Mark Cuban's Drug Company Could Save Medicare Billions
The new company uses a simple approach to provide lifesaving drugs to consumers at radically discounted prices.

Mark Cuban's online pharmacy was founded to sell prescription drugs at the lowest and most transparent prices possible. As Cuban recently told PBS News Weekend, when it comes to medication, "the reality is the only number that matters is cost. What can we as the retailer or the distributor, buy it for and how low can we sell it? So we decided to take the exact opposite approach that politicians have been taking."
That approach involves selling generic drugs for a 15 percent markup, plus $3 for pharmacy labor and $5 shipping. The result is that Cuban's company is able to sell generic drugs at significantly lower rates than typical retail prices. For example, a 30-day supply of Amlodipine, a common high blood pressure medication, costs only $3.60 at Cost Plus Drugs, while the typical retail price is $50.10.
Some drugs have even higher savings. Becker's Hospital Review recently published a list of the 50 drugs with the biggest savings at Cuban's pharmacy. Albendazole (generic for Albenza) topped the list, saving consumers over $6,000 for a 30-count supply. In all, 14 of the top 50 discounted drugs save consumers over $500 for a 30-count supply when purchased from Cost Plus Drugs.
Cuban's company is restricted to unpatented generic drugs. While Cuban can sell these drugs at a massive discount, it is worth noting that research into new drugs, as well as the costs of clinical trials, is funded by the high profit margins derived from patents. While Cost Plus Drugs is a welcome innovation for drugs that are no longer patented, Cuban's business model likely can't fund drug innovation.
Praise for the company exploded this month as customers took to Twitter to share the massive discounts Cost Plus Drugs offered on their medications. One user tweeted, "so one of my medications is $990/mo for 9 pills… with insurance… Mark Cuban's new company @costplusdrugs has it for $3.90/pill." Another person wrote, "My monthly generic meds would be less than half the price of what my insurance charges me," saying that Cuban's company "could be a game changer." Even Kim Kardashian shared her excitement for the company, writing that "everyone should be able to purchase the life saving medications they need at affordable prices!"
Why hasn't this model been done successfully before? "I don't believe it's too simplistic to say that the answer is 'greed,'" says Lucia Mueller, the vice president of operations and communications at PharmacyChecker, an organization that helps patients find affordable medication. "If your desire is to center profit instead of health outcomes, the pharmaceutical and healthcare industries have spent decades putting on a masterclass."
Cuban himself notes that Cost Plus Drugs isn't the first company to try this approach, but it is the first to succeed: "Entrepreneurs like myself will build up the companies, the equivalent of a costplusdrugs.com. And then…the five big pharmacy benefit managers or the big insurance companies, they'll buy them."
Last week, a new study from the Annals of Internal Medicine estimated that if Medicare Part D plans had purchased generic drugs from Cuban's company, Medicare could have saved $3.6 billion in 2020.
The study compared expenses on 89 generic drugs and found that 77 of the drugs were cheaper to purchase at Cost Plus Drugs. The authors wrote that their "findings suggest that Medicare is overpaying for many generic drugs." They add that "generic drug competition is a major source of prescription drug savings in the United States, but the lower prices from a direct-to-consumer model highlight inefficiencies in the existing generic pharmaceutical distribution and reimbursement system."
Cuban has been vocal on Twitter about the study, asking President Joe Biden and other political leaders to "have your people call my people and let's get this done." However, as exciting as reducing Medicare's budget sounds, progress on the issue seems unlikely. Legislative solutions to the high price of prescription drugs have often been slow-moving and stalled by partisan bickering.
According to Cuban, political inefficiency was a major driver in the creation of Cost Plus Drugs. "It was obvious there was not going to be a political solution," he told PBS News Weekend. "And even the attempts that are being discussed don't really get to the heart of the problem, setting a price or doing a discount against other prices. All these numbers work from artificially set retail and wholesale prices."
With government action on affordable health care patchy at best—despite massive spending—Cuban has used a simple idea to provide life-saving, truly affordable drugs to millions. "That people have to choose between eating, you know, their rent, and taking their medications or buying their medications in United States of America and 2022. It's just wrong," he said. "I've been incredibly blessed in that my next dollar is not going to change my life. But my ability to invest in costplusdrugs.com is an ability to change millions of lives in this country, if not tens of millions over the next two years."
Editor's Note: As of February 29, 2024, commenting privileges on reason.com posts are limited to Reason Plus subscribers. Past commenters are grandfathered in for a temporary period. Subscribe here to preserve your ability to comment. Your Reason Plus subscription also gives you an ad-free version of reason.com, along with full access to the digital edition and archives of Reason magazine. We request that comments be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of reason.com or Reason Foundation. We reserve the right to delete any comment and ban commenters for any reason at any time. Comments may only be edited within 5 minutes of posting. Report abuses.
