Cost-Plus: Rewriting the Prescription for Drug Pricing

Pharmacies today operate within a highly intricate and often unpredictable drug-pricing ecosystem. While pharmacy benefit managers (PBMs) play a central role in negotiating prices and managing formularies, the layers of rebates, reimbursement schedules, and administrative fees can make it difficult for pharmacies to anticipate their margins — or even cover their costs. For many independent pharmacies, this complexity translates into financial strain, operational inefficiencies, and limited flexibility to serve patients in a transparent and sustainable way.

The fragmented and nontransparent system can have two different patients picking up the same medication, but paying wildly different prices due to insurance coverage, formulary placement, and/or negotiated rebates — none of which are transparent to the patient. Pharmacies oftentimes find themselves caught in this crossfire, resulting in reimbursement below acquisition cost.

They say necessity is the mother of invention. A new model has emerged to not only sustainably operate a pharmacy but also focus on the most important aspect of healthcare, the patient. The cost-plus model is a radically simplified model that provides unmatched transparency into drug pricing. There are no hidden rebates, tiered formularies, or surprise clawbacks.

Discover how the Cost-Plus Pricing Model is helping pharmacies reclaim their margins and restore patient trust.

Read the full article to learn:

• The Blueprint of Cost-Plus: How a simplified "acquisition + markup" model eliminates hidden PBM fees and clawbacks.
• The Team Cuban Card Opportunity: How to leverage Mark Cuban’s affiliate network to attract new cash-pay patients.
• Navigating the Transition: Strategic advice on managing PBM contracts while moving toward a transparent pricing structure.
• Technology & Tools: The essential software features needed to manage real-time acquisition costs and online price transparency.

This post is for subscribers only

Become a member to get access to all content

Subscribe now