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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

#191

Post by refurb »

Dylan16807 wrote: post #55
refurb wrote: post #51

Earlier quoted context omitted.

That’s not how kickbacks work. A doctor could easily tell a patient “if you go to this hospital for surgery, I’ll give you $100” That’s still a kickback.

Is the doctor doing that for fun? If the doctor is getting any of the money, then that part is the kickback. If the doctor really gets nothing extra, and the hospital gets nothing extra, then that's not a kickback, it's just weird.

Huh? If a company gives you a $5 rebate for buying 5 bottles of shampoo, then it gets extra sales.

So if a $5 grocery rebate a kick-back?

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

#192

Post by adrr »

weird-eye-issue wrote: post #169
bobthepanda wrote: post #139

Earlier quoted context omitted.

Some medications are not renewed like this for good reason. Some medications require regular monitoring to ensure that bad side effects aren't happening; PrEP requires checkups every 90 days to make sure kidney function is not getting impacted.

Most medications don't require this. Blacklist the ones that do

What drugs are those? Looking at the list of most common drugs prescribed, I can't see any that shouldn't require a doctor. Maybe finasteride, viagra and retin a but those are available with a usually are available with usually free telemedicine visit at one the many telemedicine startups.

https://www.goodrx.com/drug-guide

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

#193

Post by teslabox »

adam_arthur wrote: post #187
Scoundreller wrote: post #182

Earlier quoted context omitted.

Dunno if they ship to USA, but all of the Canadian online shops shipped to me without sending over any proof. One province de-regulated dispensing of corrective lenses and anyone could get in the game, and many did!

Oh, well yeah, other countries have less regulation. It's not possible in the US right now. But good to hear you can in Canada!

Some online shops make an effort to validate vision prescriptions, others do not. My most recent contact order was through Lens Direct, who did not validate. 12 years ago I gave an incorrect phone number for the optometrist. They tried to call but did not connect, and sent me an email: 'we're going to send your contacts anyways...'

The optometrist I went to recently put me in the strongest prescription I'd ever had. Instead of using that prescription, I ordered contacts using the prescription of the glasses that I thought were fine.

There's two numbers on the contacts... diameter of the pupil (doesn't matter for most people I think) and an angle (Edit: 'Base Curve'. The third number is the power of the contact, aka 'sphere'. Glasses prescriptions have power and astigmatism, but don't have diameter or base curve). I got these off my prescription. If you don't already know how to use contacts it's important to get instructions and a followup. I read of a guy who didn't know he had to take the contacts out at night - the contacts had started to grow into his eyes?

(Edit: you can get a set of "trial lenses" from Ebay if you want to try to come up with your own prescription, or to try out your prescription before buying glasses.)

My previous comments on ordering contacts:

https://news.ycombinator.com/item?id=13691768 / https://news.ycombinator.com/item?id=29366816

Edit: I live in the United States.

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

#194

Post by LordDragonfang »

adventured wrote: post #127
friedturkey wrote: post #118

Earlier quoted context omitted.

Capitalism is what got America into its health care mess. Other countries aren't paying thousands for simple pills or insulin.

When has the US had a Capitalist market for healthcare? The US has a particularly horrible hyper regulated, government shielded, cartel-based healthcare system and has for decades - the time during which its healthcare costs have skyrocketed out of control. The US could hardly be further away from Capitalism in how its healthcare system is structured.

Having government regulations doesn't make something not capitalist. Capitalism is defined by an economic system where you can profit off of simply owning Capital (i.e. the means of production) without having to work it.

Per Wikipedia:

> Capitalism is an economic system based on the private ownership of the means of production and their operation for profit. Central characteristics of capitalism include capital accumulation, competitive markets, price system, private property, property rights recognition, voluntary exchange, and wage labor.

All of these things are true of the US healthcare market.

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

#195

Post by helloworld11 »

PragmaticPulp wrote: post #7

On one hand, we should obviously applaud anyone doing anything to bring down drug prices. On the other hand, I'm increasingly uncomfortable with just how much free marketing and PR is being applied to the "Mark Cuban Pharmacy" without much critical examination of what's going on here. Taking one of the examples straight from their homepage: They will sell you 30 Prozac tablets for $3.90: https://costplusdrugs.com/med…

Your point being what? You seem to be saying: "But it's still better with insurance and in any case it's not as ideal as I'd like (as an insured person with decent insurance)" Okay, and what about the simple fact that for those people (many millions of them) who do not have insurance, or have shitty, finicky insurance, this is still a considerable possible improvement?

