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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

#51

Post by refurb »

Dylan16807 wrote: post #44
refurb wrote: post #20

Earlier quoted context omitted.

If I got my grocery store and they say “buy 5 bottles of shampoo and mail your receipt for a $5 rebate” am I getting a “kick back”? PBM rebates are not illegal. They aren’t transparent to patients (which is a problem) but they aren’t illegal.

If the end customer gets the money then it's not a kickback. If a middleman gets the money it's probably a kickback.

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.

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

#52

Post by ALittleLight »

indymike wrote: post #22
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…

> Except nobody should actually be paying $22.80 for generic Prozac. You can drive to any local Walmart and get it for $4 and they will bill your insurance, which will count toward your deductible. Except people can, and do, all the time. Source: they lady in front of me at the pharmacy counter today, who didn't want any "risky generics".

Is the lady who didn't want any risky genetics going to buy a generic from Mark Cuban's online pharmacy?

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

#53

Post by samstave »

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…

But what rate is my insurance "billing" for the total price of the transaction with my insurance?

So - while you may be able to get nearish the same price (before the shipping) So, if Mark Cuban the Billionaire can start a pharmacy model such as this, not dealing with insurance, then what precludes market competition with his pharmacy?

Franchise license with supply chain to open ones own brick and mortar etc...

Serious questions.

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

#54

Post by Crazyontap »

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…

> You can drive to any local Walmart and get it for $4 and they will bill your insurance > and they're going to charge an extra $5.00 shipping at checkout

I'd say driving to wallmart and dealing with insurance can be as much as $5 worth of gas and time for some.

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

#55

Post by Dylan16807 »

refurb wrote: post #51
Dylan16807 wrote: post #44

Earlier quoted context omitted.

If the end customer gets the money then it's not a kickback. If a middleman gets the money it's probably a kickback.

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.

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

#56

Post by derefr »

PragmaticPulp wrote: post #25
jimt1234 wrote: post #13

I worked for a PBM back in the 90s. The company, and the whole industry, was/is shady AF. I remember once when I was volun-told to work for new program that handled "rebates". They needed a nerd to support the servers/databases. There was a presentation explaining the program and how it worked. At the conclusion, I asked, "So, this is a kick-back?", and the room went silent. "No, it's not a kick-back. It's a rebate."…

I deplore the medication rebate racket as much as anyone, but it's not a kick-back. A kick-back would go to the doctor or pharmacist for pushing the customer toward a medication. The problem in this scenario is the monetary incentive to mislead the customer. With medication rebates, the customer is getting the drug one way or another. The rebate just discounts the effective price and sends the discount to the custome…

> A kick-back would go to the doctor or pharmacist for pushing the customer toward a medication.

Why is it not a kick-back if the customer’s insurance company is the one being paid to push the customer toward a medication, via differential coverage/co-pays/etc?

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

#57

Post by gm »

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…

I'm not sure what your point is: It seems you are cherrypicking and then generalizing. For example Duloxetine (generic for Cymbalta) is $4 at CostPlus and $15 at the Walmart link. That in and of itself really does not prove anything either. I may be wrong, though, it's just one additional data point.

Maybe you can do the analysis you mention and publish it? The worst that will happen is that all us laypeople will be better informed.

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 and if someone is making obscene profit, it's an outlier like the Shkreli douchebag. Now a lot more people know that it's possible to pay a lot less. Even on TikTok I'm seeing people paying much less for their prescriptions when they bypass the insurance company and pay full retail price, which is counterintuitive as hell, and I personally would have never guessed.

So all in all, I think it's hugely positive that the secrets are getting out, and CostPlus is invariably a large part of that.

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

#58

Post by toomuchtodo »

treis wrote: post #43
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…

The amazing thing is that he's telling everyone exactly what he's doing. He wants to extract 15% as a middleman in an industry that transacts 100+ billion a year. All for running a simple website and taking on a tiny bit of transaction risk. And people think it's a charity instead of business worth billions.

In America, it is a charity effectively to provide what is essentially a public service by “only” taking a 15% cut on generics when other manufacturers are selling at magnitudes higher costs.

It’s Costco for generic meds. No one calls Costco a charity, but their employees and customers love them for being fair and their business is held up as an example of how to create value from customer loyalty. And they still generate value for their shareholders.

If you have insurance, this is likely not for you. If you are uninsured, this could be huge for you. Perspective is important.

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

#59

Post by mattnewton »

refurb wrote: post #20
jimt1234 wrote: post #13

I worked for a PBM back in the 90s. The company, and the whole industry, was/is shady AF. I remember once when I was volun-told to work for new program that handled "rebates". They needed a nerd to support the servers/databases. There was a presentation explaining the program and how it worked. At the conclusion, I asked, "So, this is a kick-back?", and the room went silent. "No, it's not a kick-back. It's a rebate."…

If I got my grocery store and they say “buy 5 bottles of shampoo and mail your receipt for a $5 rebate” am I getting a “kick back”? PBM rebates are not illegal. They aren’t transparent to patients (which is a problem) but they aren’t illegal.

I think this metaphor is missing a step - it would be like if you somehow bought "shampoo insurance," and under this policy the insurance company paid for your shampoo needs in exchange for a fixed monthly fee. And since people are buying under their shampoo insurance policies, then one shampoo company starts paying people directly to effectively direct the insurance companies dollars towards their brand. Isn't that a bit more like what is happening? You are being paid to influence the direction of your own policy.

I don't think this is as much as a problem with normal kickbacks since the party being directly "harmed" here is an insurance company not getting as good a deal as they could and their whole job is to set prices for policies to account for that. Of course, this could lead to a bigger problem, because insurance companies could account for programs like this in rates, and now you have an arms race where your policy only makes cost sense if you are getting these incentive payments.

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

#60

Post by jsnk »

This is just a rant.

I want Amazon, Facebook, Google, Apple, Walmart, all the so called evil multinational corps, billionaires like Cuban, Gates, Musk, Zuckerberg & Co. and the the government to get into American healthcare industry and dismantle the multi trillion dollars racket, change it into something functional and useful for the people.

I don't care if it will mean millions of people in the insurance, hospital administration, public and private health policies will be out of jobs. Sorry I don't. Also for doctors, medical schools, state medical license issuing bodies, you are gonna allow minimum 10x increase in new doctors entering your field. The gravy train must stop. The system must work for the people, not at the expense of the people.

Should it be socialized healthcare or free market healthcare? At this point, I don't care. Anything else is better than this heap of trash. I've experienced both systems in my life and both systems are superior to the American system. But these discussion are distractions to what's really causing the problem in the American health care system. There are trillion dollar protected class of people who make the entire system unworkable. This system needs to collapse and be replaced with something new.

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