Patient-Level Savings Using the Mark Cuban Cost Plus Drugs Company for Radiation Oncology Patients

Abstract

In 2022, the Mark Cuban Cost Plus Drugs Company (MCCPDC) launched with the goal of offering affordable generic drugs directly to patients through a transparent pricing model. This study aims to evaluate the patient-level potential savings per prescription for patients undergoing radiation oncology treatment, regardless of insurance status. We analyzed prescription patterns of radiation oncologists in 2019 using the Medicare Part D database and selected the top 100 most frequently prescribed drugs for further analysis. To evaluate potential cost savings, we obtained prescription data from the Medical Expenditure Panel Survey (MEPS) for 2019. We filtered the MEPS data based on the top 100 non-controlled drugs prescribed by radiation oncologists (MCCPDC does not sell controlled substances). We calculated the mode for the scripts of each drug and compared the prices to those offered by MCCPDC then adjusted the prices for inflation using the Consumer Price Index (CPI). We stratified scripts by payor type, including public (Medicare and Medicaid), private, and self-pay, and compared the cash price at MCCPDC to the out-of-pocket costs for patients. Our analysis included 25,421 prescriptions. Of these, 49% were covered by public payors (Medicare or Medicaid), 25% were covered by private entities (including private insurance), and 26% were self-pay. Savings were defined as the cash price at MCCPDC being lower than the copay. 40% of prescriptions had savings when purchased through MCCPDC regardless of coverage status. Savings were seen on 17% of scripts for patients covered by Medicare or Medicaid, 39% for those with private coverage, and 84% for patients who self-pay. The average savings per script were $8.80 for public payors, $6.33 for private payors, and $11.32 for self-payors. The medication with the highest average potential savings, regardless of coverage, was tadalafil, with savings of $54.63 per prescription. Among public payors, solifenacin had the highest average potential savings, with savings of $37.07 per prescription. For private payors, memantine had the highest potential savings at $62.83 per prescription. For self-pay patients, the medication with the highest potential savings was levetiracetam, with savings of $740.34 per prescription. Our study demonstrates that MCCPDC can provide substantial cost savings to patients when compared to out-of-pocket costs, regardless of insurance status. This is the first analysis to demonstrate such cost-savings at the patient-level. Radiation oncologists should consider discussing MCCPDC with patients when prescribing medications, as it has potential to reduce the financial toxicity burden for many patients.