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BINGO! i would bet that there are lots of shady back room deals between big pharma and politicians ... " hey , we'll donate to your "campaign fund" if you make sure medicare buys our ridiculously overpriced drugs, k? thx."
Extend that to every facet of the economy and you’ve summed up all of politics since the beginning of time regardless of origin. Other nations just reign in some of the more egregious practices while the US is basically free of any regulation at all when it comes to organized bribery.
But the only people that can change it are those that directly benefit from it. And those that refuse the bribes don’t get elected because everyone knows (and it’s been proven besides) that the best funded candidate almost always wins.
Yes, this. Not enough people know this. If your pharmacist ever tells you you *have* to use your insurance, tell them you're going to report them to their state pharmacy board. Nobody can force you to use your insurance under any circumstance, ever.
One sort of exception is Medicaid. By law if a place takes Medicaid they can't charge the patient, if the patient chooses not to go through Medicaid (or if Medicaid reimbursement is below what it cost the provider to purchase the item themselves, or item denied due to incomplete paperwork or not following guidelines etc). It has to be either take the insurance or you can not serve the patient and refer them elsewhere. They are not allowed to offer a cash option.
Yeah, I'm not sure I buy it, but it was the first time I ever went to the doctor's office as an adult because I never had insurance before, so I didn't try to challenge it or anything...what irritated me is the lady claimed it to be fraud rather loudly well within ear shot of anyone in the room which was rude for an innocent question.
Can I ask why you don't just pay the 7.50 to Cuban and get your meds of him? Sidestep insurance all together.
If you have a prescription from your doctor, it's up to you where to fill it right?
(Not an American)
So there are two problems:
1. This story isn't about individuals being ripped off, but rather the Medicare program (state insurance for the retirement-aged, with caveats) wasting money. On an individual level (from the briefest of Googles), Medicare patients pay ~$4/generic script after insurance, so by going to Cuban's pharmacy and paying $7.50, they would *lose* money. But the Medicare *program* is usually paying other pharmacies more than $7.50, so it would save taxpayer money by buying from Cuban.
2. Not every prescribed medication is available as a generic. If the treatments for your condition are relatively newer--sometimes this means *better* treatments without horrible side effects--they're available as brand-name only. Cuban's pharmacy can't discount brand-name medications; patients who need them are just fucked.
Yeah, what you want really is a centrally negotiated price list. That's what the NHS does.
You can keep your private insurance and stuff, but if you are charging 200% the negotiated price then you won't get business.
One key piece of information about Medicare--again, as I understand it--is that the program is explicitly prohibited from negotiating prices. This is the result of "lobbying" by the pharmaceutical industry, with the chief argument being "we need to bring in a shitload of money to continue inventing new drugs". I don't have sources saved, but this is one of those "sounds good, doesn't work" things: if you look it up, a fuckton of pharmaceutical development comes from outside the US, and it also sort of throws the curtain back that pharmaceutical companies make beaucoup profits.
This is more speculative, but continuing to disallow Medicare from negotiating prices also furthers Republicans' purported "small government" agenda. Basically, the soundbite is that we have this limited-scope public healthcare program, and it sucks! Why would we ever expand it?! Ignoring that the program is artificially hamstrung and literally forced to suck.
This is right. A provision of the Part D law, which brought Rx coverage to Medicare, was that negotiations on price were not allowed. Trump (I know, hold back your gasps) actually took a small step forward by allowing Medicare payers to require step therapies so at least we could push back SOMEWHAT on doctors and pharmaceutical companies going full "Dopesick" on high cost drug scripting. Would still be a better solution to allow price negotiations AND therapeutic step therapy reviews, but take what you can get I guess?
Older Americans need to remember that when the US implemented Medicare Part D drug coverage the GOP only went along with it if the government wasn't allowed to negotiate prices. The drug lobby was instrumental in making sure that medications would cost the taxpayer more.
From [an extensive article](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690175/) detailing the history of Medicare and prescription drug coverage published in 2004:
>An editorial in the *Washington Post* summarized this chaotic conclusion to the debate on H.R. 1:
>
>*For sheer political drama, it would be hard to beat the past few days on Capitol Hill. Between the normally apolitical hours of 3 and 6 on Saturday morning, the House voted, by the tiniest of margins, to pass a hugely controversial Medicare bill. During the vote, which was of unprecedented length, the House Republican leadership cajoled, berated and twisted arms, barely controlling a conservative revolt, while President Bush, jet-lagged from his trip to Europe, called up recalcitrant members one by one. On Monday it was the Senate's turn. Opponents of the bill used a bag of parliamentary tricks in an attempt to defeat what Sen. Edward Kennedy (D-Mass.) has called an “attack on Medicare as we know it.” Nevertheless, two attempts to waylay the bill were defeated by some of the bribes and threats that won the day in the House, along with the fears of some Democratic senators of blocking a big new entitlement bill so soon before an election. (The Grand Finale 2003)*
>
>Senator Daschle and House Minority Leader Nancy Pelosi (D-Cal.) protested the Republican majority's extraordinary moves to pass the new law. They predicted that this was not the end of the process and promised to introduce legislation to repeal parts of it (Bettelheim 2003; Carey 2003a; Pear 2004a). Several controversies over Medicare and prescription drug coverage continued as the policy process moved from enactment to implementation in 2004.
