Ah yes, who better to criticize Cuban’s pharmacy than the man who is a convicted felon for fraud and is involved in big pharma. Let’s put two and two together shall we. Why would a man who this pharmacy hurts the business of want to make an article cherry-picking some of the company’s claims so he can prove that it’s “fraudulent” when he is the one who has literally been convicted of fraud.
Lol!! You have just enough information to be quasi-dangerous..If you followed his case, you would know he's no longer in the pharmaceutical sector. Yes, he can write articles about it because that's what he understands. But the idea that somehow Mark Cuban is a risk to his future profits is absurd
The original post had little substance - the OP could perhaps show us where there are real substantial savings, which would then establish cherry picking, and actually create an argument. Instead "Shkreli bad". A clown face is a fair response.
It’s more than just “Shkreli bad”. He used TWO examples to prove his claims when there are literally thousands of products to choose from. That’s not nearly enough to make a statistically significant claim, hence “cherry-picking”. The fact that you would even consider what Shkreli is saying is laughable considering ofc he is going to criticize Mark’s pharmacy, it is literally created to put people like Shkreli out of business. Use your brain to consider what bias and agenda are. The man has been convicted of fraud yet is accusing mark of fraud of off two examples. Laughable.
There are other similar competitors. Do you really think that there are massive margins as suggested by Cuban ('Savings!') when Walmart is doing it?
You do know Walmarts business model is right? Low margins, large supply?
WTF if Mark Cuban is entering the -> exact same business <- he would be any different?
Why don't you get off your ass and show us how Martin is wrong?
Shkreli has shown 2 or 3 REAL examples.
Shkreli is showing how Cuban is using Loss Leaders for marketing purposes (that will deliberately Not sell many pills, as the market (customer base) is extremely small).
Do you really believe Cuban is somehow God's gift to the world? Cuban is using his appeal (and a narrative) to drive traffic to his website (so who really has bias and agenda? Cuban who is trying to drive traffic? or Martin who doesn't sell any drugs?). (TBH I wouldn't be surprised if Cuban is using a white label service with another pharmacy fulfilling orders - so much for the miracle).
Time to grow up.
Oh and Shkreli had a -> non <-generic drug = so it would never put him out of business.
If Shkreli sold through Cuban, Cuban would HAVE to pay Shkreli, by law.
So how does that put Shkreli out of business?
Do you even understand the difference between generic and non-generic drugs?
Just to cross check, I pulled up a random news article to grab other medication names under this claim (Actos/pioglitazone). CostPlusDrugs has it advertised for $6.60 + $5 shipping = $11.50 total. GoodRx has three different listed delivery options for under $10 with free shipping.
Disappointing to say the least, that the mass marketing of this is founded on some illusion of hope that someone's finally making a difference. Good read, thank you.
I think people want to believe something like this is possible. “99% savings, wow! We were being ripped off!” The reality is this is a fragmented and complex market with 6000+ SKUs and margin reached equilibrium competitively. Free market does its job regardless of the lies told.
The more you look into it the more it looks like a populist play for a 2024 election, which he said he might go for. The media is being an echo chamber they are, my favorite headlines that were picked up by most outlets "A Research group finds that Medicare could save billions buying drugs through Cuban's new company...". Probably the same group of researchers that calculated a 99% savings lol
DiRx has been mentioned alongside Cuban’s company and GoodRx. DiRx actually was the first to launch the model of sourcing direct from manufacturers, went live a few months before Cuban’s, offers a larger portfolio of generics (1400+ skus) and it’s prices include free shipping unlike Cuban’s where you add $5 shipping on top of the price you see. When you do the math, they’re cheaper for a majority of products (barring a few exceptions).
In any case, it is clear that US pays a lot more than other countries for medicines. Movement towards single-payer and using health technology assessment tools like QALYs and innovative payment mechanisms such as value-based-pricing and pay-for-success contracts will help incentivise more healthy years at lower cost.
For example, it is possible to use a Pay-For-Success contracts to incentivise repurposing of generic drugs to provide billions of dollars in cost savings for a relatively small-sized incentive (e.g. $100-200m). This is similar to the Netflix-style subscription model proposed for antibiotics (https://www.pinsentmasons.com/out-law/news/new-antibiotics-added-nices-netflix-style-subscription-service). The FDA's Priority Review Voucher (PRV) programme (https://www.gao.gov/assets/gao-20-251.pdf) could also be extended to address this market failure, but at the moment, drugs where the active ingredient has been approved for one indication are not eligible for PRV. This is nonsensical as the value is not in the active ingredient, but the treatment protocol (and clinical trial data) showing which active ingredients are effective for which patient populations.
