The last 20 years delivered ups and downs to long-term care (LTC) pharmacies that caused significant disruption in the M&A space. Strategic players swept across the nation, gobbling up small and middle-market businesses in order to gain market dominance. CMS underwent several rounds of updates to their reimbursement plans that either accelerated or decelerated the rate of consolidation. PBMs continue their stronghold as opaque middlemen, controlling drug prices through complex negotiations and burden LTC pharmacies with complex contracts and DIR fees1. The US economy experienced the greatest economic downturn since the great depression, followed by a decade of incredible recovery that was fortified by quantitative easing, technology, job creation and a swelling demographic. With so much momentum in the broader economy, it appears the record healthcare and pharmacy deal activity will continue roaring into 2020, for now.
