BLOG: A swing and a miss for Cuban on drug pricing
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Social media is twitterpated with Mark Cuban and his new, “revolutionary” solution to drug costs in the U.S.
Scores of physicians have lauded Cuban’s effort. He has launched a direct-to-consumer website where patients can obtain medications at low cost without involving either their insurance or a pharmacy. You’d think he’s single-handedly cured cancer, erectile dysfunction and all of the miseries of menopause the way folks are talking. I admit that my first tweet in his direction was to congratulate and compliment him, too.
Then I actually went to the website.
Costplusdrugs.com (CPD) is Cuban’s “breakthrough.” The math is pretty simple: wholesale cost + 15% markup (gotta make some money) + $3 pharmacy labor + $5 shipping. Full retail prices for the branded form of the medications in question are prominently posted, as is the percentage of “savings” a patient will garner with CPD. Very impressive, indeed. However, within 15 seconds or so, any physician who treats patients for pretty much anything will see that there is really not a whole lot going on there.
To begin with, CPD only deals with generic medications and, at the moment, only about a hundred or so. Virtual companies like GoodRx and old-fashioned brick-and-mortar stores like Costco already provide many hundreds of generic meds at comparable costs. Heck, someone sells a few hundred common generics for $4 a pop! Secondly, no one prescribes the branded medication when a generic is on the market. Who cares if Gleevec costs $2,500 when the generic is $17? The comparison makes for great headlines and clickbait, but in the end, it’s meaningless.*
It’s as if Mr. Cuban jumped into a baseball game with the bases loaded and his team down by three runs in the ninth inning and bunted for a single.
What we need is someone to take on the real costs, the patient out-of-pocket costs of medications. Someone with the entrepreneurial spirit who thinks big. A person with the chutzpah and marketing savvy to yell that the pharmaceutical emperor is naked. Someone like Mark Cuban. Nobody is being bankrupted if their wet age-related macular degeneration is responding to intravitreal Avastin (bevacizumab, Genentech), which costs $50. The real problem is the exorbitant amount of money patients pay for patent-protected, branded medications like Eylea (aflibercept, Regeneron) and Lucentis (ranibizumab, Genentech), which cost $2,000 per shot.
Come on, Mark, you’re not a singles hitter. Far from it. There is something bigger than shaving a few bucks off the cost of generic medications. Get up there and take a big ol’ Reggie Jackson-like swing at out-of-pocket costs for branded medications. A walk-off grand slam solving that would be a worthy legacy. One everyone would be happy to tweet about.
*I have very little understanding of the insulin market. Mr. Cuban’s company may very well be making an important contribution here.
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