We turn hard decisions
into working systems.
We come from pharmacy, and we're small on purpose. Understanding comes before technology — and every system we ship starts with how the work really happens.
Thomas Barus, Pharm.D, RPh
Founder & President
Dr. Barus is a residency-trained pharmacist licensed in multiple U.S. states. His career spans retail pharmacy operations, PBM strategy, analytics, management consulting, software engineering, machine learning, economics, and product development across the United States, Canada, and international markets. Milligram Health and Phios grew from that uncommon combination of pharmacy expertise, economic thinking, and product-building capability.
"I have a passion for using data to gather novel intelligence that drives product and business value in healthcare."
Milligram is founder-led: Dr. Barus remains directly involved in the problems it selects, the systems it designs, and the products it develops. When you work with Milligram, the person who understands the pharmacy counter, the claim, and the codebase is in the room.
Around those problems, Milligram brings together specialist engineering, data, design, and healthcare expertise — assembled deliberately for each product and engagement, not as a large permanent consultancy.
Healthcare doesn't need another dashboard.
It needs better ways to operate — systems that help people make good decisions, fit naturally into real work, and get sharper with experience. Technology matters only when it does that.
You see a problem the market has missed.
We help turn it into a working product.
Launchpad is our selective co-building model for operators, founders, and investors with meaningful pharmacy or healthcare problems. You bring firsthand insight, access, distribution, or capital; we bring product strategy, pharmacy expertise, data, and engineering. Together, we determine whether the problem deserves a product — and what a fair partnership should look like.
Ownership, responsibilities, investment, and economics are agreed before development begins, and reflect what each partner contributes. Your idea stays yours — what you share is confidential, and we're glad to sign an NDA before specifics.
What that looks like in practice: our founding Launchpad partner holds an ongoing revenue share in the 340B module we built together — and a working product his own business scales on.
The principles behind every engagement
We pursue meaningful problems, not projects.
We don't chase work for its own sake. We take on challenges worth solving, and pass on the ones that aren't.
We build with partners, not for them.
The people who run the operation know things we never could. Their knowledge shapes the work from day one.
We measure success in years.
A finished project isn't the goal. Systems still creating value a decade later are.
Great products.
Great to work with.
That's the whole promise. No sales machine, no account layers — just a team that knows pharmacy, builds well, and stays involved.
Have an operational challenge
worth solving?
If solving it would help your team work with more clarity and confidence, it's worth a conversation.
Start a Conversation