Enquirer Consulting Group

Reachable Buyer Map

Prepared for Dr Murtaza Khorakiwala · Wockhardt · The US hospital market · August 2026
A hospital administered medicine is not bought by the person who prescribes it. In the US it is bought by a committee, on a calendar, inside a system that has already decided what it stocks. This map is the reachable version of that US market: the segments a hospital product has to enter, who actually signs inside each one, and roughly how many of each sit there.
Community acute care hospitals
The base layer and the one most people mean when they say the US hospital market. Every one of them runs a formulary, and a new agent enters through a written review rather than a sales call. The review is scheduled, which means the opening is a date, not a mood.
Who signs: director of pharmacy, pharmacy and therapeutics committee chair, chief medical officer at smaller sites.
5,000 to 5,200
US community hospitals, out of roughly 6,100 hospitals of all types
Health systems and integrated networks
Where the decision actually consolidates. Roughly four in five community hospitals now sit inside a system, and the system decides once for all of them. This is the segment that compresses a five thousand account map into a few hundred conversations, and it is the reason a hospital launch is a named account exercise rather than a coverage exercise.
Who signs: system VP of pharmacy, system formulary or clinical standards director, VP of supply chain and value analysis.
400 to 450 systems
covering roughly 4,100 US hospitals between them
Antimicrobial stewardship leads
The seat that decides where a new gram negative agent sits in the treatment pathway, and the most underworked address in the whole market. Federal conditions of participation require a stewardship function in acute care hospitals, so the role exists almost everywhere, yet it rarely appears on a commercial target list because it holds influence rather than a purchase order.
Who signs: stewardship pharmacist, stewardship physician lead, infection prevention director, microbiology lab director.
4,000 to 5,000
US acute care hospitals running a named stewardship function
Infectious disease physicians
Small, national, and unusually connected. This community moves as a professional network rather than as a set of accounts, which makes it slow to buy and fast to talk. Reaching it is a credibility exercise that pays off inside the committees above.
Who signs: ID division chief, ID attending, transplant and oncology ID specialists, academic investigators.
9,000 to 11,000
practicing US infectious disease physicians, heavily concentrated in academic and large system sites
Group purchasing and contracting
A very small number of organizations standing between a manufacturer and thousands of hospitals. Being straight about it: this segment is not a volume channel, it is a handful of relationships that either exist or do not, and no amount of outbound substitutes for the clinical case made above.
Who signs: pharmacy contracting director, clinical contracting pharmacist, category executive.
Roughly 5 to 10 national
plus a layer of regional aggregators and system owned buying entities
Federal and long term acute care
Two channels people forget. The federal side has its own national formulary route and its own facilities. Long term acute care and outpatient infusion sit downstream of the acute stay and treat exactly the resistant infections the acute hospitals discharge.
Who signs: national pharmacy benefits leadership, facility chief of pharmacy, LTAC medical director, infusion clinical director.
160 to 175 federal centers
plus roughly 350 to 400 long term acute care hospitals and a wider outpatient parenteral infusion network

Where the openings are

1
Formulary is a committee, and you can only reach it one seat at a time. A pharmacy director, a stewardship pharmacist, an ID lead and a value analysis seat all have to see the same case inside the same review window. Reaching one of them well is a conversation. Reaching all four across several hundred systems on a schedule is a machine, and it is the part almost nobody builds before a launch.
2
Four hundred decisions cover four thousand hospitals. The market looks like five thousand accounts and behaves like a few hundred. That changes the shape of the channel completely: it is named research, not volume, and the work is knowing which system owns which hospital and who holds the pen inside it. That mapping is public, tedious and rarely done properly.
3
The stewardship seat is the opening nobody works. It exists in almost every acute care hospital by requirement, it decides where a new agent sits in the pathway, and it is not on the standard target list because it does not sign a purchase order. Influence reached early is a formulary decision reached later.
4
Outside the US it is not one market, it is a queue of national ones. Europe and the UK approve centrally and then buy country by country, each with its own access route and its own institutional buyer. The reachable map there is a series of national maps, and the sequencing of them is a commercial decision rather than a regulatory one.
Built from public registries and published national hospital and workforce counts for the US, current to the most recent published year. Counts are banded deliberately. Hospital totals move with definition, since federal, psychiatric and specialty facilities are counted differently by different sources, and system ownership changes continually through acquisition, so the system layer is a snapshot rather than a fixed list. It describes the market rather than your business, and there is nothing to buy at the end of it.
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