Key takeaways
- Operators usually leave OpenLoop over structure rather than service: they want to own the revenue.
- Under OpenLoop's proposal terms the brand receives $124 of a $249 payment by month five.
- What OpenLoop does better: it carries medication, lab and merchant costs, which is a real transfer of working capital.
- The flat-fee alternatives are PharmaBro, Rimo and Cuvo. Bask and CareValidate are different structures again.
- Before switching, ask OpenLoop in writing whether they will release your card tokens.
Why operators look for an alternative
It is rarely the clinical operation, which is genuinely strong. It is the structure.
Under OpenLoop's proposal terms the patient enters a card on the brand's interface, the charge is deposited to OpenLoop's merchant account, and OpenLoop pays the brand a Membership Services Fee every Wednesday based on its own count of net active patients.
On the semaglutide schedule the brand receives $140 of a $249 payment in month one, falling to $124 from month five. On tirzepatide the brand's share moves from about 58% to about 41% as the patient matures. The share is smallest exactly when the patient is most profitable.
What OpenLoop genuinely does better
Any alternatives page that skips this is selling rather than informing.
Out of its share OpenLoop pays for medication and base labs, carries merchant account costs and reserves, and runs a 24/7 patient support desk with a multi-layered supply chain. That is a genuine transfer of working capital and operational risk off your balance sheet.
If you do not want to fund inventory, negotiate pharmacy pricing, or carry chargeback and reserve exposure, that trade is coherent. The alternatives below all hand those back to you.
The alternatives
Compared on the structural questions rather than on features, which are broadly equivalent across all of them.
| Platform | Model | Merchant of record | Publishes pricing | Launch |
|---|---|---|---|---|
| PharmaBro | Flat fee, 3% to 1.5% txn | Your brand | Yes | 5 days |
| Rimo | Flat fee | Your brand | Yes | About 5 days |
| Cuvo | Flat fee, done-for-you | Cuvo | Yes | Fast |
| Bask Health | Fee plus percentage | Bask | No | 30 to 40 days |
| CareValidate | $2,500 to $5,000/mo plus 3.9% | CareValidate (BYO on Enterprise) | Yes | 30 days |
The question to ask before you move
Ask OpenLoop, in writing, whether they will release your stored card tokens to a processor you name, and how long that takes.
This is the entire cost of the migration. If tokens move, the switch is a data transfer and a storefront rebuild. If they do not, you are asking every active subscriber to re-enter their payment details, and a meaningful share will not.
Ask while you are still a paying customer who has not announced they are leaving. Your leverage is never higher than it is at that moment.
What changes if you own the merchant account
Four things, all of which are invisible until they matter.
- You set the retail price, and keep the entire spread between it and your fulfillment cost.
- Payouts run on your processor's schedule rather than a weekly remittance against someone else's count.
- The statement descriptor is yours, which reduces both disputes and issuer declines.
- The card tokens are yours, so the next platform decision is not a hostage negotiation.
The structure, reversed
On PharmaBro your brand connects its own Stripe account and the patient's money lands in it. You pay a published flat fee out of your revenue, which is the ordinary direction for a vendor relationship.
$1,500 to $5,000 a month, transaction fee 3% falling to 1.5%, zero revenue share, zero medication markup, LegitScript at $0, no contract term, live in 5 days.
Conclusion
The choice here is not really between vendors, it is between two business models: being paid a fee out of your patients' payments, or receiving those payments and paying a fee.
OpenLoop's version is coherent if you want the working capital carried. If you would rather own the revenue and buy fulfillment yourself, the alternatives above are structured for that, and the token question is the one to settle first.
Frequently asked questions
What is the best alternative to OpenLoop?
It depends what you disliked. For flat-fee economics with brand-owned payments, PharmaBro or Rimo. For done-for-you operation without a percentage, Cuvo. If you actually valued OpenLoop carrying your medication costs, the alternatives all hand that back to you and none of them are an improvement on that specific point.
How much does OpenLoop take?
On its published proposal schedule, roughly half of patient revenue at steady state, with the brand's share falling as the patient matures. Out of that share OpenLoop pays medication, labs, clinical consults and merchant costs, so it is not pure platform margin.
Can I move my patients off OpenLoop?
Patient records export. The question is card tokens, which sit in OpenLoop's merchant account. Ask in writing whether they will release them to a named processor before you sign anywhere else, because that answer is the real cost of the move.
References
- 1.OpenLoop, Summary of Proposed Services, 05.28.26, Schedules A to E
- 2.Cuvo published pricing
- 3.Rimo published pricing
- 4.Stripe published processing rates
Every figure above is sourced and dated. If you represent one of the platforms named here and something is out of date or wrong, write to support@pharmabro.co and we will correct it and note the change on the page.
Anmol SethiFounder
Ran direct-to-consumer telehealth brands and paid a revenue share on every dollar they earned. Built PharmaBro as the infrastructure he wanted to buy.