Pharmacy Services Administrative Organizations (PSAOs) support independent and small chain pharmacies by providing administrative, regulatory, financial, and other types of services. They act as intermediaries between pharmacies and pharmacy benefit payers, including pharmacy benefit managers (PBMs), health plans, and other payers. The Pharmaceutical Care Management Association commissioned Milliman to summarize the count by state of independent retail pharmacies that contract with a PSAO as of January 1, 2026. For the count, we used data from the National Council for Prescription Drug Programs (NCPDP), which provides a subscription service to a dataQ pharmacy file. The data contain service and relationship information self-reported by pharmacies or their PSAO to the NCPDP.
Our analysis shows 20,224 independent pharmacies contracting with a PSAO nationally. This translates to 85% of total independent pharmacies. For additional background on the key functions PSAOs perform, please refer to our 2024 PSAO landscape report.
This report was commissioned by the Pharmaceutical Care Management Association.