OBJECTIVES: Programs to increase medication adherence are receiving increased attention.  One incentive for pharmacies to implement such services is the potential increase in revenue.  The objective was to estimate changes in revenue a community pharmacy during the first three years after implementing a new medication management service (RxSync ServiceSM).   METHODS: A Markov economic model was developed using Excel.  Model inputs are average week day/weekend patient volumes, current average medication possession ratio (MPR) for chronic medication prescriptions, expected MPR for patients enrolled in the service, goals for enrolling existing and new patients into the service, current gross prescription sales, and net profit on prescription sales.   A three year time frame was used to estimate yearly increases in net revenue and monthly patient enrollment and increases in prescription volume.  Model assumptions are based on data collected from five pharmacies participating in a project with the RxSync ServiceSM.  RESULTS: A conservative scenario (70% of current target patients in 18 months) resulted in a peak of 414 additional prescriptions/month at month 30 and increases in net revenue of $2956, $8415, and $9490 for the first 3 years.  An aggressive scenario (12 months) resulted in a peak of 414 additional prescriptions/month at month 21 and net revenue increases of $4896, $9364, and $9531.  Adding a goal of 200 new patients, starting at month 6 and finishing 12 months later resulted in a peak of 1,208 new prescriptions/month at month 21 and net revenue increases of $8,438, $26,386, $27,806.  CONCLUSIONS: The model demonstrates that an effective medication adherence management program can increase net revenue for a community pharmacy.  The increases will be relatively small the first year of implementation unless a fairly aggressive recruitment strategy is used.  If economic factors are importing when starting the service, recruitment of new patients should be a high priority in the implementation strategy.