An Unlikely Alliance On Drug Prices

Can Trump And Cuban Change Healthcare?

Boghosian, Joyce N. P20260518JB-0644.jpg. 18 May 2026. Wikimedia Commons, Wikimedia Foundation,

https://commons.wikimedia.org/wiki/File:P20260518JB-0644.jpg. Accessed 18 May 2026.

For years, lowering prescription drug prices has been one of the few issues capable of generating bipartisan agreement in Washington.

Americans pay some of the highest pharmaceutical prices in the world. According to RAND Corporation, U.S. drug prices are, on average, nearly three times higher than those in comparable developed countries.¹ Prescription drug spending exceeded $722 billion in the United States in 2023, according to the Centers for Medicare & Medicaid Services.² Meanwhile, employers, insurers and patients continue struggling with rising specialty drug costs, particularly around high demand treatments such as GLP 1 medications used for obesity and diabetes.

Against this backdrop, an unlikely alignment has emerged between two figures who often occupy very different corners of the political and business landscape: President Donald Trump and entrepreneur Mark Cuban.

While they may disagree on many issues, both have spent years criticizing inefficiencies within the pharmaceutical supply chain and the role of intermediaries that stand between manufacturers and patients. More importantly, both are pursuing initiatives that seek to make prescription drugs more affordable and transparent.

For Trump, the focus has largely centered on government policy and regulatory reform. Throughout both administrations, he repeatedly targeted Pharmacy Benefit Managers, commonly known as PBMs, while advocating for increased price transparency and market competition. Trump's policy efforts have often sought to expose pricing structures that many consumers never see while attempting to reduce what he has described as excessive middleman influence. Mark Cuban approached the problem from a different direction.

Rather than changing policy first, Cuban sought to change the economics.

The Mark Cuban Cost Plus Drug Company was launched with a simple premise. Instead of operating through traditional pricing structures, the company sells medications based on a transparent formula that includes the manufacturing cost, a fixed markup and a pharmacy fee. The goal is to eliminate much of the opacity that has long characterized pharmaceutical pricing.

The company's CEO, Alex Oshmyansky, M.D., Ph.D., believes the opportunity extends beyond distribution alone. Oshmyansky notes that Cost Plus Drugs is investing in domestic pharmaceutical manufacturing supported by robotics and AI enabled computer vision systems. These technologies could eventually allow facilities to switch production rapidly between medications, helping address drug shortages while improving supply chain resilience.

The implications are significant.

The United States has become increasingly dependent on overseas pharmaceutical manufacturing over the past several decades. Bringing more production capacity back to America could improve both pricing stability and national healthcare security. The broader debate, however, extends well beyond manufacturing. Much of the attention surrounding prescription drug costs increasingly centers on PBMs.

Originally created to negotiate lower prices on behalf of consumers, PBMs have become some of the most influential organizations in healthcare. Today, a handful of large companies control a substantial share of the pharmaceutical benefits market.

Brigham Buhler, Founder of Ways2Well, argues that the PBM system has drifted significantly from its original mission. Buhler contends that many PBMs evolved from patient advocates into profit centers, driven by rebate structures that can create incentives misaligned with reducing costs. According to Buhler, the rebate system has become one of the primary drivers behind elevated drug prices, particularly for popular medications such as GLP 1 therapies. His criticism reflects growing scrutiny from policymakers, employers and healthcare entrepreneurs alike.

Scott Martin, Founder and CEO of Rescription, shares similar concerns. Martin argues that employers and patients deserve greater transparency regarding specialty drug pricing and pharmacy benefit administration. He believes the next generation of PBM models will be built around clarity, accountability and direct cost savings rather than complex rebate structures.

The financial impact on employers has become increasingly difficult to ignore.

Chris Crawford, Founder and CEO of RxSaveCard, points out that prescription drugs remain one of the most frequently utilized employee benefits. Crawford notes that self insured employers face growing pressure as specialty medications become more expensive. The challenge is especially visible with GLP 1 therapies, which can cost between $11,000 and $13,000 annually per patient.

