Branded Gleevec (imatinib) – a cancer drug that reached over $120,000 a year in list price before generic competition arrived – is listed on Cost Plus Drugs pharmacy for around $17 for a month’s supply. That price exists because the pharmacy applies a fixed 15% markup over its acquisition cost and ships it to your door without requiring insurance.
That pricing drew millions of people to the service when it launched in January 2022. Four years later, the company looks quite different from what it was at the start: more medications, a manufacturing facility, a major health system partnership, and a deal with one of the country’s largest insurers. Whether it saves you money depends on several factors that the advertised drug price alone won’t tell you.
The company was not Mark Cuban’s idea originally. Alex Oshmyansky, MD, PhD, is the co-founder and CEO. Oshmyansky, a board-certified diagnostic radiologist who completed a residency and fellowship at Johns Hopkins Hospital, had built an earlier nonprofit focused on drug affordability before Cuban came on board as a co-founder and investor. The two changed the company’s structure and name, and launched the pharmacy as a public benefit corporation – a structure that formally requires balancing profit with public health impact. Cost Plus Drugs charges a flat 15% markup over its cost, plus pharmacy fees, a deliberately simple formula intended to make the pricing legible to anyone.
How the Cost Plus Drugs pharmacy pricing model actually works
Cost Plus Drugs uses a transparent pricing formula: actual cost of the drug, plus a 15% markup, plus a pharmacy fee, plus shipping. In 2026, that breaks down to a $5 pharmacy service fee and a $5.25 shipping fee added on top of the marked-up drug cost. The company bypasses pharmacy benefit managers (PBMs) – the companies that negotiate drug prices and manage which drugs your insurance covers – by purchasing medications directly from manufacturers and wholesalers.
As of mid-2026, the company carries over 2,300 prescription products delivered by mail to patients nationwide, and is actively working with trade name manufacturers to add both single-source brands and specialty biologics to its catalog. That’s a significant expansion from the roughly 100 generics it launched with. The catalog now covers conditions ranging from cancer and heart disease to mental health, asthma, and organ transplant support.
This model works best for drugs with low acquisition costs. When the manufacturer price is already high – as with some branded generics or drugs with limited competition – the 15% markup still produces a meaningful absolute dollar figure, and the savings percentage narrows. Patients ordering a drug that costs $8 wholesale will pay something close to $19 all in. A drug that costs $200 wholesale will run closer to $238 before fees. The markup is consistent; the dollar impact varies sharply depending on the starting price.
The service requires a valid prescription from a U.S.-licensed provider. For individual consumers using the direct-to-consumer site, prescriptions are sent to the pharmacy and fulfilled by mail through URAC Mail and Specialty accredited facilities.
Why drug pricing is so hard to read in the first place
Pharmacy benefit managers play a central role in negotiating prices and managing formularies, but the layers of rebates, reimbursement schedules, and administrative fees can make it difficult for pharmacies to anticipate their margins. Two different patients picking up the same medication can pay wildly different prices depending on their insurance coverage and formulary placement.
In September 2024, the FTC sued the three largest PBMs – Caremark, Express Scripts, and OptumRx – alleging that their rebating practices encouraged higher insulin list prices and blocked access to lower-cost alternatives, driving up patients’ out-of-pocket costs. The complaint also alleged that PBMs kept hundreds of millions of dollars in rebates and fees each year. Cost Plus Drugs purchases medications directly from manufacturers and wholesalers, then posts its cost publicly. There are no rebates flowing back to an intermediary, and no spread pricing – the practice of charging insurers more for a drug than what the pharmacy actually paid.
Cost Plus Drugs is structured as a public benefit corporation, giving its social mission of improving public health equal legal standing alongside its financial obligations to investors.
When Cost Plus Drugs could actually save you money
The key variable is what you’re currently paying out of pocket through your insurance plan. Once patients paid more than $15 out-of-pocket for a generic, the Cost Plus Drugs price was cheaper nearly 80% of the time, according to a May 2026 study published in the Annals of Internal Medicine. The biggest savings accrued to people paying more than $100 out-of-pocket – in those cases, the typical patient paid about $140 using insurance but only about $25 via Cost Plus Drugs. Drugs for cancer, brain or mental health conditions, heart disease, and organ transplants produced the largest potential savings.
That study focused exclusively on generic drugs, excluding controlled substances, drugs with zero cost-sharing requirements under the Affordable Care Act, and drugs subject to special risk-management requirements. The results are also not generalizable to patients on Medicare, Medicaid, or all types of commercial coverage. A patient on Medicaid paying $1 or $3 per prescription will almost certainly do better with their plan. A patient whose insurance has a high deductible – meaning they’re paying full retail price until they hit the deductible cap – is a much stronger candidate for Cost Plus savings.
