Keep pulling the thread on Mark Cuban.
The business model of Cost Plus Drugs is to show its acquisition cost for a medication and add a 15% markup.
Pharmacy Benefit Managers (PBMs) control approximately 85% of drug formularies in the United States.
One out of three Americans do not fill their prescriptions, often because they cannot afford them.
Mark Cuban alleges that PBMs use overseas subsidiaries, such as in Ireland, to negotiate rebates with brand manufacturers to obscure the total rebate amount and for tax purposes.
Mark Cuban alleges that large insurance conglomerates "gamed" the Affordable Care Act's medical loss ratio requirements by owning providers and charging themselves higher prices.
Three companies control more than 90% of pharmaceutical distribution transactions in the United States.
Mark Cuban asserts that while a brand manufacturer might sell a drug to a distributor for $570, its actual net price after rebates to PBMs could be around $300.
CEOs of brand drug manufacturers have told Mark Cuban they cannot sell drugs at lower prices to distributors because PBMs threaten to diminish their drugs' positioning on formularies.
PBMs have threatened brand drug manufacturers with diminished formulary positioning if they work with Cost Plus Drugs.
Mark Cuban alleges that insurance companies acting as third-party administrators for self-insured employers profit from a "spread" by paying providers less than what they bill the employer for a medical procedure.
Mark Cuban advocates for states to ban "spread pricing" on medical procedures, which would cap what a TPA can charge an employer at the amount paid to the provider plus fees.
The US healthcare market is valued at approximately $6 trillion.