Mark Cuban on C-SPAN
WebProNews – Online Article – November 29, 2026 – Mark Cuban PBM Transparency Reform
The debate surrounding high prescription drug prices in the United States is intensifying — and now, one of the loudest voices belongs to billionaire entrepreneur Mark Cuban. Although he is best known for his tech ventures and sports investments, Cuban has recently turned his focus toward one of the most powerful and least understood sectors in healthcare: Pharmacy Benefit Managers (PBMs).
As drug affordability becomes a national crisis, Cuban’s critique goes far beyond celebrity commentary. Instead, it is reshaping public perception, influencing policymakers, and accelerating the demand for PBM reform — a movement that increasingly affects patients, employers, and independent pharmacies across the country.
According to Cuban and numerous industry experts, the U.S. faces the highest drug prices in the world because it is the only country that relies on PBMs to negotiate access and pricing.
Originally, PBMs were intended to secure lower drug prices for insurers by aggregating buying power. However, as time passed, critics argue that this model evolved into something far more problematic. For example:
PBM revenue often depends on manufacturer rebate size, which incentivizes higher list prices rather than lower ones.
Lower-priced drugs may be excluded from formularies if higher-priced options offer bigger rebates.
Patients frequently pay out-of-pocket costs based on the inflated list price, not the discounted price insurers actually pay.
Consequently, these practices created the now-infamous “gross-to-net bubble” — meaning the gap between rising list prices and declining net prices. PBMs and insurers profit from that spread, while patients absorb more of the financial burden.
Additionally, the PBM landscape is dominated by just three major companies — CVS Caremark, Express Scripts, and OptumRx — which collectively control nearly 80% of the U.S. prescription market. Their parent corporations also own:
Major insurance plans
Retail pharmacy chains
Specialty pharmacies
Provider networks
Because of this vertical integration, these conglomerates wield extraordinary influence over which drugs patients can access, how much they must pay, and even which pharmacies they are allowed to use.
Furthermore, the Federal Trade Commission (FTC) raised concerns that these PBMs may be steering patients toward their own affiliated pharmacies and restricting access to lower-cost alternatives. As a result, regulators fear that this concentrated power could be inflating costs throughout the entire healthcare system.
In response to these entrenched issues, Cuban launched the Mark Cuban Cost Plus Drug Company (MCCPDC) — a radically transparent model designed to bypass PBMs entirely.
His pricing formula is straightforward:
Drug cost + 15% margin + $3 pharmacy fee + $5 shipping
This means:
No rebates
No spread pricing
No hidden fees
As a result, the model exposes just how inflated traditional drug prices are. For example, some leukemia medications that cost thousands through PBM-managed plans can be purchased for under $100 through Cost Plus Drugs.
In turn, many employers and health plans are seeing true drug acquisition costs for the first time, which is already shifting expectations within the market.
This video further clarifies Cuban’s arguments and reinforces the urgency of PBM reform.
See the video HERE.
As Cuban’s message gains traction, bipartisan interest in PBM reform is expanding across Capitol Hill. Moreover, lawmakers are now focusing on several key initiatives:
Decoupling PBM compensation from drug list prices
Requiring full transparency on rebates and fee structures
Investigating PBM use of overseas Group Purchasing Organizations (GPOs)
Ensuring employers receive accurate net-cost data
At the same time, major employers are beginning to rethink traditional PBM contracts.
One of the most notable examples is Blue Shield of California, which dropped CVS Caremark in favor of a new modular system involving:
Amazon Pharmacy
Cost Plus Drugs
A separate claims processor
This new strategy aims to eliminate hidden PBM margins and could save the insurer hundreds of millions of dollars.
Furthermore, under the Consolidated Appropriations Act (CAA), employers must prove they are paying reasonable rates for healthcare services — including prescription drugs.
If they continue using PBM contracts that overcharge for generics, despite transparent alternatives, they could face class-action lawsuits from employees.
As a result, the industry’s conversation is shifting rapidly:
“How big is the rebate?” to “What is the real net cost?”
While the broader pharmaceutical supply chain undergoes unprecedented transformation, patients and independent pharmacies continue to feel the impact.
Manufacturers are seeking direct-to-patient options.
Employers are reevaluating long-standing PBM agreements.
Regulators are examining anti-competitive behavior.
And patients are demanding affordable access and transparency.
At RescueMeds, we witness these challenges daily:
Delayed or denied access to essential medications
Reimbursement models that strain independent pharmacies
Formularies driven by rebates rather than medical need
Therefore, we support reforms that increase transparency, eliminate abusive practices, and restore patient-centered decision-making.
Ultimately, Mark Cuban’s involvement in the PBM debate has become far more than a headline. Instead, his work serves as a catalyst for meaningful industry change.
For the first time, patients, employers, regulators, and pharmacies have concrete evidence of what many suspected all along:
Prescription drugs don’t need to be this expensive — PBMs made them that way.
As market forces and regulatory pressure move toward transparency, the era of the opaque middleman is beginning to contract. Employers are demanding better. Patients are expecting fairness. And the justification behind PBM pricing models grows weaker by the day.
At RescueMeds, we will continue advocating for a Workers’ Comp pharmacy system rooted in clarity, fairness, and patient-first care.
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