The effects of managed care on the retail distribution of pharmaceuticals.

The growth of managed care has resulted in substantial changes in the retail channel of distribution for pharmaceuticals. Community pharmacies' numbers and profit margins have declined, and marketshare has shifted to mail-service pharmacies as MCOs and pharmacy benefit managers have dictated reimbursement terms. Community pharmacies have consolidated to increase negotiating power and efficiency and have become more involved in direct patient care. The success of both MCOs and community pharmacies may depend on their ability to provide cooperative services that improve patients' health outcomes.