Master service agreement.

The master services agreement is the document that governs an institutional relationship with Reserve Meds. It is the durable framework under which a hospital system, a specialty clinic, a payer network, or a comparable institutional partner coordinates specialty access with us over time. It replaces case-by-case documentation with a standing legal and operational structure, and it gives both sides a record of what each has committed to. This page describes the structural elements of a typical MSA, what the negotiation and drafting timeline tends to look like, and what we flex on and do not.

Scope

The MSA defines the scope of the engagement: the geographies in which we coordinate for the partner, the therapy categories covered, the channels through which cases originate, and the partner-side operational contacts authorized to submit cases. Scope can expand over time by amendment; it is defined narrowly at the outset so that both sides have a clear picture of what is in and what is out.

Service levels

The agreement documents the service levels we commit to: intake acknowledgement within one business hour, feasibility signal within one business day, clinical and regulatory review completion within defined windows, sourcing and logistics commitments appropriate to the therapy category, and case closure within a documented window after administration. Where a case deviates from the committed window, the agreement specifies our notification obligation and the partner's remedies, which are operational rather than financial for most cases.

Commercial structure

The coordination-fee structure is documented in the MSA, typically as a schedule that distinguishes straightforward cases, complex cases, and cases requiring unusual handling. Drug cost, duty and freight, cold-chain, and any destination-specific costs flow through as documented line items, subject to the transparency standard we hold on all cases. Payment terms are negotiated; the default is per-case prepayment, with institutional credit terms available for partners meeting a financial-posture threshold. Invoice consolidation cycles are documented, as are reconciliation procedures and dispute mechanics.

Compliance representations

Both sides make a set of compliance representations. We represent that Altima Care holds the applicable US pharmacy license, that our wholesale partners hold their applicable wholesale licenses and operate under DSCSA, that we maintain the insurance the partner's diligence requires, and that we operate our pharmacovigilance and privacy programs under the frameworks described on our public site. The partner represents the corresponding items on its side, including the licensure of any receiving pharmacy, the authority of personnel empowered to submit cases, and compliance with the privacy framework applicable in the partner's jurisdiction.

Data handling and privacy

The MSA incorporates a data processing agreement, or an equivalent data-handling schedule, that documents how patient health information is handled between the parties. The schedule identifies the lawful basis for processing, the privacy frameworks that apply, the data-retention windows, the breach notification mechanics, and the cross-border data transfer posture. Where the partner operates under a specific regional privacy regime, the schedule reflects the higher of the applicable standards rather than the lower. We do not push back on privacy documentation that is in our capability to meet; we do push back on language that implies representations we cannot fairly make.

Adverse events and pharmacovigilance

The agreement documents how adverse events flow between the partner and us, including the reporting channels on both sides, the timelines for serious-adverse-event reporting, the respective obligations to notify manufacturers and regulators, and the record-retention practices that support later audit. The partner's own pharmacovigilance SOPs are respected, and our pharmacovigilance routing fits within them rather than displaces them.

Anti-kickback and anti-bribery

The MSA includes standard anti-kickback and anti-bribery language appropriate to the partner's jurisdiction, including, where applicable, compliance with the US federal Anti-Kickback Statute and the UK Bribery Act. We affirm that our coordination fee is not a rebate, is not volume-dependent, and is not paid to any prescriber or referral source. The partner affirms the corresponding items on its side. For partners in jurisdictions with specific healthcare-industry compliance requirements, additional representations are added on request.

Insurance

The agreement documents the insurance Reserve Meds and Altima Care carry, typically including professional liability, product liability, general liability, and cyber liability coverage, with the partner named as an additional insured where the partner requires it. The coverage levels are calibrated to the case volumes anticipated under the agreement; for high-volume engagements, coverage may be increased by amendment.

Term, termination, and exit

The MSA has an initial term and renewal mechanics, both negotiated. Termination for convenience is available to either party on notice, typically sixty to ninety days. Termination for cause is available on shorter notice for defined breaches. Exit obligations include orderly close-out of in-progress cases, a documented handoff of clinical and logistics records, and continued pharmacovigilance reporting for the retention period applicable rules require. We want a clean exit on both sides; we do not structure MSAs that would make unwinding the relationship punitive.

Dispute resolution

The agreement identifies the governing law and the forum for disputes. For partners in the United States, the default is a specified US state law and US arbitration; for partners outside the United States, the default is the law of the partner's jurisdiction and a neutral international arbitration forum. We are flexible on this clause where the partner's internal policies require a specific forum, provided the forum is reasonable.

Typical drafting timeline

From an exploratory call through a signed MSA, the typical drafting timeline is four to eight weeks, depending on the partner's internal legal cadence. Complex partners with extensive compliance review can run longer. A pilot-first engagement shortens the net drafting time because many of the operational questions have empirical answers by the time the MSA is drafted, which reduces the negotiation surface.

What we do not flex on

Three things. The first is our sourcing posture: every unit moves through DSCSA-serialized US specialty wholesale channels and moves through Altima Care. The second is our clinical and regulatory review posture: every case is reviewed, with human sign-off, and we decline cases that fail review. The third is our cash-pay posture: we do not structure engagements that route payer reimbursement through us, and we do not accept compensation structures that look like volume rebates. Where a partner wants to proceed on a basis that requires us to move on one of these items, we decline the MSA at the drafting stage rather than negotiate a compromise we cannot live with operationally. For broader context on our institutional posture, see enterprise and institutional partnerships.

Reviewed 2026-04-22 by Reserve Meds’s AI clinical and regulatory review agents. Human pharmacist-in-charge: Altima Care. Next scheduled review: 2026-10-22.