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Mark Cuban's pharmacy started with a cold email

beckershospitalreview.com

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Re: Mark Cuban's pharmacy started with a cold email

#141

Post by fastball »

zdragnar wrote: post #122
fastball wrote: post #70

Earlier quoted context omitted.

Isn't that exactly the problem? When you factor in the cost of health insurance, Americans pay a buttload for healthcare compared to the rest of the developed world. A big proportion of this is because when people see expensive drugs they just ¯\_(ツ)_/¯ and say "my insurance pays for it". All this once-removed cost makes it hard for people to reason about what they are overpaying for as an individual so as a society…

Hospital profit margins are razor thin in the US. Their pricing is so convoluted because they have to come up with inane contracts with insurance companies to squeeze out every dollar they can. In some instances, doctors in private practices have told me that taking Medicare or Medicaid means making less than minimum wage for certain procedures because the rates are fixed at such low values. In other cases, ER and in…

So hospitals and drug companies in the US are operating at peak efficiency without bilking anyone unnecessarily and yet a huge variety of procedures are more expensive than in the rest of the developed world.

That definitely passes a smell test.

Re: Mark Cuban's pharmacy started with a cold email

#142

Post by beaconstudios »

adam_arthur wrote: post #133
danachow wrote: post #120

Earlier quoted context omitted.

I’m not saying freer markets in some aspects of medicine would be better - but the libertarian dream in medicine is probably very naive and fails to learn from history to boot (medicine, especially pharm was much freer 120 years ago - it didn’t work out too well). And of the big problems in medicine - a prescription for glasses (which isn’t really a medical service in the US - optometry is not a medical profession) j…

You can't order corrective lenses online without a prescription. You can order frames, or reading glasses. You need a prescription for both contacts or the lenses themselves. Contacts would certainly be much cheaper without that hurdle. And I bring up vision, because it's a common problem and for less well off folk with families it can be a big expense, basically entirely unnecessarily so. Imagine making 20k/year and…

isn't forcing hospitals to post prices a form of regulation? In a free market (I'm interpreting this to mean laissez-faire - a market setup maximise competition and consumer choice must be regulated) nobody will post prices unless they have to or the procedures are elective, like plastic surgery is.

Re: Mark Cuban's pharmacy started with a cold email

#143

Post by adam_arthur »

beaconstudios wrote: post #142
adam_arthur wrote: post #133

Earlier quoted context omitted.

You can't order corrective lenses online without a prescription. You can order frames, or reading glasses. You need a prescription for both contacts or the lenses themselves. Contacts would certainly be much cheaper without that hurdle. And I bring up vision, because it's a common problem and for less well off folk with families it can be a big expense, basically entirely unnecessarily so. Imagine making 20k/year and…

isn't forcing hospitals to post prices a form of regulation? In a free market (I'm interpreting this to mean laissez-faire - a market setup maximise competition and consumer choice must be regulated) nobody will post prices unless they have to or the procedures are elective, like plastic surgery is.

Yes, I'm not advocating a free market, but a competitive market.

Fully free markets can lead to negative externalities like monopolies, pollution etc.

What leads to good societal outcomes is competitive markets. It just happens that free and competitive overlap a lot of the time. Information hiding makes a market less competitive, but is permitted under a full free market mentality. This is an area where regulations are warranted and useful.

Competitive capitalism should be the goal for most areas in modern society. Which in almost all cases only requires light regulation.

Re: Mark Cuban's pharmacy started with a cold email

#144

Post by throwaway78987 »

ALittleLight wrote: post #76

Either I don't understand the phrase "Vertical integration" or Mark Cuban doesn't. Cuban says "We basically created a vertically integrated manufacturing company." But, they don't do manufacturing, because later Cuban says "The manufacturers love what we're doing for that reason". They also apparently don't do the pharmacy aspect because Cuban says his company "charges a $3 pharmacy fee to pay the pharmacists it work…

Ok; personally knew Alex. I think there is a lack of understanding here. Yes maybe you can get some drugs cheaper at Walmart, but certainly not all “generic” drugs. Once a drug is outside patent protection, others can manufacture it but you have to show equivalence, which can require samples from the original or existing manufacturers, who can and have tightly controlled distribution to make it very challenging to get approval. Couple that with the risk of an existing manufacturer just dropping the price to eliminate any potential profit and you can see how some drugs can get into the place where there is only one source that can raise their prices as they see fit. I believe the idea here is they will eventually manufacture or source those drugs that are patent unencumbered but sole source. Yes, the system is terribly imperfect (both a physician and a chemical engineer here). Yes, it doesn’t sound like this is a charity. But expecting that the walls of regulatory capture to just fall down because it would better for all of us is just wishful thinking. Let’s save our criticism for those raising the prices of epi-pens and what not year over year. I think the criticism here is misplaced - the company was incorporated with a public mission in mind, and they seem to be moving into manufacturing; it wouldn’t make much sense to make something that can already be sold at Walmart for $4. Let’s see how it goes and wish them the best.

