Healthcare entrepreneurship is often associated with inventing something entirely new: a new drug, a new diagnostic, a new technology platform, or a new way to deliver care.
But some of the most interesting companies are doing something different. They are entering industries that already exist, studying what customers dislike about them, and rebuilding the business model around those frustrations.
That is what makes Rightway’s latest funding round worth paying attention to.
On September 24, Rightway, a pharmacy benefit management and healthcare navigation company, announced that it raised $155 million in Series E financing led by Francisco Partners, with participation from existing investors Thrive Capital and Khosla Ventures. The company says it now serves millions of members and works with 45 Fortune 500 companies.
A $155 million funding round will naturally get attention. But the more interesting question for pharmacists is not how much Rightway raised.
It is what investors believe is worth funding.
Rightway did not invent pharmacy benefits. It entered one of the most established and complicated parts of healthcare and built its pitch around several longstanding frustrations: cost transparency, confusing incentives, unpredictable spending, difficult benefit navigation, and the administrative work surrounding medications.
For pharmacists interested in entrepreneurship, there is a much bigger lesson here.
Sometimes the opportunity is not creating a new healthcare service.
Sometimes it is taking an existing one and asking why everyone finds it so difficult to use.
The business model can be the innovation
Rightway says its PBM generates revenue through a disclosed administrative fee. According to the company, manufacturer rebates are passed through to clients, it does not retain pharmacy spread, and it does not own dispensing pharmacies. It pairs the pharmacy benefit with navigation from pharmacists and certified pharmacy technicians who can help members understand their coverage, evaluate medication options, and work through pharmacy-benefit issues.
This article is not an argument that one PBM structure is better than every other model. Pharmacy benefit economics are complicated, and employers and health plans may prioritize very different things when choosing a PBM.
The entrepreneurial point is more useful than that debate.
Rightway looked at a market where customers have spent years questioning how money moves through the system and made the financial structure itself part of the product.
That is worth studying.
Entrepreneurs often assume innovation means changing what a company sells. But sometimes the bigger opportunity is changing how the company gets paid, how incentives are aligned, or how the customer experiences the service.
That can completely change the value proposition without changing the underlying category.
Rightway has also developed a product called SureSpend that places a ceiling on pharmacy spending based on projected total costs. The company says that if actual spending exceeds that agreed amount, it covers the difference, while clients retain savings when spending comes in below the target.
Again, whether that exact structure is appropriate for every organization is not the lesson.
The lesson is that Rightway is not simply selling claims administration. It is trying to sell employers something broader: greater predictability, clearer economics, medication expertise, and help navigating a complicated system.
That is a much stronger business proposition than simply saying, “We manage your pharmacy benefit.”
Frustration is often market research
This is where the story becomes especially relevant to pharmacists.
We work inside systems that generate frustration every day.
Prior authorizations stall.
Specialty prescriptions disappear into complicated routing pathways.
Patients cannot afford medications.
Caregivers struggle to coordinate therapies across multiple prescribers.
Discharge medication lists do not match outpatient records.
Drug shortages force repeated substitutions.
Formularies change.
Patients abandon prescriptions because nobody can explain what happened.
It is easy to experience those problems and treat them as unavoidable parts of healthcare.
An entrepreneur looks at them differently.
Instead of saying, “This process is terrible,” they ask why the process exists in its current form, who is frustrated by it, who pays for the consequences, and what would have to change for someone to spend money solving it.
That is an important mindset shift for pharmacists because we have unusually close exposure to the medication-use system.
We see what happens after the prescription is written.
We see the insurance rejection.
We see the patient who cannot afford the copay.
We see the prescriber’s office struggling with the prior authorization.
We see the caregiver trying to understand five medication changes.
We see the patient who never starts therapy.
Those frustrations are not just operational problems.
They are information about where healthcare is failing.
And where healthcare repeatedly fails, business opportunities often emerge.
Follow the problem, then follow the incentives
Rightway’s own description of its history illustrates this.
The company began primarily as a healthcare-navigation business. But according to Rightway, it found that it could help people navigate healthcare while still having limited influence over one of the largest and most complicated parts of their benefit: prescription medications.
So it moved deeper into the problem and built its own PBM model.
That is a useful entrepreneurial pattern.
Do not stop at the first visible symptom of a problem.
Follow it.