Our DeSci project Crowd Funded Cures, is a crowdfunding platform to create demand for clinical trial data validating safety and efficacy of open source / public good / unmonopolisable therapies (e.g. repurposing off-patent drugs, nutraceuticals, plant medicines, psychedelics, diets and lifestyle interventions) without reliance on patents using IP-NFTs, Pay-for-Success (PFS) contracts, and crowdfunded Open Source Medical Prize NFTs.
See short explainer here about how Pay-For-Success contracts can help millions of people:
I'd rebut, Mark's pricing model is different from PBM companies as he removes the middle-man price markup. Please refer to pricing models for PBM companies, as well as pharmacy retail stores as the main / core business function, as this is a comparison of apples to hamburgers. If you review pricing on generics with direct consumer purchasing, such as CVS, Walgreens, and other large retail pharmacies, you'll find these statements you make are patently false. The pricing models are skewed by a significant magnitude. Take for example, Fluoxetine, which sells at CostPlusDrugs for $3.90 & Walmart for $4.00, sells at CVS $48.29 & Walgreens for $47.65. That's the Texas market. I note you didn't cite any pharmacy retail stores here, simply the large box stores that fit into your analysis. Though you are correct in your comparison with GoodRx and other similar online platforms. The difference is that with these programs, there's a lot of hoop-jumping. With Mark's platform, the patient purchases the pharmaceuticals at the stated price, no coupon needed, no hoop jumping. Mr. Cuban's pharmacy isn't a large box store, subsequently, I'd implore you in your next analysis that you ensure to point out these remarkable differences, as they are required in a factual and complete analysis on said topic. Moreover, I'd ask that you perform a competitive analysis, perform an accurate and comprehensive 1:1 comparison so that it doesn't seem disingenuous.
I'll add that Medicare and government programs will benefit from Cuban's generic pricing model because pharmaceutical companies enjoy the benefits of illegal price fixing. Medicare / Medicaid will now be set to a standard of transparency via Mark's business model. Prior to this, the government had little to no bargaining power. Also, I'll make a correction to my previous comment in that GoodRX is a discount card program that pharmaceutical companies can opt in or opt out of, not an actual pharmaceutical drug provider or platform. This program doesn't fit within the analysis. It would be best if a proper 1:1 competitive analysis was performed for scoping purposes.
Not really how it works. CMS knows with +/- 10% how much vast majority of drugs cost. They do surveys of drug wholesaler invoices, to come up with NADAC (National Drug Acquisition Cost).
The government doesn’t have bargaining power, because they are prohibited by law from directly negotiating drug prices.
All drugs paid for by the government via Part D are “sub contracted” out to PBMs/Part D/Medicare advantage companies like Humana etc
I believe this will suffice; therefore, I'll not repeat myself. If this doesn't make sense to you, I don't think there's anything more to say on my end. I personally think this is a simple mathematics "type" logic, meaning 2+2= 4, but others may disagree. Of course, I have no desire to control your decisions or thought process, so feel free to believe as you choose.
You're way, way far off base. Basically everything you’ve said is wrong. You're interchanging PBMs with pharma companies.
It’s obvious you do not know how the pharmacy/PBM industry works, and cannot see how “usual and customary pricing” causes fluctuations across different stores, and how GoodRX and all other RX coupon cards sole purpose is to manipulate the usual and customary pricing to circumvent pharmacy contracted reimbursement rates.
Unfortunately for the entire healthcare industry, it’s much more complicated than 2+2.
Also those links you sent are completely irrelevant to anything in this discussion. Yes, it’s a reason generics at wholesale (price that pharmacy buys) are expensive, but does has little to no bearing on price deltas on non insured patients.
To the contrary, I fully understand what a PBM is. Furthermore, they are the primary tool the DoD, Medicare, & Medicaid, use for their prescriptions at a whopping "74% of drug benefits mgmt. and performed the remaining 26% of services themselves." The PBM is THE middleman & receives a generous cut. This is one of the major reason the pricing is higher. Another reason is that pharmaceutical companies are price fixing as a practice.
These two points are not only relevant to this discussion, but relevant to the entire industry as a whole. I'm looking at this from a big picture point of view & zooming in. You are looking at it from segmented pieces not linked for a full picture analysis. I implore you to incorporate your pieces (sew them together with some logic) and then analyze from that perspective. Understand what the BUSINESS perspective might be, not just the science of medicinal chemistry. In other words, you need all the pieces to link for this to make sense.
