Is 0% markup the same as the cheapest medication price?

Not always. 0% markup means the platform adds nothing to the pharmacy's price, so the brand pays whatever the pharmacy charges. The pharmacy's own price depends on the medication, whether it is branded or compounded, and the volume behind the pharmacy contract. Markup is the part of the price a brand can remove entirely, and it is usually the largest hidden cost in the pharmacy line.

Who sets the price the patient pays?

The brand. It sets the program price, the subscription terms, and what the price includes, such as the medication, provider visits, and messaging. At 0% markup, the difference between that program price and the medication's wholesale cost belongs to the brand, before consult fees, platform fees, and marketing.

If there is no markup, how does Tessic Health make money?

From its published fees: a flat monthly platform fee of $1,000 on Launch, $2,000 on Grow, or $4,000 on Scale, a one-time setup fee, and $25 per completed consult. Tessic takes no revenue share and adds nothing to medication, so its revenue does not change with what is prescribed or with what the brand charges patients.

Does 0% markup apply to compounded medications?

On Tessic Health, yes. Medication is billed at wholesale with 0% markup on every fill, on every plan. On any other platform, ask whether the markup changes by product type, because a single headline rate can hide different margins on branded and compounded products.

How can I verify a platform's markup?

Ask for the pharmacy invoice for a real fill and compare it with what the platform bills you for the same fill. List every fee attached to an order, and get the markup percentage in writing. A platform that bills at wholesale can answer all three in one email. The Tessic Health compare page lists the other questions worth asking.

Does markup matter for a small brand?

It matters most later, but it is decided at signing. At 100 patients, a $42 monthly markup costs about $50,000 a year; at 1,000 patients it costs $504,000. Markup terms are hard to renegotiate once a brand depends on a platform, so the time to insist on wholesale pricing is before launch.

What does 0% pharmacy markup mean?

Zero percent pharmacy markup means the brand pays exactly what the pharmacy charges for the medication, its wholesale price, and the platform adds nothing on top. A markup is the margin a platform adds between the pharmacy's price and the price it bills the brand. Many white-label telehealth platforms earn a large part of their money this way, commonly 20 to 40 percent on every fill, and it is hard to see because it sits inside the medication price instead of on a fee schedule. With 0% markup, the gap between what the patient pays and what the medication costs belongs to the brand, and the platform earns only the fees it publishes. The difference grows with volume: on a $140 monthly medication, a 30% markup costs a brand $42 per patient per month, or $504,000 a year across 1,000 patients. On Tessic Health, medication is sourced at wholesale and billed at exactly that price, with 0% markup on every fill, on every plan, and Tessic's revenue is the flat monthly platform fee and $25 per completed consult.

Reviewed September 11, 2026 · 6 min read

In short

0% markup means the brand pays the pharmacy's wholesale price and nothing more.
Platform markups on medication commonly run 20 to 40 percent per fill.
A markup is charged on every refill, so it costs the most once a brand has scale.
The check is simple: the pharmacy invoice and the platform's bill should match.
On Tessic Health, medication is billed at wholesale on every fill, on every plan.

On this page

What markup means in plain words
Where the money goes on one monthly fill
How markup hides
How to check a markup claim
Why markup costs the most as you grow
Markup, revenue share, and flat fees compared
The bottom line
Common questions

What markup means in plain words

A pharmacy buys medication from a wholesaler, prepares or dispenses it, and charges a price for the drug and its work. That pharmacy price is what telehealth platforms call the wholesale price. A markup is anything a platform adds between that price and the price it bills the brand. If the pharmacy charges $140 for a month of medication and the platform bills the brand $182, the markup is $42, or 30 percent.

Markup is one of three ways telehealth platforms earn money. The other two are a revenue share, meaning a percentage of everything the clinic bills, and flat fees such as a monthly platform fee or a per-consult fee. Many platforms combine them. The fee model decides how much of each patient's payment the brand keeps, so it matters as much as the price of any single fill. The fee models are compared in flat fee vs revenue share.

Start here

Do I need a medical license to start a telehealth company?

No. Licensed clinicians own the medical practice and the founder's company owns the business. Here is exactly who needs which license, and how the two companies fit together.

Read the guide

Where the money goes on one monthly fill

A hypothetical weight program priced at $199 a month, with medication that costs $140 a month at wholesale, the same example used in Why zero markup matters.

Line	Platform with a 30% markup	On Tessic Health
Patient pays the brand	$199	$199
Medication at the pharmacy's wholesale price	$140	$140
Platform markup	$42	$0
Brand pays the platform for the medication	$182	$140
Left for the brand before other costs	$17	$59

Hypothetical figures for one patient-month, before consult fees, platform fees, payment processing, marketing, and any revenue share. Across 1,000 patients, the $42 markup is $42,000 a month and $504,000 a year.