If patients cannot access medications, ask why.
Is the issue affordability?
Prior authorization?
Specialty pharmacy routing?
Benefit design?
Poor communication?
Formulary restrictions?
A lack of patient support?
Manual administrative work?
Then look at the incentives.
Who performs the work?
Who pays for it?
Who saves money if the problem is solved?
Who loses money?
Who experiences the frustration?
Who actually has the authority to change the process?
Those answers are often different.
That is one reason healthcare problems are so difficult to solve.
The person doing the work may not financially benefit from fixing the system. The organization paying for the service may never experience the friction directly. The patient may carry the burden but have very little ability to change the process.
Companies that can realign some of those incentives can create substantial value.
This is why pharmacists interested in entrepreneurship should learn to think beyond the clinical service itself.
Suppose you want to build something around medication adherence.
Your first instinct might be to create adherence coaching.
But before designing the service, ask who suffers financially when adherence is poor.
A health plan may care about hospitalizations and quality measures.
A value-based primary care group may care about total cost of care.
A pharmaceutical manufacturer may care about persistence.
An employer may care about overall health spending and productivity.
A patient may care primarily about affordability and simplicity.
The same pharmacist intervention could potentially be positioned very differently depending on whose problem you are solving.
That is what turns a clinical idea into a business model.
Pharmacists need to sell the problem they solve, not just the service they provide
This distinction is especially important in pharmacy entrepreneurship.
Pharmacists often describe offerings in terms of what they do.
“We provide medication reviews.”
“We provide adherence support.”
“We provide delivery.”
“We provide medication management.”
Those descriptions are accurate, but they do not automatically explain why someone should pay for the service.
Now change the framing.
“We help primary care practices identify medication-related risks before they become avoidable utilization.”
“We help caregivers take the medication logistics of an aging parent off their weekly to-do list.”
“We help employers reduce the administrative burden employees face when navigating high-cost medications.”
“We help patients move from a prescribed specialty therapy to actually starting treatment.”
The underlying pharmacist work may be similar.
The difference is that the service is now connected to a problem the customer understands.
That is a critical entrepreneurial skill.
Customers usually do not wake up wanting to buy a “pharmacist service.”
They want something difficult, expensive, confusing, or time-consuming to become easier.
The strongest pharmacy businesses will understand that difference.
AI is being used to remove the work around the pharmacist
There is also an important technology piece in Rightway’s announcement.
The company says part of the new capital will support additional investment in AI and pharmacy-benefit technology. Rightway has described its strategy as using AI to reduce administrative work for its pharmacy teams, identify opportunities for lower-cost or better care earlier, and allow pharmacists and technicians to provide more personalized support at scale.
That is another pattern Pharmacy Unlocked has been following closely.
The most interesting use of AI in pharmacy may not always be replacing the pharmacist’s work.
It may be removing the repetitive work surrounding the pharmacist.
That distinction matters.
If technology handles more status checks, routine information gathering, benefit lookups, repetitive documentation, and administrative routing, then pharmacists can spend more time on medication decisions, patient communication, clinical evaluation, and solving exceptions.
From an entrepreneurship standpoint, that creates another useful rule:
Automate the friction around the valuable work before trying to automate the valuable work itself.
Many healthcare businesses will create value simply by removing tasks that prevent highly trained people from doing the work they are actually trained to do.
Pharmacists know where those tasks live because we encounter them every day.
The problems pharmacists complain about may be the opportunities pharmacists are overlooking
Here is a simple exercise.
Think about the three things in pharmacy that you complain about most frequently.
Not minor inconveniences. Think about recurring problems that waste time, cost money, frustrate patients, or create risk.
Maybe it is how long prior authorization takes.
Maybe it is how difficult specialty medication access becomes.
Maybe it is medication reconciliation after discharge.
Maybe it is caregivers trying to manage prescriptions across multiple specialists.
Maybe it is patients abandoning prescriptions because they cannot navigate the cost.
Maybe it is the same drug shortage creating the same workflow problems every month.
Write those three problems down.
Then choose one and ask a different question.
Instead of:
“Why is this system so terrible?”
ask:
“If someone paid me to fix this problem, what would the solution actually look like?”
Now begin mapping it.
Where does the problem start?
Who touches it?
What information is required?
Where does the workflow break?
