NCPA Releases 2023 Digest Report

NCPA October 15, 2023

ORLANDO, Fla. (Oct. 15, 2023) – The 2023 NCPA Digest, sponsored by Cardinal Health, was released today as part of the National Community Pharmacists Association’s Annual Convention, being held Oct. 14-17 in Orlando. The NCPA Digest, which provides an annual overview of independent community pharmacy, found that the industry in 2022 represented 35 percent of all retail pharmacies in the United States. It continues to be true that no single pharmacy chain has more stores than all independents combined.

“Patients across the country look to their local independent pharmacy for critical health care services, but crippling economic pressures from pharmacy benefit managers and the broader marketplace can make it difficult to keep the doors open,” said NCPA CEO B. Douglas Hoey, pharmacist, MBA. “The NCPA Digest report helps us demonstrate the array of patient services these pharmacies offer and what they need to survive. Like those they serve, independent pharmacies are resilient, but they aren’t invincible. Reforms to the broken payment model are needed if we are to ensure successful pharmacies and healthier, happier patients.”

The 2023 NCPA Digest identifies the wide variety of services offered by independent community pharmacies in 2022: 87 percent of respondents provided flu immunizations; 80 percent offered medication therapy management; 88 percent provided non-flu immunizations; 59 percent performed blood pressure monitoring; 62 percent offered compounding; and 51 percent offered services for long-term care patients. From a philanthropic standpoint, 66 percent of independent community pharmacy owners donated to at least five local organizations in 2022, with 69 percent of pharmacies donating more than $3,000 annually to support community organizations. 

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

  • The estimated number of independent community pharmacies declined, falling to 19,432 locations in 2023 from 19,479 the year prior.
  • Independent pharmacy represented a $94 billion marketplace in 2022, with gross profit margin falling to 21 percent, its lowest point in the NCPA Digest report’s 10-year lookback window. This reflects factors like low or below-cost third-party reimbursements, inflation (which showed up in drug prices), and a higher cost of dispensing.
  • In 2022, the average prescription volume was 66,218 per store, an increase from the 63,228 prescriptions dispensed in 2021. Eighty-six percent of prescriptions at independent pharmacies are filled with a generic drug.
  • Government programs continued accounting for more than half of all prescriptions sold in independent community pharmacies, with 51 percent of total prescriptions covered by the Medicare Part D and Medicaid programs.
  • Ninety-two percent of independent community pharmacy respondents identified their primary pharmacy operation as retail pharmacy.
  • Nearly 3,500 pharmacies are participating in the CPESN® USA national network of clinically integrated pharmacies. To date, almost 250 national or local network contracts have been completed or activated.


Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 19,400 pharmacies that employ more than 230,000 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