How Mark Cuban’s drug company compares with PBMs on price: 7 notes

A September analysis by consulting firm 3 Axis Advisors, completed on behalf of Mark Cuban Cost Plus Drug Co., compared the company’s prices with what pharmacy benefit managers charged 13 commercial employer plans for the same drugs in 2024.

Here are seven things to know:

1. The analysis covered 1.2 million claims and $433.5 million in total charges. Cost Plus had prices for 71.5% of the claims but only 14.4% of the spending, or $62.4 million, because it does not sell most high-cost specialty drugs.

2. Repricing those claims at Cost Plus’ rates would have cut the PBM charges from $62.4 million to $20.8 million, a $41.7 million or 67% reduction, equal to about 9.6% of the plans’ overall drug spending.

3. Savings were concentrated in biosimilars of Humira and Stelara, which accounted for $30.7 million of the total, a 93% reduction. Generics saved 37% and brand-name drugs saved 32%.

4. The authors had no rebate data, so the brand and biosimilar comparison does not show what employers netted after rebates. They estimated rebates would need to be about $11,000 per claim to match Cost Plus’ savings on Humira and Stelara.

5. The largest per-prescription difference was for dasatinib, a leukemia drug, at an average of $24,932 under PBM pricing versus $1,987 at Cost Plus. Only three of the 10 drugs with the biggest savings had a national average drug acquisition cost benchmark, which the authors said limits employers’ ability to verify what they are charged.

6. Cost Plus was more expensive on low-cost generics. Its average labor and shipping fee is $10.40 per prescription, and 48.5% of claims had total PBM charges below that. The study also found Cost Plus’ ingredient costs were about 25% below the national average acquisition cost and that 90-day fills could cut generic claim costs by about a third because dispensing fees make up roughly half of the total.

7. The authors noted the findings cannot be extrapolated to all drug spending, since they cover only drugs Cost Plus offers. They also assumed members’ out-of-pocket costs would stay the same and used employers with different PBM contracts. The analysis comes as Cost Plus builds its employer business, including a partnership with Humana’s CenterWell and expanded PBM, health plan and hospital wholesale partnerships.