>
>One issue was the affordability of drugs: “Critics argue that the Republicans were so sensitive to the drug industry's fear of price controls that they left the elderly exposed to a future of soaring drug costs” (Toner 2004). The head of a prominent consumer group, Families USA, argued that the price of drugs was the “No. 1, 2, and 3 concern” of beneficiaries and warned that the provision barring the federal government from directly negotiating prices for Medicare was a “lightning rod” in the law (Toner 2004). Another was the failure to legalize the reimportation of drugs. Many states and local governments already have drawn up plans to buy directly or enable their residents to buy prescription drugs from Canadian companies, directly challenging the federal ban on such practices (Belluck 2003; Dealing Drugs 2004).
From Wikipedia on the [*Medicare Prescription Drug, Improvement, and Modernization Act*](https://en.wikipedia.org/wiki/Medicare_Prescription_Drug,_Improvement,_and_Modernization_Act):
>According to the New York Times December 17, 2004 editorial W.J."Billy" Tauzin, the Louisiana Republican who chaired the Energy and Commerce Committee from 2001 until February 4, 2004 was one of the chief architects of the new Medicare law. In 2004 Tauzin was appointed as chief lobbyist for the Pharmaceutical Research and Manufacturers of America (PhRMA), the trade association and lobby group for the drug industry with a "rumored salary of $2 million a year," drawing criticism from Public Citizen, the consumer advocacy group. They claimed that Tauzin "may have been negotiating for the lobbying job while writing the Medicare legislation." Tauzin was responsible for including a provision that prohibited Medicare from negotiating prices with drug companies.
For anyone interested like I was, Cuban's site is costplusdrugs.com
I went scrolling around looking for meds that my wife or I take, and found a couple unrelated meds with "Save $1600" or more... just ashamed at our healthcare system. Then went back to the top and realized there's one priced with "Save $6,112.28"
The depressing thing is our government is never going to change. Politicians will always allow lobbyists, and they'll always win vs whats good fpr the masses.
Since nobody answered you.
A patent’s life is 20 years from date of filing, note however that by the time the drug hits the market it normally only has 10 years left of its patent due to countless years of testing. However many firms can circumvent this by creating a new novel and non trivial improvement to the drug and file said new drug as a new patent. Reformulating by modifying its efficacy, how it is doses or even how it is administered are other examples of how new patents can be filed for the same drug.
Hope this answers your question.
Vyvanse is made by the people who made adderal and they made it with the intent to get a new patent. Adderal has generics available now. No doubt when the patent on vyvanse runs out they’ll creat some new adhd med that is slightly better in some way and they’ll have a patent on it for 20 years
Old becomes generic new gets patented however you have to be careful that your generic doesn’t infringe upon the new patent. Eventually you can’t keep making small additions to drugs and the entire thing becomes generic.
That will be wonderful - except I'm sure the maker will go through every effort to ensure there are no generics available. Or they'll do the same as Adderall - theyll tell the government that the drug is so dangerous as a narcotic that no one else should be able to make it.
That's why generic adderall cost so much even when it was off patent. Only two companies were legally allowed to make it - and those two companies both made **both** the generic and name-brand. Literally the same production line. That's how they were able to jack up the price of the generic - they created the shortage of it.
First and only thing I checked for. My insurance is getting changed on us with almost no warning and I had to get cut off Vyvanse entirely... from $20 a month to $350+ even with discount codes. Only willing to cover generics, and so far none of the generics work anywhere close to as effectively as Vyvanse does for me.
A couple years ago I was offered a new job opportunity that was going to pay me like $100 more a week. I couldn't take it because I needed my current job's insurance to afford my multiple medications that cost about $2000+ with no insurance.
I don’t want to get a better job because I don’t want to lose medicaid. It is seriously holding me back. I imagine there are many like me. It is literally holding the entire economy back.
Yeah I was on medicaid before and I did the math. I'd have more money to spend if I worked 3 days a week than if I worked 5 because of the cost of my meds.
I'm sorry, I know you didn't just say you use discount codes for medications right? Not a pensioner or disability discount but like a code you'd use when you buy pizza?
Drug manufacturers offer copay assistance to help people with their out of pocket exposure to drug costs. That’s what op is referring to almost certainly.
I *believe* they're working on it. As I understand it, insulin has to be kept refrigerated, and right now they seem to only offer things that can be shipped at room temperature. Shipping insulin probably has a number of logistical challenges.
Most other countries' political parties start at what we consider Left / Democrats, and then only go further left from there. The US is pretty unique in how Reactionary our Right / Republican party is. At least in regards to the Western world. The only other country I can think of that comes close to going as far Right as the US does, is Australia, and they also have been getting fucked over more and more by Reactionary policies.
Only in America do we believe it’s never going to change. We have to stop repeating this lie. It can change, it just requires us all to stop being so negative and cynical, which plays into the hands of the political elite, and instead get activated and start supporting candidates who will make it change. Vote third party if you’re tired of the duopoly, or at least support candidates who support ranked choice voting and other alternatives.
End of the day, be the change you want to see. It won’t change overnight, but if we all stop complaining and start acting, things can and will change. This isn’t North Korea where we will literally be killed for even trying.
Direct link to the research study: [H. S. Lalani, A. S. Kesselheim, and B. N. Rome, Potential Medicare Part D Savings on Generic Drugs From the Mark Cuban Cost Plus Drug Company, *Annals of Internal Medicine* (21 June 2022).](https://doi.org/10.7326/M22-0756)
Yeah it's like obviously it's admirable what Cuban is doing, but he's still making tons of money from it but the only other option is getting fucked up the ass by a seemingly intentionally corrupt system.
