Why Cash-Based Services Are Non-Negotiable in 2025
If you’re still relying on PBM reimbursements as your main source of revenue, you’re playing a losing game. Reimbursements are shrinking, DIR fees make brands on Medicare losers, and the “fill more to make more” model is dead. Adding cash-based services will create much-needed stability in your independent pharmacy.
The good news? Independent pharmacies have something the big chains can’t replicate: personalized, high-value clinical services that patients will happily pay for out of pocket.
In 2025, the pharmacies thriving the most are those that have diversified into cash-based pharmacy services. These services are PBM-proof, profitable, and build deeper patient loyalty than prescription fills ever will.
Here are the top clinical services you should be offering right now if you want to increase your profits and future-proof your pharmacy.
1. Cash-Based: Nutrient Depletion Counseling + Supplement Programs
Every day, patients leave your pharmacy with prescriptions that deplete critical nutrients (think statins + CoQ10, PPIs + magnesium). Most have no idea—and their doctors don’t mention it.
This is your opportunity to educate, build trust, and offer pharmacy-grade supplements that keep patients healthier while boosting your profit margins.
Execution Tips:
- Run a “Did You Know?” campaign highlighting common drug-induced nutrient depletions.
- Train staff to ask: “Did your doctor mention you might need a supplement with this?”
- Create bundle packages (e.g., “Statin Support Kit”) and display them at checkout.
- Offer monthly subscription programs so patients never run out.
👉 Pharmacies in PBU routinely add $5K–$15K/month in pure cash revenue just from supplement programs. Download our DIND check off template HERE.
2. Cash-Based: Pharmacogenomic (PGx) Testing
More patients (and prescribers) are realizing that “one-size-fits-all” doesn’t work when it comes to medication. Pharmacogenomic testing lets you identify how a patient’s genetics affect their drug metabolism—improving outcomes while generating cash revenue.
Execution Tips:
- Partner with a trusted PGx lab and set up easy in-pharmacy testing. (I love PlexusDX and PBU Members save!)
- Market to physicians: offer co-branded flyers showing how PGx reduces trial-and-error prescribing.
- Bundle PGx with a medication review consult for a premium service.
- Promote via short-form video: “Did you know your DNA can determine if your meds actually work?”
👉 PGx testing often commands $300–$500 per test, with a strong ROI.
3. Cash-Based: Point-of-Care Testing (POCT) & Chronic Care Programs
Patients want faster, more convenient care—and pharmacies are perfectly positioned to provide it. From flu, strep, and COVID tests to cholesterol, A1C, and blood pressure checks, point-of-care testing is an easy win.
Execution Tips:
- Start small with rapid flu and strep tests—these are high-demand.
- Add chronic care bundles (e.g., “Heart Health Package” with BP check, cholesterol test, and lifestyle counseling).
- Partner with local employers for onsite health screenings and corporate wellness programs.
- Promote on Google Business Profile: “Fast flu and strep testing available—no appointment needed.”
👉 Pharmacies offering POCT often generate $10K–$50K/year in extra cash flow with minimal overhead.
4. Cash-Based: GLP-1 Patient Support Programs
The GLP-1 craze (Ozempic, Wegovy, etc.) isn’t slowing down in 2025. Patients on these medications desperately need support for nutrition, lifestyle, and side effect management. Pharmacies can step in as the trusted partner.
Execution Tips:
- Create a monthly GLP-1 support program with weigh-ins, nutrition counseling, and supplement bundles (fiber, B vitamins, etc.).
- Run Facebook lead ads targeting “Ozempic” or “weight loss clinic” keywords in your area.
- Host a free GLP-1 Q&A event in your pharmacy or via webinar.
- Cross-promote with local weight loss clinics and dietitians.
👉 PBU members have added $5K+/month by packaging GLP-1 patient support with supplements and consultations.
5. Cash-Based: Compounding Services
Compounding remains one of the most powerful PBM-proof revenue streams. From hormone replacement therapy (HRT) to dermatology and veterinary compounds, patients will gladly pay cash for personalized medication. You don’t even have to be a compounder!!! You can help patients with compounds by dispensing 503B compounded products.
Execution Tips:
- Highlight niche compounds (BHRT, dermatology, wound care, NAD, weight loss) that chains don’t offer.
- Use direct messaging campaigns targeting physicians who frequently prescribe compounds.
- Record short patient education videos explaining how compounding solves unique needs.
- Offer free initial consults to introduce new patients to your compounding services.
👉 A single well-marketed compounding program can generate $5K–$25K/month in profit.
6. Cash-Based: Functional Medicine & Lifestyle Programs
Patients are hungry for holistic care—and pharmacies can bridge the gap between traditional medicine and wellness. Offering functional medicine consults, weight loss coaching, or lifestyle programs positions your pharmacy as a true health hub. From omega-3 testing to NAD to glucose monitoring, patients will pay for actionable insight to improve their health.
Execution Tips:
- Launch a “Pharmacy Wellness Program” that includes supplements, coaching, and lab testing.
- Charge a monthly membership fee ($49–$99) for ongoing consults.
- Cross-promote with local gyms, chiropractors, and nutritionists.
- Market via email: “Tired of band-aid solutions? Our pharmacy now offers functional medicine consults.”
👉 Functional medicine services can transform your pharmacy into the go-to wellness destination in your community. Check out PBU Member Riley’s social media for what she is offering.
Common Pitfalls to Avoid
❌ Trying to add all services at once—start with one and scale.
❌ Marketing only to existing patients—most new revenue comes from new patients.
❌ Underpricing services—cash services should reflect your expertise and value.
❌ Not tracking ROI—measure consults, conversions, and revenue for each service.
Final Thoughts: Cash Is King!
Adding cash-based clinical services isn’t optional in 2025—it’s survival. These services are profitable, PBM-proof, and deeply valued by patients. Whether you start with supplements, compounding, or GLP-1 support, the key is to pick one, market it boldly, and scale from there.
Independent pharmacies that embrace these services aren’t just surviving—they’re thriving, adding $10K–$30K/month in new profits and building businesses that run without PBMs dictating their future.
A No Brainer For Every Pharmacy Owner
Want even more ideas to add more revenue to your store? Check out Pharmacy Badass University. I’ve taken every marketing, revenue, and training strategy that’s actually worked and put them all into the University. Between our group discounts, support, and proven profit strategies, joining PBU is a no-brainer for every pharmacy owner.
