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Cencora is one of three domestic leading pharmaceutical wholesalers. It sources and distributes branded, generic, and specialty pharmaceutical products to pharmacies (retail chains, independent, and mail order), hospital networks, and healthcare providers. It and McKesson and Cardinal Health constitute over 90% of the US pharmaceutical wholesale industry. Cencora also provides commercialization services for manufacturers of pharmaceuticals and medical devices, global specialty drug logistics (World Courier), and animal health product distribution (MWI Animal Health). Cencora expanded its international presence in 2021 by purchasing Alliance Healthcare, one of the leading drug wholesalers in Europe.
Elevance Health remains one of the leading health insurers in the US, providing medical benefits to 46 million medical members as of June 2025. The company offers employer, individual, and government-sponsored coverage plans. Elevance differs from its peers in its unique position as the largest single provider of Blue Cross Blue Shield branded coverage, operating as the licensee for the Blue Cross Blue Shield Association in 14 states. Through acquisitions, such as the Amerigroup deal in 2012 and MMM in 2021, Elevance's reach expands beyond those states through government-sponsored programs, such as Medicaid and Medicare Advantage plans, too. It is also an emerging player in pharmacy benefit management and other healthcare services.