Despite the weak demand dynamics in Q1 2026, infrastructure development resumed in the retail market. On average, according to the "Census of Pharmacies in Russia" database from the analytical company RNC Pharma, 86,422 pharmacy institutions were operating in our country from January to April 2026, which is 732 more than in the same period of 2025. However, it must be noted that the colossal growth in the number of pharmacies in the Aprel chain, which has grown by nearly 1,700 pharmacies over the past year, significantly contributes to this figure. One can certainly be pleased for this organization, but relentless arithmetic suggests that at least 1,000 other pharmacy institutions closed during the same year. This is due not only to pressure from more successful competitors but also to objective processes in macroeconomics and monetary policy, as well as the outflow of parapharmaceutical consumers to marketplaces. The processes occurring in pharmaceutical retail will inevitably affect the long-term prospects of individual wholesale companies, as interaction with retail has long involved not only product supply and payment deferrals but also a certain "attachment" of specific chains to specific distributors, both in the form of direct ownership or participation in associative formats, as well as in terms of partnership conditions.

The public segment has its own specifics, and during the analyzed period, the vast majority of large specialized pharmaceutical distributors noticeably strengthened their positions. Some wholesalers are also consistently expanding their range of interests. In this regard, it is appropriate to mention the project announced by R-Pharm to localize production of the original drug toripalimab from Dr. Reddy's. Of course, large distributors are far from being involved in localizing foreign developments in Russia for the first time, but until now this has been more about complying with formal requirements. The current experience is interesting due to the need to create a market for a new innovative product, including incorporating the drug into clinical guidelines, etc. R-Pharm already has positive experience in this regard with the drug Artlegia (olokizumab), the rights to which the company acquired from Belgian UCB in 2013. A similar format has also been implemented by some domestic manufacturers; one can recall the market launch of camrelizumab (TM Areima), which was released by Petrovax in 2024. However, in the medium term, a global expansion in the number of such projects should not be expected. In March, it became known that the Ministry of Finance is beginning work to reduce budget expenditures to prevent an increase in the budget deficit, which as of January–April 2026 amounted to RUB 5.9 trillion, 1.5 times higher than the targets planned for the entire current year. While it is assumed that social spending will not be cut, it is obvious that issues of expanding the volume of state guarantees, including in matters of drug supply, are unlikely to be on the agenda anytime soon.

Table. TOP-25 Pharma Distributors by Market Share of Direct Drug Supplies (including the public segment of the pharmaceutical market), in monetary terms, in Q1 2026