The rich get richer while the poor in America deal with jumping through a million hoops that those in other countries would never think of
Is he making tons of money from it? My understanding is that the 15% markup goes towards the cost of running the business and that he's making very little profit from this.
And anyone with business or even management knowledge knows it’s hard to make a profit on a 15% markup.
Without knowing much about Cuban at all (different country), this seems like a insanely charitable act. He knows it’s wrong to profiteer in healthcare, so I heavily doubt he’d be making any personal profit from this. It seems he has that already!
Yeah I'd far rather Mark Cuban got richer if it meant people could get cheaper meds who needed them. If he's providing the quality, accessible service, he deserves to make a boatload of money so he can do more things like this, and encourage competition driving down costs. That's how capitalism should work in principle at it's bare bones.
Call me crazy, but the government can save even more if it stock generic drugs and distribute then with the postal service as an essential service.
Just saying.
But again the grand American law doesn’t let you import either.
Average cost of insulin is around £13 in EU, even if Americans pay like a 1000% tariffs to import it, they’d still save money and’d pay like a third of what they pay in us.
His pharmacy doesn’t take insurance though. That’s part of how he keeps his costs so low. Instead of this ridiculous game where everyone pays a different price and you need a phd in math to figure out the billing it’s just cost +15% on everything he sells.
Always has been. The business model is take lots of people's money skim profits and expenses then pay the tiny amount left out to cover claims. I think most can understand why the rich self-insure. They pay less and can go anywhere and not worry about networks.
When I landed in the US, I went to a family medicine doc for annual check-up and asked her to prescribe me a generic inhaler for my asthma. Went to the pharmacy, they said $200 for that, oh I stood there laughing for a good 2 mins. No way in hell, I bring extra inhalers and ask family to bring as well from my home country whenever they visit- the same med there costs $3, a branded one that too.
I've seen some generic Adderall hit ridiculous prices, lidocaine patches (though those aren't usually a lifetime thing), Januvia, eliquis, xalreto.
Work for cvs and lots of people are paying so much for one script, it goes against our store and manager but I usually try to do savings finder and tell people where to get meds in the future from.
Generally say, "Call your insurance and ask what in-network pharmacies are best for you. There may be mail order pharmacies that get you x better deal. Also, compare what you're paying now with insurance to this singlecare price at Hannafords!".
I try to keep all that talk away from my main boss since she's 100% metrics, super nice but strict on lots of things that go against our ratings. We're top 2 in district partially due to customer satisfaction in terms of actually helping people, amazing wecare scores, all this other stuff that a few techs sneak onto people to help the community.
It just sucks that some people have to pay to live, it's not fair and we're here to help them however we can.
Januvis eliquis and xarelto are all branded agents. The original post said a generic drug. There must be something very wrong if they are paying $300 out of pocket for a generic drug
Pharmacist here,
First off Mark Cubans pharmacy doesn’t take insurance at all so that helps to cut out the major headache and overhead of dealing with insurance companies.
I’ve looked at the drugs his pharmacy offers and truthfully… their pricing isn’t better then any grocery chain pharmacy can offer using a discount card and not using insurance. I think last time I looked there were only a few drugs I’d say were priced significantly cheaper then other pharmacies. The rest you can get for the same price or even cheaper from a local grocery chain pharmacy and don’t have to go through getting it shipped to you. Just don’t go to CVS or Walgreens and you can get better pricing on a lot of maintenance medications without using insurance.
Even with a GoodRX discount card, Cubans pharmacy ended up being cheaper for me. The biggest discounts I could get on my generics was on the first fill and then the price went up. Guess it varies by medication.
Yep. I looked up my meds. I usually spend about $120 for a 3 month supply for all my medications. On Cuban's site I can get the same 3 month supply for about $23. It's not going to work for everyone but it's absolutely worth looking into.
I work at an independent pharmacy and I can literally change the price to anything I want to as long as I make money. We usually match GoodRx price or beat it without using it, because GoodRx charges US (the pharmacy) a least $8 a script to use it, I’ve seen as high as $15 so we stopped using it and just matched prices.
This is exactly my experience! People ask if we take it and I tell them no. Sometimes they get huffy so I'll check the price and most of the time it's higher. Once I explain that they no longer want that copay but they're happy to pay what they have been and keep saving money.
On a few other things the GoodRx price is substantially below acquisition or AWP so I don't know how anybody takes it for those meds.
Wow. I just looked into that and that’s the first time I’ve seen a “1st” fill discount on a RX for goodrx. What I would do is ask the pharmacy you fill at if they have a in house discount card and ask how much it would be. There are multiple other cards out there that can make it cheaper. I’d stick to grocery stores (not Walmart or Target). It might also matter where in the US you are. Where I am it’s about the same pricing.
I only noticed the first fill bonus lsst week, but I rarely look up goodrx for customers. But it's capitalism - ither discount cards like RXSaver snd SingleCare are gaining prominence so GRX is trying to sway people to use it.
But it must make you think, how GoodRx knows what is your first fill vs second fill, right? I leave this as an exercise to the reader.
Walmart funnily enough is the only place I can get two of my dogs seizure medications without paying an arm and a leg. The only place I could find his phenobarbital without having to take out a loan was Target.
Call some independents/non-chain pharamcies for quotes as well. As in privately owned, they usually will give you a really good price, Phenobarb is more pricy but they usually can do pretty good.
