ideasIdea

Transparent cost-plus pricing for every oral oncology generic

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.

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.

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.

What would test it

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

Who has to act

industry

Cost to try

Small (under $1M)

Years to first evidence

Bottlenecks it attacks

Prices and value · New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.
No incentive to repurpose cheap drugs · Old, cheap drugs with anti-cancer signals never get the trials they need because no one profits from the result.

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Transparent cost-plus pricing for every oral oncology generic

Overview

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drugs

terms

bottlenecks