Bit by a Shark: 5 Reasons Why I Joined Mark Cuban Cost Plus Drug Company, PBC

Recently, I was bitten...by a shark.

Let me rewind, a bit, with a little more teeth. (Pardon the pun.)

I've been serving healthcare as a pharmacist for over two decades. I've worked in several different corners of the practice as well, like retail/community practice pharmacy, the pharma & biotech industry in clinical research, pharmacovigilance, medical affairs and even medical marketing. I've also taught in a school of pharmacy--classes like pharmacy law and policy, entrepreneurship, and business--and worked in plans and on drug pricing - like Medicaid, a smidge of Medicare, and Commercial healthcare plans and benefits most recently.

Friends, while I love the profession of pharmacy - which I equate to science nerdiness + saving lives + helping people - prescription drug pricing in the US has become seriously jacked up.

Rebates, coupons, discount cards, bridge programs, free trials, AWP vs. NADAC vs. AAC vs. MAC vs. ASP pricing - it's a labyrinth of confusion, opacity, and lawsuits. Independent pharmacies are dying due to DIR fees and Clawbacks by the PBMs, and chain pharmacists are getting burned out by being overworked with lower pay and help, particularly over the past 2 years during the pandemic.

I strive during my professional career to make healthcare and pharmacy simple to understand, but that job has become next to impossible during my career. So, I'm going to share 5 reasons why I decided to join Mark Cuban's team at Mark Cuban Cost Plus Drug Company, PBC below with you, and hope you'll join the fight with me to help make prescription drugs affordable again in the USA.

5 Reasons Why I Joined Mark Cuban Cost Plus Drug Company, PBC

1. Mission - Mark and our entire team headed by Dr. Alex Oshmyansky have committed to putting Mark's name and investing and operating this company in order to improve public health and the bottom line. I've witnessed so many patients during my career who had to make impossible choices on affording their prescription drugs or things like food, housing, or transportation to get to work. In this era when jobs are plentiful, it's easy to join an organization that aligns with a positive mission like this one. Even in hard times, it's easy - because the mission of this organization aligns with my own. Together, by rebuilding the system, we can make pharmacy simpler, more cost-effective, and easier to use.

2. It is a Public Benefit Corporation (PBC) - The Mark Cuban Cost Plus Drug Company is a public benefit corporation or PBC (not a PBM, which is a pharmacy benefit manager, and not a business entity type, BTW). One of the first messages I sent out in my new position was to my former law school professor and fellowship director of the Indiana University Robert H. McKinney School of Law Program on Law and State Government, Prof. Cynthia Baker. I actually studied these types of social benefit organizations during my fellowship year in law school in the PLSG at IU. Benefit Corporations, Low-Profit Limited Liability Companies (L3Cs), and Benefit Corp. Certifications are business formation entity types or Certifications for companies that don't always put profit above everything else. Sometimes, mission can be driving the car and profit can sit in the back seat. To be clear, I have no problem with business entities making money (for-profit and not for profit) - they need to generate revenue in order to survive and thrive, and serve even more patients in healthcare. However, what I DO have a problem with are large vertically-integrated borderline antitrust violators that have skyrocketing profits quarter after quarter, that purport doing right by their patients and client companies, but are frankly generating nothing but more profit for themselves along with their shareholders and driving up overall healthcare costs. You can do good for the world, make a little money and serve a mission through these business entity types. Gordon Gekko has no place in healthcare, IMO.

3. 503B Facility Under Construction - The pharmaceutical supply chain is a mess. Read ChinaRx or Bottle of Lies if you don't believe me (or you can listen to my conversation with ChinaRx author Rosemary Gibson here.) One of the really cool aspects of MCCPDC is that we're building a 503B outsourcing facility in Dallas, Texas where we'll be making drugs that are on shortage, like sterile water for injection. When we can't get the basic vital medications we need, we're in trouble. That and I am 100% on board with bringing pharmaceutical manufacturing back to the USA. We've let that part of our supply chain go and frankly, it's become a national security risk, IMO. We have to bring back pharmaceutical compounding and manufacturing back to the states in order to have access to vital medications that our citizens need that are safe to use.

4. You had me at Imatinib - One of the most frustrating parts of my job as a pharmacist is watching chemotherapy/cancer costs skyrocket and wreck commercial plan budgets. Most employers are honestly (and fiduciarily bound) to provide the best healthcare benefits they can to and for their employees. However, I've seen countless times where even just one cancer patient exploded a plan's drug spend with needless chemotherapy markups on already pretty expensive drugs to begin with from manufacturers. While everyone loves to bash pharma producing the drugs at high prices, I'm actually okay with pharma's pricing for the most part; they did the billions in research, so they should be paid for the R&D. It's typically the 300-600% markups on chemotherapy by providers and medical carriers (mainly through hospital infusions) that drives up costs, along with the big 3 PBMs. One drug that struck me at Mark Cuban's shop is imatinib. This is a chemotherapy that is normally very expensive, but an oral formulation drug. I did an analysis here on this drug, and our pharmacy's price is the best, bar none. Full disclosure - I forgot the $5 shipping fee - but even with those all in, our price still wins for patients. This isn't a lifestyle drug, friends, it is a life-saving one for a cancer patient.

5. Rebuild and re-imagine the entire drug supply chain - Right now, our company has 4 lines of business that we're working on:

1. Manufacturing/503B outsourcing per above,

2. Wholesaler,

3. Pharmacy and

4. an UnPBM.

What I love the most about this opportunity is that Mark, Dr. Alex, and our entire team are committed to rebuilding the entire drug supply chain from scratch. I'm going to be tasked specifically with working directly with manufacturers on brand drugs, removing rebates and all the other junk driving up drug costs, and buying direct. I know there are brave pharmaceutical companies out there who also want to join in this revolution to rebuild the supply chain that has frankly just turned into a confusing, expensive maze with no solution or easy answers. I can't wait to work with the pharmaceutical and biotech companies that share this vision! Together, we can re-imagine an easier, more user-friendly supply chain that is free of all the hidden markups and extra costs to plans and patients. Let's connect if you, like us, want to revolutionize and make simpler the drug supply chain.

This is going to be a Herculean job, and I'll admit in full transparency/vulnerability - more than slightly intimidating. But for these 5 reasons and so many more, I had to say yes to Dr. Alex, Ron Harrison, our VP of BD, and the entire Mark Cuban team.

As Mark himself says, “Always wake up with a smile knowing that today you are going to have fun accomplishing what others are too afraid to do,"1 I've got a smile on my face, and am happy knowing that I'm going to be part of the solution, rather than part of just navigating the problems moving forward.

If any of this resonates/sounds good to you, please consider joining our team. Please bookmark our jobs page. We're growing. Or you can follow our LinkedIn page. And if we've worked together in the past and you decide to apply for something, please let me know. There will be more opportunities coming soon. Let's be a part of the solution... together!??

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Dr. Erin L. Albert is Vice President, Trade Relations, and General Counsel at the Mark Cuban Cost Plus Drug Company, PBC. Opinions above, however, are her own and not necessarily those of the Company's, or Mark Cuban's.

1. Source on Mark Cuban quote: https://yourstory.com/2016/12/mark-cuban-inspirational-quotes/amp

?? BTW - were you playing along with the 5 days of word puzzles to arrive here with me? The clues were: 1. Brand 2. Drugs (a big chunk of my job immediately will be working on brand drug access) 3. Texas (where we are HQ'd), 4. Shark 5. Cuban (I think you know where these 2 words came from??). Thanks for playing along, and if you work in brand drug manufacturing, let's talk! Please PM me. ??