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The Middlemen in Healthcare – Cost Plus

Cost Plus is a drug company that did away with the middlemen in healthcare and drastically dropped the cost of medications.

Why does this matter to you? Because other billionaires will one day use their power to do the same for the rest of healthcare. Removing the middlemen allows for transparency and improves healthcare.

PBMs in Healthcare

Currently, PBMs (pharmacy benefit management companies) negotiate prices on behalf of pharmaceutical companies. They keep their upsells and are highly profitable companies.

Think of your credit card, Citi Costco. The Visa logo means that you can use it nearly anywhere. Visa charges the merchant a 1-3% fee for this convenience.

Visa is the middleman between the merchant and you. For the transaction to occur, we’ll need middlemen, one could argue. The 1-3% fee, for now, isn’t backbreaking.

PBMs can charge 100% of drug prices and benefit from upselling or upmarking the costs.

Cost Plus as a Drug Company

Cost Plus Drugs isn’t a pharmacy. Instead, it’s an intelligent business that directly negotiates with the drug manufacturer for the best possible price.

It’s still a middleman, but there is more transparency, and it is competing with some behemoths who stand to lose a lot of profits.

CosPlus adds on a 15% markup and they aren’t affiliated with any insurance company or PBM. They will also charge you for shipping.

They are partnering with True Pill, which is more of a standard mail-order pharmacy.

The Workflow for Physicians

If you are using an EMR, you likely have some connection to a Sure Scripts database. Cost Plus should populate in any e-Rx software you use, such as iPrescribe.

The pharmacy you’d choose would be “Mark Cuban Cost Plus Drug Company,” and you include the patient’s email. NCPDP ID #

For those of us who run cash-pay practices, this is quite useful. The cost savings are enormous.

The Other Middlemen in Healthcare

When any field is highly regulated, it floods quickly with middlemen.

The middlemen in healthcare, which are the biggest culprits, are insurance companies, medical groups, hospital groups, state medical boards, and board-certification groups.

I’ve addressed each and every one of these over the years in various articles. Other than the state medical board, I can bypass nearly all these when running my cash-pay practice.

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