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Cencora is one of three leading domestic 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.
Fastenal began as an industrial retailer, expanding its product portfolio from nuts and bolts to cutting tools, safety equipment, and janitorial supplies. It transitioned into a distributor by building out a dense network of branches close to its business customers. Once a customer becomes large enough, Fastenal installs vending machines and its own personnel on-site. Today, these on-site locations exceed Fastenal's branch count and remain the firm's main focus for expansion. Fastenal acts as a one-stop outsourcing partner for its industrial customers, offering value-added services along with a wide breadth of maintenance, repair, and operations supplies.