Mark Cuban discusses healthcare industry shortfalls, announces participation in TrumpRx

In his keynote address at the conference on Sunday, Mark Cuban, founder of Cost Plus Drugs, highlighted what he believed to be current shortfalls in the healthcare industry and implored attendees to help address high healthcare costs, including for prescription drugs.

According to Cuban, the key to Cost Plus Drugs' success is transparency, and he believes the same is needed to reform healthcare.

"We started Cost Plus Drugs from the perspective that we wanted people to be able to go to a website, put in the name of the drug that they had a prescription for, not only see what we were selling it for, but see what our actual cost and markup was, so that they would trust us," Cuban said.

When asked about President Donald Trump's new direct-to-consumer prescription drug website TrumpRx, Cuban said Cost Plus Drugs would be working with the administration on the initiative.

"We're working with them,” Cuban said. "We've shared our [application programing interface] so they can download our latest prices every night. The only concern I have is it'll be possible for people to game the system. A company could come along and say, 'I'm going to offer this drug at a lower cost so that I can get patients to send a prescription to us, and then from there, I'll raise my prices.'"

Aside from high prescription drug prices, Cuban also discussed prior authorization, private equity firms, and the current government shutdown and its impact on patients.

Organizations continue to focus heavily on AI

AI was a large focus of the conference, with several organizations announcing new tools, programs, and partnerships. 

For example, the American Medical Association (AMA) announced a new physician-led digital health and AI oversight hub called the Center for Digital Health and AI. The new center will work with policymakers and regulators to create healthcare technology standards and help advance new technologies.

"There really hasn't been this type of physician-led approach to innovations in tech," said AMA president John Whyte. "I think tech is going to embrace the AMA's role because they all want to understand clinical workflow."

During the conference, GE Healthcare announced plans to partner with large health systems, including Queen's Health and Duke Health, to develop a hospital operations AI software solution. The software will use AI and predictive analytics to help hospitals manage demands for beds and staffing capacity while reducing equipment downtime.

Optum* also announced a new AI-powered claims processing platform called Optum Real. The platform will connect payers' core systems and providers' EHRs to share and receive real-time information on claims-related queries, including prior authorizations, denials, and benefits coverage.

What's new in the obesity care space?

Advisory Board's Rae Woods moderated a panel discussing the current state of GLP-1s in the healthcare industry, including their clinical impact, care models, and coverage, as well as the potential future of these drugs.

The all-physician panel included Angela Fitch, cofounder and CMO of knownwell; Florencia Halperin, CMO of Form Health; Spencer Nadolsky, CEO and founder of Vineyard; and Nate Wood, director of culinary medicine at Yale University.

The panelists discussed how GLP-1s are expanding beyond just diabetes and weight loss, with several manufacturers pursuing expanded indications for Alzheimer's, heart disease, and more. They also highlighted challenges with GLP-1s, notably their high costs, the effects of long-term use, and how growing competition could impact patients and care delivery.

If you missed the panel, subscribe to Radio Advisory to hear the podcast version when it's released early next year.

When it comes to GLP-1 coverage, several speakers at the conference noted that employers are seeking out alternative drug treatments due to the high cost. Interest in bariatric surgery and nutrition-only treatments have increased recently as employers look for non-GLP-1 options.

"If you're an employer, you can cover bariatric surgery and you can cover GLP-1s," said Christoph Dankert, chief network officer at Carrum Health. "If you have to take GLP-1s for more than three years, bariatric surgery is more effective. If you think about the average employee tenure, this is how employers are thinking about it right now."

Currently, GLP-1s and weight management remain key focus areas for many organizations.

During the conference, CVS Health announced it was leading a $25 million funding round for knownwell, which offers in-person and virtual care for weight loss. Other investors include MassMutual Catalyst Fund and Intermountain Ventures.

Separately, Highmark Health announced plans to partner with preventive health company Noom to offer weight management support to its members at no cost next year. According to Highmark, it estimates that almost 2 million of its 7 million members across Pennsylvania, West Virginia, Delaware, and New York to be eligible for Noom's programs.

*Advisory Board is a subsidiary of Optum, a division of UnitedHealth Group, which is the parent company of UnitedHealthcare. All Advisory Board research, expert perspectives, and recommendations remain independent.