UPJ INSIGHT Evaluation of Potential Urologic Prescription Drug Savings With Mark Cuban Cost Plus Drug Company

By: Van Schloegel, MD, University of Kentucky, Lexington; Loyall Harris, MD, University of Kentucky, Lexington; Andrew Harris, MD, University of Kentucky, Lexington; Benjamin Dropkin, MD, University of Kentucky, Lexington | Posted on: 18 Mar 2024

Schloegel V, Harris L, Harris A, Dropkin B. Evaluation of potential urologic prescription drug savings with Mark Cuban Cost Plus Drug Company. Urol Pract. 2024;11(2):276-282.

Study Need and Importance

Prescription drug expenditure is rising annually and high costs have been directly related to patient medication adherence. Mark Cuban Cost Plus Drug Company (MCCPDC) launched in 2022 with a goal to decrease prescription drug costs. Thus far, research has focused on possible savings if Medicare purchased its annual volume of drugs at MCCPDC prices. We sought to analyze if MCCPDC can offer savings directly to urologic patients compared with other mail-order pharmacies, local pharmacies, and with patients using health insurance.

What We Found

We identified 12 urologic drugs available on MCCPDC and analyzed pricing data at 30- and 90-tab prescriptions at MCCPDC, other mail-order pharmacies, local retail pharmacies near our zip code, and patients’ out-of-pocket costs if filling prescriptions with their health insurance. Ninety-tab prescriptions had the greatest potential for savings. At MCCPDC for 90-tab prescriptions, we found 9 of 12 drugs were cheaper for patients not using insurance to fill their prescriptions, with solifenacin and tadalafil saving $20 and $12 per prescription, respectively. When comparing MCCPDC prices with patients’ out-of-pocket insurance costs at 90-tab prescriptions we found abiraterone, sildenafil, and tadalafil were the only 3 of 12 drugs that offered savings (Table).

Table. Ninety-Tab Prescription Costs From the Mark Cuban Cost Plus Drug Company Prices Compared With Most Similar Mail Order Pharmacy (DiRx), Cheapest Local Retail Pharmacy in Our Zip Code (40508), Patient’s Out-of-Pocket Insurance Costs From the 2020 and 2021 Medical Expenditure Panel Survey, and Estimated 2021 Medicare Copayment Costs

Generic drug	MCCPDC mail order, $	DiRx mail order, $	Local pharmacy, $	MEPS, $ (SD)	Medicare, $
Abiraterone	108.80	114.00	152.15	-	757.80
Alfuzosin	17.90	17.10	25.95	11.51 (8.81)	9.90
Doxazosin	19.70	22.80	22.79	17.23 (15.43)	6.98
Finasteride	12.50	25.65	20.35	9.36 (10.86)	6.08
Oxybutynin	12.50	16.20	15.21	12.61 (12.98)	5.85
Oxybutynin ER	16.10	22.80	25.75	23.41 (32.45)	17.33
Sildenafil	13.40	48.45	15.67	15.25 (9.86)	48.15
Solifenacin	13.40	42.75	33.36	9.83 (8.27)	33.75
Tadalafil	13.40	42.75	25.29	23.52 (13.41)	181.80
Tamsulosin	12.50	13.50	15.21	9.35 (14.99)	4.95
Tolterodine	53.00	48.45	37.29	94.83 (5.4)	30.15
Tolterodine ER	76.40	141.00	58.70	8.30 (12.31)	76.05
Abbreviations: ER, extended release; MCCPDC, Mark Cuban Cost Plus Drug Company; MEPS, Medical Expenditure Panel Survey.

Limitations

We were unable to compare pricing data in real time as surveys and expenditure data are delayed by several years and drug prices can change frequently. Additionally, prescription drug research is inherently limited by the lack of transparency regarding what patients are actually paying out of pocket for prescriptions.

Interpretation for Patient Care

This study emphasizes the importance of patient counseling on all pharmacy options when prescribing urologic medications given significant pricing variability at each pharmacy. Physicians should consider MCCPDC as a potentially cheaper alternative, especially when prescribing sildenafil or tadalafil.