Re: Mark Cuban's pharmacy started with a cold email

#145

Post by xeromal »

tylermenezes wrote: post #97

I recall meeting Oshmyansky when he was pitching Osh's Affordable Pharmaceuticals (I think at a YC interview day). He really has a thing for sketchy sounding names :) but I really admire how driven he is to solve this problem.

Haha, you can't be great at everything.

Re: Mark Cuban's pharmacy started with a cold email

#146

Post by lmm »

dahdum wrote: post #41
dopylitty wrote: post #23

Earlier quoted context omitted.

Even if it’s an honest statement, what happens when Cuban dies or otherwise no longer controls the business? Inevitably someone will take control and raise prices to match the rest of the industry. The root problem is having for profit companies involved in providing critical medical treatments. The solution is for people to band together and create an entity (the government) to provide these treatments at cost witho…

That’s why they formed as a public benefit corporation, it makes it more difficult to pivot towards pure profit seeking.

Does it? I remember when Etsy was making a big fuss about being a public benefit corporation and then a couple of years later they just quietly dropped it.

Re: Mark Cuban's pharmacy started with a cold email

#147

Post by lmm »

TrueGeek wrote: post #9
drinker wrote: post #3

Mark Cuban isn't doing anything Novel here, there were other pharmacies already doing this for years. My family has been using honeybee health for a couple years now and there's blink health and others (no affiliation with these companies)

These companies are not the same and are not offering drugs at cost. I searched for a drug that I’m paying a ton for (even with insurance). Honeybee doesn’t have it, Blink quoted me $1,200. With insurance it’s $600, GoodRx let’s me get it for $200.

At those prices I doubt that's a generic, which means Mark Cuban won't have it either.

Re: Mark Cuban's pharmacy started with a cold email

#148

Post by robbedpeter »

danachow wrote: post #120
adam_arthur wrote: post #95

Earlier quoted context omitted.

Should cut out the doctors for most of these too... Or at least allow people to continue to renew their medications after prescribed one time, rather than requiring further doctor's visits. Most things in medicine are expensive due to legal monopolies/improper regulations. e.g. no reason you shouldn't be able to buy prescription glasses for $10-20 dollars off the shelf. The main problem with medical costs is that it'…

I’m not saying freer markets in some aspects of medicine would be better - but the libertarian dream in medicine is probably very naive and fails to learn from history to boot (medicine, especially pharm was much freer 120 years ago - it didn’t work out too well). And of the big problems in medicine - a prescription for glasses (which isn’t really a medical service in the US - optometry is not a medical profession) j…

Where's the "didn't work out too well" come from? Prohibition never works, whether it's restricting coffee or cocaine.

Combine education and free access to everything with reasonable daily unit limits and per-substance licensing. You want meth, you go through meth safety training and get a yearlong endorsement allowing you to buy up to the daily limit at a pharmacy, no prescription involved.

Set up due process that limits or eliminates legal access to substances based on criminal or medical situations.

Drug abuse - using in inappropriate situations leading to misbehavior - can be treated as a medical issue. Misbehavior that rises to the level of criminality is already handled.

It's absurd to think that any adult in a free country has any business whatsoever telling other adults what they can ingest or do in private.

Some variation on these notions are already demonstrated across the world. The current schedule system and drug laws in America serve only the bad guys, whether it's commercial prison slave labor, drug cartels, big Pharma, or the alphabet jackboots.

Re: Mark Cuban's pharmacy started with a cold email

#149

Post by s1artibartfast »

ALittleLight wrote: post #113
s1artibartfast wrote: post #83

Earlier quoted context omitted.

They plan to both manufacture and resell. >15% markup plus pharmacy fee plus shipping and handling. This is the intent, and still cuts out at least 2 middle men between consumers and manufacturers: the insurance company and pharmacy benefit managers.

It doesn't cut out any middlemen. It adds one middleman - Mark Cuban. Literally all he is doing is buying wholesale and selling retail with a markup. He's even powered by an existing online pharmacy company (truepill). If you look up details about his factory it's supposed to be built sometime next year. On Google maps, looking at the address, I wasn't able to see any evidence of this place existing. It's also suppos…

>It doesn't cut out any middlemen.

I listed two, do you disagree that they are removed?

Re: Mark Cuban's pharmacy started with a cold email

#150

Post by s1artibartfast »

mindslight wrote: post #99
alphabettsy wrote: post #87

Earlier quoted context omitted.

> The sad thing is, all these pharmacies know about GoodRx and other discount providers. They could stop playing games and just run all scripts through these providers to get a 'cash price', but they don't. They aren’t allowed to contractually. The PBMs and insurance companies make pharmacies sign contracts that forbid them from doing this. They also forbid pharmacies from telling customers if it would be cheaper to…

Prohibiting such anticompetitive cartel behavior is yet another straightforward market reform that could be implemented tomorrow, if our political process weren't merely a game between providers and "insurers".

Agreed. This Is I why I think it is good that someone is cutting insurance and PBMs out of the supply chain.
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