艾昆纬-患者服务和市场准入季度顾问-2023年第一季度（英）-2023.3

Q1,

March2023Patient

Ser

vices

andMarket

AccessWhitePaperQuarterly

AdvisorTable

of

contentsQuarterly

overview34Newyearandfamiliarchallenges:Whattowatchinmarketaccessfor

2023Fiveyearsandcounting:Deductibleaccumulatorsandcopaymaximizersin2022Disruptioninthemarket:CostPlusDrugs81012Asembia

2023

SpecialtyPharmacySummitQuarterlyoverviewChangeisaconstantwhenitcomestomarket

You

canreadourrecentlypublishedblogaccess.Overtheyears,thebiopharmaceuticalindustryhasexperiencedits

shareofdetailingthoseeventsandtrendsonthefollowingpage.disruptions,frominnovativepayercontrolstoaglobalpandemic.2022concludedwithalarge-scalebill,theInflationReductionAct(IRA),

butits

majorhealthcareprovisionshaveyettobeenacted.Theindustryalsocontendedwithcontinuedmarginpressures,increasingpatientaccessbarriers,andcontroversialapprovalsandlaunches--

theeffects

ofwhichwillinfluencemarginsandstrategiesintheyearsahead.Additionally,thisyear,

alongwithourquarterlyadvisornewsletter,whitepapers,andblogs,wearelaunchingayear-longwebinarseriescalledIQVIA’sMarketAccessMasterClass.Theintentistodivedeeplyintomodernissuesfacingtheindustry,liketheIRA,

inaneffort

tobringmorenuancedcontenttoourthoughtleadership.TheMasterClassisfree,withallepisodesbeingrecordedandavailableon-demand.Makesuretoregistersoyoucanstay

ontopofthelatesttrends.As

weheadinto2023,theIQVIA

MarketAccessCenterofExcellenceispayingattentionto10

eventsandtrendsthatcouldshapethefuturemarketaccesslandscape.Luke

GreenwaltV

P,

MarketAccessCenterofExcellence

|

3Newyear

and

familiar

challenges:Whatto

watch

in

market

accessfor2023IN

2023,

THE

IQVIA

MARKET

ACCESSCENTER

OF

EXCELLENCE

IS

PAYINGATTENTIONTO10EVENTS

AND

TRENDSTHATCOULDSHAPE

THE

FUTURE

MARKET

ACCESSLANDSCAPE.By

Luke

Greenwalt,Vice

President,MarketAccessCenterofExcellence,IQVIAHEALTHPOLICY

AND

THE

INFLATION

REDUCTION

ACTThe

InflationReduction

Act

(IRA)

isthe

most

recentlegislationfrom

agovernmentthatisincreasinglyfocused

onpharmaceuticalspendingandattuned

tomarketaccessdynamics.

As

ofJanuary

2023,theIRArequiresfree

recommendedvaccines,$35monthly

capsonpatients’

insulinspending,priceinflationpenalties,andadjusted

biosimilarreimbursementinMedicare.Over

thenext

severalmonths,

U.S.

policymakers

andgovernmentorganizationssuchasthe

CentersforMedicare&MedicaidServices

(CMS)andtheDepartmentofHealth&HumanServices

(HHS)

areexpected

toprovideevenmoreclarity

onmanyoftheIRA’s

keyprovisionsthroughrulemaking.•

CongressionalBudget

Office

(CBO)estimates

indicatethatpremiumswilloffset

the

greaterpayerliabilitiesfrom

Part

Dredesign,but

thatcouldrequiresizableincreasesthatmaynotbe

feasibleforCMS

tooffset.The

industry

must

be

preparedforthe

possibilitythatmanufacturers

willbe

askedtoabsorbsomeofthosecosts

either

byhigherrebatesortighterutilization

management.•

CMS

iscurrently

requesting

andreviewing

commentsfrom

theindustry.

