General Billionaire Mark Cuban Opens Online Pharmacy To Provide Affordable Generic Drugs

[Eric]

First of all, WTG Mark Cuban! Secondly, people should be imprisoned for these prices.

Billionaire Mark Cuban Opens Online Pharmacy To Provide Affordable Generic Drugs

The company was launched out of stealth last year.

www.forbes.com

The Mark Cuban Cost Plus Drugs Company (MCCPDC) is a registered pharmaceutical wholesaler and purchases drugs directly from manufacturers, bypassing middlemen to lower the price of more than 100 medications, it said in a statement.

For example, the leukemia drug imatinib is priced at $47 a month on MCCPDC compared to the $9,657 retail price.

The online pharmacy’s prices for generics factor in a 15% margin on top of actual manufacturer prices and a $3 pharmacist fee, the statement said.

 

[SuperMatt]

First of all, WTG Mark Cuban! Secondly, people should be imprisoned for these prices.

Billionaire Mark Cuban Opens Online Pharmacy To Provide Affordable Generic Drugs

The company was launched out of stealth last year.

www.forbes.com

The government needed to step in the instant that insulin costs went through the roof. The pharmaceutical benefit managers collude with the pharma suppliers to keep list prices as high as possible.

How many times does it need to be said? The healthcare system in America is completely broken. Both parties should work together and replace it with something that costs far less and has far better outcomes.

 

[Joe]

I used to hate him back in the mid to late 2000s when the Spurs and Mavs had a huge rivalry.

 

[Alli]

What a mensch!

 

[AG_PhamD]

Okay, I’d like to say these articles about his pharmacy are a bit misleading…

1) Let’s be clear, this is a “cash-only” pharmacy, so insurance is not accepted. This is really only useful if your one of the 8% of Americans without health insurance, insurance does not cover your drug (probably unlikely as these are generics), or a few other unique circumstances. It’s also possible that your copay is higher than the cost of the drug, but this isn’t necessarily cheaper.

2) The example from the OP’s article, imatinib- it does not cost $9,657! Gleevec, the brand name version carries that cost, but Cuban is selling a generic. The generic can be had out-of-pocket for $40 already if you know where to look.

3) Many of the cheap medications like Prozac, Lipitor, Lisinopril, etc really are not any cheaper than what can be had using a program like GoodRx, other online mail-order pharmacies, or using an independent pharmacy.

4) It’s kinda strange they have vancomycin listed- vanco is a very, very potent antibiotic. It’s typically not something taken chronically except for C.Diff, otherwise not something you’d want to wait around for to get delivered for an acute infection.

That said, there are a few good deals I found looking through quickly. Imatinib is actually pretty good deal- but it’s a cancer drug… chances are you will have insurance one way or another if you have cancer. Chronic phase cancer meds are often a $0 copay though depending on your plan.

In general I’m not a fan of mail order pharmacies- too many problems with deliveries not coming on time or not receiving the correct amount of meds due to shoddy automation. Less patient-pharmacist interaction too which is a big enough problem with most community pharmacies.

It’s also worth noting cheapest isn’t always the best. Presumably he’s buying from the lowest bidder which is usually drugs from India and China. Not to say they can’t make good drugs, but they’re known for not having the same level of quality control. And depending on the specific drug, the manufacturer can result in clinically different outcomes (particuarly with hormones).

***My question is whether or not these prices will sustain or if this is just an introductory deal to make it seem like they’re doing something significant. Amazon was also supposed to revolutionize drug costs with their pharmacy service… but that ended up being far from the case.

I have a hard time believing they will be able to negotiate prices substantially better than their competitors in the long run. And there is a lot of competition in this space. If this business somehow actually threatened undercutting insurers, the insurers can easily rig the game in their favor- ie reducing copays while increasing premiums. Many have come before and made similar claims of revolutionizing the industry, I have yet to see much success. I guess we’ll see though…

 

[Alli]

1) Let’s be clear, this is a “cash-only” pharmacy, so insurance is not accepted. This is really only useful if your one of the 8% of Americans without health insurance, insurance does not cover your drug (probably unlikely as these are generics), or a few other unique circumstances. It’s also possible that your copay is higher than the cost of the drug, but this isn’t necessarily cheaper.