You extrapolate your privileged position to create a whole criticism of a more viable and affordable way of buying medicine that many people outside your situation would maybe embrace because they lack the same options.

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

#196

Post by LordDragonfang »

csdvrx wrote: post #103
ipaddr wrote: post #96

Earlier quoted context omitted.

For a person with enough money he seems to work harder than he should to obtain more and more.

> For a person with enough money he seems to work harder than he should to obtain more and more. Some people like to max their points in videogames. Other like to max their $ in real life. The beauty of capitalism is that the effort of the latter end up benefiting us all.

>The beauty of capitalism is that the effort of the latter end up benefiting us all.

There are countless examples of that not being the case. At best, it benefits some other people most of the time and, arguably most people only some of the time.

Keep in mind that all of the current issues with US healthcare are also caused by individuals trying to maximize their personal dollars - at the expense of the general public.

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

#197

Post by weird-eye-issue »

adrr wrote: post #192
weird-eye-issue wrote: post #169

Earlier quoted context omitted.

Most medications don't require this. Blacklist the ones that do

What drugs are those? Looking at the list of most common drugs prescribed, I can't see any that shouldn't require a doctor. Maybe finasteride, viagra and retin a but those are available with a usually are available with usually free telemedicine visit at one the many telemedicine startups. https://www.goodrx.com/drug-guide

I've taken several over the years where nothing was needed except telling the doctor or psychiatrist that "yep things are still the same". Adderall, Ritalin, Lexapro, Trazadone, Xanax, Gabapentin, and more all fit in this category for me personally

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

#198

Post by thaumasiotes »

s1artibartfast wrote: post #165
thaumasiotes wrote: post #154

Earlier quoted context omitted.

The difference would appear to be whether you buy a name-brand drug or a generic equivalent.

I don't think that has any impact whatsoever. If people think they are buying a drug from a manufacturer they are wrong. Typically they are paying insurance who pays the pharmacy, who pays the PBM who pays the Manufacturer. This is true for generics and brand-name. Each step has price negotiations and a bunch of mixed incentives.

> I don't think that has any impact whatsoever.

Then you've never bothered to compare the price of a branded drug with a generic in the same pharmacy.

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

#199

Post by danachow »

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…

> Also the number of doctors is still limited by the AMA, so even this is not fully competitive. There's an arbitrary cap on number of providers

This is an old trope but hasn’t even been superficially true for years. The AMA does not have the authority to limit the number of doctors. In any event their political influence has become less and less relevant for decades now, so even their ability to influence the number of docs is quite limited - I am not even am AMA member - I was only during medical school to get discounts on test prep. I don’t believe most of my peers are AMA members either - they belong to their specialist groups. Meanwhile the number of medical schools and students in the US has increased substantially in part due to AMA and AAMC. Meanwhile internal medicine residencies still have to fill their ranks with imported talent (foreign medical graduates) - only the lucrative subspecialties are the ones that remain limited and competitive. There are also forces at work to limit the number of MD jobs available that have nothing to do with the supply of MDs (replacement of positions with midlevels). The limit on residency positions is a partisan federal funding issue going on for years and only recently has much headway been made.

On eye care, I can of course self prescribe but even so for contact lenses I usually end up purchasing overseas from reputable retailers because of the price fixing of contact lenses - and I’ve never been asked for a prescription. It’s not that hard to get eyewear without a prescription.

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

#200

Post by thaumasiotes »

kevin_thibedeau wrote: post #152
thaumasiotes wrote: post #77

Earlier quoted context omitted.

> I think though that CostPlus, if nothing else, has opened the eyes of a great many people who just assumed medicine was like any other product where the manufacturer controls the price Like any other product? There are zero products like that. Manufacturers aren't legally able to control the price even if they propose a contract with a resale price clause. That's why everything has a "manufacturer's suggested retai…

Resale price maintenance agreements were legalized in the US in 2007.

No, they weren't. What was legalized was refusing to sell, in the future, to someone who violates such an agreement. But you can't enforce the agreement.

Note that refusing to sell to people was already legal before 2007.

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