(164) Potential Savings with Use of Cost Plus Pharmacy for Medical Treatment of Erectile Dysfunction
Authors: Schloegel V , Dropkin B 
Published: February 2024

Abstract

Introduction
With its stated goal “to end ridiculous drug prices,” the Mark Cuban Cost Plus Drug Company (MCCPDC) launched in January 2022 with over 100 generic prescription drugs available to be mailed directly to patients without the involvement of health insurance. To promote drug cost transparency, all drugs are priced at the cost to manufacture the drug with a 15% administrative markup, a $3 pharmacist fee, and a $5 shipping fee. Prior research has focused on the theoretical savings MCCPDC could offer if Medicare purchased drugs at MCCPDC prices with studies reporting a potential $3.3 billion in savings for Medicare. Prescription drug spending is continuing to rise in the United States and providers are increasingly considering patient’s out-of-pocket costs. MCCPDC touts a transparent, consistent pricing model, but it is unclear if this pricing model will actually translate to cost savings for patients.

Objective
We sought to analyze if Mark Cuban Cost Plus Drug Company (MCCPDC) can offer savings directly to patients compared with other mail-order pharmacies, local pharmacies (based on zip code of our urology clinic) and with patients using health insurance to fill prescriptions for their sildenafil, vardenafil and tadalafil.

Methods
Out of the approximately 100 generic drugs available on MCCPDC website, we analyzed the 3 drugs that are prescribed to treat erectile dysfunction. We analyzed drug prices of 30 and 90-day prescriptions at the same dose of each medication. Using Good Rx prescription drug search engine, we compared the drug prices of the cheapest mail order and local in person pharmacies near our zip code. We also included prices for the recently started telemedicine company Roman. To compare if MCCPDC could offer savings to patients using health insurance to fill their prescriptions, we extracted the out-of-pocket drug costs for patients from the 2020 Medical Expenditure Panel Survey (MEPS; a national survey that compiles data from both the pharmacy and the survey respondent to determine the exact cost of each prescription filled during that year) and the 2020 Medicare Part D spending data. Medicare Part D spending data was used to estimate the out-of-pocket cost for each medication, which is approximately a 25% copayment for Medicare prescriptions.

Results
MCCPDC offered the lowest direct-to-consumer price on sildenafil and tadalafil 90-day prescriptions (Table 1). MCCPDC saved patients approximately $10 per sildenafil and tadalafil prescription compared with the next cheapest option. We found additional, although smaller, savings at 30-day prescriptions for sildenafil and tadalafil. MCCPDC was not the cheapest option for vardenafil. Compared with Roman, MCCPDC offered cheaper prescriptions for sildenafil and tadalafil by over $300 and $900, respectively.

Conclusions
MCCPDC can offer significant cost savings to patients, especially considering the high number of sildenafil and tadalafil prescriptions each year. The transparency and consistency in pricing with MCCPDC can be utilized by providers when counseling patients on medical therapy options for erectile dysfunction.

Disclosure
No.