So what you’re saying is that he’s started a mail order pharmacy that is GoodRX. Quite often, GoodRX or SingleCare prices beat what’s offered by a lot of insurance companies. Not all insurance includes meds. My insurance for healthcare is usually quite good, but can be pretty bad when it comes to meds. On Medicare, my husband gets screwed every time with prescriptions.

 

[Huntn]

Okay, I’d like to say these articles about his pharmacy are a bit misleading…

1) Let’s be clear, this is a “cash-only” pharmacy, so insurance is not accepted. This is really only useful if your one of the 8% of Americans without health insurance, insurance does not cover your drug (probably unlikely as these are generics), or a few other unique circumstances. It’s also possible that your copay is higher than the cost of the drug, but this isn’t necessarily cheaper.

2) The example from the OP’s article, imatinib- it does not cost $9,657! Gleevec, the brand name version carries that cost, but Cuban is selling a generic. The generic can be had out-of-pocket for $40 already if you know where to look.

3) Many of the cheap medications like Prozac, Lipitor, Lisinopril, etc really are not any cheaper than what can be had using a program like GoodRx, other online mail-order pharmacies, or using an independent pharmacy.

4) It’s kinda strange they have vancomycin listed- vanco is a very, very potent antibiotic. It’s typically not something taken chronically except for C.Diff, otherwise not something you’d want to wait around for to get delivered for an acute infection.

That said, there are a few good deals I found looking through quickly. Imatinib is actually pretty good deal- but it’s a cancer drug… chances are you will have insurance one way or another if you have cancer. Chronic phase cancer meds are often a $0 copay though depending on your plan.

In general I’m not a fan of mail order pharmacies- too many problems with deliveries not coming on time or not receiving the correct amount of meds due to shoddy automation. Less patient-pharmacist interaction too which is a big enough problem with most community pharmacies.

It’s also worth noting cheapest isn’t always the best. Presumably he’s buying from the lowest bidder which is usually drugs from India and China. Not to say they can’t make good drugs, but they’re known for not having the same level of quality control. And depending on the specific drug, the manufacturer can result in clinically different outcomes (particuarly with hormones).

***My question is whether or not these prices will sustain or if this is just an introductory deal to make it seem like they’re doing something significant. Amazon was also supposed to revolutionize drug costs with their pharmacy service… but that ended up being far from the case.

I have a hard time believing they will be able to negotiate prices substantially better than their competitors in the long run. And there is a lot of competition in this space. If this business somehow actually threatened undercutting insurers, the insurers can easily rig the game in their favor- ie reducing copays while increasing premiums. Many have come before and made similar claims of revolutionizing the industry, I have yet to see much success. I guess we’ll see though…

I’m ok with mailorder services, through both UHC and now Express Scripts (Medicare) it has worked well for us for decades. Now maybe you are not referencing delivery by mail in general, but mail order pharmacies?

 

[AG_PhamD]

So what you’re saying is that he’s started a mail order pharmacy that is GoodRX. Quite often, GoodRX or SingleCare prices beat what’s offered by a lot of insurance companies. Not all insurance includes meds. My insurance for healthcare is usually quite good, but can be pretty bad when it comes to meds. On Medicare, my husband gets screwed every time with prescriptions.

It really depends on the plan and the medications you’re on. The uninsured rate for those without arc coverage is like 11%. For example, Express Scripts and Caremark, the two biggest PBMs, will not charge you more than the copay of the cost of the drug is less. If you have OptumRx, they are pretty notorious for overcharging. Several years ago copays exceeding costs were rampant, but I’m seeing less and less of that. I think that trend will continue as congress is finally mandating that PBM’s cannot ban pharmacies they’ve contracted with from informing their clients that the drug would be cheaper without insurance.

