THE OUTLOOK FOR HEALTH CARE IN 2023:

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September 29, 2022

Around the nation: Mark Cuban's drug company partners with PBM

Daily Briefing

    Mark Cuban Cost Plus Drug Company entered its first partnership with a pharmacy benefit manager (PBM), in today's bite-sized hospital and health industry news from the District of Columbia, Massachusetts, and Texas.

    • District of Columbia: The Senate on Tuesday advanced a federal spending bill that would temporarily extend two Medicare programs that boost rural hospital payments. Under the bill, the Medicare Dependent Hospital and Low-Volume Hospital programs would be extended through Dec. 17. However, if Congress does not approve the extensions before Saturday, the Medicare Dependent Hospital program would expire, and the Low-Volume Hospital programs would revert to narrower standards that restrict hospital participation. These provisions are an "extremely significant" part of the spending bill, according to Federation of American Hospitals President and CEO Chip Kahn. "The big issue is hopefully not whether but rather for how long they'll authorize the programs to go forward," Kahn added. (Kane/Goldman, Modern Healthcare, 9/27)
    • Massachusetts: The Massachusetts Health Policy Commission on Tuesday unanimously voted to approve Mass General Brigham's 18-month plan to restrict excessive expenditures. After Mass General surpassed the commission's spending growth benchmark by $293 million from 2014 to 2019, the commission in January ordered the health system to create a performance improvement plan (PIP). According to the commission, Mass General's actions could endanger the state and its care delivery system. Notably, this marks the first time the commission has gone through the approval process for a PIP. "I know there's been a lot of back and forth between the parties," said Commission Vice Chair Martin Cohen. "This PIP won't change the price disparities that exist in our state, but it does recognize that price matters to ensuring that healthcare is accessible and affordable for residents of the Commonwealth." (Hudson, Modern Healthcare, 9/27)
    • Texas: Mark Cuban Cost Plus Drug Company founder and CEO Alex Oshmyansky announced that the generic drug company will not create its own PBM after it entered a partnership with Rightway—a PBM that aims to cut prescription drug costs. "It's turned out to be much more efficient to partner with transparently minded and innovative PBMs like Rightway," Oshmyansky said. "Why build all that infrastructure ourselves when there are good actors in the space who already have done it for us?" Under the partnership, Rightway members can access almost 1,000 generic drugs offered by Mark Cuban Cost Plus Drug Company. Moving forward, Oshmyansky said the company will aim to avoid the "de facto bribes" PBMs can receive when they add drug wholesalers to their formularies. (Twenter, Becker's Hospital Review, 9/27)

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