The top 15 U.S. pharmacies accounted for nearly 75% of the nation’s $751 billion of prescription dispensing revenue in 2025, according to Drug Channels.
CVS Health led all dispensing organizations with $119 billion in revenue, followed by Walgreens at $90.8 billion and Cigna’s Express Scripts at $80.5 billion. GLP-1 medications drove nearly 60% of retail revenue growth over the last five years and contributed significantly to a 10% year-over-year increase in total prescription spending.
Centene entered the top 15 for the first time, reflecting its expanding presence in specialty pharmacy. Rite Aid’s continued store closures and bankruptcy reshaped market dynamics, while CVS and Walgreens have acquired more than 6,000 pharmacy locations since 2010.
The top 15 U.S. pharmacies by 2025 prescription revenue:
CVS Health — $119.0 billion
Walgreens Boots Alliance — $90.8 billion
Express Scripts (Cigna) — $80.5 billion
Optum Rx (UnitedHealth Group) — $50.0 billion
Walmart — $36.8 billion
The Kroger Co. — $17.1 billion
Humana (CenterWell) — $11.7 billion
Publix — $11.7 billion
BrightSpring Health Services — $11.4 billion
Albertsons Cos. — $11.3 billion
PANTHERx Rare Pharmacy — $8.0 billion
Elevance Health (CarelonRx) — $6.8 billion
Costco — $4.7 billion
Centene (AcariaHealth/Foundation Care) — $4.5 billion
Ahold Delhaize — $4.1 billion
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