In a surprising twist that bridged partisan divides and reignited debate around the pharmaceutical supply chain, billionaire entrepreneur and Cost Plus Drugs founder Mark Cuban publicly praised former President Donald Trump’s executive order (EO) targeting healthcare reform — specifically around drug pricing and Pharmacy Benefit Managers (PBMs).
Taking to X (formerly Twitter) on April 16, Cuban laid out a detailed, six-point breakdown of why he believes Trump’s order could “save hundreds of billions” of dollars if implemented with teeth.
"Put Me in, Coach!": Cuban's Message to Policymakers
Cuban’s tweet read more like a policy memo than a social media hot take. It expressed full-throated support for the executive order and suggested clear, actionable reforms that align with his ongoing efforts through Cost Plus Drugs, which has aimed to bring transparency and affordability to the drug supply chain.
“Gotta be honest. The @realDonaldTrump EO on healthcare and in particular, drug pricing could save hundreds of billions,” Cuban wrote, capping the thread with a call to action: “Put me in coach! I’m here to help.”
Breaking Down Cuban’s Six Key Proposals
Cuban’s thread outlines a vision that would dramatically rewire the incentive structures surrounding how Americans access and pay for medication.
Independent Formularies, Not Pay-for-Play
Cuban blasted the current system where PBMs control formularies — the lists of drugs covered by insurance — often influenced by rebates and profit motives. He proposed divorcing formulary decisions from PBMs and instead assigning the task to independent bodies with no financial incentives. “Make them about wellness, not pay for play like a grocery store endcap,” Cuban argued.
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Open Access to Claims Data
Under current practices, PBMs tightly control prescription claims data, forcing manufacturers to pay 5–10% of retail prices just to access information needed for research and pricing strategy. Cuban argues that full transparency to employers, states, and drugmakers would improve outcomes and eliminate waste.
He also claimed this change would help fix the 340B “double dipping” issue, a reference to a complex program designed to provide drug discounts to eligible healthcare providers.
End the “Specialty Drug” Label
Cuban challenged the very definition of specialty drugs, calling it a marketing tactic to inflate prices. He proposed eliminating the specialty tier entirely and stopping PBMs from requiring purchases through specific pharmacies — particularly those they own.
Empower Independent Pharmacies
One of Cuban’s core missions is reviving independent pharmacies, which often get squeezed by PBM policies. He called for full reimbursement for brand-name drugs and an end to the Generic Cost Ratio, which enables wholesalers to inflate prices under threat of chargebacks.
End Confidentiality Clauses
Cuban criticized non-disclosure agreements that prevent companies from negotiating directly with drugmakers.
“It’s insane that your company can’t talk to a GLP-1 manufacturer (as an example) to help you put together a wellness plan and get you a better price,” he said, referencing the popular class of diabetes and weight loss drugs.
Stop Margin-Seeking Substitution Tactics
Lastly, Cuban accused PBMs of gaming the system by replacing low-cost biosimilars with their in-house branded versions, undermining affordability while employers and drugmakers remain unaware due to lack of data transparency.
Market Reaction and Political Impact
Cuban’s endorsement could galvanize bipartisan attention, especially with ongoing scrutiny and talk around PBM practices.
Cuban’s Cost Plus Drugs model — which cuts out middlemen and sells directly to consumers — stands to gain credibility if broader industry reforms validate its structure. Any regulatory shifts in PBM power could also impact major players like CVS Health (CVS), Cigna (CI) (Express Scripts), and UnitedHealth Group (UNH) (OptumRx), all of which depend on opaque PBM profits.
While executive orders can shape federal direction, many of Cuban’s suggestions would require Congressional action or aggressive rulemaking by the Department of Health and Human Services (HHS).
Still, Cuban’s thread — viewed millions of times and met with applause across the political spectrum — suggests the drug pricing debate is evolving beyond party lines. With healthcare remaining a top voter concern for 2025, his influence may soon extend from pharmacy aisles to policy rooms.
On the date of publication, Caleb Naysmith did not have (either directly or indirectly) positions in any of the securities mentioned in this article. All information and data in this article is solely for informational purposes. For more information please view the Barchart Disclosure Policy here.
