Fizy health
Refill for cash-pay

Refill for cash-pay clinics: how the economics work

Refill is a B2B telehealth infrastructure platform whose cash-pay economics turn on aggregate 503A medication pricing, tiered software fees on transactions, and optional provider and Refill Connect costs — not pass-through per-vial cost on a public catalog. For cash-pay clinics, margin depends on whether that bundled model beats what you could negotiate alone on the SKUs you order most.

If you run a cash-pay or concierge clinic and need to know how Refill affects per-vial cost and patient pricing, this page explains the economics and how Fizy Health makes margin visible with pass-through pricing when you already prescribe.

Compare Fizy Health vs Refill
Cash-pay economics Aggregate 503A pricing Software fees on transactions Landed cost per vial Margin predictability Price-match guarantee

What does Refill mean for cash-pay economics?

For a cash-pay clinic, Refill determines how compounded medications are sourced and what the clinic pays per vial before marking up to the patient — but through an aggregate model, not pass-through catalog pricing. Refill negotiates medication rates across its 503A pharmacy network and charges tiered software fees on transactions (roughly 1.5–5% per published plans), plus monthly platform tiers and optional Refill Connect and provider encounter fees. In a cash-pay model where revenue is the spread between landed cost and patient price, the evaluation question is whether aggregate leverage minus all fees beats pass-through on your top GLP-1 and hormone lines after an honest SKU comparison.

Who feels the economics

Cash-pay margin is set by what each role can see.

In a cash-pay clinic, pricing visibility flows through three roles, each of whom needs different numbers to do their job — and aggregate pricing changes what they can see before committing.

  • Owners

    Founders setting patient prices.

    Owners set program prices off landed cost. With Refill's aggregate model, the owner confirms per-SKU rates after onboarding and must factor software fees, platform tiers, and any provider or Connect costs into margin — not just the headline pharmacy rate.

  • Operators

    Ops leads protecting the spread.

    Operations staff watch the spread on every order — medication, software fees, shipping, and platform costs. They need all-in landed cost surfaced clearly so a refill batch does not quietly cost more than the patient price assumed, especially when fees scale with transaction volume.

  • Prescribers

    Providers quoting at the visit.

    Prescribers and front-desk staff often quote patients during the visit. When per-vial cost is confirmed post-onboarding rather than live on the catalog, visit-time quoting relies on cached estimates rather than the number the clinic will actually pay at checkout.

What drives cash-pay landed cost on Refill

Landed cost in a cash-pay clinic is per-vial drug cost plus shipping, platform fees, software fees on transactions, and any provider or Refill Connect charges if you use those layers. Refill positions aggregate 503A pricing as leverage from network volume and advertises a price-match guarantee — attractive when solo pharmacy contracts are weak. The practical questions are the per-vial rate on your top SKUs after onboarding, what percentage software fee applies at your volume tier, and whether aggregate rates hold across refill cycles.

For cash-pay margin, fee stacking matters as much as the headline drug rate. A competitive aggregate price plus a 3–5% software fee on every transaction, monthly platform cost, and optional Connect or provider fees can narrow the spread you thought you had. Compare all-in landed cost on the same concentrations and supply durations — not marketing savings claims in isolation.

How pass-through pricing changes cash-pay margin

Fizy Health takes a pass-through approach built for cash-pay margin when you already prescribe. It shows resolved 503A per-vial cost on every catalog and cart line before checkout, with a disclosed facilitation fee at payment — no percentage software fee baked into medication pricing. The owner sets patient prices on the same number the clinic will pay, and staff can quote at the visit on live cost.

One clinic cart batches refill day and cart validation catches invalid SIGs, prescriber state mismatches, and stock gaps before payment, so the clinic stops paying for orders that get rejected after checkout. For a cash-pay clinic with in-house prescribers, the combined effect is margin you can see before you order and fewer surprises that erode the spread — compare that honestly against Refill's aggregate model on your top five SKUs.

Which pricing model fits a cash-pay clinic?

Refill fits if

Refill

You need telehealth infrastructure, not just a pharmacy dashboard.

  • You need a 50-state provider network without hiring prescribers in every target state.
  • Refill Connect — white-label portal, assessments, and patient billing — is central to your launch plan.
  • Pre-negotiated aggregate 503A pricing beats your solo contracts and you accept tiered software fees.
Consider Fizy Health if

Fizy Health

You prescribe in-house and need margin visible before refill day.

  • You set patient prices off landed cost and need pass-through per-vial 503A cost visible before checkout.
  • You want the facilitation fee disclosed at payment with no percentage software fee on medication cost.
  • You batch GLP-1, hormone, or peptide refills in one validated clinic cart before you pay.
If you choose Fizy Health

What a cash-pay clinic gets from pass-through pricing.

These outcomes protect cash-pay margin when per-vial cost is visible and orders are validated before you pay.

See all features
Keep evaluating Refill

More answers in the Refill evaluation guide.

See the full Refill guide
FAQ

What cash-pay clinics ask about Refill.

  • Definition

    What is Refill for cash-pay clinics?

    For cash-pay clinics, Refill is telehealth infrastructure that sources compounded medications through aggregate 503A network pricing plus tiered software fees on transactions. Margin depends on whether that bundled model beats pass-through on the SKUs you order most.

  • Pricing

    How does Refill pricing affect cash-pay margin?

    Cash-pay margin is the spread between landed cost and patient price. Refill's aggregate medication pricing plus software fees, platform tiers, and optional provider or Connect costs determine that spread — typically confirmed per SKU after onboarding rather than on a public catalog.

  • Fees

    What should cash-pay clinics ask about Refill fees?

    Ask for per-vial rates on your top SKUs, the software fee percentage at your transaction volume, monthly platform and Refill Connect costs if applicable, provider encounter fees if outsourcing clinical coverage, and whether the price-match guarantee applies to your formulary.

  • Markup

    Does Refill add a markup on medication?

    Refill negotiates aggregate 503A rates across its network and charges separate software fees on transactions rather than publishing pass-through per-vial cost. Fizy Health shows pass-through drug pricing with a disclosed facilitation fee at checkout and no percentage fee on medication cost.

  • Visibility

    Can I quote a patient at the visit with Refill?

    Because Refill per-SKU pricing is typically confirmed after onboarding, visit-time quoting may rely on estimates. Fizy Health shows live per-vial pass-through cost on catalog and cart lines so staff quote on the number the clinic will actually pay.

  • Alternative

    How does Fizy Health change cash-pay economics?

    Fizy Health shows pass-through per-vial 503A cost before checkout with a disclosed facilitation fee, batches refill day in one validated cart, and catches rejections before payment — built for cash-pay clinics that already prescribe in-house.

Sources reviewed June 2026

  • Refill public website (refill.co), reviewed June 2026.
  • Fizy Health platform capabilities reflect the live product.
Evaluate with real numbers

See cash-pay margin before you order.

See how Fizy Health shows landed cost before you quote, validates orders before you pay, and batches refill day in one cart. Free to start.

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