The news: Cardinal Health’s specialty drug business grew more than 25% in fiscal 2026, and its CEO said cold storage capacity is what limits how much of that volume the network can move. “It’s usually areas like refrigeration and freezing capabilities that tend to be more of the bottleneck,” Jason Hollar said on the company’s fourth quarter call. “Ambient is a lot easier to work through.”
Cardinal reported Q4 revenue of $63.7 billion, up 6%, and full-year revenue of $254.2 billion. Specialty products, which include oncology drugs, biologics and cell and gene therapies, are among the fastest-growing parts of its $234.8 billion pharmaceutical segment, and many of them ship refrigerated or frozen.
Cardinal plans capital spending of about $700 million in fiscal 2027, up from $649 million, mostly on distribution and manufacturing sites and technology. Hollar said the company sizes that spending to the bottleneck and judges it on cost per order, not on capacity alone. “It’s not like we’re a build-it-and-they-will-come strategy,” he said.
What changed: Cardinal has named three sites in that build.
Its Consumer Health Logistics Center in Ohio finished its first full year of operations. Hollar said over-the-counter service levels reached record highs.
A 230,000 square foot distribution center in Indianapolis opens in 2027 with what Cardinal calls an industry-first robotic storage-and-retrieval system, built with Swisslog. The network makes more than 70,000 pharmaceutical and specialty deliveries a day.
A specialty pharmacy in La Vergne, Tennessee opened this year. It is built for high-cost cell and gene therapies and sits on the company’s existing third-party logistics and specialty distribution site.
The Tennessee pharmacy follows two new gene therapy commercialization agreements in Cardinal’s 3PL business, for therapies expected to launch in fiscal 2028. With those deals, Hollar said, Cardinal exclusively serves nearly half of the cell and gene therapy market and about three-quarters of the total market.
Hollar tied the building program to service. “Our service levels are levels that we’ve never had as an enterprise,” he said. “And that’s because we’ve invested appropriately to make sure we don’t get behind that curve.”
The pattern: All three national drug wholesalers have announced network builds with added refrigerated or frozen capacity in the past 11 months.
Cencora is spending $1 billion through 2030 on its US network, announced last November": A 530,000 square foot DC in Harrison, Ohio due in spring 2027, a 430,000 square foot DC in Fontana, California due this fall, and an expansion in Dothan, Alabama that raises refrigerated storage 500% and frozen storage 200%. A month later it added a 500,000 square foot cold-chain 3PL facility in Texas for 2028 and said it had more than tripled its ultra-low and cryogenic storage across its US 3PL network.
McKesson broke ground on a $179 million, 330,000 square foot DC in Moore, Oklahoma that replaces an existing site. CEO Brian Tyler said on McKesson’s first quarter call that it will raise throughput 75% over the old building, with “advanced automation, digitally enabled logistics, and expanded cold chain capabilities.” McKesson also opened a cell and gene therapy distribution facility in fiscal 2026.
UPS bought the same capability on the carrier side. It closed a $1.6 billion purchase of Andlauer Healthcare Group, a Canadian healthcare logistics company with specialized cold-chain transport, that same month.
GLP-1 drugs also ship refrigerated, though none of the three ties its buildout to them. McKesson distributed $15 billion of GLP-1 drugs in its latest quarter, up 24% from a year earlier, said CFO Kenny Cheung. Cencora’s GLP-1 sales rose $2.3 billion year over year in its latest quarter, according to CFO Eva Boratto. At Cardinal, CFO Aaron Alt said GLP-1 growth added about 500 basis points, or five percentage points, to pharmaceutical segment revenue in the fourth quarter.
The counter: Two of the three companies say the margins on that GLP-1 volume are thin. Cardinal said in its annual report that GLP-1 sales “did not meaningfully contribute to segment profit” and that demand growth began to moderate in fiscal 2026. Cencora said its GLP-1 sales “have lower gross profit margins.” At Cardinal, the 500 basis points of GLP-1 revenue growth were offset by about the same amount from pricing changes under the Inflation Reduction Act, per Alt.
Cardinal does not tie the build to GLP-1s. Hollar named refrigeration as the bottleneck while describing specialty growth as a whole, and the company guided specialty to double-digit growth in fiscal 2027, down from the 25% pace. None of the three companies has said whether the cold storage being built for 2027 and 2028 is sized for the current pace or the slower one.
What’s unclear: Cardinal gave no figure for cost per order, refrigerated square footage, or the share of its volume that ships cold. It has not said whether the Indianapolis robotics will handle refrigerated product or only ambient.
What’s next: Cencora’s Fontana DC is due to be fully operational this fall. Cardinal’s Indianapolis DC and Cencora’s Harrison DC both open in 2027, and McKesson’s Moore site is scheduled to finish construction in 2028. The two gene therapies behind Cardinal’s new 3PL agreements are expected to launch in fiscal 2028.
