Case Study

Equality Health Group's On-site Pharmacy Achieved ROI Breakeven in Under 12 Weeks

January 23, 2024

Founded In


Entity Type

STD Clinic


Oklahoma City, OK



Contract Pharmacies


On-Site Pharmacy


When Gilead decided to take away the 340B funds from their copay cards, that almost killed our business.

Cody Turpin

CEO, Equality Health Group


Cody Turpin launched Equality Health Group (EHG) in the middle of COVID lockdown in 2020, at a time when the State of Oklahoma had redirected all its contact tracing resources away from STD programs to the pandemic. His own experience navigating the healthcare system earlier that year had left much to be desired when it came to stigma surrounding certain health conditions and how it translated to poor bedside manners. He decided to launch EHG with the sole purpose of taking care of the most ignored, hardest to serve patients and treating them right while doing so.

As the number of patients grew, sustaining the business became difficult which is counterintuitive to how the safety net programs are supposed to work. EHG had to take a step back, slow their patient intake down even as demand grew and assess their business. It became clear that manufacturer restrictions, and the changing PBM and regulatory landscape could lead to pricing and reimbursement volatility. Further, the net proceeds from contract pharmacy after their fees had the potential to run EHG out of business, or at best, leave little margin to meaningfully invest back into growing the business.

There was also the problem of capture rate and adherence when working with their contract pharmacy, which reduced the topline further (size of the pie). In EHG’s case, working with a pharmacy that was in an entirely different state meant that the care team were in the dark once the prescription had left the clinic. They often found that their patients had to navigate complex situations leading to delays with critical medications, adversely impacting disease progression.

"When you provide a patient with this awesome care at the clinic, tell them we are going to take care of them - and 3 days later, they have heard no updates on their prescription, that is a terrible, terrible feeling.” - Cody, speaking of his experience with his primary contract pharmacy  


At Alchemy, we believe safety net providers have three imperatives. It starts with the choice to rapidly build & launch a pharmacy within the four walls of their health center - what we call the ‘physical layer’ of our on-site pharmacy program. But to truly meet the moment, safety net providers need to look beyond the four walls of their pharmacy to meet patients where they are, and deploy a ‘clinical layer’ and ‘digital layer’ that removes all barriers to access, and not just stabilizes, but helps grow their 340B program for the future.

When Cody approached us in early 2023, it was immediately evident that the Alchemy model could address his concerns about sustaining and growing the business. We partnered with EHG to start with the physical layer by building out and operationalizing the on-site pharmacy first, to take control of the existing book of business and get to predictable financials. The digital layer kicked in once we were fully in network and operational. This enabled the pharmacy team to tightly coordinate with the clinicians, make data driven decisions and reach patients at the right time with the right medication removing all barriers to access. Simultaneously, our clinical team worked with Cody to design a clinical program that was most suitable for their community, which would allow EHG to identify, treat and retain net new patients. We decided to launch a mobile clinic to conduct rapid tests and create disease awareness at several local institutions and surrounding Indian Reservation, thus bringing in new patients.



  • Time to in-network with 99% PBMs - 9 weeks from BoP license issuance
  • First prescription dispensed - 9 weeks from BoP license issuance
  • Steady state volume with 95%+ capture rate - 3 months from BoP license


  • Time to break even / ROI - 12 weeks from first dispense
  • Revenue uptick from existing Rx volume - 25 - 30%
  • Pharmacy Operating Margin - averages 38% - 40% Monthly


  • “Having the pharmacy here in the clinic is definitely weight lifted off my shoulders” - EHG patient
  • Patient Adherence - 92%
  • New patient intake from mobile clinic program - Tested, enrolled and treating upwards of 30+ Hep C and HIV patients in the 1.5 Months the mobile clinic has been operational

With the on-site pharmacy driving adherence for existing patients, EHG is not only able to further expand its topline revenue (size of the pie) but also make it predictable.

Topline revenue expansion and financial stability from the on-site pharmacy program has enabled Cody and team to increase their rate of new patient intake. EHG has expanded its outreach through the mobile clinic and partnership opportunities with local institutions. One such example is the upwards of 700 additional Hep C patients who will be onboarded starting Feb 2024, through partnership with a local Behavioral Health and Drug Abuse Clinic. This represents 430% growth in patients served by the on-site pharmacy.

EHG’s success emulates the flywheel Alchemy is setting out to create for every one of our customers. It is one of Alchemy’s core values to protect the safety net for providers who deliver care to the most vulnerable and underserved communities and we remain steadfast in this mission.


Alchemy deployed a mobile clinic for EHG to acquire new Hep C patients.