Expect more retail pharmacy operators and wholesalers to accumulate significant transglobal frequent flyer miles

With is proposed acquisition of German wholesaler Celesio, McKesson creates a global distribution enterprise on the scale of Walgreens, Alliance Boots and AmerisourceBergen before them. In addition to wholesaling, Celesio operates about 2,200 pharmacies across six countries and is the No. 2 operator in the United Kingdom. 

Retail pharmacy and drug sourcing both are more and more becoming a global business. Just last week, the head of the second-biggest drug chain in Brazil announced he would be open to a buyout. So expect more of these headlines in the months to come. 

Walgreens and Alliance Boots have really established the utility in global sourcing by exceeding expectations on the synergies generated out of their deal. And AmerisourceBergen becomes a part of that enterprise in 2014. 

To be sure, now that two of the three largest U.S. wholesalers have brokered deals that places their drug procurement on a global scale, Cardinal Health may be the next company announcing a major deal. 

According to Drug Channels' Adam Fein, who broke down the deal in detail as part of his latest blog, Cardinal may be inclined to join with Econdisc Contracting Solutions, the group purchasing organization with Express Scripts, Kroger and Supervalu. Or they could deepen ties with CVS Caremark.