Stakeholdersarelikelytouse

thistimebeforerulemakingisfinalizedtopetition

fortheirinterests,

aswellaslegallychallengesomeoftheprocessandprovisionsoftheIRA.Meanwhile,pharmaceuticalmanufacturers

andotherstakeholders

must

anticipateandplanforIRA

impact.Scenario-based

modelingwillplayacrucialroleinearlystrategy

decisionmaking.Stakeholdersmust

alsolooktootherpolitical

activities

suchasexecutive

orders,

rules,andbillsthatarelikelytotackle

healthcaretransparency,pricing,andinequality.Focusremainsonthedetails:•

Itiscurrently

unclearhowpriceswillbe

negotiatedinMedicare.Whileguidelineshavebeen

releasedthatindicatethefloorofthenegotiateddiscount(maximumfairpricerangingfrom

25-60%

off

oftheprice),manufacturers

arelookingtounderstand

what

theceilingmightbe

andhoweither

sideofthenegotiationwilljustify

its

recommendations.For

now,CMS

planstopublishthe

first

10

drugs

coveredunderMedicarePart

Dthathavebeen

selected

forthe

MedicareDrugPriceNegotiationProgrambySeptember2023.DEMONSTRATION

OFVALUEThe

IRA

opensthedoorformoregovernmentoversight,

but

the

industry

hasgrappledwith

thequestion

ofvalueforyears

-either

throughalternativecontracting,

indication-based

access,

orpreviousattempts

ondrug

pricecontrol.NowCMS

willstand

upits

Drug

PriceNegotiationProgramwhichwillconductpharmacoeconomicanalyses

andnegotiateMedicarepriceswith

drug

manufacturers

aspart

ofits

charter.WhilelimitedtoMedicarefornow,marketsareprimedmorethaneverforclinicalandeconomicevaluationofcosts

andmanufacturers

willneed

tobe

prepared.•

MaximumFairPriceimplementationisanotherareaofinterest

because

negotiationswillnotinfluenceproducts’

wholesale

acquisitioncosts

(WACs).Afairexpectation

isthatmanufacturers

willbe

responsibleforprovidingadditionalrebatestopayers

who

willfloat

the

unnegotiatedcost

at

thepointofsale.Still,uncertainty

inthedrug

acquisitionchaincan

challengeforecasts

andplanning.4

|Patient

Services

and

Market

Access

Quarterly

Advisor,Q1,

March

2023Atminimum,someevolutionbeyondthetraditionalpriceandpayeraccessapproachistobe

expected

andmayevenopenthedoorforthirdparties

toweighinorforHealthTechnologyAssessment

debates

tobegin.INNOVATIONPIPELINEItisanexcitingtimeinbiopharmawith

breakthroughsinAlzheimer’s,

genetherapy,metabolic

diseases,andvaccines.The

list

goeson.Itisexciting,but

alsochallenginggiven

the

market’s

conflict

between

theneed

forinnovationandthe

finitecapacity

forcost.

Thiscapacity

isstrained

byanagingpopulation,risingcosts,andepidemics.History

hasdemonstrated

thatacure(aswith

Hepatitis

C)

isnotenoughtoearnwidespreadaccess.Aduhelm’smorerecent,

troubledlaunchhasfurther

andundeniablychangedthe

waymanufacturersareevaluatingtheirportfolios.Leqembisets

the

tonein2023asabranddefendingits

pricingdecisionat

approval.Time

willtellwhetherpublicpricejustification

becomespart

ofgenerallaunchstrategy

andwhether

otherstakeholders

willagreewith

the

evaluation.Despiteabrand’s

reasoning,payercoveragemaynotfollow,orotherorganizations,suchasthe

Institute

forClinicalandEconomicReview(ICER,)

mayhaveadifferentassessment.

Evenmorechallenging,the

industry

does

nothaveauniformunderstanding

ofvalue.The

stakes

toinvest

andlauncharehigherthanever,necessitating

careful

pipelinemanagement.Manufacturers

willhavetoconsiderthe

clinicalpositioningoftheirproducts

andmarketaccessstrategymuchearlierinthe

pre-launch

processastheboundariesbetween

both

aspects

areblurring.The

clinicalprofileofadrug

willhavebearingonits

prospects

inthemarketandultimatelyaffect

the

long-term

viability

ofadrug’s

development.Itmaynotbe

possibletosimplydefinevalue.Rather,asmarketaccessprofessionals,wemust

ask,

valuetowhom?Pharmaceuticalinnovationisontheprecipiceofnovel,sometimes

curative,developments

where

patientsareeagerforachanceat

diseasemanagementif

thecoverageandcosts

can

only

support

it.

|

5EXPANDINGPAYER

CONTROLDemandforthese

solutionsreflect

agrowingtrendamongpatients

taking

advantage

oftheiroptions.Manufacturers

mightfindopportunities

forfuturepartnership

with

suchemergingorganizationsastheylooktosupport

patients

moredirectly

andimproveaccesstotheirtreatments.

