Key takeaways
- This is a modelled scenario, not a customer account. The figures are computed from published pricing and stated assumptions so you can check the arithmetic and substitute your own numbers. Nothing here is presented as a testimonial or a result achieved by a named brand.
- At 1,000 patients billing $249/month, annual gross billings are $2,988,000.
- On a published flat-fee platform, year-one platform cost is $148,760 including setup.
- On a 20% revenue share, the same volume costs $597,600 a year.
- Neither figure includes medication and fulfillment, which you buy separately under a flat fee.
The assumptions, stated up front
Every model is only as good as its assumptions, so here they are explicitly. Change any of them and the arithmetic changes.
- 1,000 active patients, held for twelve months.
- Retail price $249 per patient per month, set by the operator.
- Flat-fee platform modelled on published Grow tier pricing: $25,000 setup, $3,000/month, 2% transaction fee, $28 consult in month one only.
- Percentage model at 20% of gross billings, which sits mid-range in operator reports.
- Medication and fulfillment excluded from both, because they are bought separately under a flat fee and carried by the platform under some percentage models.
The flat-fee model, line by line
Every figure here comes from published pricing and is reproducible with a calculator.
| Line | Calculation | Year one |
|---|---|---|
| Gross billings | $249 x 1,000 x 12 | $2,988,000 |
| Platform setup | One-time, Grow tier | $25,000 |
| Platform monthly | $3,000 x 12 | $36,000 |
| Transaction fee | 2% of $2,988,000 | $59,760 |
| Consult fee | $28 x 1,000, month one only | $28,000 |
| LegitScript | Included | $0 |
| Total platform cost | $148,760 | |
| Retained before fulfillment | $2,839,240 |
The percentage model at the same volume
A 20% revenue share on $2,988,000 is $597,600 for the year. There is typically also a platform fee on top, which this model omits in the percentage platform's favour.
The difference in platform cost alone is $448,840 a year, and it grows every month the brand grows.
The honest caveat
These two columns are not directly comparable without one more input, and any comparison that skips it is selling you something.
Under a flat fee you buy medication and fulfillment yourself. Under some percentage models the platform carries those costs out of its share. So the flat-fee column understates your true cost and the percentage column overstates the platform's margin.
The way to resolve it is a real fulfillment quote. Get a landed cost per patient per month from a compounding pharmacy, multiply by 12,000 patient-months, and add it to the flat-fee column. Then the comparison is honest.
How to use this
Substitute your own numbers. The structure is what transfers; the specific figures are illustrative.
- Replace $249 with your intended retail price.
- Replace 1,000 with your month-twelve target, not your month-one count.
- Get a real per-patient fulfillment quote and add it to the flat-fee column.
- Ask any percentage-based platform for its rate and its base in writing, then recompute.
- Compare what you keep after fulfillment, not what you pay in fees.
Every input above is published
The flat-fee figures are PharmaBro's published Grow tier: $25,000 setup, $3,000 a month, 2% transaction fee, $28 consult in month one only, LegitScript at $0.
Zero revenue share and zero medication markup, so you set the retail price and keep the entire spread against your fulfillment cost.
Conclusion
Cost models in this category are usually presented as conclusions. This one is presented as arithmetic so you can disagree with it specifically.
The structural point survives any reasonable change to the assumptions: a flat fee grows slowly with volume and a percentage grows proportionally. Get a real fulfillment quote and run it yourself.
Frequently asked questions
Is this a real customer's numbers?
No. This is a modelled scenario computed from published pricing and stated assumptions, not a customer account or a testimonial. Every figure is reproducible with a calculator so you can check it and substitute your own inputs.
Why is medication cost excluded?
Because it differs by compound, dose and pharmacy, and because under some percentage models the platform carries it while under a flat fee you buy it directly. Including a guessed figure would make the comparison look precise while being wrong. Get a real quote and add it yourself.
What changes if my price is different?
The transaction fee and any percentage scale with price, while the platform fee and setup do not. Raising price therefore improves the flat-fee model disproportionately and leaves the percentage model's share unchanged as a proportion.
Marcus ElleryHead of Payments and Billing
Works on the rebill engine, merchant routing and recovery logic. Spends most of his time on the unglamorous half of subscription telehealth: why a card failed, and whether it had to.