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CVS and Walgreens have long held a combined 40% of the U.S. prescription market, according to a Drug Channels analysis
, but Amazon's same-day delivery expansion-now reaching 45% of U.S. markets by year-end, per an AHA market scan-is forcing a reevaluation of their competitive moats. Amazon's digital-first approach, including caregiver support tools and pre-sorted medication packets via PillPack, targets seniors and caregivers, a demographic critical to Medicare Part D growth, according to a Forbes report. Meanwhile, CVS and Walgreens are closing underperforming stores at an alarming rate: Walgreens plans to shutter 1,200 locations over three years, while CVS has already closed 900, according to an Advisory Daily Briefing.The financial toll is evident. CVS's gross profit margin plummeted from 18.01% in 2020 to 13.29% in 2024, per CVS profitability ratios
, while Walgreens' margins have similarly contracted. These declines reflect not just rising operational costs but also pricing pressures from Amazon's subscription-based RxPass, which undercuts traditional pricing models, according to an Axios analysis.
Traditional pharmacies face a trifecta of challenges: shrinking margins, regulatory headwinds, and Amazon's relentless innovation. For instance, drug reimbursement rates have been slashed by insurers and government programs, squeezing profit pools, per a Placer.ai article
. Compounding this, pharmacist shortages and rising labor costs are forcing chains to automate or outsource, further straining balance sheets, as detailed in a Fool article.Amazon's AI-driven inventory management and telehealth integrations, according to a Forbes analysis
, are not just convenience plays-they're redefining customer expectations. Investors must ask: Can CVS and Walgreens replicate these capabilities without ceding market share? The answer appears bleak. Even as CVS raised its 2025 earnings forecast, according to AP News, Walgreens' stock faces a "Strong Sell" rating from Deutsche Bank, per Yahoo Finance, with a potential 15% downside, per a WBA forecast.Historical data on earnings events since 2022 offers further context. For CVS, the average 30-day return following earnings releases has been mildly negative (~–0.6%), with no statistically significant edge versus the benchmark. Walgreens, meanwhile, has seen short-term pops-peaking at +5% around day 22 post-earnings-but these gains tend to fade, ending slightly negative by day 30. Both companies' small sample sizes (4 and 5 events, respectively) limit confidence in these patterns, per a MarketBeat forecast
.
The analyst community is split. CVS has garnered a "Buy" consensus, with 19 of 23 analysts bullish on its cost-cutting initiatives and health insurance synergies, according to Yahoo Finance. However, Walgreens' outlook is murkier. While JPMorgan's Lisa Gill maintains an "Outperform" rating, per a WBA history page
, others warn of a "Reduce" consensus due to its delisting and acquisition by Sycamore Partners, as Axios reports.For Amazon, the risks are less quantifiable but no less significant. Its pharmacy revenue remains a fraction of CVS and Walgreens' $91 billion combined prescription haul, as the AHA market scan noted earlier, and regulatory scrutiny over data privacy and drug pricing could slow growth. Yet, its ability to integrate healthcare services with retail operations-think Prime membership cross-selling-gives it an edge.
Investors in traditional pharmacies must weigh short-term resilience against long-term obsolescence. CVS's recent margin improvements and Walgreens' restructuring efforts offer glimmers of hope, but Amazon's scale and innovation pace suggest a prolonged battle. For now, the prescription drug market remains a two-tiered arena: incumbents clinging to legacy models and disruptors rewriting the rules. The question is whether Wall Street is pricing in the full extent of this transformation-or waiting for the next round of earnings to catch up.
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