Why I Tell People to Look at Mark Cuban's Cost Plus Drugs

One of the hardest parts of being a Board-Certified Patient Advocate is watching good people slowly become defeated by the healthcare system. Not because they are lazy. Not because they are uninformed. Not because they are doing something wrong. They are defeated because the system is exhausting.

I sit with families every week who are trying their absolute best to hold things together while managing chronic illness, aging parents, mental health struggles, diabetes, cancer, neurological conditions, and impossible medical bills. And somewhere in the middle of all of that, they walk into the pharmacy and hear words that immediately make their stomach drop:

"That medication is going to cost $600." "Your insurance denied it." "You are in the coverage gap." "You have not met your deductible."

I cannot tell you how many times people quietly tell me they never picked up their medication because they simply could not afford it. Some are embarrassed to admit it. Others are terrified their doctor will judge them. Many start stretching doses, cutting pills in half, or trying to make it work because they feel trapped.

People should not have to live this way.

The Scale of This Problem Is Larger Than Most People Know

This is not a small or isolated issue. According to a GoodRx Research survey, 28% of Americans, roughly 46 million people, have had a prescription sent to the pharmacy that was ultimately not filled. In 2021 alone, 8.2% of adults between ages 18 and 64 reported not taking their medications as prescribed because they simply could not afford them. For uninsured adults, that number jumps to 22.9%.

The human cost is not just financial. People who experience cost-related nonadherence face 15% to 22% higher all-cause mortality. Medication nonadherence in the United States is linked to an estimated 125,000 deaths annually and accounts for at least 10% of all hospitalizations. Poor adherence contributes to more than $500 billion in avoidable healthcare costs each year.

Insulin rationing is a quiet crisis. According to research published in Diabetes Care, 17% of U.S. adults who use insulin report rationing it. Yale researchers confirmed in 2025 that 1 in 4 patients still rationed insulin due to cost in 2024. These are not statistics. These are people.

Mental health medications carry their own crisis. When people stop psychiatric medications abruptly because a refill is unaffordable, the consequences can be severe: destabilized conditions, hospitalizations, irreversible setbacks to recovery. Research confirms that 1 in 6 newly prescribed medications in primary care is never filled at all.

That Is Why I Think Resources Like Cost Plus Drugs Matter

When Mark Cuban launched this model, what caught my attention was not just the lower pricing. It was the transparency.

Healthcare pricing in America often feels like a mystery nobody can explain. Patients are expected to make life-changing financial decisions while navigating systems that are incredibly difficult to understand. The average person has no idea why one pharmacy charges dramatically more than another, why insurance sometimes costs more than cash pricing, or why copays can suddenly change. Patients feel powerless because they do not have clear information.

How Cost Plus Drugs Actually Works

Cost Plus Drugs was founded in 2022 as a public benefit corporation, co-founded by Mark Cuban and radiologist Alex Oshmyansky. The pricing model is straightforward: the drug's manufacturing cost, plus a 15% markup, a $5 pharmacy service fee, and a $5.25 shipping fee. There are no hidden markups. No mystery.

The company operates its own manufacturing facility in Dallas, Texas, opened in 2023, and ships prescriptions to patients in all 50 states. The drug catalog has grown from 100 drugs at launch in 2022 to over 6,000 medications in 2025, now including some brand-name drugs.

The savings can be dramatic. Albendazole, used to treat parasitic infections, typically costs around $500 through traditional channels. Cost Plus prices it at $35. Research published in the Annals of Internal Medicine estimated that Medicare alone could save over $3 billion on a subset of 77 generic drugs if patients used Cost Plus instead of traditional channels.

What I Appreciate About This Model, and What It Does Not Fix

What I appreciate about Cost Plus Drugs is that it pulls back the curtain. It allows people to compare. It gives some people breathing room financially when they desperately need it. Real people have shared stories of saving $4,000 per year on a single life-saving drug.

A 2024 study published in JAMA Health Forum found that uninsured patients could save money on 28.9% of their prescriptions through Cost Plus, compared to 7.1% for those with private insurance and 5.5% for Medicare enrollees. Medicaid patients saw no cost savings.

Cost Plus is not always the cheapest option for insured patients, but for uninsured or underinsured patients and specific high-cost medications, it can be genuinely transformative. It also serves as a powerful comparison tool, helping patients understand that pricing is not fixed or uniform.

Cost Plus Drugs does not solve insurance failures. It does not address hospital billing issues, physician shortages, or the emotional toll families carry every day. It is one tool in a larger toolbox.

One Thing I Always Tell People

You are allowed to ask questions. You are allowed to compare pharmacies. You are allowed to ask if there is a generic. You are allowed to ask your doctor if there are lower-cost options. You are allowed to advocate for yourself.

Most people have never been taught how to navigate healthcare. They assume whatever they are told is the only option available. That is simply not true.

Sometimes I feel like one of the biggest roles I play as an advocate is giving people permission to slow down and ask questions without shame. Healthcare moves fast. The system counts on people being overwhelmed. That is also why transparency matters so much.

Other Resources Worth Knowing

Cost Plus Drugs is one piece of a larger puzzle. Patients struggling with medication costs have multiple legitimate resources available:

• GoodRx: Free prescription discount card that compares prices at local pharmacies

• NeedyMeds: Database of patient assistance programs, disease-specific funds, and drug discount cards

• RxAssist: Comprehensive database of pharmaceutical patient assistance programs

• Medicare Extra Help (Low Income Subsidy): Federal program that can dramatically reduce Part D drug costs for qualifying beneficiaries

• Manufacturer patient assistance programs: Many pharmaceutical companies offer free or reduced-cost medications directly to qualifying patients

• Mail-order pharmacies: Often provide 90-day supplies at lower unit costs

• Cost Plus Drugs: Especially valuable for uninsured or underinsured patients, or anyone on specific high-cost generic medications

The key takeaway: always compare. A medication that costs $80 at one pharmacy may cost $12 at another or $8 through a discount program. Learning to shop for prescriptions is a skill that can save hundreds or thousands of dollars a year.

Why Transparency in Healthcare Is an Advocacy Issue

I respect that Mark Cuban was willing to challenge a system that many people are afraid to question. The core principle, that patients deserve to understand what things cost and why, is not controversial. It is basic dignity.

The Cost Plus model has already generated ripple effects across the industry. Major pharmacy chains and wholesalers have begun examining cost-plus pricing structures in response to competitive pressure. That is what happens when transparency enters a market that has operated in opacity for too long.

At the end of the day, most people are not looking for luxury in healthcare. They are looking for fairness. They are looking for honesty. They are looking for someone to help them make sense of things. That is what advocacy is really about.

A Note for Anyone Who Is Struggling Right Now

If you or someone you love is struggling with medication costs, please explore every legitimate resource available. Compare prices. Ask questions. Call your doctor's office and ask: Is there a lower-cost alternative? Is there a patient assistance program? Can we try the generic?

Slow down before assuming there are no options. Because sometimes one conversation, one resource, or one piece of information can completely change the direction of someone's healthcare journey.

To learn more about medication pricing and compare prescriptions, visit Cost Plus Drugs. For personalized help navigating insurance barriers, medication costs, or complex healthcare situations, visit Nash Patient Advocacy and Consulting.