MEDICINE SHOPPE INTERNATIONAL

Medicine Shoppe International operates in the pharmacies and drug stores category and offers pharmacists and independent investors a way to provide community based pharmaceutical care. The brand began in 1968, when St. Louis pharmacist Michael Busch opened The Medicine Shoppe pharmacy to provide personalized service and pharmacist managed care in his community. In 1970, Busch founded Medicine Shoppe International, Inc., also known as MSI, in St. Louis, Missouri, to expand through franchise ownership. The first franchised Medicine Shoppe pharmacy opened in 1971. Current records identify 94 total units, all franchised. Broader industry reports from 2025 and 2026 describe nearly 500 locations in the United States, including 297 owned by franchisees. A February 2026 report places the brand at approximately 365 stores across 43 U.S. states, along with more than 120 international locations. Earlier reports cited more than 600 locations nationwide in 1973 and 595 total stores in 2013. International operations have included Canada, China, India, Indonesia, and Japan. In 2007, the company entered the Middle East through a master franchise agreement with the Al Zahrawi Group, opening five Medicine Shoppe pharmacies in Dubai, United Arab Emirates. This was described as the brand's seventh country of operation. Cardinal Health acquired Medicine Shoppe International in 1995, and MSI expanded again through its 2003 acquisition of Medicap Pharmacies Inc. The brand remains focused on patient centered community pharmacies that serve as local healthcare resources, rather than relying only on a transactional retail pharmacy model.

Pharmacies and drug stores serve an essential healthcare need, although the research does not provide total addressable market or growth rate figures for this exact category. The broader U.S. healthcare sector represents a multi trillion dollar economy, with pharmaceutical services as a core component. An aging global population is increasing demand for medication management and chronic disease care, which supports reliance on accessible local pharmacists. Greater consumer attention to health, along with a preference for personalized service over large chain interactions, fits Medicine Shoppe International's original pharmacist managed, patient centered approach. More complex prescription medications and increased attention to preventive health and wellness also expand the role of community pharmacists as healthcare advisors. Pharmacy services generally benefit from recurring customer needs and are largely resistant to recessions. Competition includes highly consolidated national chains alongside independent and franchised community pharmacies. Medicine Shoppe International focuses on a premium franchise opportunity within the Alternative Care sub sector, with an emphasis on close patient relationships and pharmacist led service instead of the volume based approach used by larger competitors. Demand for local healthcare access remains relevant in underserved areas, while the trust associated with a long standing community pharmacy brand may support additional expansion. Healthcare policies that favor community based care and preventive services can also support this type of franchise model.

The investment requires substantial capital and is positioned within the Alternative Care sub sector. The 2025 and 2026 FDD data generally lists the initial franchise fee as $0, a figure that must be excluded from consideration because it represents a data gap. One 2026 document lists a $10,000 fee for new franchisees, indicating that the fee can vary by program or agreement. Across the broader franchise market, initial fees often range from $25,000 to $50,000 or more. Total estimated investment for a Medicine Shoppe International franchise ranges from $478,000 to $961,000 under 2025 and 2026 FDD data. That exceeds the sub sector range of $294,531 to $623,123. A 2024 FDD gives a range of $513,050 to $894,876, while a 2026 FDD gives a range of $513,050 to $895,653. Leasehold improvements range from $55,000 to $175,000, and opening inventory ranges from $95,000 to $170,000. The 2025 FDD lists Furniture, Fixtures and Equipment at $42,000 to $95,000; pre opening costs at $3,000 to $10,000; signs and installation at $15,000 to $35,000; grand opening and marketing at $4,000 to $34,000; accounts receivable financing at $60,000 to $100,000; computer and pharmacy equipment at $26,000 to $40,000; Retail Solutions at $0 to $14,075; Telepharmacy at $0 to $35,865; and accreditation costs at $3,050 to $7,500. The initial budget also includes $175,000 to $245,000 in additional funds for the first three months of operation. Ongoing charges include a royalty of 5% of gross sales in 2025 data, while other 2026 data lists a 3.00% royalty. Licensing a co branded or full branded store carries a stated monthly fee of $599 for a five year term in 2026 data. Cardinal Health, Inc. acquired MSI in 1995 and is headquartered in Dublin, Ohio. As of April 2023, Brad Cochran was Executive Vice President of retail distribution at Cardinal Health and President of Medicine Shoppe International Inc., providing corporate leadership for the brand.

The operating model centers on personalized service, direct patient interaction, prescription fulfillment, medication therapy management, and health and wellness services tailored to local needs. The emphasis on pharmacist managed care points to a highly involved owner operator model. A franchisee may be a pharmacist or a hands on investor who participates in the clinical and business sides of the pharmacy. Specific staffing requirements are not provided, but a typical community pharmacy requires pharmacists, pharmacy technicians, and administrative support staff. The format is designed for a community retail presence rather than a drive through or kiosk model. The investment ranges for leasehold improvements, from $55,000 to $175,000, and signs and installation, from $15,000 to $35,000, suggest a dedicated physical storefront. Corporate support from Medicine Shoppe International and Cardinal Health includes guidance from field consultants, technology platforms for pharmacy operations, and marketing programs supported by the 1% advertising fee. Cardinal Health's supply chain provides access to pharmaceutical products and distribution channels. The source does not state the duration or location of initial training, but the complexity of pharmacy operations indicates instruction in operating procedures, patient care protocols, and business management. The brand has a concentrated presence in the Northeast and Midwest, with particular strength in Pennsylvania and New York. Missouri, Indiana, and New Jersey are identified as secondary markets. Medicine Shoppe International operates in 36 states plus Washington D.C. According to 2024 FDD data, the largest regional concentration is 98 franchise locations in the South. The lighter presence in the Southeast and Western regions may leave room for expansion. A co branded or full branded store has a five year agreement term.