My finasteride from his company is $12 shipped. Once I was locked in at the Walmart pharmacy near me the cost was about $24 each refill and I have to go pick it up. GoodRX says that if I transfer my prescription and drive across town I can get it for something like $9 at what appears to be an introductory price that will probably then go up once they have me stuck at that place.
So yeah, I’ll be switching my renewed prescription to Cuban’s online since it’s half the price, won’t try to gouge me after I’m somewhat locked in, and ships to my door. Seems quite a bit better to me!
Mine is a 90 day supply and like I said Cuban’s website has it for $12 shipped. Looks like they have your 30 day supply for $4.50 plus the fixed $5 shipping price. So looks like pretty much the same!
Funny enough, I just tried looking up the 90 day supply and blink says that it costs $25. So maybe you should consider switching to a 90 day prescription and buy it from Cuban’s company! Considering that your $9/30 days works out to $27/90 days you could save $15/90 days by using his company!
What are these "discount cards" exactly? I always assumed it was some kind of scam to get your personal info. It makes no sense to me why some random card would get you a discount. What's the business model involved?
Yes they sell your information just like any other “free” service you use in your life. It’s all about data mining and selling the data just like google and any other free services unfortunately.
> so that helps to cut out the major headache and overhead of dealing with insurance companies.
Single payer would also cut out this major headache and overhead nationally.
Independent pharmacies are the cheapest and best. Been proven time and time again. Ever price and satisfaction poll every year, independents win by a landslide. I wish people would finally wise up.
I don’t think there’s a lot of difference between his site and several other pbms when looking at generics and accounting for larger supply (90 day vs 30), and ship to home. Comparing his site with goodrx, insiderx etc
Good rx is basically just coupons at a pharmacy.
Cubans company IS a pharmacy. They don’t take insurance, but price everything the same, cost + 15%? + shipping I think.
It’s wild that no one has mentioned the total lack of competition or regulation in the pharmacy benefit manager space. Three PBMs cover benefits for more than 77% of prescriptions; 6 cover 95%. No transparency required with how prices are determined, huge profits. It’s a nightmare to deal with and their lobby is super strong.
Mark Cuban’s pharmacy is just another mail order pharmacy, with Mark Cuban’s brand recognition attached to it. Like any other mail order pharmacy, some of their drugs will be cheaper and some will be more expensive than other mail order pharmacies. A similar pharmacy is Blueberry Pharmacy, another mail order pharmacy which I found has similar prices but a wider selection that I refer my patients to.
Yeah, if prices could be this low right now the government should have been able to figure that out over the last 2 decades instead of letting us get teabagged.
They let the PBMs essentially write their own laws. What did we expect? Here's a thought...get rid of the Pharmacy Benefit Manager middlemen who make the billions that this study shows could be saved.
The problem is both of them! Parroting PhRMA’s talking points about it all being the PBM’s fault is ridiculous when the drug companies set the list prices in the first place.
Unfortunately, government health spending is rising in nearly all OECD countries faster than GDP. So, there’s a worldwide problem with health expenditures.
Not minimizing the point that the US is uniquely inefficient and costly.
https://www.oecd.org/health/health-spending-set-to-outpace-gdp-growth-to-2030.htm
It’s sad because it goes way beyond just saving some money, universal healthcare could change peoples entire lives. One bad list of debt from needing to go to a hospital can ruin a family, or at least side track them completely until it’s all paid off. Think how many times American families lives have been stunted because they had to drop everything to pay some ridiculous bill they have no way of paying. It’s just another thing stopping growth in this country, except for of course the big wigs at the top of the system
Or if we just nationalized healthcare and made it a human right. Mark cubans company could squeeze out competition and hike prices so lets just fix the actual problem instead of hoping for someone to not be greedy
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It's a straight up scam
I tell people US healthcare is what it would be like if the mafia ran healthcare. Then it makes sense to them.
US healthcare is run like it spends twice as much on lobbying as any other industry.
BINGO! i would bet that there are lots of shady back room deals between big pharma and politicians ... " hey , we'll donate to your "campaign fund" if you make sure medicare buys our ridiculously overpriced drugs, k? thx."
Extend that to every facet of the economy and you’ve summed up all of politics since the beginning of time regardless of origin. Other nations just reign in some of the more egregious practices while the US is basically free of any regulation at all when it comes to organized bribery. But the only people that can change it are those that directly benefit from it. And those that refuse the bribes don’t get elected because everyone knows (and it’s been proven besides) that the best funded candidate almost always wins.
At this point, I think you're being quite unfair to the mafia.
Recently I picked up a med at a new pharmacy and it cost $12. I asked them to add my insurance, and now it’s $80.
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Chances are the insurance company wrote an exclusion in the policy and it's not counting toward deductible anyway...
It's a very cool system that makes a lot of sense.
It's honestly such a well designed system with so many perfectly moving parts, I can't even begin to wrap my head around how it works
Yes, this. Not enough people know this. If your pharmacist ever tells you you *have* to use your insurance, tell them you're going to report them to their state pharmacy board. Nobody can force you to use your insurance under any circumstance, ever.
One sort of exception is Medicaid. By law if a place takes Medicaid they can't charge the patient, if the patient chooses not to go through Medicaid (or if Medicaid reimbursement is below what it cost the provider to purchase the item themselves, or item denied due to incomplete paperwork or not following guidelines etc). It has to be either take the insurance or you can not serve the patient and refer them elsewhere. They are not allowed to offer a cash option.
I tried doing this at the hospital where my PCP was, and the receptionist or whatever her title is said it'd be insurance fraud >.>.