It's disconcerting that the cited DoJ action doesn't inspire a pause that you may be missing something in your analysis.... Moreover, this response makes little sense & your last paragraph makes no sense.
Cubans Coinbase- like company which imploded was also falsely represented.
The model of paying depositors 9% on their Crypto was proved to be a fast-talking lie. It is video taped and then pulled to shreds by a knowledgeable crypto guy. Cuban is sitting with the head of the company and nodding in agreement. Not sure if Cuban knew the guy was spewing bullshit but if you are promoting the company, he should know the fundamentals.
The real way to offer transparency is to list NADAC price. CMS has collected this data for its own cost plus model (NADAC + flat dispensing fee), and the numbers are available to anyone.
WAC, AWP, MAC etc are all literally just made up figures.
Great quick article. When I first saw it advertised I was really skeptical on the pricing and it turns out it was too good to be true. That's for the insight, Martin!
Ah yes, who better to criticize Cuban’s pharmacy than the man who is a convicted felon for fraud and is involved in big pharma. Let’s put two and two together shall we. Why would a man who this pharmacy hurts the business of want to make an article cherry-picking some of the company’s claims so he can prove that it’s “fraudulent” when he is the one who has literally been convicted of fraud.
Lol a Mark Cuban Stan
Lol!! You have just enough information to be quasi-dangerous..If you followed his case, you would know he's no longer in the pharmaceutical sector. Yes, he can write articles about it because that's what he understands. But the idea that somehow Mark Cuban is a risk to his future profits is absurd
If you think he isn’t invested in big pharma…you’re not the brightest. He still holds stock.
Shkreli never sold generic pharma.
Thats not Shkreli business model. His model was off patent, but nobody created the drug. Thats Not a generic drug.
And anyway Cuban is just a pharmacy via web buying generic drugs.
Generic drugs can be made by anyone (as long as FDA approved).
Generic medicine is CHEAP and sold by Walmart ffs.
Non-Generic medicine is EXPENSIVE - Cuban is Not doing anything about that.
🤡
What an insightful response
The original post had little substance - the OP could perhaps show us where there are real substantial savings, which would then establish cherry picking, and actually create an argument. Instead "Shkreli bad". A clown face is a fair response.
It’s more than just “Shkreli bad”. He used TWO examples to prove his claims when there are literally thousands of products to choose from. That’s not nearly enough to make a statistically significant claim, hence “cherry-picking”. The fact that you would even consider what Shkreli is saying is laughable considering ofc he is going to criticize Mark’s pharmacy, it is literally created to put people like Shkreli out of business. Use your brain to consider what bias and agenda are. The man has been convicted of fraud yet is accusing mark of fraud of off two examples. Laughable.
The business model is a generic drug pharmacy.
There are other similar competitors. Do you really think that there are massive margins as suggested by Cuban ('Savings!') when Walmart is doing it?
You do know Walmarts business model is right? Low margins, large supply?
WTF if Mark Cuban is entering the -> exact same business <- he would be any different?
Why don't you get off your ass and show us how Martin is wrong?
Shkreli has shown 2 or 3 REAL examples.
Shkreli is showing how Cuban is using Loss Leaders for marketing purposes (that will deliberately Not sell many pills, as the market (customer base) is extremely small).
Do you really believe Cuban is somehow God's gift to the world? Cuban is using his appeal (and a narrative) to drive traffic to his website (so who really has bias and agenda? Cuban who is trying to drive traffic? or Martin who doesn't sell any drugs?). (TBH I wouldn't be surprised if Cuban is using a white label service with another pharmacy fulfilling orders - so much for the miracle).
Time to grow up.
Oh and Shkreli had a -> non <-generic drug = so it would never put him out of business.
If Shkreli sold through Cuban, Cuban would HAVE to pay Shkreli, by law.
So how does that put Shkreli out of business?
Do you even understand the difference between generic and non-generic drugs?
Just to cross check, I pulled up a random news article to grab other medication names under this claim (Actos/pioglitazone). CostPlusDrugs has it advertised for $6.60 + $5 shipping = $11.50 total. GoodRx has three different listed delivery options for under $10 with free shipping.
Disappointing to say the least, that the mass marketing of this is founded on some illusion of hope that someone's finally making a difference. Good read, thank you.
Question is how many gullible people are there that will just fall for this type of marketing?
I think people want to believe something like this is possible. “99% savings, wow! We were being ripped off!” The reality is this is a fragmented and complex market with 6000+ SKUs and margin reached equilibrium competitively. Free market does its job regardless of the lies told.