Perhapsoneexampleexistswith

telemedicine,whichsaw

aboost

after

COVID-19.Some

companiesnowuseonlineplatforms

todiagnose,prescribe,andevendistribute

medicines–mostlygenerics

fornow–tospecific

populations.Nowmorethanever,patients

areoneonlineadvertisement

awayfrom

beingdiagnosedforamental

healthdisorderandprescribedanSSRI.Payercontrolhasbeen

ontherise

foryears

asrestrictionratesaregrowingandfewer,select

products

achievepreferentialstatus.

Already,thenumberofuniqueformulary

exclusionsaveragedover600

across2023’snationalpreferredformularies.But

thatisonly

onepieceofthe

fullcontrolpicture.

Formulary

restrictionsandexclusions

areexpandingintonew

marketsthathavepreviously

been

considereduntouchable,suchasoncologyandevensomeprotected

classes.

Thiscouldbe

anunexpected

shift

with

sizeableaccessandmarginimplicationsformanypharmaceuticalbrands,particularly

aspayers

must

compensatefornew

costliabilitiesunderthe

IRA.

Monitoringandforecasting

willprovevital

tolong-term

success.New

accesspoints

arenotwithout

theirchallenges.Cost

containmentcompaniesarealsomakingheadwayinthe

market,moving

prescriptionsthroughpharmacydiscountcards

andotherchannelstokeepspending.Itwillbe

challengingbut

necessary

tomeasurethesealternative

sitesinordertoensurethattreatments

areasaccessibleasforecasts

mightexpect.Whileformulary

levers

arealreadyanestablished

formofcontrol,it

isIQVIA’s

expectation

thattheindustrywillalsosee

payers

addtotheirtoolkits.

One

waytheindustry

mightexpect

tosee

payers

manageaccessisthroughtriagingpatients

orlimitingtreatmentpopulations.Nationalcoveragedeterminations(NCDs),coveragewith

evidencedeterminations(CEDs),andself-administereddrug

exclusionlists

(SAD

lists)areexistingmechanismswithin

CMS.

Thoughnotcommonlyusedtoday,they

provideanoption,orinspiration,forfutureaccessmanagement.MODERN

PRACTICES

FORLAUNCHGiven

risingpayercontrol,manufacturers

arehavingtoadjust

theirexpectations

forlaunch.Success,inwhateverwayit

isdefined,

maynotbe

achievableforseveralyears

orevenlongerafter

launchdependingonpayeraccess.Manyoftoday’s

forecasts

donotproperlyaccountforthe

delayinformulary

uptakethathastakenplaceoverthe

years,

putting

launchbrandsinapositiontooffer

vouchers

andbridgeprogramstobypassdelayedcoverage.NEW

SITES

OF

CARE

AND

ACQUISITIONWith

payerrejections

andcost-sharingontherise,patients

arelookingbeyondtheirbenefits

inordertofillprescriptions.As

oneexample,pharmacydiscountcards

mayaccountforless

than6%ofallprescriptions,but

morethan10%ofinsuredpatients

use

at

least

one.They

havenearly

doubledinprevalencesince2017

andareontracktogrowaspatients

encountermorebarrierstoaccessandarecompelledbythepotentialsavingsout-of-network.

Cost

PlusDrugs,

identified

asapublic-benefit

corporation,isanemergingvariationonthediscountcard,

offeringastreamlinedsupplychainandtransparentpricingonmanygenerics.

Weexpect

toseemoresuchentries

intothisspaceinthefuture.However,these

programscan

havelong-termeffects

onthe

performance

ofabrandaswellasthesustainability

ofits

support

programwhen

they

struggletotransitionpatients

toinsurance.Of

thetop10

mostsuccessful

launchesbetween

2020-2022,nearly

allhadaggressive

patient

support

programs,with

sometimesasmuchas80%

ofvolumebeingfully

offset

bymanufacturer

support.6

|Patient

Services

and

Market

Access

Quarterly

Advisor,Q1,

March

2023Pricingpressuresfrom

the

IRA

makethestakes

evenhigherin2023.Manufacturers

willhavetopayrebatestoMedicareforanypriceincreasesthatexceedtheconsumerpriceindex(CPI),makinglaunchpriceparticularly

important.

Manufacturers

willalsohavetoconsiderhowthe

timingofpricenegotiationwillaffectthe

longevity

ofabrand.Notably,smallmoleculesstandtofacenegotiationsoonerthanlargemolecules,at

9years

after

launchinstead

of13.the

IRA.