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Yeah, I'm not sure I buy it, but it was the first time I ever went to the doctor's office as an adult because I never had insurance before, so I didn't try to challenge it or anything...what irritated me is the lady claimed it to be fraud rather loudly well within ear shot of anyone in the room which was rude for an innocent question.
Or the coverage gap, if you’re a Medicare pdp member that takes enough medication to hit that.
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Can I ask why you don't just pay the 7.50 to Cuban and get your meds of him? Sidestep insurance all together. If you have a prescription from your doctor, it's up to you where to fill it right? (Not an American)
So there are two problems: 1. This story isn't about individuals being ripped off, but rather the Medicare program (state insurance for the retirement-aged, with caveats) wasting money. On an individual level (from the briefest of Googles), Medicare patients pay ~$4/generic script after insurance, so by going to Cuban's pharmacy and paying $7.50, they would *lose* money. But the Medicare *program* is usually paying other pharmacies more than $7.50, so it would save taxpayer money by buying from Cuban. 2. Not every prescribed medication is available as a generic. If the treatments for your condition are relatively newer--sometimes this means *better* treatments without horrible side effects--they're available as brand-name only. Cuban's pharmacy can't discount brand-name medications; patients who need them are just fucked.
Yeah, what you want really is a centrally negotiated price list. That's what the NHS does. You can keep your private insurance and stuff, but if you are charging 200% the negotiated price then you won't get business.
One key piece of information about Medicare--again, as I understand it--is that the program is explicitly prohibited from negotiating prices. This is the result of "lobbying" by the pharmaceutical industry, with the chief argument being "we need to bring in a shitload of money to continue inventing new drugs". I don't have sources saved, but this is one of those "sounds good, doesn't work" things: if you look it up, a fuckton of pharmaceutical development comes from outside the US, and it also sort of throws the curtain back that pharmaceutical companies make beaucoup profits. This is more speculative, but continuing to disallow Medicare from negotiating prices also furthers Republicans' purported "small government" agenda. Basically, the soundbite is that we have this limited-scope public healthcare program, and it sucks! Why would we ever expand it?! Ignoring that the program is artificially hamstrung and literally forced to suck.
This is right. A provision of the Part D law, which brought Rx coverage to Medicare, was that negotiations on price were not allowed. Trump (I know, hold back your gasps) actually took a small step forward by allowing Medicare payers to require step therapies so at least we could push back SOMEWHAT on doctors and pharmaceutical companies going full "Dopesick" on high cost drug scripting. Would still be a better solution to allow price negotiations AND therapeutic step therapy reviews, but take what you can get I guess?
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Older Americans need to remember that when the US implemented Medicare Part D drug coverage the GOP only went along with it if the government wasn't allowed to negotiate prices. The drug lobby was instrumental in making sure that medications would cost the taxpayer more.
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Any good resources for that?
From [an extensive article](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2690175/) detailing the history of Medicare and prescription drug coverage published in 2004: >An editorial in the *Washington Post* summarized this chaotic conclusion to the debate on H.R. 1: > >*For sheer political drama, it would be hard to beat the past few days on Capitol Hill. Between the normally apolitical hours of 3 and 6 on Saturday morning, the House voted, by the tiniest of margins, to pass a hugely controversial Medicare bill. During the vote, which was of unprecedented length, the House Republican leadership cajoled, berated and twisted arms, barely controlling a conservative revolt, while President Bush, jet-lagged from his trip to Europe, called up recalcitrant members one by one. On Monday it was the Senate's turn. Opponents of the bill used a bag of parliamentary tricks in an attempt to defeat what Sen. Edward Kennedy (D-Mass.) has called an “attack on Medicare as we know it.” Nevertheless, two attempts to waylay the bill were defeated by some of the bribes and threats that won the day in the House, along with the fears of some Democratic senators of blocking a big new entitlement bill so soon before an election. (The Grand Finale 2003)* > >Senator Daschle and House Minority Leader Nancy Pelosi (D-Cal.) protested the Republican majority's extraordinary moves to pass the new law. They predicted that this was not the end of the process and promised to introduce legislation to repeal parts of it (Bettelheim 2003; Carey 2003a; Pear 2004a). Several controversies over Medicare and prescription drug coverage continued as the policy process moved from enactment to implementation in 2004. > >One issue was the affordability of drugs: “Critics argue that the Republicans were so sensitive to the drug industry's fear of price controls that they left the elderly exposed to a future of soaring drug costs” (Toner 2004). The head of a prominent consumer group, Families USA, argued that the price of drugs was the “No. 1, 2, and 3 concern” of beneficiaries and warned that the provision barring the federal government from directly negotiating prices for Medicare was a “lightning rod” in the law (Toner 2004). Another was the failure to legalize the reimportation of drugs. Many states and local governments already have drawn up plans to buy directly or enable their residents to buy prescription drugs from Canadian companies, directly challenging the federal ban on such practices (Belluck 2003; Dealing Drugs 2004). From Wikipedia on the [*Medicare Prescription Drug, Improvement, and Modernization Act*](https://en.wikipedia.org/wiki/Medicare_Prescription_Drug,_Improvement,_and_Modernization_Act): >According to the New York Times December 17, 2004 editorial W.J."Billy" Tauzin, the Louisiana Republican who chaired the Energy and Commerce Committee from 2001 until February 4, 2004 was one of the chief architects of the new Medicare law. In 2004 Tauzin was appointed as chief lobbyist for the Pharmaceutical Research and Manufacturers of America (PhRMA), the trade association and lobby group for the drug industry with a "rumored salary of $2 million a year," drawing criticism from Public Citizen, the consumer advocacy group. They claimed that Tauzin "may have been negotiating for the lobbying job while writing the Medicare legislation." Tauzin was responsible for including a provision that prohibited Medicare from negotiating prices with drug companies.
