In the article, the authors consider the processes of scaling and growth of capital concentration in pharmacy retail, complications of the situation of small businesses in the commercial segment, the share of which by the end of 2024 will amount to almost 2/3 of the market. Competition, aggressive organic growth of networks, fiscal pressure act as a factor of systemic pressure on the profitability of small networks and individual pharmacies and trigger the process of structural transformation of retail, in which market power is gradually transferred to large players, which can create problems for the development of regional distributors focused on unstructured pharmacy retail. The absorption of assets in pharmaceutical retail and the growth of sales in the commercial segment indicate the prerequisites for market stabilization, the regrouping of assets in which emphasizes the existence of the problem of declining profitability of pharmacy retail, which intensifies the process of consolidation of the pharmacy link in the logistics system of market supply.