Regardless,thisfirst

yearwillhaveimplicationsforfuture

biosimilarlaunches

aswellasthefavorabilityofbiosimilardevelopmentaltogether.DEDUCTIBLE

ACCUMULATORS

AND

COPAYMAXIMIZERSThe

numberofdeductibleaccumulatorsandcopaymaximizers

aregrowingevery

year.They

cost

supportprogrambudgets

billionsofdollarsintotal

andaccountforamajority

ofspecialty

drugs’

copaycard

spending.They

alsocontinuetoplayagrowingroleinpayerbudgets,both

becomingastrategic

leverandpresentingacontracting

pitfall

forbrandssubject

tothecontrol.Combinedwith

marginpressuresthatcontinuetoimpactthe

industry,

launchpricepressureswillbe

ahottopicinthe

comingyears.

With

one-third

ofrecentlaunchespricedabove$200,000

peryear,

agrowingnumberofproducts

launchedat

pricesabove$1

million,andtherobust

pipelineofinnovationset

tolaunchinthenextfew

years,

weexpect

thelaunchpricedebatetointensify.Manufacturers

must

beginpreparingtheirevidencestrategy

now.To

counter

manufacturer

and

patient

mitigation,

theseprograms

have

evolved

over

time.

Some

use

variablecopays

while

others

might

resemble

a

traditionalcoinsurance

benefit,

making

it

difficult

for

manufacturersto

budget

appropriately.

The

use

of

variable

copays

alsocreates

a

challenge

to

identify

patients

that

are

bettersuited

for

rebate

programs

or

debit

cards

instead

oftraditional

copay

cards.

In

2023,

manufacturers

mustanalyze

their

accumulator

and

maximizer

exposure,

evengoing

so

far

as

to

incorporate

these

dynamics

into

theirpre-launch

forecasts.

They

must

also

strategize

to

ensurethe

long-term

sustainability

of

their

support

programs.PHARMACY

BIOSIMILARSOne

ofthe

largest

brandsinthehistory

ofbiopharma,Humira,willfacedirect

competitionin2023asbiosimilarsofadalimumabenterthe

market.Amgen’sAmjevita

willleadwith

exclusivity

inJanuary

andseveralothers

willfollowinJuly.Adalimumabisunlikeinsulinglargine,the

first

pharmacy

biosimilar,inmanywaysandisthereforeaneventtowatchin2023.Stakeholdersacrossthe

industry

willbe

watchingtosee

whatstrategies

both

innovatorandbiosimilarmanufacturersemployforpricing,contracting,

marketing,andpatientsupport.

Currentexpectations

mayhavesettled

onmodest

discountsandbrand-likestrategies,

butit

remainstobe

seen

what

eachcompanywilldo.Biosimilarsuccessliesintheeyeofthebeholderastherearemanyways

thatonecan

view

the

market.Given

the

recentgrowth

ofthese

programs,theindustry

response,the

regulatory

responseofmoreandmorestate

bans,

patientadvocacy,

andmorepublicawareness,these

controlswillremaincontroversial.Treatingproducts

likeoncologics,HIV

anti-virals,Hepatitis

C,

andmultiplesclerosisdrugs

asnon-essentialmedicationisbad

forpatients

andpublichealth.Legislatorsarewellwithin

theirrights

toseek

bansforprogramsthathurt

patientoutcomes.PATIENTACCESSDISPARITIESFromthe

inside,wewillalsobe

watchingthemarket’sresponse.The

extent

towhichpayers

coverbiosimilaradalimumab,aswellasthe

frequency

ofpharmacysubstitution,

remainsuncertain

andunstable.

Despitecurrentdynamics

thatfavorLantus

overits

biosimilars,dynamics

couldchangedependingonthecompetitivemarketforadalimumabandshifting

payerliabilitieswithHealthequity

isapriority

forthe

industry,

includingIQVIA.

For

now,industry

isonly

beginningtoaddressdisparities,

but

alreadypoliciesareinfluencingclinicaltrialdesignandinvestigatinghealthdeserts.

Marketaccessalsohasaroletoplay,byidentifyingandaddressingstructuralaccessbarriers

acrosspopulations.

|

7Several

drug

manufacturers

pledged

funds

to

addressdisparities

and

disadvantages

in

healthcare.

As

marketaccess

practitioners,

we

see

this

as

an

opportunityto

look

at

equity

as

a

whole-

from

symptom

totreatment.

As

solutions

are

developed

that

willhopefully

bridge

gaps

in

representation

and

diagnosis,the

industry

already

has

many

tools

at

its

disposalto

minimize

barriers

to

access.

