Mark Cuban Reads Random Thoughts!
[Post below was originally the 5th bullet point in “Sunday musings…” 1/16/2022″. After engaging a bit with Mr. Cuban (who is very accessible for a man as famous as he is) about drug costs and generics I wrote and posted this in the hope that Mark would put his considerable intellect and influence to the task of drug costs as a whole. To start a front to attack all of the financially malignant players (health insurers, PBM’s, bloated government regulations etc.) that stand between patients and the care they need and deserve. Mark recently did just this on X.com and elsewhere.]
Mark Cuban has launched a website/business called “Cost Plus Drugs” (costplusdrugs.com) to much fanfare, especially on Social Media of all sorts (Cuban is a plays SM like Yo Yo Ma plays cello). The concept is quite simple: buy generic drugs at wholesale cost, mark ’em up 15%, add a handling fee of $5 and ship ’em off to a waiting patient. The fanfare part comes in the marketing on the website. Each drug is compared with the retail price of the branded drug from which it was spawned. For example, $41 for a chemo drug compared with $9,600 for the brand. Brilliant, right?
Meh…not so much. First of all, if a super expensive drug is off-patent and there is now a generic equivalent on the market, essentially no one prescribes the branded drug anymore (caveat: equivalent in potency, side effects, etc.). Secondly, there are several options out there already doing a very nice job of this, thank you very much, without the hullabaloo surrounding Mr. Cuban’s offering. GoodRx and Costco come to mind. There’s somebody out there, can’t remember who, offering hundreds of generics for $4.00 a month. To the extent that Cost Plus Drugs continues to pressure the pharmaceutical industry and its high prices I suppose Cuban’s entry is a net positive.
Let’s step back and look at the real issue here, though: groundbreaking, new treatments are too expensive. I’m not talking about the outlandish prices of these branded, patent-protected drugs that people like Mark Cuban bandy about to make the price of their generic look so virtuous. No, I’m talking about the amount of money that comes out of the pockets of the people who need the newer medications for which a generic equivalent is not available (or who for whatever reason cannot take a particular generic). For all of Cuban’s bluster and bravado, the bruises that he is getting from patting himself on the back are all for naught. With very few exceptions people aren’t struggling to pay for generic chemo drugs, they are breaking the bank on the newer, more effective drugs.
In general, new drugs come in one of two varieties: minimally changed versions of existing drugs/”me too” drugs from a competing company in order to be in the market space, or truly innovative and new drugs that are a measurable upgrade in all ways from existing treatments. Yes, to be sure, there are some newcomers into a therapeutic space that have a similar mechanism of action as legacy drugs but really do work better in that treatment pathway, but they are a small minority; most are the same drug with a slightly different concentration or secondary delivery ingredients, patented and priced as if they were groundbreaking, new developments.
Where we need someone of Mark Cuban’s intellect, entrepreneurial zeal and all-around chutzpah is when the very best treatments, standard of care treatments, are not available as generics. Here the unholy triumvirate of manufacturer/pharmacy benefit manager (PBM) and insurance company put profit before patient (and healthcare worker) welfare. New, innovative treatments are priced so that the manufacturer can give a handsome rebate (kickback) to the PBM. A patient is then charged a co-pay which is a percentage of that artificially elevated price. This co-pay reduces the financial obligation of the insurance company to pay for the medication. If you’ve ever wondered why a medicine which was priced at $100 ten years ago is now $1,000, this is it.
If the Mark Cubans of the world want to have a real impact on the healthcare costs that matter, the costs to the patient themself, let them turn their attention here. It does us no good to have another do-gooding middleman saving patients a few dollars on widely available generic medications. This is the equivalent of hitting a single when you’re down 10 runs in the ninth. In eye care we don’t need someone to shave off a couple of bucks from the cost of Avastin as the first-line treatment for the devastating, sight-stealing disease macular degeneration; it’s like $50, so patients drop 10 bucks in the bucket on the way out. At big places like the Cleveland Clinic they pay more to park.
No, what we need is someone to step in and figure out how regular folks can afford Eylea or Lucentis, the branded medications that a majority of these patients end up needing when the Avastin stops working (as it almost always does). At $2000 a pop that 20% co-pay can run into thousands of dollars each year for folks who need injections every few weeks, sometimes forever. Cancer treatments that cost $40,000 per dose or truly revolutionary, life-saving drugs like the hepatitis C drugs that came out a few years ago that are now “only” $10-15,000. 20% of that is meaningful to most folks. Step up to the plate and take a swing at these, Mr. Cuban. Figure out how people who have terrible diseases that aren’t really all that rare can afford their medicine. You’re not a singles hitter. Figuring this out is the equivalent of hitting a walk-off grand slam in the 7th game of the World Series.
You were made for this, Mark.
This entry was posted on Wednesday, January 28th, 2026 at 12:57 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.