Prescription savings across oncology: A cost comparison of Mark Cuban Cost Plus Drugs pharmacy against 2021 Medicare Part B and Part D claims.

Abstract

18 Background: The Mark Cuban Cost Plus Drug Company (MCCPDC) was established in 2022 to provide more affordable and transparent access to prescription medications. While prior work has demonstrated the cost-efficacy of MCCPDC, there remains a need to increase awareness of this public-benefit corporation, especially among healthcare professionals and patients using oncologic drugs covered by Medicare Part D and B. Methods: We identified 9 cancer-directed drugs available for purchase on the MCCPDC pharmacy. Potential savings were estimated by substituting the unit price for Medicare claims with the pricing models offered by MCCPDC. We evaluated oncologic claims utilizing 2021 Medicare Part B and D Spending by Drug data. We extracted the total dosage units, beneficiaries, and average spending per dosage unit for each respective drug. The unit price was determined from Medicare claims and then compared against cost projection using MCCPDC 30-count (30c) and 90-count (90c) supplies. When MCCPDC offered multiple dosages, the most expensive dose was chosen to provide a conservative estimate. We used the National Average Drug Acquisition Cost (NADAC) database to adjust for raw ingredient and manufacturing cost changes between 2021-2023. Results: Across the 9 selected oncological drugs, estimated Medicare Part D and B spending totaled $1.21 billion. When filled at the 30c and 90c MCCPDC unit price point, projected costs were $203 million and $147 million respectively (% savings; 83%, 88%). All drugs claimed on Medicare Part D demonstrated an advantaged 90c price point when filled through MCCPDC (% savings range: 40-98%). At the 30c price point, only anastrozole was unfavorable (% loss; 7%). Out of the three drugs claimed on Medicare Part B, capecitabine and temozolomide demonstrated savings at both 30c and 90c unit price points (% savings range; 28-80%). Methotrexate remained unfavorable at either MCCPDC price point when compared to Medicare B coverage (% loss; 18%, 129%). In total and across Medicare Part D and B claims, estimated savings when filled at the MCCPDC 90c unit price point are $1.06 billion. Conclusions: We demonstrate a potential annual savings of $1.06 billion with MCCPDC compared to Medicare D and B coverage. An awareness of current drugs offered by MCCPDC and particularly those with a highly favorable price point may allow healthcare professionals to more effectively navigate the socioeconomic barriers to care often faced by patients. [Table: see text]