Dear Colleague,
Mega-PBMs hate being outed. The angriest phone call I ever got was several years ago from a PBM executive after he read a quote from me in the New York Times. He was livid about what I said (the truth) and that his company was in the spotlight. That exchange helped inspire the part of this video at 1:21 minutes.
So, about 3-years ago when billionaire celebrity Mark Cuban started talking about PBMs, I was intrigued. In 2021, I wrote this open letter to him saying I liked his message, but his company was off-track using mail order rather than community pharmacies.
Fast forward to this year, following periodic meetings with the Mark Cuban Cost Plus Drugs (MCCPD) team, I met Mark and his partner at a White House event, where NCPA members (Kansas pharmacy owner and NCPA Board member, Dared Price and Pennsylvania pharmacy owner, Chichi Ilonzo Momah) spoke to a panel of White House advisers and FTC Chair Lina Khan.
Cuban made this memorable statement at the 38:58 mark.
One attribute Cuban brings to the market is a loud voice—millions of fans and social media followers. Love him or hate him, when he opens his mouth, he gets a reaction. And he's been opening his mouth about mega-PBMs and saying what we've been saying for years—they're out of control, increasing healthcare costs, and killing small businesses. His voice is also reaching one of the hardest groups to reach: Fortune 1000 CEOs whose companies give PBMs their power by hiring them. Raising awareness among CEOs is critical, and he's doing it.
I wondered, why would a billionaire be interested in supporting lower drug costs and, indirectly, helping independent pharmacies. So, when the opportunity to do a podcast with Cuban, Erin Albert, Pharm.D., J.D., and Antonio Ciaccia came up, I jumped at it.
You can listen here.
Here are a few topic highlights:
What's it going to take to get employers to wake up and stop hiring the PBMs? (26:00)
Are plan brokers the henchmen of the PBMs or is it the other way around? (48:00)
Change the name of your company to the "Cost Plus, Plus" Drug Company (57:30)
One question I asked is why independent pharmacies should trust his company. And, let's be real, he didn't get to be a multi-billionaire (Guess who is by far the richest "shark" on "Shark Tank) by accident. He wants to make money. That doesn't bother me as long as it's not at independent pharmacy's or the patient's expense.
The MCCPD raised their dispensing fee from $8 to $12 in late September. NCPA had sent multiple surveys on the cost of dispensing to MCCPD that showed $8 wasn't consistent with COD surveys. Pharmacy owners aren't going to get rich from a $12 dispensing fee, but compared to what PBM's typically pay, a predictable, reliable, transparent $12 fee would be a breath of fresh air.
While cost plus for specific prescriptions is MCCPD's current offering, it's no secret they want to form a network of pharmacies to offer to employers. The ask from MCCPD to pharmacy owners was to consider signing up for their network. Should you? While there's no guarantee MCCPD will continue to be an ally, you know what the current payment model looks like, and it's atrocious. Cuban doesn't claim to have all the answers, but he has accelerated the conversation around predictable, transparent, and simplified pharmacy payment models—the opposite of what PBMs offer now. As with any offering, trust but verify and go in with eyes open, but why not give it a shot?
Best,
B. Douglas Hoey, Pharmacist, MBA
NCPA CEO
