Mark Cuban pharmacy & Medicare

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I posted recently about the Mark Cuban pharmacy, CostPlusDrugs.com, which sells direct to consumers and transparently charges a price of 15% over cost plus S&H. This now sells 300 generic drugs at large discounts from standard pharmacies with middlemen.

A group at Harvard calculated how much Medicare could save.

https://www.wsj.com/articles/buying-from-mark-cubans-pharmac…

**Buying From Mark Cuban’s Pharmacy Could Save Medicare Billions, Study Says**
**The program for seniors could have saved as much as $3.6 billion over one year if it had bought generic drugs from the pharmacy, Harvard Medical School researchers estimate**
**By Joseph Walker, The Wall Street Journal, June 20, 2022**

**...**
**A group of Harvard Medical School researchers say that Mr. Cuban’s “cost plus” business model could also benefit health insurers, including Medicare, which spent an estimated $115.6 billion on prescription drugs last year, or nearly a third of total U.S. drug spending. ...**

**Medicare’s drug program, called Part D, was created in 2003 and prohibits the government from directly purchasing medicines. Instead, private health insurers offer hundreds of different coverage plans around the country that are supposed to compete for patients by offering the lowest possible drug costs.** [This so-called system is maddening because each potential insurer offers a different list of covered drugs that changes every year. The drugs themselves are handled by a complex supply chain of middlemen which add markups. – W]

**Yet the paper, while pointing to a potential path for trimming Medicare spending, doesn’t address the costlier, tougher target of brand-name drugs that are protected from competition by patents. In 2020, generics represented 88% of Medicare prescriptions but only 19% of spending...** [end quote]

Before buying any generic prescription, regardless of insurance, check CostPlusDrugs.com, Blinkhealth.com and GoodRx.com. You could save hundreds of dollars compared with the insured price. I did for years with my cancer drug. The cheapest way is often 90-day mail order. If we can do it, Medicare should do it also.

Wendy

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Before buying any generic prescription, regardless of insurance, check CostPlusDrugs.com, Blinkhealth.com and GoodRx.com. You could save hundreds of dollars compared with the insured price. I did for years with my cancer drug. The cheapest way is often 90-day mail order. If we can do it, Medicare should do it also.

It depends. It works if you’re taking cheap generic drugs. But if you’re taking a $10,000/year medication, then it makes more sense to use your Part D drug insurance. You have to model each case individually based on the insurer’s drug formulary and which coverage “tier” the drug lands in, which is why some many people are getting screwed.

The two cheapest drugs I take cost $3 for a 90-day supply on my Aetna Part D plan (i.e., $12/year for each) Cash price on GoodRX for a year’s supply of the two would be about $70. Aetna charges $260 for a 90-day supply of the 3rd generic I take ($1,000+ per year) I have my doctor write a prescription for a 365-day supply in one fill and I can get it for less than $350 on GoodRX.

intercst

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a 365-day supply in one fill and I can get it for less than $350 on GoodRX.

I used to do that for a different drug–40 years ago. Cost: $30 (1 yr supply). Now, the identical cheap drug today is literally “not allowed to be sold” at that quantity.

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This now sells 300 generic drugs at large discounts from standard pharmacies with middlemen.

They manufacture the drugs themselves, so they are able to control a wide variety of factors. What they do NOT do is produce their own APIs (Active Pharmaceutical Ingredients)–the DRUG PART of the DRUG (i.e. the REAL medication). Most other manufacturers rely on outside producers of the APIs because making the actual drug is not cheap when made in relatively low volumes (most producers ARE low-volume buyers).

I also check Amazon Pharmacy because they offer the full range of drugs AND can offer them with OR without Part D coverage. A variety of drugs can NOT be purchased more than 90 days in advance, so there is that limitation.

Be sure to check your Part D drug administrator (mine is Express Scripts this year). They DO have mail order options that could save money. A variety of generic drugs are available with ZERO COPAY if ordered from their home delivery service every 90-days via mail order. I let them be sent using their auto-refill service and (thus far) no problems. I ONLY get pills, tablets, etc (i.e. drugs that will NOT be damaged by high heat or freezing temps). I specifically have ALL drugs in liquid form be hand-delivered locally by a local pharmacy. These can be expensive items, so having them go bad in transit (due to high temps or freezing) is an issue I am very careful to avoid. Neither CVS nor Walgreens do hand-delivery, so I use Capsule Pharmacy. They are in 3-5 cities, including NYC. Their model is built around delivery.

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Wsj article notes Cuban also adds $5 for shipping and $3 for pharmacist fees.

We used to have an LBYM Drugs board where such info was collected and discussed.

For generics on the list Walmarts $4 for 30 day supply or $10 for $90 day supply can still be best deal around.

We all hope the Cuban program will cause other companies to trim cost and match his pricing.

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a 365-day supply in one fill and I can get it for less than $350 on GoodRX.

I used to do that for a different drug–40 years ago. Cost: $30 (1 yr supply). Now, the identical cheap drug today is literally “not allowed to be sold” at that quantity.

Right. I’m sure you can’t get a 365-day fill for a narcotic or something addictive.

intercst