The more you look into it the more it looks like a populist play for a 2024 election, which he said he might go for. The media is being an echo chamber they are, my favorite headlines that were picked up by most outlets "A Research group finds that Medicare could save billions buying drugs through Cuban's new company...". Probably the same group of researchers that calculated a 99% savings lol
I had initial impression. I could save this $ by buying generic at my local Walmart pharmacy at their prices or through GoodRx. Not a big deal
DiRx has been mentioned alongside Cuban’s company and GoodRx. DiRx actually was the first to launch the model of sourcing direct from manufacturers, went live a few months before Cuban’s, offers a larger portfolio of generics (1400+ skus) and it’s prices include free shipping unlike Cuban’s where you add $5 shipping on top of the price you see. When you do the math, they’re cheaper for a majority of products (barring a few exceptions).
On the other hand, according to this paper, US pays too much for generic drugs:
https://healthpolicy.usc.edu/research/u-s-consumers-overpay-for-generic-drugs/#:~:text=Nonetheless%2C%20by%20one%20estimate%2C%20U.S.,generics%20of%20nearly%20%242.4%20trillion
But this paper by RAND alleges that US pays less for generic drugs (although pays more for branded drugs):
https://www.rand.org/news/press/2021/01/28.html
In any case, it is clear that US pays a lot more than other countries for medicines. Movement towards single-payer and using health technology assessment tools like QALYs and innovative payment mechanisms such as value-based-pricing and pay-for-success contracts will help incentivise more healthy years at lower cost.
For example, it is possible to use a Pay-For-Success contracts to incentivise repurposing of generic drugs to provide billions of dollars in cost savings for a relatively small-sized incentive (e.g. $100-200m). This is similar to the Netflix-style subscription model proposed for antibiotics (https://www.pinsentmasons.com/out-law/news/new-antibiotics-added-nices-netflix-style-subscription-service). The FDA's Priority Review Voucher (PRV) programme (https://www.gao.gov/assets/gao-20-251.pdf) could also be extended to address this market failure, but at the moment, drugs where the active ingredient has been approved for one indication are not eligible for PRV. This is nonsensical as the value is not in the active ingredient, but the treatment protocol (and clinical trial data) showing which active ingredients are effective for which patient populations.
Our DeSci project Crowd Funded Cures, is a crowdfunding platform to create demand for clinical trial data validating safety and efficacy of open source / public good / unmonopolisable therapies (e.g. repurposing off-patent drugs, nutraceuticals, plant medicines, psychedelics, diets and lifestyle interventions) without reliance on patents using IP-NFTs, Pay-for-Success (PFS) contracts, and crowdfunded Open Source Medical Prize NFTs.
See short explainer here about how Pay-For-Success contracts can help millions of people:
https://www.youtube.com/watch?v=FwAOJc_IsVk
More of a deeper dive (including the crypto aspect):
https://crowdfundedcures.medium.com/pay-for-success-contracts-a-new-model-to-develop-new-therapies-from-old-drugs-f69b2189184d
King of cherry picking 👑
I'd rebut, Mark's pricing model is different from PBM companies as he removes the middle-man price markup. Please refer to pricing models for PBM companies, as well as pharmacy retail stores as the main / core business function, as this is a comparison of apples to hamburgers. If you review pricing on generics with direct consumer purchasing, such as CVS, Walgreens, and other large retail pharmacies, you'll find these statements you make are patently false. The pricing models are skewed by a significant magnitude. Take for example, Fluoxetine, which sells at CostPlusDrugs for $3.90 & Walmart for $4.00, sells at CVS $48.29 & Walgreens for $47.65. That's the Texas market. I note you didn't cite any pharmacy retail stores here, simply the large box stores that fit into your analysis. Though you are correct in your comparison with GoodRx and other similar online platforms. The difference is that with these programs, there's a lot of hoop-jumping. With Mark's platform, the patient purchases the pharmaceuticals at the stated price, no coupon needed, no hoop jumping. Mr. Cuban's pharmacy isn't a large box store, subsequently, I'd implore you in your next analysis that you ensure to point out these remarkable differences, as they are required in a factual and complete analysis on said topic. Moreover, I'd ask that you perform a competitive analysis, perform an accurate and comprehensive 1:1 comparison so that it doesn't seem disingenuous.
