,000

>=$30,000, <$40,000

>=$40,000, <$50,000

>=$50,000, <$75,000 >=$75,000

<5 3.2 23.4 20.4 * * * * * *

5-14 5.0 21.7 * * * * * * *

15-24 6.2 7.0 6.4 9.0 7.6 6.4 * * *

25-34 12.2 11.2 12.1 10.3 8.9 7.2 7.7 7.4 6.6

35-44 16.9 24.8 16.5 13.2 15.8 10.4 11.5 9.5 8.4

45-54 23.2 32.8 30.7 21.7 17.4 13.4 14.8 13.9 11.3

55-64 29.4 40.6 36.8 28.4 25.2 19.5 20.0 19.6 15.4

65-74 27.2 42.2 35.3 33.2 23.9 25.4 22.8 22.0 19.1

75+ 27.9 39.4 38.8 32.5 29.8 23.7 26.0 24.0 26.4

Source: Medical Expenditure Panel Survey, 2016, NACDS Economics Dept.* Cell size not large enough to report.


TABLE 50. PRESCRIPTION UTILIZATION BY AGE AND PRIMARY PAYMENT TYPE, PRESCRIPTIONS FILLED AT RETAIL PHARMACIES, 2016

Prescriptions/Year Dollars/Year Dollars/Prescription

Age Group Cash Customers1 Medicaid2 Other 3rd

Party3Cash

Customers Medicaid Other 3rd Party

Cash Customers Medicaid Other 3rd

Party

<5 1.8 4.5 6.3 $35.15 $429.92 $574.74 $20.04 $94.70 $91.28

5-14 2.1 7.0 5.2 $57.55 $844.83 $691.10 $27.42 $120.30 $133.14

15-24 2.9 7.5 7.5 $67.14 $875.22 $1,076.20 $23.46 $116.86 $144.27

25-34 3.2 13.3 9.6 $151.32 $1,228.53 $1,289.30 $47.87 $92.44 $133.95

35-44 5.0 20.5 13.8 $219.43 $1,934.19 $1,695.33 $43.68 $94.12 $122.63

45-54 6.0 29.8 18.7 $218.75 $2,831.78 $2,702.49 $36.24 $95.14 $144.47

55-64 8.4 39.1 24.6 $244.82 $3,292.85 $3,058.85 $29.17 $84.22 $124.30

65-74 10.0 38.5 28.0 $205.87 $2,297.52 $3,759.30 $20.63 $59.69 $134.05

75+ 11.2 * 31.8 $246.66 * $3,292.78 $22.11 * $103.64

Overall 5.1 15.0 19.9 $165.53 $1,430.55 $2,507.22 $32.43 $95.59 $125.79

Percent of Prescriptions 5.2% 12.7% 82.1%

Percent of Prescription Dollars 1.4% 10.4% 88.2%

Percent of Prescription Customers 17.0% 14.2% 68.8%

Cash customers were defined as those paying 90 percent of total prescription spending out of pocket.Medicaid customers were defined as those paying more than 50 percent from Medicaid sources.Other 3rd party customers were the remaining group. Source: Medical Expenditure Panel Survey, 2016 and NACDS Economics Department.

Medical conditions data have not been released for 2016, so this analysis of medical conditions is based on 2015 data. Patients with high blood pressure spend the most per year, more than any other patients with other given diagnoses. Table 51 lists annual prescription drug spending per person, for a given diagnosis. Patients with high blood pressure (essential hypertension) spent an average of $2,938 in 2015. Patients with high cholesterol (diseases of lipid metabolism) spent an average of $3,358 in 2015. These numbers could vary from year to year, however, depending on the number of generic therapeutic equivalents that are on the market for a given diagnosis.

Many of the top diagnoses are what are termed comorbid conditions – that is, the patient has more than one condition. To illustrate this, we show the top products for patients with the top four diagnoses in terms of spending. All of the top diagnoses have drugs that are used to treat other conditions in the top 10 by prescriptions.


TABLE 51. AVERAGE ANNUAL PRESCRIPTION DRUG SPENDING BY PATIENTS WITH GIVEN DIAGNOSIS, 2015 Sorted by Total Dollar Spending on Prescription Drugs

Diagnosis

Annual Prescription Dollars per

Person

Annual Prescriptions per Person

Dollars per Prescription

Total Prescription Spending By Individuals with Diagnosis (millions)

