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A Less Bitter Pill

Ron Wayne

I NEVER SAW THE NEED to buy prescriptions from anywhere other than the local pharmacy until—for reasons that still aren’t clear—a medication I’ve been taking for years jumped in price.

Until January, I’d been paying $8.86 a month for the medication through my Humana Medicare Advantage plan. Suddenly, it jumped 200% to $26.85. In a series of calls, Humana agents gave me the following varied reasons:

  • The manufacturer increased the price.
  • I’d reached my donut limit for co-pays, which wasn’t true.
  • My health care provider didn’t respond to a request for additional information—a request I never heard about.
  • The manufacturer changed the drug from Tier 5 to Tier 4, which meant the drug went from a 33% co-insurance payment to a $30 maximum co-pay. This might be the correct reason, but it took multiple calls to find this out. The situation is absurd and has me reconsidering Humana when open enrollment comes around again at the end of the year.

I decided to see how much the generic alternative would cost through Mark Cuban’s Cost Plus Drug Company. I had to register online and provide a form to my doctor’s office. I’m now getting three months for just $40.26 plus shipping. I chose the faster shipping because I was worried my medication wouldn’t get here before I ran out of pills, which must be taken daily. Conventional shipping is just $5. Faster shipping is $15.

But even at $55.26, I’m saving money. Three months through Humana would have cost $80.55. I expect future refills will require only regular shipping for a total of $45.26 or $15.09 monthly—a savings of $35.29 a quarter or $141.16 a year. I received a $6 discount for ordering three months’ worth at a time, which also saves on shipping charges compared to buying every month.

Cuban’s start-up eliminates “pharmacy benefit managers” and negotiates directly with the manufacturers. While Cost Plus works with some insurance plans, mine isn’t one of them. Consumer advocate Clark Howard said this about Cost Plus: “There’s a lot of dirty dealing that goes on from those pharmacy benefits managers that handle those prescription plans…. Mark Cuban is trying to make drugs clearer, simpler and cheaper to buy.”

The company has grown to two million customers since its 2021 launch and now offers more than 1,000 prescriptions. All have been generic drugs until this past March, when the firm offered its first brand-name medication, a drug for hypothyroidism.

This was my first time ordering drugs from somewhere other than CVS or a similar pharmacy. I was a bit wary—but I took comfort from Cuban’s name credibility.

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