Say It So They Buy ItEpisode 3
PBM Sent Him a Restraining Order. So He Built their #1 Competitor
Breck L. Rice spent 23 years fighting for community pharmacies, surviving a PBM restraining order to co-found ServeRx, now the #1 workers' comp pharmacy payer. Learn how same-day payment models save self-insured employers 20-30% on drug spend.
About this episode
Breck L. Rice has spent over 23 years fighting for community pharmacies, starting as a director at the industry's original third-party claims processor, getting hit with a temporary restraining order when he left a PBM that didn't want him talking, and eventually co-founding Serve Rx, now the largest third-party payer in the country for workers' compensation pharmacy claims.
This episode digs into a question most business owners never think to ask: why do the people actually delivering care, pharmacists, doctors, nurses, operate on razor-thin margins while the middlemen sitting between them and the patient rake in the majority of the profit? Mark and Breck unpack how Serve Rx built a business model that guarantees pharmacies same-day payment (without even waiting to collect), how self-insured employers are unknowingly overpaying 20-30% on drug spend, and why an industry that's already won its growth phase is now focused on account management, PR, and expanding into adjacent markets like peptide delivery.
Bottom line: when you strip out the bureaucracy sitting between patients and care, everybody wins except the middleman, and Breck's built a business proving it.
Thanks to Breck for sharing this story with us.
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Also in the conversation
- How Serve Rx guarantees payment to pharmacies on the first fill, even before verifying the claim, so patients aren't left waiting in pain
- The state-fee-schedule complexity of workers' comp billing (and why the state where the injury happened matters more than where the patient lives)
- Why self-insured employers are sitting on massive, invisible drug-spend savings, and what a real-world example of those savings looks like
- A first look at new mucosal (buccal) peptide delivery technology showing 93% bioavailability, no needles required
In their words
“We take the risk on that first fill. The pharmacy gets paid whether we ever collect or not.”
Breck L. Rice · 11:45
“Community pharmacy margins used to sit in the mid-30s. Today they are single digits.”
Breck L. Rice · 18:20
“We make a thin margin off the state fee schedule. We do not take a cut of the drug price.”
Breck L. Rice · 13:10
“They sent me a restraining order, so I went and built their number one competitor.”
Breck L. Rice · 5:30
Chapters
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Questions this episode answers
What does ServeRx do for community pharmacies?
ServeRx helps community pharmacies get paid for workers' compensation claims. It takes on the risk of the first fill, verifies and bills the claim on the back end, and guarantees payment to the pharmacy whether or not it ultimately collects.
How does ServeRx make money?
ServeRx makes a thin margin off the state fee schedule rather than taking a cut of the drug price.
Why did Breck Rice start ServeRx?
He spent 20-plus years in community pharmacy starting at Third Party Solutions, the industry's original third-party claims processor. A PBM acquisition and a non-compete fight pushed him to co-found ServeRx.
What has happened to community pharmacy margins?
Margins have collapsed from the mid-30s to single digits, driven in large part by PBM consolidation and models like CVS/Caremark that changed who profits in the drug supply chain.
How does ServeRx go to market now?
It moved away from a large outbound sales team toward a smaller account management function and growth driven by industry conferences.
What is the buccal peptide technology Breck mentions?
It is a roof-of-mouth delivery method for peptides that his podcast network has partnered with. He sees it as a potential compounding revenue source for community pharmacies.
