Trump’s New Prescription Plan vs. Mark Cuban’s: Experts Weigh In
Written by
Heather Altamirano
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Angela Corry
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Fed up with soaring prescription drug costs, billionaire Mark Cuban launched the Mark Cuban CostPlus Drug Company, an online pharmacy offering low-cost generic medications, with co-founder Alex Oshmyansky, M.D., Ph.D in 2022. Now, President Donald Trump is promoting his own solution: TrumpRx, a platform coming soon that connects consumers directly with drug manufacturers for discounted prices, bypassing insurance for costly medications such as weight-loss and fertility treatments. But how do the two compare? Experts weigh in.
Trump vs. Cuban: Power vs. Transparency
Trump’s plan relies on government backing, while Cuban has an independent approach.
“The core goal centers on most-favored-nation pricing, which means Americans pay the same low prices that countries like France and Germany pay,” said finance expert Andrew Lokenauth with Be Fluent in Finance. “This is classic top-down pressure: the government negotiating directly with pharma giants like Pfizer and Eli Lilly in exchange for tariff relief.”
Cuban’s method flips that model. His CostPlus Drug Company reveals the actual cost and adds a fixed 15% markup to cover operating expenses, plus a $5 pharmacy fee and a $5 shipping fee.
“Trump’s betting that government power can bend these corporations into compliance, and here’s the concern: when the pressure lifts, prices tend to creep back up,” Lokenauth said.
Cuban’s transparency model shows consumers how much a drug really costs to make, creating lasting market pressure without involving politics. TrumpRx, however, offers discounted prices but keeps the underlying costs confidential.
“You’re told Ozempic drops from $1,000 to $350 per month through TrumpRx. That sounds great until you ask: what does it actually cost to make? Nobody knows,” Lokenauth explained.
How Pharmacy Benefit Managers Factor In
Pharmacy Benefit Managers (PBMs) are companies that serve as middlemen between health insurance plans, pharmacies and drug manufacturers. They have a lot of power and have their hand in everything from rising drug costs to influencing what medications patients have access to, how much insurers pay and what the pharmacies are paid, which has raised concerns according to the Commonwealth Fund.
Cuban believes the key to decreasing costs is to limit the role of PBMs. At a 2024 University of Pennsylvania panel discussion on drug pricing, Cuban said he is trying to reduce PBMs’ interference.
“I don’t need to do this for more money,” Cuban said. “My joy comes from screwing the PBMs. Every one of these sales that we close [directly with the drug] manufacturers is like a great day with the sun shining brightly for me.”
“Cuban, by being in the business, is able to document true costs and expose where the money lies under the construct of transparency,” said Gary Jacobs, a long-time federal lobbyist and author of “The Zen Lobbyist: A Mindful Approach to Transforming Healthcare. “If the president required the PBMs to do the same, we would finally understand where the money goes and, from there, provide relief to consumers.”
Who Benefits from Each Plan
Lokenauth says TrumpRx will help a limited group:
- People with high-deductible health plans who haven’t met their deductible.
- Those taking specialty drugs insurance often excludes.
- Medicaid beneficiaries gaining access to Most-Favored-Nation pricing.
“Most Americans with decent insurance won’t benefit. If your copay is $20 through insurance but the TrumpRx cash price is $350, you’ll still use your insurance,” Lokenauth said.
CostPlus Drug Company targets a slightly different group:
- The uninsured, an estimated 27.2 million Americans.
- People on high-deductible plans benefit year-round, not just before hitting their deductible.
- Small business owners and self-employed workers who buy their own insurance.
“CostPlus is built for the long haul. It’s a company selling drugs at fair prices, without relying on government enforcement,” Lokenauth said.
Limitations of TrumpRx
TrumpRx may help some Americans, but its long-term effectiveness is uncertain. Cuban’s transparency model creates market pressure; TrumpRx depends on temporary agreements with pharmaceutical companies. Changes in administration could alter the deals and prices might rise again.
Another drawback: TrumpRx requires purchases outside of insurance. That means costs do not count toward deductibles or out-of-pocket maximums.
“You’re essentially paying twice — once for premiums, again for medications. Cuban’s model works whether you have insurance or not,” Lokenauth said.
The Bottom Line
There’s no denying that CostPlus is reshaping the industry. As GOBankingRates previously reported, Cuban’s company signed a deal to provide TrumpRX its application programming interface (API), meaning TrumpRX will pull real-time pricing data from Cuban’s transparent marketplace.
“That’s the government admitting Cuban was right about transparency,” Lokenauth said. “But instead of adopting his full model, they’re creating a hybrid that keeps pharma companies and PBMs in the game.”
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