Mark Cuban Pitches Five Fixes to Cut Healthcare Costs and Take On Drug Middlemen

October 21, 2026 - 11:14

The Cost Plus Drugs cofounder told Texas lawmakers that insured patients are often better off paying cash, and laid out five fixes built around price transparency.

Mark Cuban brought his campaign against high prescription prices to the Texas Capitol, arguing that the arrangements between drugmakers, insurers and pharmacy benefit managers leave patients paying far more than they should. He described the tactics used by middlemen as "contractual terrorism," saying contracts and rebate structures hide real prices and punish anyone who tries to compete on cost.

Cuban's five step plan centers on transparency. He wants patients to see the actual price of a drug before purchase, cash prices to be available to everyone regardless of insurance status, and rules that stop middlemen from blocking cheaper alternatives. He also pressed for limits on spread pricing, where a middleman charges more than it pays and keeps the difference, and for requirements that savings from rebates reach patients at the counter rather than disappearing into the supply chain.

The billionaire, who cofounded Cost Plus Drugs, said his own company sells many generics at a set markup plus a flat pharmacy fee, and that the model proves prices can fall when the process is simple. He told lawmakers that insured patients are frequently quoted more than cash customers for the same medicine, a gap he called a symptom of a system built to obscure costs.

Cuban acknowledged that changing the market faces steep resistance from entrenched interests but said state lawmakers can act on transparency and pricing rules without waiting for Washington.