These

tools

could

seemajor

innovations

in

the

coming

years

as

investmentsin

equity

continue.Inrecentyears,

publiclegaldisputeshavechallengedpractices

within

the

340B

programandthe

HealthResourcesandServices

Administration’s(HRSA)authority

topenalizemanufacturers

forlimiting340Bdistribution.

Inthe

absenceofclarity

around340B

scope,manufacturers

areattempting

tolimit340B

tothe1996patientdefinition,whileproviders

arepushingtoexpandthe

program.Pressureisonlawmakerstobetter

clarifythe

scopeandrules,

asthescale

ofthisprogramcouldnothavebeen

anticipatedwhen

it

wasfirst

designed.PERSISTING

340B

CHALLENGESAddingtothe

intensity

oftheissueareprovisionsinthe

IRA

thatallowfor340B-reimbursed

prescriptionstobe

excludedfrom

inflationary

discounts.Given

thegenerallackofvisibility

into340B

transactions,

thelargepreponderanceofMedicareclaimsthatarealsotransacted

throughthe

340B

channel,andthe

complexdebatesurroundingthe

issue,the

programwillcontinuetobe

controversial.340B

remainsoneofthelargest

margin-mitigatingconcerns

fordrug

manufacturers

today.

Explosivegrowthinthechannel

hasdoubledutilizationoverthelast

5years

with

little

signofabatement.The

financialincentiveforcoveredentities

toexpand

theuse

340Bishighandthereislittle

appetite

from

legislatorsorregulatorstomakechangestothesystem.Fiveyearsand

counting:

Deductibleaccumulatorsand

copaymaximizersin

2022By

JamesBrown,Vice

President,U.S.

MarketAccessStrategy

Consulting,IQVIARahelEhrenberg,Principal,U.S.

MarketAccessStrategy

Consulting,IQVIARuthyGlass,PhD,

Consultant,U.S.

MarketAccessStrategy

Consulting,IQVIABenjaminPlotnik,Associate,

U.S.

MarketAccessStrategy

Consulting,IQVIAIntroductionIQVIA

hasreported

ondeductible

accumulatorandcopaymaximizerprogramssince2017.

Thelast

publicationin2020,ThreeYearsIn:DeductibleAccumulatorsandCopayMaximizersin2020,examinedtheirprevalenceandcost

impact

sinceimplementation.Accumulatorsandmaximizersexist

toextract

themostvaluefrom

manufacturer-supportprograms,offsettingpatientdeductibles

andcopays,

aswellasthe

payerexpenditures.

Wecontinuetomonitorthese

plansandevaluatewhat

they

meanforpatients

andthecopaycardbudgets

thatsupport

them.8

|Patient

Services

and

Market

Access

Quarterly

Advisor,Q1,

March

2023Over

theyears,

accumulatorsandmaximizershavemanaged

to

grow

despite

many

stakeholders’

opposition.In2021,

43%

ofcoveredlives

incommercialplanswereinplansthathaveimplementedaccumulators,while45%wereinplansthathaveimplementedmaximizers.The

growth

ofaccumulatorandmaximizerplanshasled

totheirincreasedproportion

intotal

assistancespend,costing

manufacturers

morethananestimated$5billiondollarsincopaybudgets.

Pharmaceuticalmanufacturers

andpatientadvocacy

groupshavefiledlawsuits

againstthepharmacy

benefit

managers(PBMs)andpolicymakers

thatarebehindaccumulatorandmaximizerproliferation.State

governmentspassed

andimplementedbansthatprohibited»

Accumulatorandmaximizerprevalence/growthtrendsvary

acrossandwithin

therapeuticareas,mostly

reflecting

differencesinpatientsupportprogramdesigns.»

Growth

inaccumulatorandmaximizerprevalenceislargelydriven

bythe

increasedsaturation

withinlargespecialty

pharmaciesthatareverticallyintegratedwith

pharmacy

benefit

managers.•

Costs:»

Patientcost

exposures,

andthus,

the

buy-down

ofacopaycard

redemptionwithin

anaccumulatorormaximizerplan,is3-5

timesmorethanthatofredemptionswithin

traditionalplans.deductible

accumulatorsinanystate-sponsored

plans.Nevertheless,

accumulatorsandmaximizers,combined,affect

asmanyasathirdoftheprivately

insuredpatientsusingspecialty

medicinesforconditionsthatincludeautoimmunedisordersandcancer.»