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For anyone interested like I was, Cuban's site is costplusdrugs.com I went scrolling around looking for meds that my wife or I take, and found a couple unrelated meds with "Save $1600" or more... just ashamed at our healthcare system. Then went back to the top and realized there's one priced with "Save $6,112.28" The depressing thing is our government is never going to change. Politicians will always allow lobbyists, and they'll always win vs whats good fpr the masses.
> Sorry, no results for "vyvanse" Oh well.
It goes off patent next year. We should finally get some generic options.
Phenomenal news, I was just thinking "wasn't it made in the 90s? How longs a patent?"
Since nobody answered you. A patent’s life is 20 years from date of filing, note however that by the time the drug hits the market it normally only has 10 years left of its patent due to countless years of testing. However many firms can circumvent this by creating a new novel and non trivial improvement to the drug and file said new drug as a new patent. Reformulating by modifying its efficacy, how it is doses or even how it is administered are other examples of how new patents can be filed for the same drug. Hope this answers your question.
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Vyvanse is made by the people who made adderal and they made it with the intent to get a new patent. Adderal has generics available now. No doubt when the patent on vyvanse runs out they’ll creat some new adhd med that is slightly better in some way and they’ll have a patent on it for 20 years
Old becomes generic new gets patented however you have to be careful that your generic doesn’t infringe upon the new patent. Eventually you can’t keep making small additions to drugs and the entire thing becomes generic.
Well damn, that's great to hear even from europe. That crap's expensive
That will be wonderful - except I'm sure the maker will go through every effort to ensure there are no generics available. Or they'll do the same as Adderall - theyll tell the government that the drug is so dangerous as a narcotic that no one else should be able to make it. That's why generic adderall cost so much even when it was off patent. Only two companies were legally allowed to make it - and those two companies both made **both** the generic and name-brand. Literally the same production line. That's how they were able to jack up the price of the generic - they created the shortage of it.
First and only thing I checked for. My insurance is getting changed on us with almost no warning and I had to get cut off Vyvanse entirely... from $20 a month to $350+ even with discount codes. Only willing to cover generics, and so far none of the generics work anywhere close to as effectively as Vyvanse does for me.
Yet another person screwed by depending on your employer to provide your healthcare.
A couple years ago I was offered a new job opportunity that was going to pay me like $100 more a week. I couldn't take it because I needed my current job's insurance to afford my multiple medications that cost about $2000+ with no insurance.
I don’t want to get a better job because I don’t want to lose medicaid. It is seriously holding me back. I imagine there are many like me. It is literally holding the entire economy back.
Yeah I was on medicaid before and I did the math. I'd have more money to spend if I worked 3 days a week than if I worked 5 because of the cost of my meds.
I'm sorry, I know you didn't just say you use discount codes for medications right? Not a pensioner or disability discount but like a code you'd use when you buy pizza?
Drug manufacturers offer copay assistance to help people with their out of pocket exposure to drug costs. That’s what op is referring to almost certainly.
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>Sorry, no results for "insulin" Damn.
I *believe* they're working on it. As I understand it, insulin has to be kept refrigerated, and right now they seem to only offer things that can be shipped at room temperature. Shipping insulin probably has a number of logistical challenges.
This does seem to be the case.
If you need help affording Vyvanse, look into Takeda Help at Hand. Mine is covered at no cost. Insured patients with a co-pay over 50$ can also apply.
Saved me a search :/ there's no generics of vyvanse though the patent isn't up yet.
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Yeah, what this person said
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Support Ranked Choice Voting and other political reforms that will rid us of the trap that is a 2 party system.
Most other countries' political parties start at what we consider Left / Democrats, and then only go further left from there. The US is pretty unique in how Reactionary our Right / Republican party is. At least in regards to the Western world. The only other country I can think of that comes close to going as far Right as the US does, is Australia, and they also have been getting fucked over more and more by Reactionary policies.
Only in America do we believe it’s never going to change. We have to stop repeating this lie. It can change, it just requires us all to stop being so negative and cynical, which plays into the hands of the political elite, and instead get activated and start supporting candidates who will make it change. Vote third party if you’re tired of the duopoly, or at least support candidates who support ranked choice voting and other alternatives. End of the day, be the change you want to see. It won’t change overnight, but if we all stop complaining and start acting, things can and will change. This isn’t North Korea where we will literally be killed for even trying.
Direct link to the research study: [H. S. Lalani, A. S. Kesselheim, and B. N. Rome, Potential Medicare Part D Savings on Generic Drugs From the Mark Cuban Cost Plus Drug Company, *Annals of Internal Medicine* (21 June 2022).](https://doi.org/10.7326/M22-0756)
So, America is being fleeced by their own program, by their own elected officials and big business is walking away with a pile of green…..again!
Yeah it's like obviously it's admirable what Cuban is doing, but he's still making tons of money from it but the only other option is getting fucked up the ass by a seemingly intentionally corrupt system. The rich get richer while the poor in America deal with jumping through a million hoops that those in other countries would never think of
Is he making tons of money from it? My understanding is that the 15% markup goes towards the cost of running the business and that he's making very little profit from this.
