The businessman hasn’t been shy about expressing his disapproval of traditional pharmacy benefit managers (PBMs) over the years, mainly for the way they exponentially increase the costs of meds in the United States.
Cuban attributes the US’ high drug prices to PBMs—often considered the “middlemen” within the pharma supply chain—arguing that their rebate-driven model encourages inflated pricing by rewarding drugs with larger rebates instead of those that might be more affordable to patients.
He’s also accused PBMs of pressuring independent pharmacies via what he describes as unfair reimbursement rates and aggressive audit tactics. That was why he started Cost Plus Drugs in 2022, a public benefit corporation that sells medication directly to consumers with a 15% markup.
Cutting out the middlemen in prescription drug pricing
Patients might be wondering, why are the prices so affordable? The Cost Plus Drug website2 summarizes the concept in saying that, “Our prices are the true cost to get each medication from the manufacturer to you. We cut out the pharmacy middlemen and negotiate directly with manufacturers to get the best possible price. Then, we show you exactly how much you’ll pay for us to keep our business running and how much it will cost to prepare and ship your prescription.”
TrumpRx’s role in reshaping the drug supply chain
TrumpRx was originally introduced this past September, with Pfizer being one of the first manufacturers to sign on—a move that not only satisfies Trump’s July most-favored nation executive order that requested a reduction of drug prices, but provides the Big Pharma company with a three-year grace period during which its products won’t be subject to tariffs.3
“We are proud to join President Trump at the White House to celebrate this landmark agreement that is a win for American patients, a win for American leadership, and a win for Pfizer,” said Albert Bourla, Pfizer’s chairman and CEO. “By working closely with the Administration, we are lowering costs for patients and enabling greater investment in the US biopharmaceutical ecosystem by ending the days when American families alone carried the global burden of paying for innovation. This is about putting all patients first and ensuring America remains the world’s leading engine of medical breakthroughs.”
TrumpRx to serve as a search engine for affordable drug access
Cuban clarified in his keynote that TrumpRx, which is set to make its debut by early 2026, will not be acting a direct seller or drug distributor, but rather, it will serve as a “search engine” or referral site for DTC drug websites, such as Cost Plus Drugs.1
Although he did have concerns about other companies deceiving customers by offering lower prices and then pulling rug out from under them, he also felt that the program is “the most beautiful, amazing, brilliant thing” that he’s ever seen, and is a positive for the company and patients alike.
“As our volumes go up, our costs go down,” Cuban said via Chief Healthcare Executive’s coverage of the session.4 “The price for patients go down. So for us, it'll be great, right? It just means more people.”
In a post on X last month, Cuban had originally rated TrumpRx a “B,” due to PBMs’ lack of concern about marketplace disruption. This was reflected by their stock prices failing to take a major hit.1
What’s next for direct-to-consumer drug models?
While Cuban remains optimistic, other industry experts are taking a more cautious approach. Jesse Mendelsohn, executive vice president at Model N, told Pharmaceutical Executive that TrumpRx’s overall impact on drug pricing is still to be determined.
“That remains to be seen. Right now, this is just another venue or route for patients to get therapy as opposed to a sea-change,” Jesse Mendelsohn, Model N’s executive vice president told Pharmaceutical Executive in a recent video interview.4 “Most people will typically use insurance for drugs. Since that’s the case, the things that impact how insurers reimburse for drugs and how manufacturers incentivize payers to list drugs aren’t going to change very much.
“There will be access expansion. As manufacturers get used to these types of platforms, get a better handle on the type of discounting, and understand the logistics, there might be more sets of patients they can target with DTC products. At this point, I don’t think it will have a broad impact on how drugs are listed and purchased.”
References
1. Vogel S. Mark Cuban Says Cost Plus Drugs Will Partner With TrumpRx. Healthcare Dive. October 20, 2025. Accessed October 22, 2025. https://www.healthcaredive.com/news/mark-cuban-cost-plus-drugs-partner-trumprx/803180/
2. Cost Plus Drugs website. https://www.costplusdrugs.com/
3. Hollan M. Pfizer Announces Agreement with Trump Administration to Lower Prices, Join TrumpRx, and Avoid Tariffs. Pharmaceutical Executive. September 30, 2025. Accessed October 22, 2025. https://www.pharmexec.com/view/trump-announce-government-direct-patient-website-report
4. Hollan M. How Will TrumpRx Impact Manufacturer-Produced DTC Programs? Pharmaceutical Executive. October 21, 2025. Accessed October 22, 2025. https://www.pharmexec.com/view/trumprx-impact-manufacturer-produced-dtc-programs