The

averagebuy-down

per

copaycard

redemptionisincreasingat

agreaterratewithin

maximizerscomparedtoaccumulators,driven

largelybyevolving

maximizerdesigns.As

accumulatorandmaximizerplanscontinuetotakerootinprescriptioncost-sharingeconomics,data-driveninsightsareneeded

toestablish

theirtrue

impact.Inatimewhen

pharmaceuticalmarginsarebeingcompressed,patientcost-sharingisrising,andsupportbudgets

arestrained,

it

ismoreimportant

thaneverforthe

industry

tounderstand

andquantify

thisimpact.

Thisreport

provides

the

data

andanalytics

requiredtodoso.»

As

aresult,

patients

willexhaust

theirassistancefunds

soonerandmorefrequently

in2022comparedtoprioryears.•

Policy:»

By

2022,14

states

passed

laws

prohibitingthe

useofdeductible

accumulators,thoughthey

can

onlyapply

tostate-sponsored

planssuchasthoseinthehealthcareexchanges.EXECUTIVE

SUMMARY»

State

laws

thatprohibitdeductible

accumulatorshavebeen

largelyineffective

at

stunting

accumulatorgrowth

amongcommercially-insuredpatients

instates

thathaveimplementedthem.•

Prevalence:»

Acrossselect

specialty

markets,exposuretoorprevalenceofaccumulatorandmaximizerplansgrewfrom

14%

ofcommercially-insuredpatients

in2019

to33%

in2022.Clickheretoreadthefullwhitepaper:Five

YearsandCounting:Deductible

AccumulatorsandCopayMaximizersin2022

|

9Disruptionin

themarket:CostPlusDrugsBy

JayKrippes,

Field

Director,NationalAccounts,

IntegratedPatientServices,

PatientSupport

Services

CenterofExcellenceHannahDeibert,

NationalAccountManager,IntegratedPatientServices,

PatientSupport

Services

CenterofExcellenceMarkCubanisawell-known

entrepreneurandinvestor,best

known

forhisroleasowner

oftheDallasMavericksbasketballteamandasapanelist

onthetelevisionshow"Shark

Tank."

Inrecentyears,

Cubanhasalsobeen

vocalabout

the

highcosts

ofprescriptiondrugsinthe

UnitedStates.

Cubanstates,

“The

only

true

understanding

ofdrug

pricingthatconsumersorpatients

haveisvia

thepharmabroMartin

Shkreliiwith

theideathatyoucanraiseadrug

priceby5000%...if

youcan

raiseit

by5000%,there'sareallygood

chanceyoucan

reduceit

by5000%.”That

conceptwasthe

genesisofCuban’sproposedsolutioncalled“Cost

Plus”

pricing.trust

because

Iwasputting

mynameonit.

It's

the

onlybusinessI've

everput

mynameon.”MCCPDCintendsnottochargemuchmorethanthedrug

manufacturing

costs."Every

product

wesellispricedexactly

the

same

way,"

Cubansaid

inthemissionstatement.

"Our

cost

plus

15%.”The

15%

markup

is

basedonthe

per-pillpricethatMCCPDCpays

topurchasedrugsfrom

thesuppliers.Cubancontinues,“We

doourbesttopriceourdrugs

asclosetothe

manufacturer’s

priceas

possible.”Cubanintroducesradicaltransparency

pricingforthesegenericdrugs

thatwillallowthepublictosee

the

totaldrug

cost

charged."Every

American

shouldhaveaccesstosafe,

affordablemedicines,"headds.

"It

isjust

asimportant

tointroducetransparency

tothe

pricingofdrugs,

so

patients

know

theyaregetting

afairprice."The

patientwillpaythe

actual

drug

manufacturing

costplus15%

with

two

additionalflatfees:1)

$3.00

pharmacyfillper

drug

per

order,and2)

$5.00

mailordershippingchargeaccordingtothe

website.On

January

19,

2022,CubanlaunchedMarkCubanCostPlusDrug

Company(MCCPDC)stating,

“We

started

thiscompanyasaneffort

todisruptthedrug

industry

anddoourbest

toendridiculousdrug

prices.”The

conceptbehindcost

pluspricingissimple:apharmaceuticalmanufacturer

producesagenericdrug

andsellsit

forapricethatisequaltothecost

ofproduction

plusasmallprofit

margin.This

pricingmodelisintendedtomakegenericdrugsmoreaffordableforconsumerswhilestillallowingthe

manufacturer

toturn

aprofit.Likemanyexperts,

Harvard

MedicalSchoolresearcherswereintriguedbythisultra-money-savingpharmaceuticalendeavor--

whichiswhy

theydecidedtoquantify

exactly

howhelpfulthese