Lincoln International and L.E.K. Consulting have co-authored a guide to growth opportunities in healthcare logistics in 2026 and beyond.

Volume 1

A mapping of the healthcare logistics ecosystem

Healthcare logistics is not a single market but rather an interconnected set of market subsegments, with specialized operators managing the flow of products and information between manufacturers and providers. See Exhibit 1 & 2.

Upstream, pharmaceutical, medical device and diagnostics manufacturers produce a wide variety of products under tightly regulated quality systems and a distributed global manufacturing footprint. Their labeling, serialization, temperature and service-level requirements cascade downstream, shaping the operational burden for all logistics partners.

Large broadline logistics providers, such as UPS, Fedex and DHL, play a critical role in moving bulk and parcel volumes from manufacturing plants and distribution centers to distributors and providers. Their value proposition centers on balancing speed, cost and temperature integrity at scale, often leveraging global networks and standardized operating models.

Distributors–both broadline and specialty–aggregate supply, manage inventory, provide last-mile replenishment and provide a growing list of supply chain services to hospitals, labs and non-acute sites of care. They act as buffers during shortages and differentiate through fill rates, cold-chain reliability and integration into provider procurement and track-and-trace systems. In addition, distributors have increasingly begun to sell their own self-manufactured or private label products, especially in medical devices. Distributors may work with repackagers, like Safecor, who take devices / medicines from manufacturers and repackage them to meet customer needs (e.g., unit dose prescriptions)

A growing layer of cold-chain specialists support temperature-sensitive therapies through validated packaging, cryogenic handling, sensors and real-time condition monitoring. As biologics, cell and gene therapies and personalized medicine expand, these capabilities move from premium add-ons to mission-critical infrastructure.

On the reverse‑flow side of the ecosystem, device reprocessors collect eligible single‑use devices, reprocess and / or repair them to approved standards and return them to use, reducing waste and total cost of care. Their operating models depend on reliable reverse logistics, documented chain of custody and consistent provider adherence to segregation and collection protocols.

Healthcare‑specialized 3PLs and couriers focus on orchestration rather than scale, managing warehousing, cross‑dock operations and temperature‑controlled last‑mile delivery, including STAT, OR‑direct and specimen movements. These providers win business based on SOP discipline, validated equipment, auditable chain of custody and time‑definite performance for clinically critical moves.

A distinct but closely related role is played by freight forwarders, particularly for international product flows. These players coordinate cross‑border transportation across air, ocean and ground, managing carrier selection, customs clearance, trade compliance and handoffs across jurisdictions. In healthcare, forwarders differentiate through validated lane management, temperature‑controlled air freight capabilities, regulatory expertise and the ability to dynamically reroute shipments during disruptions. These capabilities have become increasingly valuable amid geopolitical volatility and capacity constraints.

Finally, a set of reverse logistics and waste management providers handle returns, recalls, refurbishment and compliant destruction of regulated or hazardous waste. These services create value by accelerating credit and replacement cycles, minimizing write‑offs and maintaining rigorous regulatory documentation, capabilities that providers prioritize for risk control and audit readiness.

Overlaying the physical logistics network is a growing layer of software and data platforms that support planning, visibility and execution across the healthcare supply chain. Technology‑enabled players such as Altana, Flexport and other logistics software providers aggregate data across shippers, carriers and geographies to improve end‑to‑end visibility and predict disruptions. In healthcare‑specific applications, these platforms are increasingly tailored to regulated workflows, incorporating serialization data, temperature and condition monitoring and compliance documentation. Their asset‑light, data‑centric models offer scalable growth potential and the opportunity to become system‑of‑record or system‑of‑insight layers across a fragmented logistics ecosystem.

Overlaying the physical network is an increasingly important digital layer: logistics software, data visibility platforms and AI-enabled orchestration tools. These asset-light players aggregate data across shippers and carriers, predict disruptions and enable proactive intervention. As fragmentation persists across the ecosystem, these platforms are well-positioned to become system-of-record or system-of-insight layers.

The result is a fragmented but high-barrier ecosystem where specialization, compliance credibility and data integration drive competitive advantage.

[1] https://www.weforum.org/stories/2024/08/healthcare-costs-digital-tech