Which pieces require pharmacist expertise?
Which parts are repetitive?
What could technology handle?
Who benefits financially if the problem disappears?
And perhaps most importantly, who would actually pay for the solution?
That last question matters because a good idea is not automatically a good business.
The person experiencing the problem may not always be the customer.
A patient may benefit from the solution, while the health plan, employer, health system, manufacturer, or physician practice is the organization with the financial incentive to fund it.
Understanding that distinction is how business models begin to form.
You do not have to launch a startup to think like an entrepreneur
This mindset is useful even if you never start a company.
Suppose you work inside a hospital and repeatedly see discharge medication problems.
One option is to complain about the process.
Another is to map exactly where the breakdown occurs, quantify how much staff time it consumes, identify the downstream consequences, propose a pharmacist-supported workflow, and measure whether the new process works.
That is entrepreneurship inside an existing organization.
The same approach applies in health plans, pharmaceutical companies, digital-health businesses, community pharmacies, hospitals, physician practices, and health systems.
People who can identify expensive problems and design better systems around them become valuable almost anywhere.
The $155 million is the signal, not the lesson
A large funding round does not prove that Rightway’s PBM model will ultimately outperform every alternative.
Private financing reflects investor expectations about future growth. It is not independent validation of every claim a company makes about its model, and it certainly is not a final verdict on the future of pharmacy benefits.
But capital does provide a useful signal.
Francisco Partners just led a $155 million investment in a company positioning itself around pharmacy-benefit transparency, care navigation, more predictable spending, pharmacist support, and technology.
That tells us something about the types of problems sophisticated investors believe are worth solving.
And pharmacists should notice the broader pattern.
Some of healthcare’s biggest opportunities are hiding inside systems that already exist.
The opportunity is not always to invent another medication or another clinical service.
Sometimes it is to look at an established healthcare process and ask why it is so difficult, why the incentives work the way they do, and whether the entire experience could be designed differently.
Pharmacy is full of those opportunities.
We experience them every day.
The challenge is learning to see them as more than frustrations.
Because the next time you find yourself saying, “There has to be a better way to do this,” you may be looking at something more valuable than a complaint.
You may be looking at a market signal.
Resources & Citations
1. Rightway. “Our Series E and What Comes Next for Rightway.” September 24, 2026.
Primary company source announcing the $155 million Series E financing led by Francisco Partners, with participation from Thrive Capital and Khosla Ventures. Rightway also describes its current reach across millions of members and 45 Fortune 500 clients, its administrative-fee revenue model, rebate pass-through approach, lack of retained spread and pharmacy ownership, pharmacy-navigation model, and plans to invest the new capital in AI and pharmacy-benefit technology. Claims about Rightway’s own performance and business model are company-reported.
Rightway Series E announcement
2. Rightway. “Rightway Raises $155 Million as It Leads the Next Generation of Pharmacy Benefits.” September 24, 2026.
Formal financing announcement confirming the $155 million Series E led by Francisco Partners, with participation from existing investors Thrive Capital and Khosla Ventures, and describing the financing as supporting Rightway’s continued growth in pharmacy benefits, navigation, and technology.
3. MobiHealthNews. “Rightway Raises $155M to Expand Pharmacy Benefits Technology.” September 24, 2026.
Independent reporting confirming the Series E financing, Francisco Partners as lead investor, participation from existing investors, Rightway’s reported Fortune 500 client base, and plans to expand its AI capabilities and pharmacy-benefit technology.
4. Rightway. “Pharmacy Benefit Manager Solutions.” 2026.
Company description of Rightway’s PBM model, including its administrative-fee structure, stated 100% rebate pass-through approach, zero spread pricing, lack of owned pharmacies, pharmacist-led navigation, and total pharmacy-spend guarantee.
5. Rightway. “SureSpend.” 2026.
Company materials describing Rightway’s SureSpend pharmacy-spending guarantee, treatment of rebates, member costs, pharmacy-team support, and approach to predictable pharmacy spending.
6. Rightway. “Comparing Revenue Models in the PBM Industry.” September 1, 2026.
Company explanation of its stated PBM revenue model and the differences it emphasizes between administrative-fee structures, rebate retention, spread pricing, pharmacy ownership, formulary incentives, and auditability. This source reflects Rightway’s characterization of its own model and the broader PBM market.