Mark Cuban Cost Plus Drug Company is teaming up with EmsanaRx, a pharmacy benefit manager (PBM) focused on employer plans, to make lower-cost prescription drugs more accessible to patients through their employers.
The program, EmsanaRx Plus, is described as an “independent pipeline” for employers to provide drugs to employees through Cost Plus Drugs, an online pharmacy that offers more than 1,000 of the most in-demand generic drugs at significantly lower prices.
“Like Cost Plus Drugs, EmsanaRx seeks to disrupt the existing pharmacy supply chain to eliminate the unnecessary price gouging and profiteering that burdens businesses and consumers with high drug costs,” Cuban said. “By partnering with a company like Cost Plus Drugs that is committed to transparency and has the technological capabilities to adapt to the needs of self-funded employers, we are able to bring more affordable drugs to a broader segment of the American public.”
Cost Plus Drugs is a direct-to-consumer prescription drug company that aims to cut out the middleman by purchasing drugs directly from manufacturers and then selling them “at our cost + a fixed 15% margin.” The partnership with EmsanaRx will allow Cost Plus Drugs, which currently does not accept insurance, to serve the 156 million Americans covered by employer-provided health care.
Cost Plus Drugs founder and CEO Dr. “This helps save the health care system overall money by offering employers a way to save millions of dollars in health care costs,” Alex Oshmianski told Yahoo Finance. “This helps eliminate the practice of wildly inflated fake ‘list’ prices for drugs that patients are often asked to pay, especially if they are on a high-deductible plan.”
How EmsanaRx is different from most PBMs
Mark Cuban Cost Plus Drug Company has consistently criticized the role PBMs play in the US health care system and singles out PBMs for their role in setting America’s exorbitant drug prices.
The National Association of Insurance Commissioners defines PBMs as “third-party companies that create formularies, negotiate rebates (discounts paid by the drug manufacturer to the PBM) with manufacturers, process claims, and act as intermediaries between insurance providers and pharmaceutical manufacturers.” pharmacy chains, review drug utilization, and sometimes manage mail-order specialty pharmacies.”
Oshmyansky explained to Yahoo Finance that PBMs “serve an intermediary, payment processing function, but many charge exorbitant fees for the services they provide. This amount often confuses complex financial engineering.”
EmsanaRx CEO Greg Baker emphasized that his company is different from other PBMs because its financial goals are aligned with its customers, not shareholders.
“We’re completely transparent and unlike other PBMs, all employer data is available to clients so they can verify how we’re performing and how much money they’re saving,” Baker told Yahoo Finance.
Unlike the three largest PBMs—CVS Caremark, Express Scripts and OptumRx—EmsanaRX “doesn’t own all the business channels in the ecosystem or build large revenue offshore entities without providing any added value,” Baker added. completely transparent business – no hidden fees or business practices.
There are also costs when drugs are simply not covered: A May 2022 report by health consulting firm Xcenda found that 1,156 drugs were excluded from health care coverage by at least one of the three largest PBMs. This was an increase of nearly 1,000% since 2014. Among those exclusions, “brand-name drugs without a generic or biosimilar alternative accounted for nearly half (47%) of total formulary exclusions, leaving patients with fewer treatment options.”
‘Fproblems in the generic drug market
While Mark Cuban’s Cost Plus Drug Company has used generic drugs to disrupt Big Pharma by cutting costs, the generic drug market itself has had problems.
“While widely used brand-name drugs often attract competition from multiple generic manufacturers, some decades-old drugs have limited competition,” says a July 2022 journal article in the Annals of Internal Medicine. “Between 2014 and 2017, 1 in 5 generic drugs combined among drugs with limited competition doubled in price. Federal and state investigators have accused several generic drug makers in limited markets of anticompetitive conduct, including price-fixing; Five drug makers plead guilty in federal investigation.
Supply chain disruptions also pose a major challenge to the generic drug market, as most are manufactured outside of the United States. According to the report, manufacturers generally keep 35% of the revenue, with the rest “split between wholesalers, pharmacies, pharmacy benefit managers and insurers.”
The report added that the emergence of the Mark Cuban Cost Plus Drugs Company actually highlights “failures in the generic drug market that deserve the attention of federal policymakers to ensure that all patients have access to low-cost generic drugs.”
In partnership with EmsanaRx, Mark Cuban Cost Plus Drugs Company is working to extend lower-cost generic drug benefits to at least some employer-provided plans.
“To date, most employers have not been able to offer these affordable medications to their employees,” Baker said. “We provide exclusive access to the lowest-cost drugs that Cost Plus provides…For the first time, an employer can provide a product that gives employees and their families direct access to lower-cost drugs, eliminating the traditional middleman. essentially adds cost. Just as importantly, EmsanaRx Plus provides employers with access to information they typically don’t have today when employees are searching for cheaper drugs through other avenues in the marketplace.”
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Adriana Belmonte is a reporter and editor covering politics and health policy for Yahoo Finance. You can follow him on Twitter @adrianambells and contact her at adriana@yahoofinance.com.
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