Tim Smith, Alec Young, Cameron O'Brien, Jacob Duncan, Matthew Rashid, Trevor Magee, Kyle Fitzgerald, Matt Vassar
{"title":"Medicare Savings for Seizure Drugs by Adopting the Mark Cuban Cost Plus Drug Company Model.","authors":"Tim Smith, Alec Young, Cameron O'Brien, Jacob Duncan, Matthew Rashid, Trevor Magee, Kyle Fitzgerald, Matt Vassar","doi":"10.2147/CEOR.S516583","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Epilepsy is a lifelong diagnosis, often requiring pharmacologic management. Despite the chronicity of this disorder, there has been a rise in medication cost over the years. To address this, Mark Cuban Cost Plus Drug Company (MCCPDC) has created a more affordable option to obtain patients' prescriptions. Focusing on epileptic medication, this study examines the potential cost saving benefit of MCCPDC compared to Medicare Part D plans.</p><p><strong>Methods: </strong>We conducted a cross-sectional review identifying the prices of anticonvulsants available on MCCPDC compared to the 2021 Medicare Part D spending data. Prices for dispensing and shipping fees were recorded for the minimum quantity (30ct) and maximum quantity (90ct). We compared standardized unit prices for 30 and 90-day periods between Medicare and MCCPDC drugs.</p><p><strong>Results: </strong>Of the 16 anti-seizure medications shared between MCCPDC and Medicare, Medicare spending reached nearly $1 billion. Analyzing 30ct prescriptions, we found potential savings in 60% of the drugs, amounting to $172 million when comparing individual drug costs on MCCPDC to Medicare. However, when averaged across all 30ct drugs, MCCPDC prices were 14.85% higher than Medicare, indicating that higher costs for certain drugs offset the savings from others. For 90ct prescriptions, savings were $373 million in 80% of drugs, a 31.63% reduction compared to Medicare prices.</p><p><strong>Conclusion: </strong>Our study highlights the potential savings with MCCPDC, especially among the 90ct medications, demonstrating that a cheaper alternative to chronic medications is possible if the pricing of MCCPDC is used. We recommend that physicians educate patients on MCCPDC and their specific medications to find more accessible pricing. MCCPDC could alleviate financial burdens and enhance access to essential medications for patients, especially in the context of the Medicare-enrolled population.</p>","PeriodicalId":47313,"journal":{"name":"ClinicoEconomics and Outcomes Research","volume":"17 ","pages":"447-453"},"PeriodicalIF":2.2000,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182730/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ClinicoEconomics and Outcomes Research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/CEOR.S516583","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Epilepsy is a lifelong diagnosis, often requiring pharmacologic management. Despite the chronicity of this disorder, there has been a rise in medication cost over the years. To address this, Mark Cuban Cost Plus Drug Company (MCCPDC) has created a more affordable option to obtain patients' prescriptions. Focusing on epileptic medication, this study examines the potential cost saving benefit of MCCPDC compared to Medicare Part D plans.
Methods: We conducted a cross-sectional review identifying the prices of anticonvulsants available on MCCPDC compared to the 2021 Medicare Part D spending data. Prices for dispensing and shipping fees were recorded for the minimum quantity (30ct) and maximum quantity (90ct). We compared standardized unit prices for 30 and 90-day periods between Medicare and MCCPDC drugs.
Results: Of the 16 anti-seizure medications shared between MCCPDC and Medicare, Medicare spending reached nearly $1 billion. Analyzing 30ct prescriptions, we found potential savings in 60% of the drugs, amounting to $172 million when comparing individual drug costs on MCCPDC to Medicare. However, when averaged across all 30ct drugs, MCCPDC prices were 14.85% higher than Medicare, indicating that higher costs for certain drugs offset the savings from others. For 90ct prescriptions, savings were $373 million in 80% of drugs, a 31.63% reduction compared to Medicare prices.
Conclusion: Our study highlights the potential savings with MCCPDC, especially among the 90ct medications, demonstrating that a cheaper alternative to chronic medications is possible if the pricing of MCCPDC is used. We recommend that physicians educate patients on MCCPDC and their specific medications to find more accessible pricing. MCCPDC could alleviate financial burdens and enhance access to essential medications for patients, especially in the context of the Medicare-enrolled population.