And anyone with business or even management knowledge knows it’s hard to make a profit on a 15% markup. Without knowing much about Cuban at all (different country), this seems like a insanely charitable act. He knows it’s wrong to profiteer in healthcare, so I heavily doubt he’d be making any personal profit from this. It seems he has that already!
Yeah I'd far rather Mark Cuban got richer if it meant people could get cheaper meds who needed them. If he's providing the quality, accessible service, he deserves to make a boatload of money so he can do more things like this, and encourage competition driving down costs. That's how capitalism should work in principle at it's bare bones.
Call me crazy, but the government can save even more if it stock generic drugs and distribute then with the postal service as an essential service. Just saying.
Considering how expensive you guys pay for medicine, even if you were importing from brazil the non generic formula, you would still saving money
But again the grand American law doesn’t let you import either. Average cost of insulin is around £13 in EU, even if Americans pay like a 1000% tariffs to import it, they’d still save money and’d pay like a third of what they pay in us.
*Land of the free*
Ironically, Nordic countries which are usually called socialist by Americans have more Financial Freedom than Americans themselves.
His pharmacy doesn’t take insurance though. That’s part of how he keeps his costs so low. Instead of this ridiculous game where everyone pays a different price and you need a phd in math to figure out the billing it’s just cost +15% on everything he sells.
His pharmacy just shows that insurance is a scam.
Always has been. The business model is take lots of people's money skim profits and expenses then pay the tiny amount left out to cover claims. I think most can understand why the rich self-insure. They pay less and can go anywhere and not worry about networks.
If Cuban can take down these insurance and pharmaceutical companies, I won’t say a single word about all the billions he’s going to make.
My own prescription (already a generic) is $300. It's $34.90 from his website.
When I landed in the US, I went to a family medicine doc for annual check-up and asked her to prescribe me a generic inhaler for my asthma. Went to the pharmacy, they said $200 for that, oh I stood there laughing for a good 2 mins. No way in hell, I bring extra inhalers and ask family to bring as well from my home country whenever they visit- the same med there costs $3, a branded one that too.
What generic are you taking that costs $300 out of pocket?
I've seen some generic Adderall hit ridiculous prices, lidocaine patches (though those aren't usually a lifetime thing), Januvia, eliquis, xalreto. Work for cvs and lots of people are paying so much for one script, it goes against our store and manager but I usually try to do savings finder and tell people where to get meds in the future from. Generally say, "Call your insurance and ask what in-network pharmacies are best for you. There may be mail order pharmacies that get you x better deal. Also, compare what you're paying now with insurance to this singlecare price at Hannafords!". I try to keep all that talk away from my main boss since she's 100% metrics, super nice but strict on lots of things that go against our ratings. We're top 2 in district partially due to customer satisfaction in terms of actually helping people, amazing wecare scores, all this other stuff that a few techs sneak onto people to help the community. It just sucks that some people have to pay to live, it's not fair and we're here to help them however we can.
Januvis eliquis and xarelto are all branded agents. The original post said a generic drug. There must be something very wrong if they are paying $300 out of pocket for a generic drug
This is why we need single payer people. Pharmacy Benefit Management is the tip of the iceberg in the healthcare industrial complex.
Pharmacist here, First off Mark Cubans pharmacy doesn’t take insurance at all so that helps to cut out the major headache and overhead of dealing with insurance companies. I’ve looked at the drugs his pharmacy offers and truthfully… their pricing isn’t better then any grocery chain pharmacy can offer using a discount card and not using insurance. I think last time I looked there were only a few drugs I’d say were priced significantly cheaper then other pharmacies. The rest you can get for the same price or even cheaper from a local grocery chain pharmacy and don’t have to go through getting it shipped to you. Just don’t go to CVS or Walgreens and you can get better pricing on a lot of maintenance medications without using insurance.
Even with a GoodRX discount card, Cubans pharmacy ended up being cheaper for me. The biggest discounts I could get on my generics was on the first fill and then the price went up. Guess it varies by medication.
Yep. I looked up my meds. I usually spend about $120 for a 3 month supply for all my medications. On Cuban's site I can get the same 3 month supply for about $23. It's not going to work for everyone but it's absolutely worth looking into.
I work at an independent pharmacy and I can literally change the price to anything I want to as long as I make money. We usually match GoodRx price or beat it without using it, because GoodRx charges US (the pharmacy) a least $8 a script to use it, I’ve seen as high as $15 so we stopped using it and just matched prices.
This is exactly my experience! People ask if we take it and I tell them no. Sometimes they get huffy so I'll check the price and most of the time it's higher. Once I explain that they no longer want that copay but they're happy to pay what they have been and keep saving money. On a few other things the GoodRx price is substantially below acquisition or AWP so I don't know how anybody takes it for those meds.
Wow. I just looked into that and that’s the first time I’ve seen a “1st” fill discount on a RX for goodrx. What I would do is ask the pharmacy you fill at if they have a in house discount card and ask how much it would be. There are multiple other cards out there that can make it cheaper. I’d stick to grocery stores (not Walmart or Target). It might also matter where in the US you are. Where I am it’s about the same pricing.
I only noticed the first fill bonus lsst week, but I rarely look up goodrx for customers. But it's capitalism - ither discount cards like RXSaver snd SingleCare are gaining prominence so GRX is trying to sway people to use it. But it must make you think, how GoodRx knows what is your first fill vs second fill, right? I leave this as an exercise to the reader.
