Individuals with health insurance are more likely to spend less on generic drugs when using their benefits compared to going through Mark Cuban's Cost Plus Drug Company, according to a study published June 14 in JAMA Health Forum.
"Savings varied substantially by health insurance type, with uninsured patients achieving the greatest benefit," the researchers wrote. "Promoting transparent cost-plus pharmacy models, such as MCCPDC, can reduce out-of-pocket costs for a specific subset of patients."
Researchers used a sample of more than 843 million prescription pharmacy fills for 124 generic drugs in 2019. They then matched generic drugs sold by Cost Plus in March 2023 to the sample prescriptions using codes from the National Drug Code Directory and other drug information.
To account for potential differences in drug costs from 2019 to 2023, the study adjusted out-of-pocket costs in its sample using the drug-specific percentage change in CMS' National Average Drug Acquisition Cost, then compared the difference in patients' out-of-pocket costs with Cost Plus' prices.
Cost Plus' direct-to-consumer online pharmacy model launched in 2022. In response to the study, Mr. Cuban told Becker's the company has "lowered prices dramatically since [2023], so I'm positive the savings are much greater today."
According to the study, insured patients could have spent less on 11.8% of prescriptions if they had been purchased from Cost Plus. Estimated cost savings were $4.96 per prescription, including shipping.
No cost savings were observed among Medicaid enrollees. Medicare enrollees spent less on 5.5% of prescriptions filled through Cost Plus, commercial members spent less on 7.1%, military members spent less on 9.9% and individuals without insurance spent less on 28.9%.
Median estimated cost savings per prescription was highest for uninsured individuals at $6.08, $5.05 for military members, $4.64 for Medicare, and $3.69 for commercial insurance.
Among prescriptions that led to savings, 50.3% saw savings of less than $5, and 28.4% had savings greater than $10.
The researchers noted that their findings were consistent with a 2021 study of Costco’s direct-to-consumer pharmacy, which found higher spending among 11% of Medicare Part D claims. They also noted that a 2023 study of the 20 most-prescribed generic drugs found that out-of-pocket costs for 20% of prescriptions were higher for Prime members at Amazon Pharmacy.
Finally, the researchers noted that the cost and supply of drugs sold by Cost Plus changes frequently, and the company only sold 26% of available expensive generics in May 2023. The study did not evaluate the potential cost savings of in-person prescription pickup.