The three biggest drug middlemen in America spent decades robbing you blind.
Now a billionaire and the Trump White House are cutting them out entirely.
And what Cuban revealed on Fox & Friends Wednesday morning is already changing what you pay at the pharmacy.
The Scam That's Been Draining Your Wallet for Decades
Pharmacy Benefit Managers – odds are you've never heard of them, which is exactly how they wanted it.
CVS Caremark, Express Scripts, and OptumRx control 80% of the prescription drug market in this country.
Their job was supposed to be lowering your drug costs.
Instead, House Oversight Chairman James Comer exposed how these three companies ran a scheme to enrich themselves while driving up what you pay at the counter.
The FTC confirmed it – PBM-affiliated pharmacies generated $7.3 billion in excess revenue from specialty drug markups alone between 2017 and 2022.
They played a game called "spread pricing" – charging your insurance plan one amount, paying the pharmacy less, and keeping the gap.
https://twitter.com/EricLDaugh/status/2046941347500769386?s=20
They steered sick patients toward their own pharmacies even when cheaper options existed nearby.
And when Congress finally dragged their executives in to testify, those CEOs refused to explain why a single drug carries 600 different prices across the country.
Six hundred prices. For the same pill.
What Cuban and Trump Are Doing About It
Mark Cuban launched Cost Plus Drugs in 2022 with one mission: cut out the middlemen and sell you drugs at manufacturing cost plus 15%.
That's the entire model. Manufacturing cost, 15% markup, $5 pharmacy fee, roughly $5 shipping.
A cancer drug the system was marking up to $2,000 a month? Cost Plus sells it for $13.
Droxidopa – a drug a friend of Cuban's needed after a devastating accident – was running $10,000 every three months through traditional channels.
Cost Plus got it down to $90.
Vanderbilt researchers calculated that if Medicare bought just seven common cancer drugs through the Cost Plus model, it would save $661.8 million – a 78.8% cut in what the government and patients were paying.
Meanwhile, Trump was doing something no president had managed before.
In May 2025, he signed the Most-Favored-Nation executive order – requiring drug manufacturers to offer Americans the same prices they charge other developed nations.
By February 2026, TrumpRx.gov was live.
Ozempic dropped from $1,028 a month to $350. Wegovy from $1,349 to as low as $149.
An asthma inhaler from $504 to $201. A COPD inhaler from $458 to $51. Insulin for $25 a month.
Sixteen major pharmaceutical manufacturers have now signed MFN deals – ending the arrangement where Americans subsidized cheap drugs for the rest of the world.
The Bigger Play Nobody Is Talking About
On the streets of Pittsburgh Wednesday morning, Cuban told Doocy something that makes this more than a business story.
Cost Plus Drugs is integrating its medication list directly into TrumpRx.
They are working to bring generic drug manufacturing back from overseas to Dallas.
An entrepreneur who could have endorsed any Democrat presidential candidate is instead partnering with the Trump White House to dismantle the system that bled American patients for decades.
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Democrats spent four years calling Trump's drug pricing push a fantasy while Big Pharma's middlemen kept picking your pocket.
Trump got 16 pharmaceutical giants to blink.
Cuban built the infrastructure to handle the ones who won't.
The PBMs built an empire on the assumption that nobody would ever cut them out.
They were wrong.
Sources:
- Taylor Penley, "Mark Cuban shoots down presidential bid as he teams up with Trump admin to cut healthcare costs," Fox News, April 22, 2026.
- White House, "Fact Sheet: President Donald J. Trump Launches TrumpRx.gov to Bring Lower Drug Prices to American Patients," whitehouse.gov, February 2026.
- White House, "Fact Sheet: President Donald J. Trump Announces Largest Developments to Date in Bringing Most-Favored-Nation Pricing to American Patients," whitehouse.gov, December 2025.
- James Comer, "Comer Releases Report on PBMs' Harmful Pricing Tactics and Role in Rising Health Care Costs," House Committee on Oversight and Government Reform, July 2024.
- Federal Trade Commission, "Pharmacy Benefit Managers: The Powerful Middlemen Inflating Drug Costs and Squeezing Main Street Pharmacies," ftc.gov, July 2024.
- Ruchika Talwar et al., "Projected Savings for Generic Oncology Drugs Purchased via Mark Cuban Cost Plus Drug Company Versus in Medicare," Journal of Clinical Oncology, 2023.