PharmacyLive for cash-pay clinics: how the economics work

Landed cost in a cash-pay clinic is per-vial drug cost plus shipping and any handling fees. In a PharmacyLive portal, the deploying pharmacy sets those numbers in their instance — not PharmacyLive as a vendor. The practical questions for a cash-pay clinic are what semaglutide and tirzepatide cost per titration step in that portal, how shipping is calculated, and whether rates hold across refill cycles.

For cash-pay clinics using one compounder, a well-configured PharmacyLive portal may be enough if pricing is transparent inside that instance. For clinics comparing landed cost across multiple compounders — or routing GLP-1 and peptides to different partners — each PharmacyLive portal has its own pricing silo, which makes network-wide margin planning harder.

Fizy Health takes a pass-through approach built for cash-pay margin at the clinic layer. It shows resolved 503A per-vial cost on every catalog and cart line before checkout, with a disclosed facilitation fee at payment — so the owner sets patient prices on the same number the clinic will actually pay across every assigned partner. There is no per-vial markup layer hidden inside a pharmacy-negotiated rate; the drug cost passes through and the platform fee is stated.

On the operations side, one clinic cart batches the refill day and cart validation catches invalid SIGs, prescriber state mismatches, and stock gaps before payment. For a cash-pay clinic using multiple compounders, the combined effect is margin you can see before you order and fewer surprises that quietly erode the spread — without replacing whatever PharmacyLive portal each pharmacy runs on fulfillment.