The Mark Cuban Cost Plus Drug Company partners with EmsanaRx, a pharmacy benefits manager (PBM) focused on employer plans, to make lower-cost prescription drugs more accessible to patients through their employers.
The program, EmsanaRx Plus, is described as “a stand-alone pipeline” allowing employers to provide drugs to employees through Cost Plus Drugs, an online pharmacy that offers more than 1,000 of the most popular generic drugs at dramatically reduced prices.
“Like Cost Plus Drugs, EmsanaRx is working to disrupt the current pharmacy supply chain to eliminate the unnecessary markup and profiteering that burdens businesses and consumers with high drug costs,” Cuban said in a statement. Press release. “By partnering with a company as committed to transparency as Cost Plus Drugs, and with the technology capabilities to adapt to the needs of self-funded employers, we are able to bring lower-cost drugs to a broader American audience. “
Cost Plus Drugs is a direct-to-consumer prescription drug company that aims to cut out the middleman by buying drugs directly from manufacturers and then reselling them “at our expense + a fixed 15% markup.” The partnership with EmsanaRx would allow Cost Plus Drugs, which currently does not accept insurance, to serve the 156 million Americans covered by employer-provided health care.
“It helps us save the healthcare system money by providing employers with a way to save millions of dollars on their healthcare expenses,” said Dr. Alex Oshmyansky, founder and CEO of Cost Plus Drugs, at YahooFinance. “It helps us get closer to eliminating the practice of false ‘list’ prices of wildly inflated pharmaceutical products that patients are often asked to pay, especially if they have a high-deductible plan.”
How EmsanaRx differs from most PBMs
The Mark Cuban Cost Plus Drug Company consistently criticizes the role PBMs play in the US healthcare system, singling out PBMs because of their role in determining exorbitant drug prices in the United States.
The National Association of Insurance Commissioners defines PBMs as “third-party companies that act as intermediaries between insurers and pharmaceutical manufacturers” by creating “formulas, negotiating rebates (rebates paid by a drug manufacturer to a PBM ) with manufacturers, handle complaints, create pharmacy networks, review drug usage, and occasionally manage specialty mail-order pharmacies.”
Oshmyansky explained to Yahoo Finance that PBMs “serve an intermediate payment processing function, but many charge way too much for the services they render. That amount, though often, is obscured by complicated financial engineering.”
EmsanaRx CEO Greg Baker pointed out that his company differs from other PBMs because its financial goals are aligned with its customers rather than its shareholders.
“We are completely transparent and unlike other PBMs, all employer data is available to clients so they can confirm our performance and how much money they are saving,” Baker told Yahoo Finance.
Unlike the three largest PBMs – CVS Caremark, Express Scripts and OptumRx – EmsanaRX “does not own all the business channels in the ecosystem or create offshore entities that generate huge profits without providing additional value”, said added Baker. “We operate a completely transparent business – no hidden fees or business practices.
Costs are also incurred when drugs are simply not covered: a May 2022 report from Xcenda, a healthcare consulting firm, found that 1,156 drugs were excluded from healthcare coverage by at least one of the three largest PBMs. This is an increase of nearly 1,000% since 2014. Of these exclusions, brand name drugs “without a generic or biosimilar alternative accounted for almost half (47%) of total formulary exclusions, leaving patients with fewer treatment options”.
‘Fproblems in the generic drug market »
As the Mark Cuban Cost Plus Drug Company leverages generic drugs to disrupt Big Pharma by cutting costs, challenges have arisen in the generic drug market itself.
“Although widely used brand name drugs often attract competition from multiple generic manufacturers, some decades-old drugs have limited competition,” said a July 2022 journal article in the Annals of Internal Medicine. “One in five generic drugs doubled in price between 2014 and 2017, concentrated among drugs with limited competition. Federal and state investigators have accused several generic drug makers in limited markets of anticompetitive behavior, including price fixing; in the federal investigation, five drugmakers admitted wrongdoing.
Supply chain disruptions also pose a major challenge for the generic drug market, as most are manufactured outside of the United States. insurers. »
The report adds that the emergence of the Mark Cuban Cost Plus Drugs Company highlights “failures in the generic drug market that deserve the attention of federal policymakers to ensure that all patients have access to low-cost generic drugs.” .
By partnering with EmsanaRx, Mark Cuban Cost Plus Drugs Company is looking to at least extend the benefits of lower-cost generic drugs to some employer-provided plans.
“Until now, most employers have been unable to provide these affordable drugs to their employees,” Baker said. “We are allowing exclusive access to the lowest cost medications provided by Cost Plus. …For the first time, an employer can provide employees and their families with a product that gives them direct access to lower cost medications and removes the “traditional middleman that inherently adds cost. Equally important, EmsanaRx Plus allows the employer to access data they typically don’t have today when employees seek lower-cost medications from others channels in the market.
Adriana Belmonte is a reporter and editor and covers politics and health care politics for Yahoo Finance. You can follow her on Twitter @adrianambells and contact her at firstname.lastname@example.org.
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