Please
to post comments
We need a billionaire who'll do for pharmaceuticals what Jobs did for electronics, and Musk is doing for electric cars and rocketry.
Yeah, no. Steve Jobs is not even close to an electronics pioneer, nor a cheap and useful computer pioneer. Musk is not a cheap EV pioneer, but he is a cheap reliable rocket pioneer. So you get 1 out of 4.
Jobs combined readily available technologies into a non-obvious and clearly superior product. He wasn't just a marketing guy.
Steve Jobs sold the Computer For The Rest of Us, but it was never (nor is it now) a cheap or low-cost item.
I think you're confused. You seem to think I was saying those two invented things. That's not what I was saying and not what they did.
Those two broke through the conventions and stasis in their respective industries and got them moving again. Not just in their own companies but industry wide.
Jobs pushed personal computing out of the realm of hobbyists and IBM office plans. The iPod and iPhone were ground breaking products five years ahead of the competition.
Musk did the same thing with EVs, creating a product that was also five years ahead of what GM, Ford and Nissan were offering. He made EV's desirable and then aspirational.
The starship is 20 years ahead of all the others, and other rocket companies have been knocked out of their complacency and are innovating again.
Edison and Henry Ford also did the same.
This is what the drug industry needs. Someone to push it out of its rut.
We need to end the practice of evergreening drug patents.
#LibertariansForGivingPeoplesStuffAway
"who'll do for pharmaceuticals what Jobs did for electronics"
Nonsense. That is the current model (overpriced, under powered, walled garden with name cache). We need Michael Dell.
A guy making drugs in his dorm room?
Jobs and Musk pushed their whole industries forward. Dell didn't.
Here's hoping.
Though, if the numbers given here are correct then I'm suspicious of what prevented some previously greedy person from charging a mere 100% markup, make a ton of money, and still undercut the competitors by huge amounts. I doubt this is the whole story, and I wouldn't be surprised if there's some regulatory story here that has led to these conditions.
TFA says that those companies got bought up by the crony companies and disappeared.
I saw that, that's suspicious as well, as there are a lot of people willing to undercut these other groups that could just keep popping up if it was so easy. It has all the signs of a highly regulated industry.
And so I want to know what Cuban's supposed secret is. The idea that it's simply he's not greedy seems like advertising more than anything.
It's like auto insurance. Pretty much every company has the same rate within a few dollars
It's not collusion, they just know how much they can get away with and do
There needs to be a reason nobody has successfully done this before, undercutting costs dramatically with still-ridiculous profit margins in order to corner the market. It's a basic rule of economics that if you're overcharging, someone is going to swoop in and undercut you, and you'll have to cut prices to match.
There's more to this than we're being told. I'm going to guess that part of the problem is distribution, and that there's certain rules in Medicare/Medicaid that keep them from embracing certain models that leads to everyone chasing Medicare dollars.
That seems like a good guess. Medicare only allows one to buy from those 5 companies or something. But, I don't know.
I hope I'm just wrong and this is just that it really did take this long for some venture capitalist to jump into this field and stick it out.
Like, here's their website: https://www.costplusdrugs.com/
They list a leukemia drug, saying a 30 count costs 39.00 dollars from them, and 9657.30 dollars from other pharmacies. If some other venture firm had come in, limited their price to a mere 10,000% mark-up, and sold only that drug, they would be opening themselves up to huge profits.
It appears the non-generic version of the drug brought in 3.5 billion dollars in revenue in 2016. So, let's presume this new firm is able to get 1% of that market, even with that lower margin that one drug is bringing in about 18 million dollars in profit a year. No RnD because you're just reselling generics. That's a ROI that would be almost impossible for any company to buy out directly, unless the investors were just straight up stupid.
Lots of assumptions there though. I do not know if this is even close to correct, my only point is that it seems suspect that it's as simple as greed, but really short term, easily bought out by other companies greed.
But this is Reason. Surely if there'd been a sniff of such a story, they'd've had a reporter on it.
If Cost Plus became a major Medicare supplier, would they still be able to offer the same discount to everyone, let alone to Medicare or Medicaid?
Or, would the regulatory and compliance red tape clog up the works and make the entire concept much less efficient?
"Or, would the regulatory and compliance red tape clog up the works and make the entire concept much less efficient?"
This. Cuban has no idea what he's getting into.
He can only sell that cheap because he doesn't give 10% to the big guy.
Federal charges (or suicide) within 30 days.
This "article" is just advertising copy.
This.
