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For U.S. patients with migraine headaches, epilepsy and Parkinson's disease, getting prescription drugs through an ordinary commercial health insurance plan is often cheaper than buying them through the Mark Cuban Cost Plus Drug Company, a team of neurologists reports.
Dr. Hussain Lalani, a neurologist at Brigham and Women's Hospital in Boston, and five colleagues measured the performance of Mark Cuban's pharmacy by shopping there for 79 generic drugs frequently used to treat neurologic conditions.
The researchers then compared Mark Cuban's price with typical commercial plan prices for the drugs given in previously published papers.
Mark Cuban's pharmacy had only 33 of the drugs included and just two of the prices on those drugs were cheaper than the amount an insured patient would pay for the drugs out of pocket.
And when comparing the total cost, only 18 of the 33 drugs available through Mark Cuban were cheaper than an ordinary commercial health plan.
Based on the study, "if all commercial prescriptions were filled in a direct-to-consumer pharmacy, the aggregate [out-of-pocket] expenditures would increase by $82 million," the researchers estimated.
The researchers' paper appeared Tuesday on JAMA Network, a website affiliated with the Journal of the American Medical Association.
The backdrop: Big U.S. pharmacy benefit managers have frequently lused complicated, often confidential negotiating strategies to hold down patients' out-of-pocket costs for covered drugs.
Critics have accused the big PBMs of increasing their own revenue by using strategies that might hold down the patients' copays but increase total prescription spending for employer health plan sponsors and other "payers."
Mark Cuban, an entrepreneur known for his work as a shark on "Shark Tank," has tried to compete against the PBMs by setting up a mail-order pharmacy that charges a set amount over the wholesale cost of each drug provided.
Margaret Kyle, an economics professor at Mines Paris-PSL, noted in a paper published earlier this year in the Journal of Economic Perspectives that, although prices for brand-name drugs are high in the United States, U.S. prices for generic drugs tend to be low.
Related: Drug costs are more complicated than you think, economist warns
The big PBMs and some benefits specialists, including Ed Kaplan of Segal, have predicted that newcomers like Mark Cuban will have a hard time outperforming the big PBMs.
What the Lalani group's results mean: If other researchers conduct similar tests and get similar results for other types of drugs, it would support the big PBMs' arguments that they've done a good job of holding down U.S. prescription drug costs.
If other researchers come up with different findings, that could be a sign that Mark Cuban and the managers of the new "transparent PBMs" are correct and the big PBMs have been pushing up drug costs. Or, it could instead be a sign that pharmacy players each ave unique strengths and weaknesses. Cost-conscious patients may always have to shop for drugs at several different sources and not assume that one player or one type of player will always beat out the competition.
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