Mark Cuban Slams PBMs – Pharmacy Benefit Managers

Mark Cuban Low Cost Drug Company

Mark Cuban, the billionaire entrepreneur and owner of the NBA’s Dallas Mavericks, is at it again. Now he is going after pharmacy benefit managers, PBMs, for the high prices that they charge people and charging that this is part of the reason why healthcare costs are so high in America and why he started The Mark Cuban Cost Plus Drugs Company.

“While PBMs are at the crux of this, the enablers are big companies that agree to these deals. They listen to consultants who may double dip AND charge companies for putting them in horrible deals,” tweeted Mark Cuban.

“I learned this the hard way when the Mavs and my companies started the process of moving our drug coverage to a rebate free PBM and cost plus drugs,” he added. We were paying the consultant $30 to $40 PER MONTH PER EMPLOYEE to put us in an awful deal”

“The reality is that its employees who pay the extreme prices noted in the article, it’s employees that subsidize the rebates,” said Mark Cuban. “The employees pay through higher deductibles and co-pays and denials. If your employer is getting rebates there is a good chance you are subsidizing them. If you are an employer taking rebates, it’s the drug they use to rip you off.”

The comments came after the news that American agencies like Medicare – which provides healthcare to the elderly and the indigent – will be able to now negotiate the prices that they pay to the pharmaceutical companies for their medications. This is something private insurance companies in America do, but the government failed to implement such a “no brainer” policy due to pressure from corporate lobbyists.

A pharmacy benefit manager (PBM) is a company that manages prescription drug benefits on behalf of health insurers, Medicare Part D drug plans, large employers, and other payers. PBMs negotiate with drug manufacturers and pharmacies to control drug spending, and they have a significant behind-the-scenes impact in determining total drug costs for insurers, shaping patients’ access to medications, and determining how much pharmacies are paid.

PBMs typically provide services like developing and maintaining formularies, which are lists of prescription drugs that are covered by a health plan, negotiating discounts and rebates with drug manufacturers and the processing of prescription drug claims.

But PBMs have been criticized for their role in rising prescription drug costs. Some critics argue that PBMs have too much power and that they use their power to extract high prices from drug manufacturers and pharmacies. Others argue that PBMs’ utilization management tools can make it difficult for patients to access the medications they need.