Hannah Mamuszka and Lena Chaihorsky interview entrepreneur Mark Cuban about why U.S. drug and healthcare prices are so high — and what he’s building to counter them. Cuban walks through the drug supply chain: brand manufacturers sell to three dominant distributors, then pharmacy benefit managers (PBMs) — the three largest of which are owned by or own major insurers — use rebates to set formulary placement, which he argues drives list prices up and can block patients from the drugs their doctors prescribe. He describes the gap between a drug’s list price and its much lower “net” price after confidential rebates, and argues that opacity and confidentiality clauses keep even self-insured employers from knowing what they actually pay. His prescription: transparency and direct contracting (“if you can schedule it, you can negotiate it”), plus his ventures — Cost Plus Drugs (cost + 15% markup), Cost Plus Wellness, a Dallas plant making shortage drugs, and a proposed bank-account-based alternative to insurance (the “10 plan”). He also urges employers to run their contracts through AI tools to spot unfavorable terms.
October 1, 2026
Episode 7: Mark Cuban Gets Real on Health Insurance: The House Always Wins
