Mark Cuban has spent more than five years building something the healthcare industry is still figuring out how to respond to.
What started as a mail-order pharmacy selling generic drugs at transparent prices has grown into a sprawling operation spanning manufacturing, wholesale distribution, retail pharmacy, direct contracting and federal drug policy. Each added layer has been designed to add volume, drive down costs and cut out the big intermediaries that Mr. Cuban argues has made U.S. drug pricing indefensible.
“I came in as an entrepreneur and said, let’s just look at this as like I would any Shark Tank company. And really, what it comes down to is just following the information flow and money flow,” he said at Becker’s Chief Pharmacy Officer Summit in April. “Our ultimate product isn’t drugs, it’s trust. Trust equals transparency, divided by self interest.”
Though Mr. Cuban has not disclosed revenue figures publicly, he forecasted “billions” in future sales. As for the company’s current growth rate? “Every day, it’s a new record.”
Here is how each piece of his healthcare playbook fits together.
1. Drug supply (Cost Plus Drug Co.)
The company grew from a cold email from Alex Oshmyansky, MD, PhD, a radiologist and entrepreneur who pitched Mr. Cuban on the concept of a pharmacy that would sell generic drugs at transparent prices. Mr. Cuban pushed his future co-founder to think beyond just distribution.
Cost Plus Drugs officially launched in early 2022 with a few dozen generics and scaled quickly, reaching 2 million customer accounts within its first 13 months. By early 2024, the catalog had crossed 2,000 medications. At the pharmacy summit, Mr. Cuban put the current count at roughly 4,000, spanning generics, branded drugs and biosimilars.
To anchor the supply side, the company built an $11 million, 22,000-square-foot manufacturing facility in Dallas that began producing sterile injectables in shortage in 2024, starting with epinephrine and norepinephrine in vial sizes common in hospitals. The plant can produce millions of doses annually and has since expanded to manufacture other medications, including Pitocin and pediatric cancer drugs.
The branded side of the Cost Plus portfolio has grown in parallel. Recent additions include Xofluza, Yaz and Climara, along with the company’s most high-profile branded deal to date: Eliquis, one of the most widely prescribed oral anticoagulants in the U.S., which Bristol Myers Squibb and Pfizer began offering through the platform in April at $345 for a 30-day supply.
2. Hospital wholesale (Cost Plus Drugs Marketplace)
While Cost Plus Drugs started as a consumer-facing pharmacy, the company opened a second front in early 2024 with the launch of its “Marketplace,” a standalone wholesale business supplying medications to hospitals, surgery centers, clinics, long-term care facilities and retail pharmacies. The division stocks thousands of medications, with a focus on injectables that frequently fall into shortage.
The first health system to sign on was Franklin, Tenn.-based Community Health Systems. The partnership began in March 2024 with shipments of epinephrine and norepinephrine to nine CHS hospitals — a deal that came together after months of late-night exchanges between CHS leaders and Dr. Oshmyansky about utilization trends and supply pain points. CHS executives described the relationship as fundamentally different from a typical vendor arrangement.
By mid-2024, CHS had expanded the agreement to all 71 of its hospitals, starting with 12 generics and projecting savings of several hundred thousand dollars. Louisville, Ky.-based ScionHealth followed as the second system partner in May 2024, spanning 94 hospitals. In their own respective partnerships with the company, Tacoma, Wash.-based MultiCare said it saved $1.1 million in seven months on 125 generics, and Philadelphia-based Penn Medicine also began procuring through the platform.
In March 2026, Cost Plus Drugs partnered with GraphiteRx to embed its pricing inside existing hospital procurement workflows, giving pharmacy teams a side-by-side comparison against traditional wholesalers without changing their purchasing systems.
Still, Mr. Cuban has been candid that the economics have not been enough to overcome institutional inertia everywhere. At the pharmacy summit, he said the biggest barrier to Marketplace growth has not been price, but convincing hospital procurement departments to step outside the GPO contracts they’ve traditionally used.
3. Pharmacy network (Team Cuban Card)
The consumer side of Cost Plus Drugs extends beyond the mail-order website through an affiliate pharmacy network that allows customers to use the company’s pricing at physical pharmacy locations. Mr. Cuban pitched the concept to independent pharmacy owners in early 2023, with the collaboration centered around the “Team Cuban Card,” which functions like an insurance card at the checkout counter. He told Becker’s at the time that the move was part of a larger movement to prevent more local pharmacy closures.
“Unfortunately, [independent pharmacies are] not in the small communities like they used to be just because they can’t afford to stay open,” he said. “But if we lose them, then the PBMs control everything.”
The network launched with 36 pharmacies and expanded quickly as major grocery chains signed on. By late 2025, the Team Cuban Card was live at more than 17,000 pharmacies across the country, including locations at Albertsons, Publix and Kroger.
