Disrupting Drug Costs: The Role of Cost-Plus Pricing in Reducing Medicare Spending on Hypertension Treatments

Objective: To assess potential Medicare cost savings if Mark Cuban Cost Plus Drug Company (MCCPDC) pricing were applied to antihypertensive medications. Study Setting and Design: We conducted a cross-sectional analysis comparing Medicare Part D spending with MCCPDC pricing for selected antihypertensive drugs. Data Sources and Analytic Sample: Eighty-seven antihypertensive medications were compared between Medicare Part D and MCCPDC. Volume-adjusted expenditure estimates were calculated under three scenarios: (1) applying MCCPDC prices to all medications, (2) applying MCCPDC prices only to drugs priced lower than Medicare, and (3) applying MCCPDC prices to guideline-recommended first-line therapies. Principal Findings: In 2022, Medicare spent $4.9 billion on the included medications. Of these, 39 of the 30-count and 58 of the 90-count medications showed cost savings under MCCPDC pricing. Estimated savings totaled $670.1 million (30-count) and $1.4 billion (90-count). Among 47 first-line agents, MCCPDC pricing produced estimated savings of $222.6 million (30-count) and $584.1 million (90-count). The average 90-count price reduction was 23.2% overall and 21.1% among first-line therapies, with several agents showing substantial price advantages. Conclusion: Adopting MCCPDC pricing could reduce Medicare costs for antihypertensive drugs, especially through 90-count supplies and first-line therapies. Targeted implementation—focusing on medications with clear cost and clinical advantages—may yield meaningful savings. These results support broader policy efforts to incorporate transparent, value-based drug pricing models into Medicare.