By Patricia Prewitt, Consumer Education Advocate
What is CostPlusDrugs?
CostPlusDrugs online pharmacy was started by Mark Cuban (TV show Shark Tank and business entrepreneur) in 2022 as a public-benefit corporation with the promise of disrupting the pharmaceutical industry to make prescriptions more affordable for patients. Its stated social mission is to improve public health while providing transparency so patients know they are getting a fair price. Most of us know that prices for prescription drugs vary widely, depending on the prescription plan you have. CostPlusDrugs promises to “cut out the middlemen to offer hundreds of common generic medications at wholesale prices.”
Initially, 100 frequently prescribed generic medicines were offered. Now the company boasts access to over 1,000 medications. On April 4, 2023, they added their first four brand name diabetes medications from Janssen.
How is it different from a traditional or mail-away pharmacy?
In the traditional prescription plan model, pharmacy benefits managers (PBMs) like CVSCaremark, Express Scripts, and OptumRx set tiered-based pricing with medical insurance companies, while negotiating acquisition prices and rebates from manufacturers to decide what product will be on each tier. Those savings are typically not passed along to the patient. You have probably paid a low (Tier 1) price of $4, or $25 (Tier 2) product, or $50 (Tier 3), or an even higher cost, if you chose a 20% cost sharing option, and for specialty medications.
CostPlusDrugs pricing is straightforward and transparent. It is the actual negotiated wholesale cost of the medication, plus a 15% markup, plus a $3.00 pharmacy dispensing fee plus shipping costs of about $5.00. The shipping costs will vary based on location.
Can I save money?
The short answer is “maybe.” The first step would be to see if your medication is offered by CostPlusDrugs. Check your pill bottle or your pharmacy receipt for the EXACT name, strength, form and quantity. Once you determine your medication is offered, compare your current out-of-pocket cost to the price for the same product on their website. The search tool is very easy to use. Be careful to match the prescription to its exact details. There are many, many medications, and forms differ for capsules, tablets, extended release, etc.
It could be that using your current prescription insurance is more cost effective. Prices change constantly, and the savings of a few dollars may not be worth the hassle to change pharmacies. The dispensing fee and shipping would negate any savings if you currently pay only $4.00 for your prescription—or even $10.00 for a 90-day supply.
I found my prescription at a much better price! So, what’s the catch?
Expect to pay the full cash (by credit card) price for your prescription before it ships. If electing to use CostPlusDrugs, you are NOT using your prescription insurance. It may take you longer to reach your medical or prescription insurance deductible. In most cases, this cost does NOT accrue against your “out-of-pocket” insurance plan. For those with a yearly 7.5% tax deduction for medical expenses, this may be an important consideration.
Practical Considerations:
CostPlusDrugs requires the use of a computer, an established patient online account, and a credit card. Set up an account BEFORE asking your clinician to use this online pharmacy to transmit your Rx. Each patient must have their own individual account. You will also need a NEW prescription from your provider. Your current pharmacy will not initiate a transfer of an existing prescription.
Make sure you calculate shipping time so that you will not be without needed medication. No returns, no controlled substances, no patient accounts under the age of 18 and other restrictions apply. You should also consider your need to interact with a pharmacist for questions, especially if this is a new therapy, rather than a familiar maintenance medication.
About the author: Patricia Prewitt is a local Massachusetts resident who spent over 30 years in the pharmaceutical industry. Tricia is a consumer education advocate, and loves helping people find ways to save money on their prescriptions. More information and many free resources are available on her website at https://mypersonalrxadvisor.com/resources/
Favorite Quote: “Act as if what you do makes a difference. It does.”- William James
Disclaimer: Content provided is for education purposes only and is not intended as a substitute for advice from a qualified medical professional. The opinions expressed within are those of the author.