4. PBM partnerships
Before launching the affiliate pharmacy network, Cost Plus had initially explored creating its own pharmacy benefit manager. After scrapping those plans, the company turned to partnerships, teaming up first with the PBM Rightway in 2022. The same year, Cost Plus added EmsanaRx as its second partner by launching a supplemental drug discount product designed for existing employer-sponsored drug benefits.
By mid-2025, the company had more than 25 partnerships with pass-through PBMs, with the collaborations aimed at helping plan sponsors lower their drug spending. All contracts are published publicly, mirroring the transparency model that Cost Plus applies to its drug pricing.
The broader market impact of the Cost Plus approach has drawn notice from legacy players. By early 2024, major PBMs including Express Scripts and CVS Caremark had announced their own cost-plus-style transparent pricing models, with Walgreens’ former CEO telling investors that the market had evolved to create pressure to provide “the Cost Plus experience.”
5. Health plan partnerships
As Cost Plus Drugs has grown, a handful of payers have integrated the company’s offerings directly into member benefits.
Capital Blue Cross, a Harrisburg, Pa.-based insurer, became the first health plan in the country to partner with Cost Plus in early 2023, allowing its roughly 1 million members to use their insurance cards on the platform and apply prescription costs toward their deductible if eligible. The relationship expanded in April, with the insurer adding coverage of two Cost Plus biosimilars (Humira and Stelara alternatives) for its commercial members.
In early 2025, Network Health, the insurance arm of Wisconsin-based Froedtert ThedaCare Health, integrated Cost Plus into its Medicare Advantage pharmacy network. The insurer built a fully electronic claims integration with its PBM, Express Scripts, processing prescriptions in real time and allowing purchases to count toward members’ Part D accumulators.
In April, Humana announced that its CenterWell Pharmacy unit will integrate Cost Plus Drugs’ SwiftyRx digital platform to process prescriptions and develop new employer-sponsored prescription solutions, with CenterWell serving as a distributor for the program. The partnership will also extend to eligible Humana employees.
6. Direct contracting (Cost Plus Wellness)
One of Mr. Cuban’s most recent initiatives extends the transparency model beyond drugs and into how hospitals and providers get paid. Cost Plus Wellness, which he detailed at the pharmacy summit, is a direct contracting platform that connects self-insured employers with healthcare providers through publicly posted contracts — no intermediaries, no spread pricing, no balance billing, no prior authorization requirements and no hidden administrative fees.
Mr. Cuban has described the platform as an “open-source project” rather than a business. All contracts carry 30-day payment terms, and insurers are explicitly barred from using any of them.
The platform currently lists 27 published contracts covering at least 9,200 providers and 193 facilities, most of them concentrated in the Dallas-Fort Worth area, with Mr. Cuban saying more will be added across the country. Dallas-based Baylor Scott & White Health was among the first major systems to sign on. Cost Plus Wellness distinguishes between contracts it has directly negotiated and “community contracts” that providers self-publish using the platform’s template, with the earliest adopters being small and midsize self-insured employers.
7. Manufacturing innovation (modular pods)
Cost Plus Drugs is now taking its Dallas manufacturing model and shrinking it into tractor-trailer-size modular pods that can produce sterile injectables virtually anywhere.
Mr. Cuban discussed the concept at the pharmacy summit, framing it as the company’s most consequential long-term play. The pods can be deployed to hospital campuses, disaster zones or research facilities and can switch between drugs in approximately four hours. Rare disease therapies that have historically cost upward of $500,000 and taken six months to produce, he said, could now cost roughly $50,000 and potentially take less time.
“Over the long term, it is going to be our biggest business and will save the most lives and money,” he added.
8. Federal partnerships
Alongside its private-sector expansion, Cost Plus has aligned with two federal initiatives aimed at broadening access to affordable medications and strengthening domestic drug production.
TrumpRx: The Trump administration announced the platform in September 2025 as a federal direct-to-consumer website connecting patients with prescription drugs at discounted “most-favored-nation” prices. The site launched in February 2026 with 43 drugs and has since expanded past 50, with major manufacturers including Pfizer, AstraZeneca, Eli Lilly and Novo Nordisk now participating.
Cost Plus feeds daily pricing updates to TrumpRx, which functions as a referral hub rather than a direct seller. Mr. Cuban has been publicly supportive of the initiative while noting that some drugs listed on TrumpRx are already available as cheaper generics through Cost Plus.
Equip-A-Pharma: In May 2025, Cost Plus was among four partners selected for Equip-A-Pharma, a collaboration between HHS, the Defense Advanced Research Projects Agency and the private sector aimed at bolstering U.S.-based drug manufacturing using AI and other technologies. Cost Plus deployed an AI-enabled automated platform to produce active pharmaceutical ingredients, including lidocaine and diltiazem, with each partner expected to submit an abbreviated new drug application to the FDA within a year of the program’s launch.
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