--- title: "Health & Personal Care Stores — NAICS 446" url: "https://vantainsights.com/industry/446-health-personal-care-stores" naics: "446" naics_frame: "2017" updated: "2026-10-22" --- # Health & Personal Care Stores NAICS 446 *Overview, trends and FAQs are VantaInsights Analysis, AI-drafted. Figures under Industry at a Glance are direct federal pulls, each with its source and year.* ## Industry at a Glance Sector-wide aggregates across all businesses classified under NAICS 446 (2017 classification frame). > **Note:** In NAICS 2022 this is part of 456, “Health and Personal Care Retailers”, which is broader. | Figure | Value | Source | Year | | --- | --- | --- | --- | | Employment | 1.1M | US Census CBP | 2023 | | Establishments | 89K | US Census CBP | 2023 | | Annual Payroll | $43.0B | US Census CBP | 2023 | | Avg Annual Wage | $40,288 | Derived from US Census CBP | 2023 | | Market Size | $383.5B | US Census Economic Census, comparative statistics on the NAICS 2017 definition | 2022 | ## Industry Overview Health and personal care stores (NAICS 446) covers retail pharmacies, drugstores, optical goods retailers, and specialty health and wellness stores selling prescription medications, over-the-counter drugs, vitamins, beauty products, and medical supplies directly to consumers. The subsector has undergone dramatic consolidation and structural transformation, with CVS Health, Walgreens Boots Alliance, and Rite Aid historically dominating the pharmacy chain landscape, though Rite Aid's 2023 bankruptcy filing reduced the competitive field. Prescription dispensing drives the economic engine: pharmacy operations typically generate 70-80% of revenue for major chains, with front-store merchandise (beauty, personal care, OTC medications) providing supplementary margin. Pharmacy benefit manager (PBM) reimbursement rates are the critical profitability variable. CVS Health's ownership of Caremark (the largest PBM) creates vertical integration advantages, while independent pharmacies operating under cooperative banners like Good Neighbor Pharmacy and Health Mart face persistent reimbursement pressure from the three dominant PBMs (Caremark, Express Scripts/Cigna, and OptumRx/UnitedHealth). The subsector is regulated at both federal and state levels. DEA registration and controlled substance scheduling govern opioid and other scheduled drug dispensing. State boards of pharmacy license individual pharmacists and pharmacy locations. HIPAA privacy requirements apply to all prescription data handling. The expansion of pharmacy scope-of-practice laws in states like California and Oregon now permits pharmacists to prescribe hormonal contraceptives and initiate certain treatments, expanding the clinical role beyond traditional dispensing. ## Industry Trends - CVS Health and Walgreens are each closing 900+ locations through 2026 as e-commerce, reduced front-store traffic, and PBM reimbursement pressure undermine the economic model of traditional drugstore density - Amazon Pharmacy and Mark Cuban's Cost Plus Drugs are disrupting prescription pricing transparency and mail-order fulfillment, pressuring brick-and-mortar pharmacy margins on generic medications - State pharmacy scope-of-practice expansion in California (SB 493), Oregon, and Colorado now allows pharmacists to prescribe hormonal contraceptives, naloxone, and certain travel medications, creating new clinical revenue streams - PBM reform legislation advancing in Congress and at FTC targets rebate pass-through requirements and spread pricing practices that independent pharmacists argue suppress reimbursement below dispensing costs - Specialty pharmacy for high-cost biologics and gene therapies is growing rapidly as a revenue segment, with CVS Specialty, Walgreens-owned AllianceRx, and independents competing for contracts with manufacturers and health plans ## Available Reports - [44611 Pharmacies & Drug Stores](https://vantainsights.com/reports/44611-pharmacies-drug-stores) ## Industry Groups - [4461 Health & Personal Care Stores](https://vantainsights.com/industry/4461-health-personal-care-stores) ## Specialty Reports Available on Request - [446110 Pharmacies & Drug Stores](https://vantainsights.com/industry/446110-pharmacies-drug-stores) - [446120 Cosmetics, Beauty Supplies, & Perfume Stores](https://vantainsights.com/industry/446120-cosmetics-beauty-supplies-perfume-stores) - [446130 Optical Goods Stores](https://vantainsights.com/industry/446130-optical-goods-stores) - [446191 Food (Health) Supplement Stores](https://vantainsights.com/industry/446191-food-health-supplement-stores) - [446199 All Other Health & Personal Care Stores](https://vantainsights.com/industry/446199-all-other-health-personal-care-stores) ## Frequently Asked Questions ### What is NAICS 446? NAICS 446 classifies retail pharmacies, drugstores, optical goods stores, and specialty health retailers. CVS Health and Walgreens dominate the segment with approximately 17,000 combined US pharmacy locations, though both are executing multi-year store closure programs. The subsector excludes hospital pharmacies and pharmacy benefit managers, which are classified separately. ### How do pharmacy benefit managers affect drugstore profitability? PBMs, led by CVS Caremark, Express Scripts (Cigna), and OptumRx (UnitedHealth), negotiate drug prices with manufacturers and set reimbursement rates paid to pharmacies for each prescription dispensed. Reimbursement rates often approach or fall below dispensing costs for generics, squeezing margins for independent pharmacies. CVS Health's vertical integration with Caremark creates structural advantages, while independents rely on cooperative purchasing groups to maintain viability. ### Why are CVS and Walgreens closing hundreds of stores? Both chains overbuilt retail footprints during decades of aggressive expansion. E-commerce growth, particularly Amazon Pharmacy and direct mail-order fulfillment, has reduced front-store foot traffic. PBM reimbursement compression and rising labor costs (pharmacist wages, staffing mandates) have eroded per-store profitability. Both companies announced 900+ closures to consolidate into higher-performing locations and redirect investment toward primary care clinics and digital health services. ### What role does specialty pharmacy play in this subsector? Specialty pharmacy dispenses high-cost biologic drugs, oncology treatments, and gene therapies that require cold-chain handling, patient counseling, and outcomes monitoring. This segment generates outsized revenue per prescription and is growing rapidly as the pharmaceutical pipeline shifts toward biologics. CVS Specialty, AllianceRx Walgreens, and independent specialty pharmacies like PharMerica compete for payer contracts and manufacturer distribution agreements. ### How is pharmacy scope of practice expanding? States including California (SB 493), Oregon, and Colorado have granted pharmacists prescriptive authority for hormonal contraceptives, smoking cessation medications, travel vaccines, and naloxone. This scope expansion positions pharmacies as primary care access points, particularly in underserved areas. The clinical revenue from these services partially offsets declining dispensing margins and differentiates brick-and-mortar locations from mail-order competitors. ## Related Industries - [4242 Drugs & Druggists' Sundries Merchant Wholesalers](https://vantainsights.com/industry/4242-drugs-druggists-sundries-merchant-wholesalers) - [4541 Electronic Shopping & Mail-order Houses](https://vantainsights.com/industry/4541-electronic-shopping-mail-order) - [6215 Medical & Diagnostic Laboratories](https://vantainsights.com/industry/6215-medical-diagnostic-laboratories) - [621 Ambulatory Health Care Services](https://vantainsights.com/industry/621-ambulatory-health-care-services) - [812 Personal & Laundry Services](https://vantainsights.com/industry/812-personal-laundry-services) --- Markdown mirror of https://vantainsights.com/industry/446-health-personal-care-stores, built from the same data on each request.