OBJECTIVES: To explore the estimation of cost calculations for delivery drug therapy distribution (unit dose, floor stock, and discharge) for neonates by using American Model with local cost. METHODS:  It is a 6-months cross-sectional analysis of drug distribution services for neonates in 2016. It was at 300-Bed Maternity and Pediatrics Hospital in Riyadh, Saudi Arabia. The cost calculated pediatrics drug therapy management services delivered to 82 beds. The physician prescribed the medications. The pharmacist reviews and prepared drugs and distributed through unit dose system, floor stock distribution, and discharge medications services. The medications prepared through ASHP standards and facilities. The nurse administers drugs and follows up by doctors. The fast moving oral and topical medications included in the study. The cost Model calculated based on variable expenses including personal cost, material, and supply cost. Fixed cost was including direct cost, non-salary cost, and overhead cost. All cost used of US dollar currency and local prices RESULTS:  The estimated cost of delivery of drug therapy services for all total number adults beds per day was (1,253.9 USD). It contained three types; the unit dose system (792.43 USD), drug floor stock distribution system (368.98 USD), and discharge medication order (92.48 USD). The cost of delivery of medicines to single bed per day was (32.66 USD) with the highest estimated cost of delivery discharge medication (18.5 USD), followed by unit dose services (9.66 USD) and floor stock therapy (4.5 USD). The majority of cost came from overhead cost, and material and supply in floor stock services and discharge medication delivery; while the personal cost in unit dose services delivery. The total estimated annual expenditures of Drug distribution services were (457,673.01 USD). CONCLUSIONS: The estimation cost of delivery neonatal medication therapy is a part of pharmacoeconomic program at pharmacy services and future vision 2030 in Saudi Arabia.