Independent pharmacy ownership doesn’t come with a playbook...but it would be helpful. In the latest RedSail Media podcast episode, Fair Jones, Owner of Sav-More Drugs and Gifts in Grenada, Mississippi, offers an unfiltered look at what it takes to own an independent pharmacy.

A University of Mississippi pharmacy graduate and longtime community pharmacist, Fair entered ownership in 2019 after years in chain pharmacy, just months before COVID reshaped healthcare and accelerated long‑standing reimbursement pressures.

Since then, she’s navigated pandemic disruption, shrinking margins, inventory strain, and the realities of modern independent ownership—all while remaining committed to the community that depends on her pharmacy.

From 2010-2024, 312 independent pharmacies closed in Mississippi. Rather than retreat, Fair leaned into data, tightened operations, rethought cash flow, and ultimately found her voice as an advocate—for patients, peers, and legislators about the realities independent pharmacies face every day.

We spoke with Fair to gather owner‑level, actionable takeaways for independent pharmacy owners who are building sustainable businesses in today’s landscape.
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Actionable Takeaways for Independent Pharmacy Owners

1. Treat Every Claim Like a Business Decision

One of Fair’s biggest wake-up calls came when she began reviewing claims line by line after becoming an owner.

“Going into ownership, I had to very quickly learn, I have to literally look at every single claim to make sure that we’re making money,” said Fair.

Owners need to:

• Review reimbursement at the prescription level, not just the monthly summaries and reports
• Identify repeat drugs and payers that don’t make a profit
• Use claim data to guide purchasing, stocking, and contract decisions

2. Assume Reimbursement Pressure Is Permanent

Fair shared a moment that pushed her from frustration to action: filling multiple prescriptions for a patient and realizing the pharmacy made just $0.88 total, before labor and supplies.

Fair explained, “It’s not the same model it was 20 or 30 years ago where the more prescriptions you fill, the more money you make. Every year, you’re kind of having to figure it out again because things change so quickly.”

This is a policy problem that affects daily operations, and it’s going to take a while before it gets better.

What owners should do:

• Stop waiting for reimbursement to “get better”
• Build operational systems that protect cash flow regardless of payer behavior
• Plan around rules resetting every January

3. Use Medication Synchronization to Stabilize Cash Flow

Fair credits medication synchronization as one of the most impactful changes in her pharmacy.

She said, “Without med sync and tight inventory control, I don’t know how we would have made it through these reimbursement challenges. Med sync really changed my pharmacy.”

What owners should do:

• Commit fully to med sync
• Use sync cycles to anticipate inventory needs and cash inflows
• Align patient communication so expectations are clear

4. Keep Inventory Lean

Inventory control is not optional when margins are tight.

Fair explained, “We try to keep inventory as low as possible. We don’t keep things on the shelf that we’re not going to use in the next month.”

What owners should do:

• Order based on actual usage, not habit
• Reduce shelf stock that ties up cash
• Pair inventory management with med sync to avoid overbuying

5. Diversify Revenue

Fair’s pharmacy includes a large front-end gift shop that helped during COVID—but she’s clear about its role.

“My goal is to have [the pharmacy and front-end] both be equally sustainable without needing the other,” said Fair.

The diverse revenues streams should strengthen your overall business, and in turn, revenue.

What owners should do:

• Diversify thoughtfully (vaccines, clinics, retail, wellness)
• Avoid relying on non-pharmacy revenue to cover pharmacy losses
• Evaluate each revenue stream independently

6. Educate Patients to Become Advocates

Fair didn’t plan to become an advocate for pharmacy benefit manager (PBM) reform. It started with just telling people the truth.

“Our customers had no idea this was happening. Once they knew, they were our biggest cheerleaders.”

What owners should do:

• Explain challenges and why you can’t accept
• Share real examples of how reimbursement affects care.
• Invite patients into the conversation.

Conclusion

Fair Jones’ story is about adaptation. Her experience reinforces what many owners already feel: independent pharmacy success today requires financial awareness, disciplined operations, smart technology, and the willingness to speak up.

For pharmacy owners, the message is clear: when you combine data visibility with operational control and honest advocacy, you don’t just survive, you lead.

You can watch or listen to the full episode below:
‍PBM Reimbursements Are Breaking Pharmacies with Fair Jones