What does Promise Pharmacy pricing mean for a clinic P&L?

You can plan the structure: which SKUs drive volume, expected refill cadence, and the patient price points your market supports. What you cannot plan up front with Promise Pharmacy is the COGS number itself, because per-vial wholesale rates are not public. That gap matters most for high-volume GLP-1 programs, where a small per-vial difference multiplied across hundreds of monthly refills swings the bottom line. Before margin depends on it, ask your account manager for written per-vial cost on your top three SKUs and confirm whether the rate is fixed or moves at wholesale volume tiers.

Also clarify how ancillary costs hit the P&L. Promise Pharmacy advertises no hidden fees, but shipping, cold-chain handling, and payment processing terms are not published on the site. If any of those are billed separately from the portal drug rate, the wholesale line understates true landed cost. Build your margin model on the all-in number per vial delivered, not the headline wholesale rate alone.

Fizy Health inverts the planning problem when you order across assigned 503A partners. It shows resolved per-vial 503A cost on each catalog and cart line before checkout, with a separately disclosed facilitation fee at payment. For a P&L, that means COGS is a number you can read before you commit, so you can set patient pricing and project gross margin from day one instead of after portal onboarding.

Building the whole refill day in one cart reinforces the model: each line shows its cost, so you can see total COGS for a batch and the margin it implies before you submit a single payment. Owners who manage to a target gross margin get a faster loop — see cost, set price, confirm spread — without waiting on an account manager to fill in the most important line on the page.