Reducing men’s health drug costs: exploring the impact of the Mark Cuban Cost Plus Drug Company model on Medicare savings

In 2022, national health expenditures in the United States were estimated to have grown from 2.7% to 4.3% and increased further in 2023, reaching an estimated $5.2 trillion. Medicare alone, in 2021, accounted for 21% of national health care spending, amounting to $689 billion in total Medicare expenditures. The Mark Cuban Cost Plus Drug Company (MCCPDC) Model offers a solution by providing prescription medications at lower costs. The objective of this study was to assess the effectiveness of the MCCPDC model in reducing men’s health drug costs compared to Medicare Part D. A comprehensive analysis was conducted on the “Men’s Health” drugs available through the MCCPDC. Prices, including dispensing and shipping fees, were collected for the minimum quantity (30 count) and maximum quantity (90 count) from the MCCPDC. Unit costs and total savings were calculated, and unit prices for 30 count and 90 count prescriptions were compared between Medicare and the MCCPDC. Of the 15 medications in our sample, Medicare’s expenditure amounted to $1.8 billion, with the MCCPDC displaying lower prices overall compared to Medicare. Evaluating 30 count prescriptions, 11 of 15 (73.3%) men’s health drugs resulted in total cost savings of $1.1 billion. For 90 count prescriptions, all 15 drugs yielded savings totaling $1.3 billion. Our study findings highlight substantial potential for cost savings if Medicare were to adjust its contracted rates to those currently set by the MCCPDC. We recommend that healthcare providers include the MCCPDC in patient counseling sessions to educate patients about accessing medications at lower prices. Integrating the MCCPDC as a resource can contribute to significant savings and improve medication affordability.

Medicare; Men’s health drugs; Mark Cuban Cost Plus Drug Company; Medication affordability; Cost savings

[1] CMS. Projected. 2023. Available at: https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nationalhealthaccountsprojected (Accessed: 20 July 2023).

[2] KFF. The facts about Medicare spending. 2023. Available at: https://www.kff.org/interactive/the-facts-about-medicare-spending/ (Accessed: 06 June 2023).

[3] Center for Medicare Advocacy. Medicare Enrollment numbers. 2023. Available at: https://medicareadvocacy.org/medicare-enrollment-numbers/ (Accessed: 29 June 2023).

[4] Medicare Interactive. Medicare Part D drug coverage. Available at: https://www.medicareinteractive.org/get-answers/medicare-prescription-drug-coverage-part-d/medicare-part-d-coverage/part-d-basics (Accessed: 01 March 2018).

[5] KFF. Distribution of Medicare beneficiaries by sex. 2022. Available at: https://www.kff.org/medicare/state-indicator/medicare-beneficiaries-by-sex/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D (Accessed: 28 October 2022).

[6] National Institute of Diabetes and Digestive and Kidney Diseases. Definition & facts for erectile dysfunction. 2022. Available at: https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts (Accessed: 29 August 2022).

[7] Aggarwal R, Yeh RW, Dahabreh IJ, Robertson SE, Wadhera RK. Medicare eligibility and healthcare access, affordability, and financial strain for low- and higher-income adults in the United States: a regression discontinuity analysis. PLOS Medicine. 2022; 19: e1004083.

[8] Biddell CB, Spees LP, Trogdon JG, Kent EE, Rosenstein DL, Angove RSM, et al. Association of patient-reported financial barriers with healthcare utilization among Medicare beneficiaries with a history of cancer. Journal of Cancer Survivorship: Research and Practice. 2024; 18: 1697–1708.

[9] Raheem O, Xing M, Cooper C, Hyman M, Modi P. The role of advanced practice providers who treat men’s health urologic conditions: an analysis of Medicare and commercial claims in the United States. The Journal of Sexual Medicine. 2023; 20: i191–i192.

[10] Cortese BD, Chang SS, Talwar R. Urological drug price stewardship: potential cost savings based on the mark Cuban cost plus drug company model. The Journal of Urology. 2023; 209: 309–311.

[11] Madden JM, Bayapureddy S, Briesacher BA, Zhang F, Ross-Degnan D, Soumerai SB, et al. Affordability of medical care among Medicare enrollees. JAMA Health Forum. 2021; 2: e214104.

