Mark Cuban is urging to pass the proposal to governors and all known politicians, stating it could reduce healthcare spending in a state. The Cost Plus Drugs model shows the purchase price, adds transparent markup and pharmacy fees, allowing customers to see the final price; many insured customers still buy because the cash price is often lower than what their insurance plans require them to pay.

Five points for Texas: First, allow patients to buy the same drug at a lower cash price and count that expenditure towards deductibles within state authority, exchanging savings for competition. Second, require state, city, county, and school districts to use standardized contracts with pharmacy benefit managers and third-party administrators; he claims existing texts can be hundreds or even over a thousand pages, which he calls "contract terrorism," and is willing to provide his own written templates for free, which can be modified as open source. Third, the prices, costs, rebates, guarantees, pharmacy reimbursements, related compensations, and audit rights paid by taxpayers must be disclosed to break information asymmetry through price discovery. Fourth, abolish non-disclosure clauses so employers can compare prices and terms. Fifth, give a serious violation one chance, and if repeated, suspend Texas government procurement qualifications for a period, treating audits as investments: spending $10 million to block $100 million in waste yields a tenfold return.

The company has production and wholesale capabilities in Dallas, with a website serving all fifty states, combating opaque price differences with a cost-plus markup of about 15% plus fixed pharmacy fees. The target is pharmacy benefit managers managing prescription plans, not the prescribing rights of doctors.

In market mechanisms, this is a strike against intermediaries in state procurement rules: buyers are patients who want cash prices counted towards deductibles and public employers, while sellers are benefit managers who survive on contract thickness and non-disclosure clauses. Funding shifts from rebates and price differences to visible markups. Beneficiaries are pharmacies with lower cash prices and taxpayers; those under pressure are vertically integrated insurance-benefit management-affiliated pharmacies. The event driver is the policy list, not new drug approvals.

When cash prices are lower than insurance copays, the plan itself is a markup machine.

Source: Public information