Rx Finance for Businesses in Healthcare

Case Studies

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CFO-Led Transformation: Reducing Labor Costs through Hub-and-Spoke Optimization in a Long-Term Care Pharmacy

As the CFO of a large long-term care (LTC) pharmacy with a growing network of facilities, it became clear that the business was facing unsustainable labor costs due to inefficiencies in workforce management and operational processes. With labor costs exceeding $5 million annually, I knew that transforming our business model was essential for long-term financial stability and growth.

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Transformation: Shifting from Customization to Automation in a Pharmaceutical Hub Business


The CFO practice leader at a pharmaceutical hub business providing specialized support for patient access, medication adherence, and financial assistance programs spearheaded a transformative financial initiative to address growing inefficiencies in customized service offerings. The hub’s services relied heavily on manual labor, customization, and bespoke client needs, resulting in high operational costs and diminishing returns.

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Optimizing Sales Forecasting and Profitability for a SaaS Company Providing Solutions to Home Health Agencies

One of Finstru’s team members, serving as part of the FP&A (Financial Planning and Analysis) function, collaborated with the commercial team at a SaaS company specializing in software solutions for home health agencies. The FP&A team was tasked with improving sales forecasts, optimizing profitability, and reducing churn while implementing better pricing strategies. Utilizing SaaS-specific metrics such as Customer Lifetime Value (LTV)Customer Acquisition Cost (CAC)churn raterecurring revenuebookingsannualized contract value (ACV), and price sensitivity, the team drove significant improvements in financial performance.

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Developing a Resource Allocation Model for New Product Launches at a Fortune 50 Pharmaceutical Company

One of Finstru’s team members, as part of the FP&A (Financial Planning & Analysis) function at a Fortune 50 pharmaceutical company, was tasked with optimizing the allocation of resources for the launch of new pharmaceutical products. With significant investments at stake, the success of product launches depended on precise financial planning, efficient use of resources, and clear visibility into key financial metrics.

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Contracting and Pricing Team-Led Transformation: Optimizing Central Fill Solutions for a Fortune 200 Pharmaceutical Client

Our team was engaged by a Fortune 200 pharmaceutical company that was utilizing central fill solutions from a division within their company. This central fill division handled high-volume prescription dispensing, product fulfillment, and logistics services. However, the existing contracts with the pharmaceutical company had created a significant negative margin for our division. The contracts were poorly structured and lacked a clear understanding of the cost inputs required to service the client effectively, leading to substantial financial strain.

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Centralizing Accounting Functions for the Fourth-Largest Pharmaceutical Wholesaler in the U.S.

The fourth-largest pharmaceutical wholesaler in the United States, servicing independent pharmacies, faced a significant challenge with its decentralized accounting functions. The company’s financial operations were spread across various locations, leading to inefficiencies in financial reporting, cash application, and internal controls. Finstru’s team member, serving as the controller, was tasked with spearheading an initiative to centralize all accounting functions into a shared services environment at the corporate office. This initiative aimed to streamline operations, enhance efficiency, and reduce costs.

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Electronic Voucher Distribution Optimization for a Pharmacy Solutions Company

A Finstru Rx Finance team member, while working at a Pharmacy Solutions company, identified a major revenue decline caused by a shift in prescription fill cycles. The company had traditionally used an electronic voucher distribution system tied to monthly prescription refills, but a transition to quarterly fills led to a drastic reduction in transactions, cutting revenue by nearly a third. The change disrupted cash flow, affected pricing strategy, and posed challenges for patients’ ability to access and afford medications.

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A Finance Leader’s Strategic Utilization Approach for GPO Profitability

While serving as a finance leader at a Group Purchasing Organization (GPO) specializing in the Long-Term Care (LTC) pharmacy space, a significant opportunity was identified to enhance customer profitability, increase rebate generation, and grow the GPO’s EBITDA. The GPO provided an extensive list of products; however, purchasing behavior among LTC facilities was fragmented, leading to diluted purchasing power, missed rebates, and an overall impact on profitability.

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Team Leader Implements 340B Optimization Project for a Specialty Clinic

A specialty clinic participating in the 340B Drug Pricing Program was facing several challenges in managing compliance, inventory, and maximizing the financial benefits of the program. The clinic primarily focused on treating chronic conditions, requiring regular access to high-cost specialty medications. However, the complexity of the 340B program was causing the clinic to miss out on potential savings and revenue opportunities, putting a strain on its financial health.

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Controller and VP of Finance Analyzes Customer Profitability for a Pharmaceutical Wholesaler

A finance team member working as the Controller and VP of Finance for the fourth-largest pharmaceutical wholesaler and distributor in the USA identified concerns around the company’s declining profitability. The company’s revenue streams were spread across various regions, but the North East stood out as particularly challenging in terms of profitability. The company had a vast network of customers with varying credit terms, pricing agreements, and purchasing behaviors, which were becoming increasingly difficult to manage and optimize.

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Prior Authorization: Optimizing Market Access for GLP-1 Therapies

A finance team member working at a healthcare technology company identified several challenges related to patient access, reimbursement, and adherence for Glucagon-like peptide-1 (GLP-1) therapies. These medications, commonly prescribed for diabetes and weight management, were facing barriers due to high costs, strict insurance coverage requirements, and complicated prior authorization (PA) processes. As a result, pharmaceutical companies were experiencing reduced patient uptake and adherence, impacting their revenue growth and market presence.

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M&A: Leading the Finance Side of a Strategic Healthcare Technology Acquisition

A finance team member at a major pharmaceutical distribution company was tasked with leading the financial aspects of acquiring a healthcare technology company that specialized in prescription cost-saving solutions. The acquisition aimed to enhance the company’s portfolio, improve prescription affordability, and strengthen its market position in healthcare technology.

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Joint Venture: Leading the Finance Side of an Oncology Joint Venture

A finance team member working at a large healthcare services company led the financial aspects of forming a joint venture with a major healthcare provider. The partnership aimed to combine the two companies’ strengths in oncology research, clinical trials, and cancer care services. The primary objective was to enhance access to oncology clinical research, accelerate drug development, and expand treatment options for patients within community oncology practices.

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How Our Financial Expert Improved Patient Program Forecasting and Cash Flow Management for a Healthcare Service Provider

A leading healthcare service provider specializing in patient support programs collaborated with pharmaceutical companies to manage Patient Assistance Programs (PAPs). These programs offer financial assistance for patients’ medication costs, funded directly by pharmaceutical companies through periodic budget allocations. The provider encountered significant cash flow issues due to inaccurate patient enrollment forecasts and delayed reimbursements.

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Biotech: Managing Sales Growth Amid High Cash Burn Rate

A biotech company was experiencing rapid growth in sales due to the successful launch of a new therapeutic. However, the company’s aggressive investment in R&D, clinical trials, and marketing resulted in a high cash burn rate. Despite increasing revenue, the business faced pressure to manage its cash flow efficiently and sustain operations while investing in future product development.

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Improving Cash Flow Through Chargebacks Reconciliation at a Pharmaceutical Wholesaler and Distributor in the US

A pharmaceutical wholesaler distributor in the U.S., handling a diverse portfolio of pharmaceuticals, including brand-name and generic drugs. This wholesaler serves pharmacies, hospitals, and other healthcare providers nationwide, operating on thin margins and facing significant working capital requirements due to extensive inventories and complex pricing agreements.

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