Cutting out the Middleman

By Paula Rosado

3 min read

I’m not a big follower of The National Basketball Association, but when Mark Cuban, owner of the Dallas Mavericks, told Forbes last year that the pricing for generic drugs was “ridiculous” I stood up and took notice.

You may remember Mark Cuban from the ABC reality series, Shark Tank. He also co-owns 2929 Entertainment, but his interests lie beyond basketball and reality shows. In an interview with Forbes Magazine, January 20, 2022, Cuban said that he wanted to “show that capitalism can be compassionate” and he added Cost Plus Drugs to his line of investments.¹

My leukemia drugs are very, very expensive

I’m a leukemia patient and I’ve been prescribed imatinib to treat this blood cancer. In the United States the retail price of this medication is $9,657 per month. It’s not a price for the faint of heart and results in many blood cancer patients scrambling for their life-saving treatment.

Here’s where I get interested in what Mark Cuban is doing.

Imatinib is a generic drug. It is also sold under the brand name Gleevec. Not every drug has a generic version until the patent has expired and the drug is tested and approved by the FDA. This can take decades. The Wall Street Journal reports that in some cases the markup on generic drugs exceeds 1000%. Maybe this is why Imatinib is so expensive?

Saving money of drugs by cutting out the middleman

The Mark Cuban Cost Plus Drug Company (MCCPDC) cuts out middlemen. It is a registered pharmaceutical wholesaler and purchases drugs directly from manufacturers and works with drug manufacturers and pharmacies to negotiate rebates and cost-saving discounts.

The online pharmacy’s prices for generic drugs factor in a 15% margin on top of the actual manufacturer prices along with a $3 pharmacist fee. For someone like me, my leukemia drug (imatinib) now costs $47 a month!

Reducing markups all along the supply chain

“The Mark Cuban Cost Plus Drug Company is trying to reduce patient’s drug costs by really any means necessary,” said CEO Alex Oshmyansky in an interview with the Dallas Morning News January 19, 2022. “In our online pharmacy, we’ve essentially found a category of drugs which are extremely expensive, not really because of the price from the manufacturer, but because of the price markups due to middlemen in the supply chain, primarily pharmaceutical wholesalers and pharmaceutical benefit managers.”²

Oshmyansky said that thousands of people created accounts when the Cost Plus website launched in January 2022. The company only accepts cash, currently, but Oshmyansky hopes to be able to add insurance as a payment option in the future. Currently, most insurance deductibiles and co-pays are higher than the prices charged by Cuban's online pharmacy.

In order to order medications from the Cost Plus website, customers must contact their doctors for a new prescription.

Lowering the cost of drugs reduces the burden

Cutting out the middleman makes a big difference in the cost of generic drugs. Cholesterol medication Atorvastatin typically costs over $55. The Cost Plus charge is $3.60. Blood pressure prescription Amlodipine usually runs around $50. Cost Plus has it listed at $3.30. It’s all on their website.

I’ve been astonished at the prices of some of the drugs I've been prescribed. It can really place a blood-cancer patient in a bind. What meds are really necessary and what can I do without? This is one of the questions I’ve asked myself.