It's shameful.
Yeah, because the Cuban health system is so great.
Sad thing is, I'm not sure if this comment is meant as a joke or not.
Good sarcasm is like that.
Joke of a comment for joke of an article
This is only possible because a billionaire wants to do it. A company that had shareholders would raise prices to that of its competitors.
Not true. There are many, many non-profit organizations in healthcare. Their pricing is not distinguishable from that of for-profit companies.
There's a lot of room for undercutting the numbers they're naming and still generating profits so high that it would be among the most profitable companies in the world. So, something is fishy here.
It's only possible with massive volume, but whether there is one share or a million the margins do not change.
Elizabeth Warren's head exploded when she read this article.
God damn I love capitalism.
*Not trying to imply that MedicAid or Medicare are capitalist, just love that someone is willing to take the risk with ostensibly their money.
Mark is about 12 years late to the party, #DirectPrimaryCare clinics (which are ins free) have been doing wholesale meds since 2010 at 95% less than retail.
Over all #dpc wholesale meds are 80% cheaper than amazon, 70% cheaper than goodrx, and 45% cheaper than Cuban.
Why hasn't this model been done successfully before? "I don't believe it's too simplistic to say that the answer is 'greed,'" says Lucia Mueller, the vice president of operations and communications at PharmacyChecker, an organization that helps patients find affordable medication. "If your desire is to center profit instead of health outcomes, the pharmaceutical and healthcare industries have spent decades putting on a masterclass."
Sounds like an unbiased source.
Cuban has been vocal on Twitter about the study, asking President Joe Biden and other political leaders to "have your people call my people and let's get this done." However, as exciting as reducing Medicare's budget sounds, progress on the issue seems unlikely.
Because Joe Biden's childish metric of how successful a bill is, is based on how much money they spend. When your goal is to spend a ton of money regardless of how effective or how targeted, you're not going to be interested in finding ways to be more efficient. You've got that huge budget, and if you want to keep it, you have to keep spending it, so buy the most expensive stuff.
It's also useful to use federal dollars to buy expensive drugs from big companies that can owe you favors later. It's not your money, after all, you're just directing it to people, and they can help you out later.
Color me skeptical. OK I have been meaning to examine this claim more closely, but someone should point out that we are talking about GENERIC drugs. And generic drug prices have been falling for 10 or so years. In 2020, when inflation was 4.2%, drug prices fell 1.8%. Don't let's give Cuban credit for what competition is doing.
The loudest complaints of the anti-drug company lobby are about the prices of patented drugs. Without missing a beat, the usual suspects calling for price controls for new drugs (e.g., Harvard's Aaron Kesselheim) have "validated" Cuban's ideas for lowering prices of generic drugs. That is suspiciously like bait and switch.
You might have expected Cuban and Kesselheim to applaud the declining prices of generic drugs, but if they have, that is news to me.
Nice press release a Reason 'editor' has decided to print.
Maybe you should try being remotely honest. Even GoodRx says that the average retail price for amlodipine is half of what you say it is.
https://www.goodrx.com/amlodipine?c=homepage-lander-sem-7&optly_audience=%7Bgeoiplogo%7D&utm_campaign=127243741&utm_content=7699746781&utm_source=google&utm_medium=cpc&utm_term=kwd-54255549541&gclid=EAIaIQobChMIoOy_6YvR-AIVnBXUAR3lDQkJEAAYASAAEgJP1fD_BwE&gclsrc=aw.ds
And BOTH of you are using exaggerated "full retail" that nobody actually pays.
Yeah, it seems like this isn't some brand new idea Cuban came up with. Thanks for injecting some reality here. I mean, I was skeptical, but I didn't look up the exaggerated claims at all.
The idea that high profits on current commodities are needed to fund the R&D on tomorrow's commodities is anti-economic.
Take out the estimated $1B to get the FDA to pass a new drug and the R&D costs fall substantially...
"The idea that high profits on current commodities are needed to fund the R&D on tomorrow's commodities is anti-economic."
An idea that does not even apply here because these are generic drug prices we are talking about. Generic drugs have no R&D costs, only the cost of bioequivalency testing, filing an ANDA, and actual manufacturing expenses.
“That approach involves selling generic drugs for a 15 percent markup, plus $3 for pharmacy labor and $5 shipping.”
Progressives will complain about the capitalistic markup.
To protect their investment in the undumb Right, the Kochs should provide Reason writers with remedial science and math instruction.
Ron has long and clearly with the program in defending Pharma patent trolls , but Emma seems unaware of the quantitative bottom line: most of the most widely prescribed drugs are fairly simple molecules costing tens to hundreds of dollars a kilogram or less, which translates into pennies to dimes a pill.