I'll add that Medicare and government programs will benefit from Cuban's generic pricing model because pharmaceutical companies enjoy the benefits of illegal price fixing. Medicare / Medicaid will now be set to a standard of transparency via Mark's business model. Prior to this, the government had little to no bargaining power. Also, I'll make a correction to my previous comment in that GoodRX is a discount card program that pharmaceutical companies can opt in or opt out of, not an actual pharmaceutical drug provider or platform. This program doesn't fit within the analysis. It would be best if a proper 1:1 competitive analysis was performed for scoping purposes.
Not really how it works. CMS knows with +/- 10% how much vast majority of drugs cost. They do surveys of drug wholesaler invoices, to come up with NADAC (National Drug Acquisition Cost).
The government doesn’t have bargaining power, because they are prohibited by law from directly negotiating drug prices.
All drugs paid for by the government via Part D are “sub contracted” out to PBMs/Part D/Medicare advantage companies like Humana etc
I'd argue that's EXACTLY how that works:
https://www.fiercepharma.com/pharma/massive-price-fixing-lawsuit-44-states-aim-to-claw-back-billions-from-20-generic-companies
https://www.policymed.com/2019/05/coalition-of-44-states-files-antitrust-suit-against-20-generic-companies-for-alleged-price-fixing.html
https://www.justice.gov/opa/pr/former-generic-pharmaceutical-executive-pleads-guilty-role-criminal-antitrust-conspiracy
https://www.justice.gov/opa/pr/former-top-generic-pharmaceutical-executives-charged-price-fixing-bid-rigging-and-customer
I believe this will suffice; therefore, I'll not repeat myself. If this doesn't make sense to you, I don't think there's anything more to say on my end. I personally think this is a simple mathematics "type" logic, meaning 2+2= 4, but others may disagree. Of course, I have no desire to control your decisions or thought process, so feel free to believe as you choose.
You're way, way far off base. Basically everything you’ve said is wrong. You're interchanging PBMs with pharma companies.
It’s obvious you do not know how the pharmacy/PBM industry works, and cannot see how “usual and customary pricing” causes fluctuations across different stores, and how GoodRX and all other RX coupon cards sole purpose is to manipulate the usual and customary pricing to circumvent pharmacy contracted reimbursement rates.
Unfortunately for the entire healthcare industry, it’s much more complicated than 2+2.
Also those links you sent are completely irrelevant to anything in this discussion. Yes, it’s a reason generics at wholesale (price that pharmacy buys) are expensive, but does has little to no bearing on price deltas on non insured patients.
To the contrary, I fully understand what a PBM is. Furthermore, they are the primary tool the DoD, Medicare, & Medicaid, use for their prescriptions at a whopping "74% of drug benefits mgmt. and performed the remaining 26% of services themselves." The PBM is THE middleman & receives a generous cut. This is one of the major reason the pricing is higher. Another reason is that pharmaceutical companies are price fixing as a practice.
These two points are not only relevant to this discussion, but relevant to the entire industry as a whole. I'm looking at this from a big picture point of view & zooming in. You are looking at it from segmented pieces not linked for a full picture analysis. I implore you to incorporate your pieces (sew them together with some logic) and then analyze from that perspective. Understand what the BUSINESS perspective might be, not just the science of medicinal chemistry. In other words, you need all the pieces to link for this to make sense.
It's disconcerting that the cited DoJ action doesn't inspire a pause that you may be missing something in your analysis.... Moreover, this response makes little sense & your last paragraph makes no sense.
https://www.gao.gov/products/gao-19-498
My riff on the above: https://thefrontierpsychiatrists.substack.com/p/the-devils-advocate-martin-shkreli?r=1ct8f&utm_campaign=post&utm_medium=web&utm_source=direct (And I feel free to cross refer on substack :)
Great article, thx.
Cubans Coinbase- like company which imploded was also falsely represented.
The model of paying depositors 9% on their Crypto was proved to be a fast-talking lie. It is video taped and then pulled to shreds by a knowledgeable crypto guy. Cuban is sitting with the head of the company and nodding in agreement. Not sure if Cuban knew the guy was spewing bullshit but if you are promoting the company, he should know the fundamentals.
First example from article:
Claimed savings: 99%
Actual savings: 60%
Conclusion:
Eat my ass faggot
W
Same question for EQRx — where’s the savings?
The real way to offer transparency is to list NADAC price. CMS has collected this data for its own cost plus model (NADAC + flat dispensing fee), and the numbers are available to anyone.
WAC, AWP, MAC etc are all literally just made up figures.
Interesting
Great quick article. When I first saw it advertised I was really skeptical on the pricing and it turns out it was too good to be true. That's for the insight, Martin!