A pharmaceutical clearinghouse establishes relationships with a network of FNA Agents servicing requests from patients under institutional patient assistance programs, and with a network of pharmaceutical providers. In response to the clearinghouse receiving a patient request for a pharmaceutical from an FNA Agent, the clearinghouse obtains a subsidy from at least one in-network pharmaceutical provider and provides the subsidy to the FNA Agent; the subsidy may be cash, in-kind pharmaceutical or a combination thereof.