NCPA Releases 2021 Digest Report

Annual report examines community pharmacy, changing pharmacy payment model

NCPA October 11, 2021

CHARLOTTE, N.C. (Oct. 11, 2021) – The 2021 NCPA Digest, sponsored by Cardinal Health, was released today as part of the National Community Pharmacists Association’s Annual Convention. The NCPA Digest, which provides an annual overview of independent community pharmacy, found that the industry in 2020 represented 34 percent of all retail pharmacies in the United States and a $67.1 billion marketplace.

“In a time unlike any other, the importance of community pharmacists has never been more obvious,” said NCPA CEO B. Douglas Hoey, pharmacist, MBA. “The NCPA Digest report highlights that, just as counseling, checking for drug interactions and facilitating medication adherence are core competencies, so now must vaccinations by pharmacists join the list. But independent pharmacies can’t provide these or other public health services if they aren’t in business due to crippling pharmacy direct and indirect remuneration fees and other market pressures. Digest data helps us demonstrate the value of independent pharmacies to payers, policymakers and the media, and bolsters our ongoing work to change the pharmacy payment model to compensate and recognize pharmacists for the services they do and can provide.”

The 2021 NCPA Digest identifies the wide variety of services offered by independent community pharmacies: in 2020, nearly 79 percent of respondents offered medication synchronization services; 73 percent offered medication therapy management; 84 percent provided flu immunizations; 80 percent provided non-flu immunizations; and 53 percent performed blood pressure monitoring. From a philanthropic standpoint, 60 percent of all independent community pharmacy owners donated to at least five local organizations in 2020, with 50 percent of pharmacies donating more than $3,000 annually to support community organizations.

Additional highlights from the NCPA Digest covering the 2020 independent community pharmacy marketplace include:

  • This year’s Digest report uses IQVIA for the total number of independent pharmacies, which is 19,397 as of June 2021. The store count in previous years’ Digest reports was based on an NCPA analysis of NCPDP data and NCPA research, which most recently produced a store count of 21,683 in 2019.
  • Ninety-five percent of independent community pharmacy respondents identified their primary pharmacy operation as retail pharmacy. Nearly 5 percent identified as compounding, long-term care, or specialty.
  • Between 2014-20, the generic dispense rate increased from 80 percent to 86 percent.
  • Seventy-four percent of community pharmacies serve population areas of 50,000 or fewer.
  • 3,483 pharmacies are participating in the CPESN® USA national network of clinically integrated pharmacies. To date, over 100 national or local network contracts have been signed, completed, or activated.
  • In 2020, average prescription volume was 57,648 per store, a very slight increase from the 57,414 prescriptions dispensed in 2019.
  • Government programs continue to grow in importance, with 55 percent of total prescriptions covered by the Medicare Part D and Medicaid programs.
  • The top four point-of-care services provided are SARS-CoV-2 diagnostic testing (32 percent), blood glucose (24 percent), influenza (24 percent), and rapid strep (22 percent).


Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing nearly 19,400 pharmacies that employ approximately 215,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America’s most accessible health care providers. To learn more, visit