Study Finds Cost Plus Drugs Undercuts PBM Pricing on Many Drugs
Becker's Hospital Review reports on a September analysis by consulting firm 3 Axis Advisors, conducted on behalf of Mark Cuban Cost Plus Drug Co., comparing its prices to what PBMs charged 13 commercial employer plans in 2024. Across 1.2 million claims worth $433.5 million, Cost Plus had pricing for 71.5% of claims but just 14.4% of spending, since it lacks most high-cost specialty drugs. Repricing those claims at Cost Plus rates would have cut charges by 67%, with the largest savings on Humira and Stelara biosimilars; Cost Plus was actually more expensive than PBMs on many low-cost generics due to its flat $10.40 fee. The authors caution findings cannot be extrapolated to all drug spending and lacked rebate data needed to assess employers' net costs.