Although the exact amount a pharmacy can make on a prescription in the United States will vary massively, reports have it that pharmacies make around 20 – 30% of the medication’s cost.
However, note that numerous factors such as insurance negotiations, generic versus brand-name drugs, as well as other discounts or rebates factor into their earning.
Note that how pharmacies pay to get medications is another important factor that will genuinely matter. To do business, pharmacies navigate the complicated negotiations that come with obtaining drugs. This could be negotiations between pharmacies, drug manufacturers, or even wholesalers.
With prescription sales making up over 90 percent of independent pharmacy sales on average, to achieve massive success, these businesses will have to seek ways to boost their prescription volume. This is because the more you sell, the more you’ll make.
Factors That Determine How Much Pharmacies Make on Prescription Medications
Negotiations with Insurance Companies
Pharmacies in this modern age tend to have contracts with numerous insurance providers, which will determine the reimbursement rates for prescription medications.
This is a component of their everyday operation that should be done with extensive care especially since it impacts the final amount pharmacies get for dispensing a particular drug.
Generic vs. Brand-Name Medications
In this line of business, keep in mind that the choice between generic and brand-name medications has a way of impacting business profit margins.
Generic drugs are known to possess lower acquisition costs for pharmacies, and this more or less entails higher profit margins when dispensed. Brand-name drugs usually have higher costs but are known to have higher reimbursement rates.
Manufacturer Rebates and Discounts
You have to understand that these financial arrangements could in many ways impact the overall income and profit of a pharmacy.
Keep in mind that any pharmacy that can succeed in securing favorable terms with manufacturers will be able to make more profit from drugs sold.
Pharmacy Benefit Managers (PBMs)
Pharmacies in this modern age tend to contract with PBMs, and the terms of these contracts will indeed have a say when it comes to reimbursement rates and overall profitability.
However, you need to understand that the agreement and working relationship between pharmacies and PBMs can be intricate and will differ across different contracts.
Just as was noted above, when a customer gets a prescription filled, they aren’t only paying for the medication, they are also paying for a service fee referred to as the dispensing fee.
Note that these fees vary and will most often depend on factors such as location, pharmacy size, as well as contractual agreements with insurance providers.
Aside from the cost that comes with starting this business, you need to take into consideration the expenses that come with running the business.
Most often, the expenses that come with running a Pharmacy include things like staffing, rent, utilities, and technology, and all these will indeed factor into the pharmacy’s profit margin. Efficient management of these expenses will ensure that the pharmacies can maximize their earnings on each prescription.
This simply refers to the exact amount paid out-of-pocket by individuals, and this is known to contribute to the pharmacy’s revenue.
In this line of business, the relationship between copayments and the overall cost of the medication will indeed positively or negatively affect a patient’s decision to fill a prescription, and this also impacts the pharmacy’s volume and income.
Volume and Competition
You need to extensively analyze the volume of prescriptions filled by the pharmacy as well as the level of competition in the surrounding area especially since they will impact profit margins.
Keep in mind that higher prescription volume will lead to economies of scale. In contrast, intense competition will take away business or force pharmacies to adjust pricing strategies to ensure they stay competitive.