Health insurers go all in on Mark Cuban's drug company

It's been a busy year by any measure for Mark Cuban Cost Plus Drug Co., but especially within the world of health insurance.

If a keynote speech from Cost Plus Drugs' CEO at the insurance industry's largest annual conference isn't enough indication that insurers are paying attention, the company has rolled out three major partnerships within the industry since the start of this year.

In January, Capital Blue Cross became the first insurer in the nation to collaborate with Cost Plus Drugs, allowing its members to use their insurance cards with the company and be reimbursed or put the cost toward their deductible if eligible. The Harrisburg, Pa.-based payer cited savings of up to 80 percent on commonly prescribed generic medications.

In August, Blue Shield of California chose Cost Plus Drugs as a preferred pharmacy provider, shaking up its traditional PBM model with CVS Caremark. With the reorganization, CVS will continue providing specialty medications to Blue Shield's 4.8 million members, and Cost Plus Drugs and Amazon Pharmacy will handle the rest. 

Most recently, Salt Lake City-based Select Health, the insurance arm of Intermountain Health, partnered with Cost Plus Drugs to bring lower cost medication offerings to its more than 1 million members.

During the aforementioned keynote at AHIP's June conference, Cost Plus Drugs CEO and co-founder Alex Oshmyansky, MD, PhD, detailed how the company's retail pharmacy network and cheap drug prices have been turned into a benefits solution for health plans.

In April, Cost Plus Drugs launched an affiliated retail network of pharmacies, which has increased to more than 2,000 locations after securing deals with large chains spanning multiple states, including Kroger. 

Cost Plus customers can receive a Team Cuban Card to purchase prescription drugs at an affiliated pharmacy, which shares a similar pricing as the mail-order model. That model — which sells generics alongside a $5 pharmacy dispensing fee, $5 shipping fee and a 15 percent profit margin — now includes more than 1,000 of the most highly utilized and/or high-cost generic medications. 

"Each individual card has a unique member ID which is tied to a patient's history, so we can track their medication usage and add on as a benefits solution," Dr. Oshmyansky said in June. "I tell people to kind of think of it as a second insurance card."

Cost Plus Drugs will also lease out the adjudication infrastructure within its affiliated pharmacy network so customer claims that come from using the Team Cuban Card can be sent to a private payer.

Dr. Oshmyansky said drug purchases can potentially be applied toward a member's deductible if the company works with an affiliated PBM or the plan is designed to function that way. 

"One of the other things we're working towards at the moment is the ability to lease out the Cost Plus retail network to potential plan sponsors so that they can have their own Cost Plus pharmacy network, and then pass on those savings to their clients," he said.

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