Pharmaceutical Supply Chain Analysis 2013–2023

This document is a report analyzing the pharmaceutical supply chain from 2013 to 2023. It aims to clarify drug distribution and payment processes while estimating the share of total prescription medicine spending among various stakeholders. The report details total gross drug expenditures, which have increased from $269 billion in 2013 to $670 billion in 2023. It highlights that manufacturers retained 49.9 percent of total spending on brand medicines in 2023, a decline of over 16 percentage points from 2013. The report also discusses the significant role of pharmacy benefit managers (PBMs) and other entities in the supply chain, which accounted for the largest portion of new spending on brand medicines. Additionally, it examines the growing impact of the 340B Drug Pricing Program, noting that margins for 340B providers have increased significantly. The findings build on previous analyses conducted in 2017 and 2020, indicating ongoing trends in the pharmaceutical market.