# Transparent cost-plus pricing for every oral oncology generic

Source: https://onco.cc/ideas/idea-cost-transparent-generic-pricing/  
OnCo record `idea-cost-transparent-generic-pricing` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Generic imatinib and abiraterone can cost patients hundreds of dollars a month through insurance yet be sold at cost plus a fixed markup by transparent pharmacies; making that the default channel for oral cancer generics would save patients and plans money.

## Summary

Mark Cuban Cost Plus Drug Company publishes its acquisition cost, a 15% markup, a pharmacy fee and shipping for each drug, including oncology generics such as imatinib, abiraterone, anastrozole, letrozole and capecitabine. Prices are often far below insurance copays on specialty tiers. Payers can add such pharmacies to networks, waive the deductible for them, or use their prices as a reference in formulary tiering.

## Fields

- Kind: Idea
- Last checked: 2026-09-10
- Hypothesis: Routing oral oncology generics through transparent cost-plus pharmacies will cut patient out-of-pocket cost for those drugs by more than half for most commercially insured patients and cut plan spend.
- Rationale: For old generics the acquisition cost is public and low; the gap to what patients pay is pure distribution margin.
- Proposed test: A self-insured employer pilot: offer cost-plus pharmacies as a zero-copay option for oral oncology generics and measure patient cost, plan cost and adherence against the prior year.
- Maturity: being-tested-at-scale
- Actor: industry

## Sources

- Mark Cuban Cost Plus Drug Company: https://costplusdrugs.com/

## Connected records

- drugs: [Abiraterone acetate](https://onco.cc/drugs/abiraterone/), [Imatinib](https://onco.cc/drugs/imatinib/), [Letrozole (and other aromatase inhibitors)](https://onco.cc/drugs/letrozole/), [Tamoxifen](https://onco.cc/drugs/tamoxifen/)
- terms: [Financial toxicity](https://onco.cc/terms/financial-toxicity/), [Oncology drug pricing and price transparency](https://onco.cc/terms/drug-price-transparency/)
- bottlenecks: [No incentive to repurpose cheap drugs](https://onco.cc/bottlenecks/b-generic-repurposing/), [Prices and value](https://onco.cc/bottlenecks/b-drug-pricing/)

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