Essential Hypertension $3,256 30.3 $107.53 $230,438

Diseases of Lipid Metabolism $3,531 33.0 $107.15 $199,942

Diabetes Mellitus $5,210 40.7 $128.04 $141,692

Joint Disorder $2,866 22.8 $125.94 $136,223

General Symptoms $4,699 41.4 $113.37 $129,128

Neurotic Disorders $3,858 29.6 $130.21 $114,638

Depressive Disorders $3,973 32.5 $122.40 $108,272

Back Disorder $3,191 24.7 $129.26 $89,142

Diseases of Esophagus $4,001 37.5 $106.65 $84,453

Other Soft Tissue Disease $4,370 33.4 $130.67 $71,816

Other Arthropathies $3,502 33.4 $104.75 $71,669

Asthma $3,132 25.6 $122.53 $69,651

Osteoarthrosis $3,938 34.3 $114.92 $62,571

Allergic Rhinitis $2,490 22.6 $110.14 $61,364

Chronic Ischemic Heart Disease $4,378 46.7 $93.78 $50,400

Rheumatoid Arthritis and Related Disorders $8,876 49.2 $180.36 $40,174

Chronic Sinusitis $2,439 18.7 $130.64 $38,901

Respiratory System/Other Chest Symptoms $2,975 23.2 $128.13 $37,367

Injury $2,215 20.4 $108.60 $35,712

Skin Symptoms $9,001 51.3 $175.31 $34,685

Digestive Diseases $5,867 41.3 $142.10 $34,405

Cardiac Dysthythmias $4,212 36.5 $115.34 $33,982

Fluid/Electrolyte Disorder $948 9.0 $104.87 $33,021

Disorder of Thyroid $3,055 33.1 $92.30 $32,455

Stomach Function Disorder $3,931 27.9 $141.03 $32,322

Viral Hepatitis $41,940 34.8 $1,205.79 $32,176

GI System Symptoms $6,304 37.9 $166.33 $31,143

Psychoses $6,317 40.6 $155.53 $30,206

Source: Medical Expenditure Panel Survey, 2015 and NACDS Economics Department.


TABLE 52. TOP PRODUCTS TAKEN BY PATIENTS WITH TOP DIAGNOSES, 2015

Essential Hypertension

Product Total Spend (millions)

Total Prescriptions (millions)

Dollars per Person Used to Treat

Lisinopril Tab 20 MG $556 36 $58.08 high blood pressure

Amlodipine Besylate Tab 10 MG $945 35 $101.98 high blood pressure


Hydrochlorothiazide Tab 25 MG $193 33 $22.17 high blood pressure

Lisinopril Tab 10 MG $336 32 $40.95 high blood pressure

Omeprazole Cap Delayed Release 20 MG $1,204 31 $137.65 heartburn and acid reflux disease

Metformin HCl Tab 500 MG $487 28 $61.24 diabetes

Glucose Blood Test Strip $2,327 23 $268.87 diabetes

Atorvastatin Calcium Tab 20 MG (Base Equivalent) $1,304 23 $239.64 high cholesterol


Diseases of Lipid Metabolism


Simvastatin Tab 20 MG $1,104 30 $159.26 high cholesterol

Simvastatin Tab 40 MG $893 29 $126.04 high cholesterol

Omeprazole Cap Delayed Release 20 MG $1,099 27 $145.69 heartburn and acid reflux disease







Diabetes Mellitus




Omeprazole Cap Delayed Release 20 MG $477 14 $124.66 heartburn and acid reflux disease

Insulin NPH (Human) (Isophane) Inj 100 Unit/ML $4,310 13 $1,502.74 diabetes

Lancets $216 13 $36.48 diabetes


Insulin Glargine Soln Pen-Injector 100 Unit/ML $7,075 13 $3,641.03 diabetes

Metformin HCl Tab SR 24HR 500 MG $289 12 $101.07 diabetes

Atorvastatin Calcium Tab 20 MG (Base Equivalent) $740 11 $307.11 high cholesterol

Joint Disorder

Omeprazole Cap Delayed Release 20 MG $591 16 $161.72 heartburn and acid reflux disease

Albuterol Sulfate Inhal Aero 108 MCG/ACT (90MCG Base Equiv) $685 11 $288.76 asthma

Tramadol HCl Tab 50 MG $200 11 $61.80 pain



Simvastatin Tab 20 MG $467 11 $245.42 high cholesterol

Glucose Blood Test Strip $955 11 $290.05 diabetes

Atorvastatin Calcium Tab 20 MG (Base Equivalent) $626 11 $298.87 high cholesterol


Hydrochlorothiazide Tab 25 MG $57 10 $24.86 high blood pressureSource: Medical Expenditure Panel Survey, 2015 and NACDS Economics Department.

73NACDS CHAIN MEMBER FACT BOOK, 2018-2019

NACDS: The Voice of Chain PharmacyNACDS represents traditional drug stores and supermarkets and mass merchants with pharmacies. Chains operate more than 40,000 pharmacies, and NACDS’ chain member companies include regional chains, with a minimum of four stores, and national companies. Chains nearly 3 million individuals, including 157,000 pharmacists. They fill over 3 billion prescriptions yearly, and help patients use medicines correctly and safely, while offering innovative services that improve patient health and healthcare affordability. NACDS members also include more than 800 supplier partners and over 60 international members representing 20 countries. For more information, visit www.NACDS.org.

Copyright © 2018 National Association of Chain Drug Stores

http://www.NACDS.org

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