Has this ever happened to you too? I’d really like to hear about it in the comments below. Thank you so much for reading.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Blood-Cancer.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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Yolanda Brunson-Sarrabo Moderator & Contributor
This was such an insightful read, Maria! I worked in the fashion industry so there's a similar cost thought when the middleman is added at the beginning of producing the product and the time it gets to the targeted customer, and that can be a pretty penny! You bring up a good point and I think this is where the transparency with your doctor comes into play. I won't say all but most doctors write prescriptions for the most popular drug without considering if your insurance will take it if the insurance does take it, how much is the co-pay? We really have to be cognizant and ask those questions while they write out these prescriptions. I think many get hesitant we hear the drug may be generic, but when it means cutting $$$ off the cost of getting the drug, it allows for some possibilities, especially if the drug does the same thing and has a good outcome as the branded medication. It also takes the doctors doing their part to know the best route in generic and prescribing meds that will be a win for us whether branded or not. I was ecstatic when I no longer needed those extra drugs that are claimed necessary and partners during treatment
Paula Rosado Moderator
Being able to discontinue a medication is a major win in my books! A generic drug and a name brand drug are basically the same, it just takes longer for the generic to reach the public. There seems to be a tug of war that the patient is caught in between. A middle man mania! The multiple for profit insurance companies each with their own procedures and reimbursement schedules hire armies of administrators to process forms. Staying on top of it all requires hospitals and doctor's offices hire medical coders who try to maximize reimbursements. It's incredible to see just how expensive this tug of war can be! I cannot say that it does much good for the health of the patient and I am very interested in how patients can avoid it all together, keeping as much money as we can in our own pockets.
Ramae Hamrin Moderator & Contributor
<inline-mention username="Maria Valente" user-id="3654780"/> That's really cool. I just went to his website, and the drug I take (lenalidomide) isn't on there (yet). I am so impressed by the savings on the other drugs, though. Especially on Imatinib! You know I am a big proponent of lowering the cost of prescription drugs. The one I take is $11,000 a month for 11 oral doses. We finally got the out-of-pocket maximum lowered to $2000 for Medicare patients, but that still leaves out many others who may not be able to afford their drugs. It's a work in progress, but we are finally getting somewhere! I'm so glad you are getting the word out about this (and are paying SO much less!) -- Ramae (Blood-Cancer.com team)
1. Paula Rosado Moderator
 <inline-mention username="Ramae Hamrin" user-id="3651272"/> That's a hefty price for Lenalidomide! One thousand dollars per pill! That's more per gram than gold, silver, diamonds put together! Even with Medicare that price is out of the reach for so many patients. At these prices a patient may often think, "Am I worth it?" and if so, "how can I afford it?". Having options makes all the difference to a person's self worth, not to mention that the better able we are to take care of ourselves the better it is for everyone. Emergency hospital visits are extremely expensive on the health are system. I really do hope that Cost Plus will be able to expand and give patients what we need at a price that we can afford. Thanks so much for commenting Ramae 😀
Ann Harper Moderator & Contributor
I can’t believe how much your medicine cost initially. That’s insane. I’m so glad you found out about MCCPDC. Thanks for letting us know. Ann (BloodCancer.com Team member)
1. Paula Rosado Moderator
 <inline-mention username="Ann Harper" user-id="3637920"/> From what I understand Gleevec (Imatinib) is often the first treatment option for CML patients. It is widely used and recommended. Wider access to this treatment makes a big difference for leukemia patients. It's a life saver. Thanks so much for commenting 😀
sfpdf Member
Super helpful article, Maria, even as I’m lucky to be down to a minimal number of meds and to have had good health insurance so that this hasn’t been a major issue for me. Hope you’re able to continue getting off meds and stay in good health!
1. sfpdf Member
 <inline-mention username="Maria Valente" user-id="3654780"/> I’ve taken an entire pharmacy of meds for side effects, more from the SCT than the leukemia, over the past few years. I’m down to Amlodopine (BP), Hydrocortisone (fatigue), Trazadone (sleeplessness) and OTC supplements for loss of bone density. I also still take Acyclovir, since I’ve not been able to successfully get revaccinated. Over the past couple+ years, I’ve had extensive respiratory issues which have led to long courses of Prednisone, which has led to most of the meds I’ve taken for side effects, which, other than the above, I’m gladly off of at this point. Hope I can keep it that way! Sfpdf (Peter)
2. Paula Rosado Moderator
 <inline-mention username="sfpdf" user-id="4205529"/> I hope so too! I have not had good experiences with Prednisone either. Sometimes it seems like the side effects can take over life as much as the disease. I am hoping that a treatment change might give me more control. Isn't that what it's all about? Let's bring this to kneel. Absolutely.