A pharmacy following 6 warfarin patients and a pharmacy following 80 are not the same business. They do not carry the same risk, spend the same hours, or earn the same money from the work. Some software in this space charges them the same flat fee. Some of it does price by panel size — but on a curve whose first band is wide enough to swallow most of the range, so a pharmacy following 2 patients pays what a clinic many times its size pays. Here is what Praxio costs at every size, and the reasoning behind it.
The 3 ways this usually gets priced
Before the ladder itself, it is worth being precise about what we think is wrong with the alternatives — including the one that looks most like ours.
One flat price for everybody
The most common model, and the one we used to run. It is simple, and it is quietly regressive: the pharmacy with 4 patients subsidises the one with 90. A flat monthly fee that a large clinic barely notices is the entire reason a small one stays on a spreadsheet. We charged a single rate for a long time and could not construct an honest defence of it.
Per user
You pay for each login. This works badly for anticoagulation specifically: the pharmacist, the technician entering results, the person covering vacation and the physician reviewing outliers are 4 accounts, and the fourth is the one that ends up shared. Per-user pricing pushes clinics toward shared credentials, which is a documentation and traceability problem long before it is a billing one. Every Praxio row includes unlimited users for exactly this reason.
Per patient, on the wrong curve
Per-patient pricing already exists in this market. It is the model ours most resembles, which is exactly why the difference matters more than the resemblance — and the difference is the shape of the curve, not the idea behind it.
The usual failure is at the bottom. The first band is drawn wide — a single price covering everything from the first patient up to several dozen — and pitched at the top of that range. A pharmacy following 2 patients then pays what one following dozens pays, for a fraction of the work and a fraction of the revenue. There is no reading of that which makes sense for the smaller pharmacy, so it does the rational thing and stays on a spreadsheet. That is the pharmacy with the most to gain from a dose calendar and an audit trail, and the least room to absorb a missed follow-up, priced out by the shape of a table.
The second failure is at the top. Charged per head with nothing capping it, growth turns into a rising bill, and pruning the roster before renewal starts to look attractive — a grotesque thing to have anyone weighing when the roster is a list of people on a high-risk drug.
The fix is not to abandon per-patient pricing. It is to get both ends of the curve right: free where the work is genuinely trivial, capped where it plateaus, and real steps in between rather than one wide band pretending a 2-patient pharmacy and a busy clinic are the same job.
Proportional to the pain
Your workload scales with your panel. Your revenue scales with your panel. The only defensible thing for your software to do is scale with it too — and then stop.
That is the whole design. 5 bands, a ceiling, and one conversation above it:
| Warfarin patients | You pay |
|---|---|
| 1–2 | Free, permanently |
| 3–4 | $19/month |
| 5–10 | $39/month |
| 11–30 | $59/month |
| 31–60 | $79/month |
| 61–125 | $99/month |
| More than 125 | Let's talk |
All amounts are CAD per month, per pharmacy. You already know what one managed patient is worth to your practice. Take that number, multiply it by your panel, and hold it next to your row. The arithmetic takes about 10 seconds, and it is the only test of a price that matters — which is why we would rather you ran it than sat through a call where we ran it for you.
Why it is free at 2
If you follow 1 or 2 warfarin patients, the honest answer is that software should not cost you anything. The work is small enough to hold in your head, and any subscription at all is worse than the spreadsheet you already have.
This is also the band the rest of the market prices out. When a 2-patient pharmacy is quoted the same monthly fee as a clinic many times its size, staying on a spreadsheet is not stubbornness — it is arithmetic. We would rather win that pharmacy at zero and keep it as its panel grows than send it a bill it is right to refuse.
So the first 2 are free, permanently — not a trial, not a countdown, not a card on file that starts charging in 14 days. If your panel stays at 2 for 3 years, you pay nothing for 3 years. If it grows, the ladder is published above and you will have known the number the whole time.
We are aware this is also good for us. A pharmacy that starts free and grows into a paying row is a better outcome than one that never starts. Both things are true, and we would rather write that down than pretend the free tier is charity.
Where the ladder stops
The top row is a ceiling, not a starting point for negotiation. Past 61 patients you pay $99 a month whether you follow 70 or 125.
Above 125 the page stops quoting and we agree the price with you. That is a stated limit rather than a hidden one: a panel that size arrives with a migration, more than one site and a team, and none of that is settled by a slider. It stays indexed on patients — that is still the only thing we count.
What the ladder rules out is the other model, where the bill climbs with every patient added and never stops. Past 125 there is a price to agree, but it is agreed once, not metered by the head. The clinic running the largest anticoagulation programme in its region is doing the work the health system most wants done well, and billing it per head, forever, would make us a tax on the exact behaviour we are trying to support.
The same product on every row
There is no tier where something you need sits behind a higher price. Every row includes:
- Every dose checked against the written protocol your clinic configures
- INR history, trends and time in therapeutic range
- Printable dosing calendars and prescriptions
- Appointment scheduling and reminders
- Team access with owner, editor and viewer roles
- Export of everything to CSV, whenever you want
The only thing that changes between rows is how many patients you follow.
How to evaluate this without booking a demo
A demo is a controlled environment. What you want to know is how the software behaves on your data, on a Tuesday, with a patient whose INR came back at 5.2.
- Start free and enter your 2 most annoying patients. Not a sample file — the 2 that take the longest today.
- Time the routine task. Result in, dosing calendar out, next appointment booked. If that is slower than your spreadsheet, nothing else matters.
- Try to get your data back out on day one, before you depend on it.
- Check the audit trail. Who changed what, and when.
- Find your row before you grow into it, so the price is never news.
What counts as a patient?
A warfarin patient you are actively following. Your row is set by how many you are following at the time, so a panel that shrinks moves you back down.
What happens when I cross into the next band?
Your row changes and the new rate applies from that point. Every band is published above, so you can see the next one coming long before you reach it.
Is the free tier a trial?
No. There is no countdown and no card. 1 or 2 patients is free for as long as that is your panel.
Do I pay per user?
No. Every row includes unlimited users, so everyone who touches the workflow gets their own login and their own audit trail.
What about more than 125 patients, or multiple locations?
Both go the same way: a conversation. Above 125 patients the page stops quoting a number, and one agreement across several locations is not something a ladder can express honestly either. It is the only row with a call attached, and what comes out of it is still indexed on patients.
Can I cancel?
Any month. Your data is yours and exports to CSV on the way out.