The Real Eisman Playbook Mark Cuban Shares His Plan For Fixing Drug Prices in America | The Real Eisman Playbook Ep 50
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Mar 16, 2026 
Mark Cuban, entrepreneur and founder of Cost Plus Drugs and Cost Plus Wellness, explains why U.S. prescription pricing is broken. He breaks down how PBMs shape costs. He outlines his transparent cost-plus pricing model and how employers and patients can use it. He also discusses scaling, manufacturer barriers, and strategies to disrupt incumbent players.
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Deductibles Drive Patient Financial Trauma
- U.S. patients face opaque, unaffordable healthcare economics that make deductibles more important than premiums.
- Mark Cuban says doctors ask which pharmacy you use but not whether you can afford the prescription, which forces hospitals into lending roles.
PBMs Are The Hidden Pricing Gatekeepers
- Pharmacy Benefit Managers (PBMs) are unique to the U.S. and control pricing and coverage decisions for most patients.
- Cuban explains PBMs set patient prices at the pharmacy, decide formulary placement, and negotiate rebates with manufacturers.
Rebates Make Sick Patients Subsidize Drug Deals
- Rebates negotiated by PBMs are paid by manufacturers but largely captured by PBMs and employers, not patients, inflating patient costs during deductibles.
- Cuban details a $1,000 drug with a $400 rebate where the sick patient pays the full $1,000 while PBMs keep a cut.