How markup hides

Markup rarely appears on a line of its own. It is usually folded into a single medication price, so the brand sees what it pays per fill without ever seeing what the pharmacy charged. It can also arrive under other names: a pharmacy fee, a fulfillment fee, a per-order charge, or a dispensing fee billed by the platform on top of the pharmacy's own price. Each looks small on a term sheet, and each is charged on every refill, for every patient, for as long as the brand runs.

0% markup describes the platform's cut, not the pharmacy's. The pharmacy still charges its own price for the drug and for the work of preparing, dispensing, and shipping it. The promise of 0% markup is that nobody between the pharmacy and the brand adds to that price.

How to check a markup claim

Any platform can say it passes medication through at cost. These checks confirm it:

Ask for the pharmacy's invoice for a real fill, next to what the platform bills you for the same fill. With 0% markup, the two numbers match.
Ask for every fee attached to an order: pharmacy fees, fulfillment fees, per-order charges, and anything billed per shipment.
Get the markup as a percentage, in writing, and ask whether it changes by medication, by branded or compounded product, or by plan.
Model your medication cost at ten times your current patient count. A per-fill markup grows in exact step with your growth.
Ask whether you can see the wholesale cost at all. If medication pricing is a black box, assume a margin sits inside it.

Why markup costs the most as you grow

A markup is charged per fill, so it grows in direct proportion to the number of patients on medication. A brand with 100 patients pays about $50,000 a year for a $42 monthly markup. A brand with 1,000 patients pays $504,000 a year for the same margin, and one with 5,000 pays over $2.5 million, while the platform's cost to process each fill barely changes.

Markup also shapes the medicine. A platform that earns a spread on each fill has a financial interest in what gets prescribed, how often, and at what dose. That pressure can push protocols toward higher-margin medications and more frequent fills without anyone intending it. With 0% markup, the platform earns the same whatever the prescriber chooses, which keeps the prescribing decision with the clinician, where the law puts it. The full worked example is in Why zero markup matters.

Markup, revenue share, and flat fees compared

Fee type	How it is charged	What happens as you grow	On Tessic Health
Medication markup	A margin added to every fill	Grows with every patient and every refill	0% on every fill, on every plan
Revenue share	A percentage of everything the clinic bills	Grows with every dollar of revenue	None, on any plan
Per-consult fee	A flat amount per completed visit	Grows with visits, which grow more slowly than patient count	$25 per completed consult, the same in all 50 states
Platform fee	A flat monthly amount	Stays the same	$1,000, $2,000, or $4,000 a month, after a one-time setup fee

The bottom line

Medication is usually the largest cost in a prescription program, so the pharmacy line decides unit economics more than any other. A platform that bills medication at wholesale and publishes its other fees lets a brand model its margin at 10,000 patients before it has 100. Tessic Health's terms are on the pricing page; what it costs to start totals year one, and how to launch a GLP-1 clinic shows where the pharmacy line fits in a real program.

COMMON QUESTIONS

What founders ask next.

Is 0% markup the same as the cheapest medication price?: Not always. 0% markup means the platform adds nothing to the pharmacy's price, so the brand pays whatever the pharmacy charges. The pharmacy's own price depends on the medication, whether it is branded or compounded, and the volume behind the pharmacy contract. Markup is the part of the price a brand can remove entirely, and it is usually the largest hidden cost in the pharmacy line.
Who sets the price the patient pays?: The brand. It sets the program price, the subscription terms, and what the price includes, such as the medication, provider visits, and messaging. At 0% markup, the difference between that program price and the medication's wholesale cost belongs to the brand, before consult fees, platform fees, and marketing.
If there is no markup, how does Tessic Health make money?: From its published fees: a flat monthly platform fee of $1,000 on Launch, $2,000 on Grow, or $4,000 on Scale, a one-time setup fee, and $25 per completed consult. Tessic takes no revenue share and adds nothing to medication, so its revenue does not change with what is prescribed or with what the brand charges patients.
Does 0% markup apply to compounded medications?: On Tessic Health, yes. Medication is billed at wholesale with 0% markup on every fill, on every plan. On any other platform, ask whether the markup changes by product type, because a single headline rate can hide different margins on branded and compounded products.
How can I verify a platform's markup?: Ask for the pharmacy invoice for a real fill and compare it with what the platform bills you for the same fill. List every fee attached to an order, and get the markup percentage in writing. A platform that bills at wholesale can answer all three in one email. The Tessic Health compare page lists the other questions worth asking.
Does markup matter for a small brand?: It matters most later, but it is decided at signing. At 100 patients, a $42 monthly markup costs about $50,000 a year; at 1,000 patients it costs $504,000. Markup terms are hard to renegotiate once a brand depends on a platform, so the time to insist on wholesale pricing is before launch.

KEEP READING

The next questions on the list.

All guides

Reviewed September 11, 2026. Tessic Health guides are general information for founders, not legal advice. Laws, agency guidance, and ad platform policies change; confirm the specifics for your business with health-care counsel. Tessic Health claims restate what tessichealth.com publishes on its pricing, platform, and security pages.