The investment range of $478,000 to $961,000 exceeds the Alternative Care sub sector averages and places significant weight on careful unit level analysis. Royalty information includes 5% of gross sales in 2025 data and 3.00% in other 2026 data, with a 1% advertising fund contribution. Medicine Shoppe International has operated since 1968, was acquired by Cardinal Health in 1995, and expanded through the acquisition of Medicap Pharmacies Inc. in 2003. Its international activity has included Canada, China, India, Indonesia, Japan, and the United Arab Emirates, where five pharmacies opened in Dubai in 2007. Historical unit counts provide context but vary by reporting period. A 1973 report cited more than 600 locations nationwide, and the brand had 595 total stores in 2013. In 2010, 473 locations were franchised, compared with 292 in 2024. Reports from 2025 and 2026 describe nearly 500 U.S. locations, including 297 owned by franchisees. A February 2026 report lists nearly 365 U.S. stores and more than 120 international locations. These figures indicate changes in the system over time and may reflect refranchising, market optimization, closures, or new openings rather than a simple linear growth pattern. Cardinal Health's continued involvement, including Brad Cochran's leadership as of April 2023, indicates ongoing corporate support for the brand and its unit operations.

Medicine Shoppe International's growth has developed through expansion, contraction, and market changes rather than a consistent upward path. The brand had more than 600 locations nationwide in 1973 and 595 total stores in 2013. Franchised U.S. locations declined from 473 in 2010 to 292 in 2024, according to FDD data. More recent reports describe nearly 500 U.S. locations, including 297 franchised units, in 2025 and 2026. A February 2026 report cites nearly 365 stores across 43 U.S. states and more than 120 international locations. The 94 total franchised units identified in current records present another measure of the system and show why unit counts should be reviewed by reporting period and source. Cardinal Health's 1995 acquisition gave the brand backing from a global healthcare services and products company. MSI broadened its network through the 2003 acquisition of Medicap Pharmacies Inc. In 2007, it entered the Middle East through a master franchise agreement with the Al Zahrawi Group, opening five Medicine Shoppe pharmacies in Dubai, United Arab Emirates. That move marked the seventh country of operation. The brand's advantages include recognition dating to 1968, Cardinal Health's supply chain scale and operating resources, and a focus on personalized service and pharmacist managed care. Those features distinguish it from larger chains with more transactional models. The inclusion of Telepharmacy as an initial expenditure category, listed at $0 to $35,865 in the 2025 FDD, also shows attention to remote healthcare and digital operating methods.

The preferred candidate should support the brand's patient centered community pharmacy mission. Michael Busch founded the company as a pharmacist, and pharmacist managed care remains central to the operating concept, making a licensed pharmacist background highly useful for direct involvement in clinical services. The opportunity also accepts independent investors, who would need business judgment, management ability, and an interest in local healthcare services. Specific multi unit expectations or requirements are not stated, although the established franchise system may offer room for growth for high performing franchisees. Territory strength is concentrated in the Northeast and Midwest, especially Pennsylvania and New York. Missouri, Indiana, and New Jersey are established secondary markets. The brand operates in 36 states plus Washington D.C., and the 2024 FDD identifies 98 franchise locations in the South, the largest regional concentration. The Southeast and Western regions have lighter coverage and may offer access to underserved areas. No specific period from signing to opening is provided. The listed pre opening costs and leasehold improvements indicate a structured development process. The agreement term for a co branded or full branded store is five years.

The brand dates to 1968 and has operated with Cardinal Health's backing since its acquisition in 1995. Its patient centered community pharmacy model serves an aging population and consumers seeking personalized healthcare services. Estimated investment ranges from $478,000 to $961,000, above the stated Alternative Care sub sector averages. The system covers 36 U.S. states plus Washington D.C. and has operated internationally in Canada, China, India, Indonesia, Japan, and the United Arab Emirates. Expansion opportunities are identified in areas with lighter coverage, including parts of the Southeast and West. The operating model also includes Telepharmacy, which appears in the 2025 FDD expenditure schedule at $0 to $35,865. PeerSense provides due diligence information that includes SBA lending history, a Loan Activity Score of 48, rated Fair, location maps with Google ratings, FDD financial data, and side by side comparison tools. Franchise buyers can use that information to evaluate the investment and discuss potential SBA or conventional financing with appropriate lenders. PeerSense is a commercial capital advisory firm, not a lender, and does not approve or provide loans.