Crawford estimates that while roughly 35 percent to 45 percent of employees could potentially benefit from these medications, only a fraction of large employers currently provide broad coverage because of the cost burden. At the same time, Crawford acknowledges that the largest PBMs remain deeply entrenched within the healthcare ecosystem, making wholesale disruption difficult in the near term. This is where technology may become increasingly important.

Joel Radford, Cofounder and Managing Partner at Engagys LLC, believes health insurers are entering a new phase of AI adoption. Radford observes that many payers are moving beyond basic chatbot implementations and beginning to deploy more sophisticated applications designed to improve member engagement and personalization.

According to Radford, insurers increasingly view AI not simply as a cost reduction tool but as a competitive differentiator capable of creating individualized healthcare experiences. That evolution could ultimately improve patient navigation, medication adherence and healthcare outcomes while reducing administrative inefficiencies.

The convergence of artificial intelligence, pharmaceutical manufacturing and pricing transparency may prove especially powerful. Harvard Medical School researchers have argued that administrative complexity remains one of the largest contributors to excess healthcare spending in the United States.³ The Brookings Institution has similarly noted that increasing transparency across healthcare transactions could significantly improve market efficiency.⁴ This is where the efforts of Trump and Cuban begin to intersect.

Trump's focus on transparency and market reforms seeks to expose pricing distortions and increase competitive pressure. Cuban's business model attempts to create an alternative system that bypasses many of the structures critics believe contribute to inflated prices. Neither approach alone is likely to solve every problem. Drug development remains extraordinarily expensive. Regulatory requirements remain extensive. Specialty medications continue to drive a growing percentage of overall healthcare spending. Yet the emergence of multiple approaches aimed at reducing costs suggests the industry is entering a period of meaningful change.

Many healthcare experts believe the future may involve a combination of reforms rather than a single breakthrough solution. Greater transparency, domestic manufacturing, AI driven operational efficiencies, PBM modernization and increased competition could collectively reshape how prescription drugs are priced and delivered. The stakes are enormous.

According to the Kaiser Family Foundation, nearly one in three Americans report not taking medications as prescribed because of cost concerns.⁵ For many families, lowering prescription drug prices is not an abstract policy debate. It is a quality of life issue. That reality helps explain why this unusual alignment between a former billionaire television personality turned president and a billionaire entrepreneur has captured so much attention.

In a political environment where agreement often feels impossible, prescription drug costs remain one of the few issues where business leaders, policymakers, employers and patients increasingly agree on the diagnosis.

The debate now centers on who can deliver the cure. If efforts from leaders like Trump, Cuban and a growing ecosystem of healthcare innovators succeed, the next decade could finally bring something American patients have been waiting for far too long.

A healthcare system where lower costs and better outcomes are not mutually exclusive.

Works Cited

1. Mulcahy, Andrew W., et al. International Prescription Drug Price Comparisons. RAND Corporation, 2024, https://www.rand.org.

2. Centers for Medicare & Medicaid Services. “National Health Expenditure Data.” CMS, 2024, https://www.cms.gov.

3. Cutler, David M. “Administrative Costs in the U.S. Health Care System.” Harvard Medical School, https://hms.harvard.edu.

4. Brookings Institution. “Improving Transparency in Health Care Markets.” Brookings, https://www.brookings.edu.

5. Kearney, Audrey, et al. “Public Opinion on Prescription Drug Costs.” Kaiser Family Foundation, 2024, https://www.kff.org.

6. Mark Cuban Cost Plus Drug Company. “Company Mission and Pricing Model.” https://costplusdrugs.com.

7. Congressional Budget Office. “Prescription Drug Pricing and Market Competition.” Congressional Budget Office, https://www.cbo.gov.

8. Peterson Center on Healthcare. “Understanding Pharmacy Benefit Managers.” Peterson Center, https://www.petersonhealthcare.org.