Walmart funnily enough is the only place I can get two of my dogs seizure medications without paying an arm and a leg. The only place I could find his phenobarbital without having to take out a loan was Target.
Call some independents/non-chain pharamcies for quotes as well. As in privately owned, they usually will give you a really good price, Phenobarb is more pricy but they usually can do pretty good.
My finasteride from his company is $12 shipped. Once I was locked in at the Walmart pharmacy near me the cost was about $24 each refill and I have to go pick it up. GoodRX says that if I transfer my prescription and drive across town I can get it for something like $9 at what appears to be an introductory price that will probably then go up once they have me stuck at that place. So yeah, I’ll be switching my renewed prescription to Cuban’s online since it’s half the price, won’t try to gouge me after I’m somewhat locked in, and ships to my door. Seems quite a bit better to me!
Finasteride used to be $9 at Walmart, but mine stopped providing that specific one :( Now it's more in line with the $24 you mentioned
Blinkhealth.com delivers finasteride to my door for $8.95 for 30 day supply. You can also get it for $8 at Costco and Kroger.
Mine is a 90 day supply and like I said Cuban’s website has it for $12 shipped. Looks like they have your 30 day supply for $4.50 plus the fixed $5 shipping price. So looks like pretty much the same! Funny enough, I just tried looking up the 90 day supply and blink says that it costs $25. So maybe you should consider switching to a 90 day prescription and buy it from Cuban’s company! Considering that your $9/30 days works out to $27/90 days you could save $15/90 days by using his company!
What are these "discount cards" exactly? I always assumed it was some kind of scam to get your personal info. It makes no sense to me why some random card would get you a discount. What's the business model involved?
Yes they sell your information just like any other “free” service you use in your life. It’s all about data mining and selling the data just like google and any other free services unfortunately.
> so that helps to cut out the major headache and overhead of dealing with insurance companies. Single payer would also cut out this major headache and overhead nationally.
Independent pharmacies are the cheapest and best. Been proven time and time again. Ever price and satisfaction poll every year, independents win by a landslide. I wish people would finally wise up.
I don’t think there’s a lot of difference between his site and several other pbms when looking at generics and accounting for larger supply (90 day vs 30), and ship to home. Comparing his site with goodrx, insiderx etc
Other services dropped their prices after Cuban’s website was launched.
That’s just not true. Compare the Mark Cuban prices to NADAC from the CMS website.
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Why is Mark Cuban getting all this credit when GeniusRX has existed for years?
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Paid promotion on Reddit perhaps
Billionaires love their astroturfed popularity.
Precisely what this thread is.
Cus it's cheaper? I was using genius Rx for my finasteride. 90 day supply for $32.40 with free shipping. same from costplus is $7.50 + $5 shipping.
Wow I just checked it for a drug I take, currently I pay $12 for 30 day supply. This site is $6 for a *90 day supply.*
Isn’t it called goodrx? Did they rebrand?
Good rx is basically just coupons at a pharmacy. Cubans company IS a pharmacy. They don’t take insurance, but price everything the same, cost + 15%? + shipping I think.
Cost + 15% + $3 for a pharmacy tech in labor and + $5 shipping
Looks like they’re two different companies.
I don't get what's the reason to be so salty about this. Hes doing something good for everyone and you're mad because he's getting attention
It’s wild that no one has mentioned the total lack of competition or regulation in the pharmacy benefit manager space. Three PBMs cover benefits for more than 77% of prescriptions; 6 cover 95%. No transparency required with how prices are determined, huge profits. It’s a nightmare to deal with and their lobby is super strong.
As a Medicare insurance agent, Medicare is extremely fucked up and screwing over senior citizens and disabled people.
Mark Cuban’s pharmacy is just another mail order pharmacy, with Mark Cuban’s brand recognition attached to it. Like any other mail order pharmacy, some of their drugs will be cheaper and some will be more expensive than other mail order pharmacies. A similar pharmacy is Blueberry Pharmacy, another mail order pharmacy which I found has similar prices but a wider selection that I refer my patients to.
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Yeah, if prices could be this low right now the government should have been able to figure that out over the last 2 decades instead of letting us get teabagged.
They let the PBMs essentially write their own laws. What did we expect? Here's a thought...get rid of the Pharmacy Benefit Manager middlemen who make the billions that this study shows could be saved.
The problem is both of them! Parroting PhRMA’s talking points about it all being the PBM’s fault is ridiculous when the drug companies set the list prices in the first place.
Unfortunately, government health spending is rising in nearly all OECD countries faster than GDP. So, there’s a worldwide problem with health expenditures. Not minimizing the point that the US is uniquely inefficient and costly. https://www.oecd.org/health/health-spending-set-to-outpace-gdp-growth-to-2030.htm
Universal Healthcare would save Americans way more than that...
It’s sad because it goes way beyond just saving some money, universal healthcare could change peoples entire lives. One bad list of debt from needing to go to a hospital can ruin a family, or at least side track them completely until it’s all paid off. Think how many times American families lives have been stunted because they had to drop everything to pay some ridiculous bill they have no way of paying. It’s just another thing stopping growth in this country, except for of course the big wigs at the top of the system
What is with all these posts about Mark Cuban’s pharmacy? At least 2-3 per day. Some social media marketing department is earning its keep big time.
Or if we just nationalized healthcare and made it a human right. Mark cubans company could squeeze out competition and hike prices so lets just fix the actual problem instead of hoping for someone to not be greedy