Cost Plus Drugs does not accept insurance. The $17 listed for a medication is the entire transaction, with no insurance claim running in the background that counts toward your deductible. Patients close to hitting their plan’s annual deductible should factor this in: cash spending at Cost Plus Drugs won’t help reach that threshold. Patients managing several conditions, or those with high-cost drugs their insurer covers at a reasonable copay, may find their insurance remains the better deal for most prescriptions even if Cost Plus is cheaper on a few.
How Medicare prescription coverage works in 2026 follows the same logic – the best deal for any one person depends heavily on their specific drugs, their current coverage, and where they are in their plan year.
The CenterWell partnership: what it means beyond the website
On April 27, 2026, Humana’s CenterWell Pharmacy announced a partnership with Mark Cuban Cost Plus Drug Company to develop new, end-to-end employer prescription solutions. CenterWell Pharmacy – which employs more than 500 pharmacists providing around-the-clock patient support – will serve as an official pharmacy partner of Cost Plus Drugs.
Cost Plus Drugs’ digital pharmacy platform SwiftyRx will be used by CenterWell for its medication order intake operations. SwiftyRx uses AI to automatically verify prescriptions, check benefits, and transfer scripts between pharmacies, enabling easier patient onboarding, automated benefit checks, and reduced costs to fill prescriptions. The platform is also expected to allow CenterWell to offer home delivery pharmacy services to Humana employees enrolled in the Humana Associate Benefit Plan.
This deal extends beyond Cost Plus Drugs’ original direct-to-consumer model. Rather than selling cheaper drugs to individual patients online, the company is licensing its software stack and pricing infrastructure to a pharmacy that already operates at scale inside the employer benefits market – a move toward functioning as a pharmacy technology and infrastructure company, not only a pharmacy.
What has changed since 2022
When the pharmacy launched in January 2022, it carried a much smaller catalog. Cost Plus Drugs opened a 22,000-square-foot manufacturing facility in Dallas in 2023, a step toward manufacturing some of its own medications rather than buying entirely from third-party suppliers.
In December 2024, Penn Medicine announced a partnership with Cost Plus Drugs through its Cost Plus Marketplace, securing the top 100 most frequently dispensed generic drugs – including antibiotics, cancer treatments, blood thinners, and asthma medications – for the health system’s retail pharmacy network, which fills over 1.5 million prescriptions annually across 16 locations. That deal brought Cost Plus Drugs into institutional supply as well as consumer sales.
The company has moved from a niche online pharmacy selling generics cheaply to individuals toward a pricing and technology platform embedded in larger health systems and employer plans. Whether that translates to lower costs for more people depends on how quickly employers and health systems adopt the model, and whether the savings visible on paper survive contact with the contracts that govern actual plan benefits.
The bottom line: how to know if it’s right for you
Cost Plus Drugs works best for patients paying substantial out-of-pocket costs for generic medications whose current insurance plan offers little help on those particular drugs. If your insurer covers a medication with a $10 copay, the Cost Plus price – drug cost plus 15%, plus $5 pharmacy fee, plus $5.25 shipping – may not beat that, even before accounting for lost deductible progress.
To compare, find the medication on the Cost Plus Drugs website and note the total price including the pharmacy fee and shipping. Then compare that figure against your actual out-of-pocket cost through your insurance plan – not the retail price your insurance shows, but what you actually pay at the counter or through mail order. Because the $5.25 shipping fee applies once per shipment regardless of how many prescriptions are included, ordering multiple medications together lowers the effective per-drug cost compared with a single-prescription comparison.
The 2026 Annals of Internal Medicine study found the strongest case for Cost Plus savings in oncology and psychiatry, where high cost-sharing on generics is common. For those patients, checking the Cost Plus price before filling a prescription is a reasonable step – not a replacement for insurance, but a comparison worth making each time a prescription is due.
Disclaimer: This information is not intended to be a substitute for professional financial advice, investment advice, tax advice, or legal advice, and is provided for informational purposes only. Always seek the guidance of a qualified financial advisor, accountant, or other licensed professional regarding your personal financial situation or investment decisions. Do not make financial, investment, or tax decisions based solely on information presented here. Past performance is not indicative of future results, and all investments carry risk, including the potential loss of principal.
AI Disclaimer: This article was created with the assistance of AI tools and reviewed by a human editor.
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