Cuban is simply treating drugs past their patent life as the cheap commodities that they are.
"Retail" prices for healthcare in the US are completely fictitious. Pull out your latest statements and look for the "adjusted" amounts. "Adjusted", what does that mean? Adjusted by whom? For what reason? You're never told.
The amounts are eye-watering. The stated price is easily 2 or even 6 TIMES the amount actually paid in some cases. So, what is the true cost of healthcare in the US? No one knows, and that's intentional. But it's not much more than the amount that Medicare pays. The US government is the only insurer who openly publicizes exactly what they will cover and how much they will pay. CMS is the only transparent insurer in the entire industry. Remember that when your mailbox starts filling up with Medicare "Advantage" flyers (yeah, those are " advantage" plans, alright -- but the advantage is not yours.)
Everyone should know that buying generics at a discount is as easy as going to a discount retailer like Costco or an online pharmacy. The "trick" is to NOT use insurance for these, buy them out of pocket.
Dr. David Belk wrote a book on this subject, and I highly recommend it. I pulled out my own bills and saw exactly what he describes. I then went to Costco and compared prices. I've been looking at Medicare plans and reading the details. It is rather infuriating that this has been made so difficult to understand. Like all scams, I suppose. I just didn't expect that so many people would be "in" on it.
His website has the details, https://truecostofhealthcare.org/
I used to take a medication that cost $180 per month and that was just the insurance co-pay. About six months after I started it the patent expired and it was available in a generic. The cost went to $3.75 a month after the Pharmacist recommended that I just pay for it out of pocket and not through insurance where I'd have $10 co-pay.
I noticed that nobody mentioned the 400 lb. gorilla in the room. Most European Countries and Canada tell the Drug Companies what they can charge for medication. The US doesn't. In effect we are subsidizing those countries.
Just what we need - another incentive for illegals to flood across our border. If Cuban offered all these medications at a penny a pill, the lunatic left will still say it's all about white privilege and is racist, put another 75 billion into the (mid term / Presidential election year) budget to help those who can't afford a penny a day.
The model works because it has a very narrow, SKU-controlled product line. It isn't trying to be all things to all people, so their inventory requirements are very tight. The are basically buying a product and sending it on without anything added, so there is no need for innovative employees (who cost a lot more). Most of the work can be automated, so you need a minimal workforce.
It is a highly efficient, low-cost operation because they have targeted a very small product line with low costs and multiple providers (generic drugs).
Think of it this way. If you want to sell t-shirts and you know 75% of the market is black, grey, and white, producing only those three colors allows you to have almost no dead inventory (colors that don"t sell), low wholesale pricing (due to both your purchase volume as well as the total volume of the product purchsed by all retailers), cheaper warehousing and distribution costs, and lower skill requirements in employees. Plus with online, direct-to-consumer sales you are using the highest-profit sales channel there is.
The problem with such bare-bones companies is they usually can't resist trying to be more than what they are. If they stay as a SKU-controlled, generic-only, direct-to-consumer company, they can stay reasonably profitable indefinitely. If they try to expand their product line too far (targeting lower-volume, higher margin drugs or trying to grt into patrnted drugs) they would screw up the model. And nothing will cause a company to dail faster than having your product line and your business model be incompatible.
First of all, if each order comes with $8 in flat fees that have to be paid, then the actual cost for that prescription is $11.60. That might seem like picking at nits until you realize that Amlodipine is one of hundreds of prescriptions that Walmart sells for $9 for a 30 day supply. They've had their $4 prescription program for 15 years, and introduced the $9 tier more recently. The national average cost for a gallon of gas as of today is $4.87. An estimated 90% of Americans live within 15 miles of a Walmart store. Even if you're driving an 8 cylinder pickup you're still probably getting close to 15 MPG city. So including the cost to drive to the store in a truck and pick up your prescription from the drive-thru window, the same prescription costs $13.87. If you're like most people you probably don't drive an 8 cylinder pickup that gets 15 MPG. If you're in a medium sedan from the last 15 years you probably get something more like 25 MPG. Splitting the difference, at 20 MPG the total cost including driving to the store would be $12.66. Suddenly we're talking about an extremely trivial savings. Which is great, don't me wrong. But Cuban's approach is not at all novel. Low margin, high volume. The story of literally every discount retailer since the industrial revolution. This warranted an entire 827 word hagiography?
You're right about the $8. I guess it would depend on whether they charge $5 per drug or $5 per order. If you get 5 drugs and they all ship together as one order for $5, it would make a difference ($20 per order, but $240 per year on shipping alone would make a difference for a lot of people).
Anyone know if is per order or per drug?