[12] Mark Cuban cost plus drug company. Everyone deserves safe and affordable medications. 2023. Available at: https://www.markcubancostplusdrugcompany.com (Accessed: 17 July 2023).

[13] Lalani HS, Kesselheim AS, Rome BN. Potential Medicare Part D savings on generic drugs from the mark Cuban cost plus drug company. Annals of Internal Medicine. 2022; 175: 1053–1055.

[14] Foster ED, Deardorff A. Open science framework (OSF). Journal of the Medical Library Association. 2017; 105: 203.

[15] OSF. The Impact of Cost-Plus Drug Pricing on Medicare Part D Expenditures. Available at: https://osf.io/3xvqd (Accessed: 23 October 2024).

[16] Cohen J. Mark Cuban’s online pharmacy projected to disrupt the prescription drug market, but there are a few caveats [Update]. 2022. Available at: https://www.forbes.com/sites/joshuacohen/2022/02/03/mark-cubans-online-pharmacy-projected-to-disrupt-the-prescription-drug-market-but-with-caveats/ (Accessed: 03 February 2022).

[17] Cortese BD, Dusetzina SB, Luckenbaugh AN, Al Hussein Al Awamlh B, Stimson CJ, Barocas DA, et al. Projected savings for generic oncology drugs purchased via mark Cuban cost plus drug company versus in Medicare. Journal of Clinical Oncology. 2023; 41: 4664–4668.

[18] de Bono JS, Logothetis CJ, Molina A, Fizazi K, North S, Chu L, et al.; COU-AA-301 Investigators. Abiraterone and increased survival in metastatic prostate cancer. The New England Journal of Medicine. 2011; 364: 1995–2005.

[19] Scott LJ. Abiraterone acetate: a review in metastatic castration-resistant prostrate cancer. Drugs. 2017; 77: 1565–1576.

[20] Wei Z, Chen C, Li B, Li Y, Gu H. Efficacy and Safety of Abiraterone acetate and enzalutamide for the treatment of metastatic castration-resistant prostate cancer: a systematic review and meta-analysis. Frontiers in Oncology. 2021; 11: 732599.

[21] Cubanski J. FAQs about the inflation reduction act’s Medicare drug price negotiation program. 2024. Available at: https://www.kff.org/medicare/issue-brief/faqs-about-the-inflation-reduction-acts-medicare-drug-price-negotiation-program/ (Accessed: 31 January 2024).

[22] CMS. Part D improvements. 2024. Available at: https://www.cms.gov/inflation-reduction-act-and-medicare/part-d-improvements (Accessed: 15 February 2024).

[23] Johns Hopkins Carey Business School. Generic vs. brand name and the cost of bad news. 2024. Available at: https://carey.jhu.edu/articles/generic-brand-medication-cost (Accessed: 15 February 2024).

[24] Socal MP, Bai G, Anderson GF. Factors associated with prescriptions for branded medications in the Medicare Part D program. JAMA Network Open. 2021; 4: e210483.

[25] U.S. Food and Drug Administration. Generic drugs. 2023. Available at: https://www.fda.gov/drugs/buying-using-medicine-safely/generic-drugs (Accessed: 12 July 2023).

[26] Tichy EM, Hoffman JM, Tadrous M, Rim MH, Suda KJ, Cuellar S, et al. National trends in prescription drug expenditures and projections for 2023. American Journal of Health-System Pharmacy. 2023; 80: 899–913.

[27] Vincent Rajkumar S. The high cost of prescription drugs: causes and solutions. Blood Cancer Journal. 2020; 10: 71.

[28] Johnson & Johnson. Court issues ruling in ZYTIGA® patent infringement litigation. 2018. Available at: https://www.jnj.com/media-center/press-releases/court-issues-ruling-in-zytiga-patent-infringement-litigation (Accessed: 23 October 2024).

[29] European Medicines Agency. Zytiga: EPAR—Summary for the public. 2022. Available at: https://www.ema.europa.eu/en/documents/overview/zytiga-epar-summary-public_en.pdf (Accessed: 22 October 2024).