This story appears in the September–October 2026 issue of Dispense Times.
By Owen BonDurant, Partner, Independent Rx Consulting
Declining reimbursement, inflation, and a shortage of good employees — the list of challenges facing pharmacy owners goes on and on. These pressures make day-to-day operations difficult, and they leave many owners wondering why anyone would want to buy their business at all.
The reality is very different. Here’s an outline of the current market for buying and selling pharmacies in 2026. Because the forces driving each segment differ, we’ve broken the discussion into three categories: retail, long-term care, and compounding.
Retail
From 2020 through most of 2024, the number of retail pharmacy transactions ran well below normal. A few factors drove this lull: COVID-19, then the COVID vaccine rollout, kept many pharmacies profitable enough that owners weren’t in a hurry to sell, and double DIR fees created further uncertainty.
2025 reversed that trend, and the industry saw more transactions than in perhaps any year on record. 2026 hasn’t matched that pace — we believe largely because of uncertainty around MFP — but demand remains strong. Make no mistake: there are plenty of buyers for retail pharmacies.
Many young pharmacists recognize they can lower operating costs with technology, layer in high-margin clinical services, and expand across a larger geographic footprint than a single storefront ever could. At the same time, multi-store owners are seeing meaningful reimbursement improvements, from MFP to Medicaid, and are capitalizing by adding locations. Multiples currently run anywhere from 2x to more than 3x earnings, depending on location and business mix.
Long-Term Care
Like retail, long-term care (LTC) pharmacy transactions slowed from 2020 through 2024 for the same reasons. Since then, it’s been a seller’s market, and demand for LTC pharmacies has exploded.
That surge comes from a mix of factors: the expansion of Medicare at Home is widening the addressable market, and healthcare providers are increasingly integrating vertically. We’re seeing nursing homes, behavioral health organizations, and other providers acquire pharmacies outright to control service levels and capture the profit themselves. As a result, multiples for LTC pharmacies have climbed steadily over the past two years.
Compounding
The compounding pharmacy market never slowed down, and demand has only intensified over the past few years. Consumer demand for compounded medications is projected to grow 5–8% annually over the next decade, driven not only by patients discovering compounding as a viable alternative treatment but also by GLP-1 demand and the potential approval of additional peptide therapies.
That growth outlook, combined with strong gross margins, has drawn no shortage of interested buyers. As with long-term care, vertical integration is playing out here too, with telehealth companies and other providers acquiring compounding pharmacies to control both service quality and profit. Supply hasn’t kept pace with patient demand, and with more buyers than available pharmacies, multiples have risen for several years running, making this a clear seller’s market.
Getting Ready, on Both Sides
All of the above only matters if you can bring buyers good information. Preparation is everything.
If you’re selling: Get your financials in order. Show consistent, real profitability — resist the urge to make tax moves that minimize reported profit, and separate personal expenses from the business. Operate cleanly and let the numbers tell the story.
If you’re buying: Get yourself ready too. Conserve cash, improve your credit, and lower your personal expenses so you can comfortably live on less during the transition.
A great business can’t change hands if either side isn’t ready. Preparation on both sides of the table is what makes a sale actually happen.
Owen BonDurant is a Partner at Independent Rx Consulting. owen@independent-rx.com | independentrxconsulting.com