A big part of my job is finding the most clinically effective treatments and the lowest cost and I do work with patients to make sure they can afford their meds. GoodRx and similar programs do come in handy, but it’s usually if the person is between insurances or their insurance or has come internationally for treatment or doesn’t cover the medication (ie Propecia or benzos and Medicare). Granted, in MA there are very few uninsured people here because of our state funded programs which I realize is not the case in many places.

Also note that the costs of this pharmacy do not include shipping, which is $5 for regular shipping, $15 for expedited.

For example, Lisinopril 20mg is $4.20/30 days or $6.60/days with Mr. Cuban… plus $5+ for shipping. With my insurance it would $1.49/30 days or $2.87/90 days. At Walmart it’s $4/30 days and $8/90 days at Shaw’s. At another online pharmacy (with free shipping) it’s $3/30 days or $9/90 days. My dad takes this exact Rx and pays less than $10 for 90 days through UHC/OptumRx at the local pharmacy.

Another thing to consider is that cash prescriptions don’t count towards your deductible or medicare donut hole, which may not always be the best depending on what’s expected in the future.

This business doesn’t offer a huge incentive over existing options for already low cost drugs. There may be some select drugs where they can get a better deal… but most of these drugs are not that common. The #2 advertised drug on the front page is albendazole, which is used for treating tapeworm and similar parasitic infections- which is rare-very rare in the US. And idk why you’d wait to have it delivered by mail when infections are considered time sensitive.

Idk, this largely seems like hyped up marketing to me. “Cutting out the middlemen” does not really describe how they’re saving money. Most of the drugs I’ve looked at end up being the same price or more when you factor in shipping as other options.

If we want drug prices to change there has to be fundamental changes to the underlying system. And that’s my problem with hyping up something like this, it’s nothing new and takes the eye of the ball of actually having proper reforms.

 

[AG_PhamD]

I’m ok with mailorder services, through both UHC and now Express Scripts (Medicare) it has worked well for us for decades. Now maybe you are not referencing delivery by mail in general, but mail order pharmacies?

I suppose it’s a matter of preference and convenience, especially if you’re on top of your meds as I’m sure most people are here. I am very much opposed in seniors and those who have no interested in understanding what it is they are taking.

There have been many cases of people, especially seniors, having zero idea what they are taking and one day for whatever reason a certain drug doesn’t show up- the prescriber forgot to send in a refill, there was an insurance issue, the mail order pharmacy messed it up, it got lost in the mail, whatever. So they stop taking the medicine figuring that’s what the doctor decided or not noticing at all and then suffer some catastrophic health event and maybe death. This actually happened to a great uncle(?) of mine- I didn’t know him.

At least if they go to a pharmacy they’re more likely to have a relationship with its staff, there’s usually greater level of oversight when you can talk to the patient, there’s an opportunity for questions to be asked without having to dial through phone menus, etc.

Conversely mail order has been shown to extremely wasteful (adding unnecessary cost). First, they generally only send 90 day supplies which is fine if the patient is going to take it chronically, but creates enormous waste if the medication ends up being switched. Like a patient will stop taking a medication, but mail order will automatically send it. When the refills run out, prescribers get a message and most blindly approve the refills, continuing the cycle. There’s been instances of people dying and the shipments not stopping.

I had a problem like this with ExpressScripts almost a decade ago. I was taking 800mg of gabapentin 4x and day x 90 day supply = 270 giant horse pills. I stopped taking it and for almost 2 years they kept sending it to me. I would call to stop it, it wouldn’t come for a month, and then next thing you know you have more on your doorstep. I had like 1600-1800 pills. Amazing too considering some states now consider gabapentin a controlled substance.

We have certain programs at my hospital where residents end up continuing to get their meds through mail order (esp if they’re non-formulary) or outpatient programs where meds get counted by staff for compliance. Usually the mail order pharmacy uses automation to count- typically weight based counting. ExpressScripts generally gives slightly more than they should, but there’s a couple MOP’s that routinely are undercount (and we know because they are shipped to the hospital). If it’s several $0.25 pill who cares, but it’s a different story if it’s several $50 pills.