Editorial
Take That, Pharma Bros Deval (Reshma) Paranjpe, MD, MBA, FACS
H
“
ometown boy makes good”. I’m talking about famous Pittsburgh export and billionaire Mark Cuban’s latest venture, Cost Plus Drugs, a national online pharmacy which promises generic drugs priced strictly at cost plus 15% markup and pharmacist fee. The pharmacy doesn’t accept insurance, so patients pay directly. Patients can purchase medications outright with a prescription, and the prices are often far less than the copays they would ordinarily pay using their insurance. Cost Plus Drugs has also established its own pharmacy benefit manager and is building a Dallas production facility to manufacture its own generics in the US. Cost Plus Drugs ships to all 50 states. Radiologist and child prodigy Alex Oshmyansky MD, Ph.D. is the inventor and CEO of Cost Plus. Oshymyansky pitched Cost Plus Drugs to Cuban, who believed and invested in the concept. The aim is to reduce the cost and thereby expand access to lifesaving prescription drugs upon which many Americans depend. Cost Plus negotiates directly with manufacturers, bypassing middlemen and pharmacy
benefit managers. This represents a massive disruption to a prescription drug industry which has made significant and onerous markups routine.
The most notorious example of outrageous markups in recent years was the doing of so-called “Pharma Bro” Martin Shkreli, who in 2015 acquired the manufacturing license for Daraprim and raised the price 56x, from $13.50 to $750 per tablet. Not to be outdone, Mallinckrodt Pharmaceuticals acquired and raised the price of corticotropin, a drug invented in 1952, from $40 per vial in 2000 to around $40,000 per vial today under the brand name Acthar Gel. Both drugs are vital and life-saving—the former is an antiparasitic agent and the latter an anti-seizure agent. The intent of the acquisitions and price hikes in both cases was to make the drug in question a massive “cash cow” for the pharmaceutical company. However, patients who needed these drugs for
their very survival suddenly found themselves being bankrupted and/or at risk of dying. Some of the savings that Cost Plus offers are modest. Some are astounding. Atorvastatin, which retails for $55.80, is only $3.60 for a 30day supply. Imatinib, the generic for Gleevec, would be $2502 for a 30-day supply; at Cost Plus, a 30-day supply is only $17.10. Cost Plus does not yet offer insulin or ophthalmic drops, but it does offer 100 commonly used vital medicines from antihypertensives to SSRIs to antibiotics with at least 90% savings on many of them. Currently, 10% of all Americans have had to skip medication doses due to cost. That figure increases significantly among lower income brackets and the elderly. We all know that being priced out of access to medications causes decreased compliance, poorer outcomes/quality of life and increased morbidity/ mortality among our patients. Cost Plus Drugs could be a lifesaver and a gamechanger for patients who cannot afford their medications, people on fixed incomes, and everyone else. Continued on Page 6
ACMS Bulletin / February 2022
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