How Flexible Dosing Medications Can Help Your Pharmacy Thrive

Independent pharmacies are under immense pressure. Reimbursements are falling, and pharmacy benefit managers continue to squeeze margins. Many pharmacies are stuck filling high volumes of low-margin prescriptions just to stay afloat, all while trying to deliver quality care to their communities.

Real Value Rx offers a smarter path forward. Instead of chasing volume, its program helps pharmacies increase profitability through changes such as dispensing FDA-approved, underutilized formulations. These products are often excluded from maximum allowable cost lists, and offer better reimbursement.

This isn’t about making a quick buck. It’s a long-term strategy grounded in compliance, and smarter business practices. Real Value Rx also ensures compliance with the Drug Supply Chain Security Act (DSCSA) and minimal disruption to prime vendor agreement (PVA) rebate structures. By identifying a few high-impact prescriptions, pharmacies can improve care, and build a more stable future.

In a session at the Total Pharmacy Solutions Summit Summer 2025 event, Stephanie Zimmerman, director of business development at Real Value Rx; Tom Napolitano, senior vice president and general manager at Real Value Rx; and Luke Gunderson, director of sales at Real Value Rx, discussed how Real Value Rx is helping pharmacies grow by offering more than 5000 generic medications, and flexible formulations.

READ MORE: Unlocking Pharmacy Value Through Payer Program Engagement

Read on for some key takeaways from their presentation:

• Apply the 80/20 rule: A small percentage of scripts, inventory, and clinical interventions drive most of a pharmacy’s outcomes and profi t. Focus on what actually moves the needle.
• Rethink formulations: Switching to underused strengths or alternative vehicles can improve patient care and significantly boost margins.
• Smarter dispensing pays: Flexible dosing and adjunct therapies often o er better reimbursement while meeting specific patient needs.
• Support is built-in: These products are often covered, come with co-pay assistance, and Real Value Rx can provide a local list of high-performing items for your state and plans.
• Access beyond the big 3: Many high-value generics and formulations come from small manufacturers that major wholesalers don’t carry. This program helps pharmacies access those options.
• Audit- and compliance-ready: Success depends on tight internal processes, not avoiding certain products. These offerings are compliant with DSCSA and supported by full traceability.
• Generic compliance ratio (GCR) and PVA flexibility: Many of these items fall outside GCR calculations, meaning you can improve margins without jeopardizing PVAs—there’s more wiggle room than most realize.
• Be the bridge to prescribers: Providers don’t always know about better formulations unless pharmacists inform them. With simple, value-based conversations, you can position your pharmacy as the go-to for smarter, patient-centered therapies.
• Pharmacists drive better care: You are often the only one positioned to recognize when a patient isn’t fully responding to therapy, and you have the clinical credibility to recommend smarter alternatives that improve outcomes and margins.
• Provider collaboration is easier than you think: Real Value Rx offers cobranded materials, product specialists, and local prescriber data to support outreach and make clinical conversations with providers simple, not saleslike.
• No operational overhaul required: You can start with just one product, one prescriber, or one patient. Most pharmacies see significant returns without switching wholesalers or disrupting workflows.
• Compliance and sustainability are top priorities: Products are FDA-approved, DSCSA-compliant, and selected for therapeutic need. Real Value Rx advises against overuse to avoid any issues with audit risk or “aberrant drug” lists.

To read these stories and more, download the PDF of the Total Pharmacy August issue here.