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OneroRx is a pharmacy oasis for the underserved

Originally published in Chain Drug Review/April 29, 2024

WEST DES MOINES, Iowa — From the start, OneroRx’s mission has been to provide a pharmacy lifeline to those in urban communities and rural areas living in a “pharmacy desert” without access to a neighborhood drug store. These deserts are continuing to multiply, creating significant obstacles for people to access vital prescriptions and important information relating to drug interactions, dosages and potential side effects.

OneroRx was founded in 2016 by John Pappajohn, an Iowa visionary

who had a passion for helping those in underserved communities. As an early venture capitalist, Pappajohn focused heavily on health care and medical technology, and OneroRx was one of many beneficiaries of his entrepreneurship. In 2019, current president and chief executive officer Joseph Dunham II joined OneroRx, bringing his experience in executive leadership positions at several private and public health care companies. Through 25 years in the industry, he has overseen more than $1 billion in mergers and acquisitions as well as advisory transactions.

The leadership team at OneroRx has always been focused on making health care accessible to everyone. They use the efficiencies of telepharmacy operations to reestablish pharmacy care in neglected markets, supported virtually by other retail locations. This holistic and integrated approach to pharmacy patient care combines telepharmacy services, prescription counseling, medication delivery and a digital ecommerce platform to immediately and positively impact community health and wellness.

OneroRx has leaned into a robust acquisition strategy throughout the Midwest to support its mission of providing integrated and accessible health care. As of May 2021, it had six pharmacies and 20 employees in one state and $6 million in annual revenue. In October 2021, it acquired a 22-location group in Iowa. In 2022, the company grew its portfolio by another 22, including a 15-location group in Missouri. By the end of 2023, OneroRx had 64 locations and more than 600 employees in six states and had more than $278 million in annual revenue.

Joseph Dunham II
Joseph Dunham II

“We are very excited about the growth we have seen over the past two years,” said Dunham. “We are committed to continuing to provide our patients with the best possible care and to expanding our reach to more people who need our services.”

This industry comes with its own challenges: DIR fees; continued restrictions on 340B programs that impact certain providers’ ability to provide care; and PBMs’ continued attempts to restrict networks and direct patients to their affiliated pharmacies that conflict with the patient’s right to choose.

Despite these hurdles, OneroRx remains optimistic for 2024 and plans to continue growing by expanding into new markets. It hopes to address medication affordability with the introduction of its cash card this year. The acquisition of specialty pharmacies will help decrease the cost of some of the most expensive prescriptions. It is also bridging the gap between patients and their community’s health resources by training select staff as community health workers (CHWs).

Operationally, OneroRx is improving efficiencies across the company, including standardizing its pharmacy management system and creating a business intelligence dashboard to consolidate key performance metrics. Building up its med sync program will benefit the pharmacy workflow while driving better patient adherence. As AI is developing across all industries, OneroRx is searching for ways to use it to improve efficiencies and patient safety.

Patient education is another focus for 2024, including combatting vaccine hesitancy and counseling on products to address drug-induced nutrient depletion.

“The industry continues to evolve just like everything else, and we are dedicated to searching for ways to use that to improve patient care,” said Dunham. “I believe there are opportunities for expanding care through partnerships with covered entities like long-term care facilities and hospitals. We are also going to see more demand for medical at-home going forward, which requires specialized compliance packaging capabilities.”




Joseph Dunham II, president and CEO


2929 Westown Pkwy, Suite 100, West Des Moines, Iowa 50266

Phone: (800) 601-9624


INDUSTRY RANK — 24 in sales, 21 in stores


  • Sales — $278.9 million

  • Number of drug stores — 64

  • Number of states operating — 6

  • Number of stores opened in 2023 — 12

  • Number of stores planned in 2024 — 4

  • Average store size — 2,500 sq. ft.

*CDR estimate. N/A= Not available.


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