Operations
How many independent pharmacies are there? It depends who's counting.
Two industry groups count the same stores and land about 4,000 apart. Here's why, and what both numbers agree on.
Ask how many independent pharmacies operate in the United States and you'll get two very different answers, depending which trade association you ask.
The 2026 NCPA Digest, released at the National Community Pharmacists Association convention in October, estimates 18,988 independent community pharmacies, essentially flat from 18,960 in 2025. By NCPA's count, independents make up nearly 37% of U.S. retail pharmacies.
Meanwhile, the Pharmaceutical Care Management Association (PCMA), the trade group for pharmacy benefit managers (PBMs), puts the 2026 figure at 23,046. It also reports independents grew by 67 stores over the past year while chain stores fell by 1,924, or 5.5%.
Why roughly 4,000 stores separate the two
The groups don't define "independent" the same way, and they don't draw on the same source. PCMA counts retail independents in the National Council for Prescription Drug Programs (NCPDP) database. NCPA produces its own estimate for its annual Digest. Neither group fully reconciles its number with the other's. Each also has a stake in the story the number tells: NCPA's members are independent pharmacy owners pressing for PBM reform, and PCMA represents the PBMs.
What both counts agree on
Chain closures are driving most of the net loss in retail pharmacy, and the independent footprint has held roughly steady over the past year.
The number underneath the count
Store counts don't measure store health. NCPA reports the average independent filled 65,795 prescriptions in 2025, down from 67,601 in 2024, a drop of about 2.7%. Government programs now account for nearly half of all independent prescriptions, so Medicare and Medicaid payment rules carry more weight on each store's margins than ever.
For operators: When a vendor, payer or legislator cites a pharmacy count, ask whose number it is and how "independent" was defined.
Sources: NCPA, 2026 NCPA Digest (via Pharmacy Times, Oct. 4, 2026); PCMA, "The State of the Pharmacy Market"; NCPA 2025 Digest release.