In this episode of ShiftShapers, host David A. Saltzman sits down with Vinay Patel, PharmD, founder of MakoRX, to expose why prescription pricing remains so confusing—and what can be done to fix it.

Patel breaks down how pharmacy benefit managers (PBMs), vertical integration, and opaque pricing structures are driving up costs for patients—while limiting access and undermining local pharmacies. From subscription pharmacy programs to cash-pay and compounding models, Patel shares bold, practical solutions for bringing real transparency back into the healthcare system.

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🔑 Key Takeaways from This Episode

1. The Truth About Prescription Pricing
    Patel explains how PBMs and vertically integrated systems distort drug pricing—making it difficult for patients to know what they’re really paying and why.
   
   
   
2. The Power of Local Pharmacies
    Community pharmacies often serve as the most frequent healthcare touchpoint for patients. Their role in building trust, offering consultations, and providing accessible services is critical to public health.
   
   
   
3. How MakoRX’s Subscription Pharmacy Program Brings Real Cost Transparency
    Patel details a model offering 300 commonly prescribed medications for a flat monthly fee—providing predictable costs and supporting a national network of independent pharmacies.
   
   
   
4. Breaking Up Healthcare Oligopolies
    To fix what’s broken, Patel supports breaking up vertically integrated giants, allowing regional players to compete on quality, service, and fair pricing.
   
   
   
5. The Role of Compounding and Cash-Pay Pharmacies
    With growing demand for affordability, Patel highlights how compounding and cash-pay pharmacies are offering lower-cost alternatives and bypassing insurance constraints.
   
   
   
6. A Vision for Integrated, Transparent Care
    Patel explores a future where technology enables collaboration between pharmacists and medical providers—creating a more coordinated, transparent, and patient-focused care model.
   
   
   

⏱️ In This Episode

00:00 Introduction and Guest Welcome
 00:54 Vinay Patel's Career Journey
 04:28 Challenges in the Healthcare System
 05:49 Political Perspectives on Healthcare Reform
 14:17 The Role and Importance of Community Pharmacies
 20:02 Subscription Pharmacy Programs
 25:30 Future Trends in Pharmacy and Healthcare
 27:20 Conclusion and Farewell