The Chris Cuomo Project - How Mark Cuban is Disrupting Big Pharma and Taking on Politics

Episode Date: December 3, 2024

Mark Cuban (entrepreneur, investor, and founder, Cost Plus Drugs) joins Chris Cuomo to discuss disrupting Big Pharma, lowering healthcare costs, and how transparency can fix the system. Cuban also responds to Megyn Kelly’s criticism of his political views and shares his thoughts on polarization, ranked choice voting, and why innovation is key to solving America’s biggest challenges. Follow and subscribe to The Chris Cuomo Project on Apple Podcasts, Spotify, and YouTube for new episodes every Tuesday and Thursday: https://linktr.ee/cuomoproject Join Chris Ad-Free On Substack: http://thechriscuomoproject.substack.com Support our sponsors: Oracle See if your company qualifies for this special offer at Oracle.com/CCP That’s oracle dot com slash CCP. AG1 AG1 is offering new subscribers a FREE $76 gift when you sign up. You’ll get a Welcome Kit, a bottle of D3K2 AND 5 free travel packs in your first box. So make sure to check out DrinkAG1.com/ccp to get this offer! Select Quote Get the right life insurance for YOU, for LESS, at SELECT QUOTE DOT COM SLASH CHRISC to get started 120Life For a limited time, Try 120Life and save 20% off. Just use the code “CHRIS20” at checkout at 120life.com Learn more about your ad choices. Visit megaphone.fm/adchoices

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CBC News. Mark Cuban. Big name, probably watch or listen just because of him. But he is going to tell you what's going on with our ability to get and afford medication that will blow your mind. I'm Chris Cuomo, welcome to the Chris Cuomo Project. Mark Cuban is known for a lot of things. He was very high profile in the last election.

Him talking about what he now understands about the pharmaceutical industry, and more importantly, the business, what he learned about politics, what he sees as solutions. And then this really crazy story about Megyn Kelly. Here it is. Support for the Chris Cuomo project comes from Get Main Lobster.

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with your order. So go to everydaydose.com slash Chris, you get 25% off plus five free gifts with your first order. Mark Cuban, where are you sitting? I'm in Dallas, Texas in my office with my background because my office is a mess right now with the dump. I like it. Well, I have to tell you, I think there are a lot more people who are interested

in what you have to say than what is represented over your shoulder right now, which is no one. Yeah, you know, basketball is basketball, but there's a lot of fun stuff going on. People were surprised when you went heavy into health care, specifically pharmaceuticals and how people get them and how it's priced. What do you believe in your education of that process people don't get about the dynamic of getting medicine and treating illness in America. That it is the most opaque industry I've ever seen or been connected to.

That the problem isn't the industry itself or even the supply chain so much as the lack of transparency. And that's what led to Costplusdrugs.com being created. When you say opaque, when you say lack of transparency, what should be happening that isn't? Well, let's start back to what is happening. So just think about the process when you get a prescription. The doctor says you need drug ABC.

The next question is, you know, here are the different economic options. Let's talk about what you can or can't afford or what your deductible is. It's a simple question. What pharmacy do you use? And if you have a deductible that is more than your savings account, fear immediately sets in

because you don't know what that price of medication is going to be. And so what we just, well, what I've pushed through was, okay, let's create a company that is very straightforward. When you go to costplusdrugs.com, you look up the name of the medication, whatever it may be, Metforum, it could be, and Matnib, whatever it is. And if it's one of the 2,500 we carry, then it'll come up.

And one of the first things you'll see is we show you our actual cost That is what we truly paid for it. Then we show you there's a 15% markup Which we thought was fair allows us to stay in business But isn't outrageous and then there's a $5 fee for the pharmacist to review, you know We ask you what other medications you're taking etc And then there's a $5 shipping fee if you want a mail order. And we have other options where you could pick it up at a local pharmacy through our network. And by doing that, that transparency literally changed the game. So people were able to see

what they actually were going to pay for a drug before they did so. And that fear all of a sudden, those stories that you heard about, you know, somebody standing in line at the pharmacy, realizing what it costs and not being able to afford it and having to walk away, those stories ended. Are you saving people money? Oh my God, yeah. I mean, it's nonstop. I mean, I use the example of imatinib. It's considered a quote unquote specialty drug when there's nothing special about it

other than the fact that it's used for chemotherapy. Well, there's still to this day for that fact that you walk into, excuse me, the biggest chain pharmacy, there's a good chance that if you say you need to pay cash, you're gonna pay $2,000. And depending on the strength, if you go to costplusdrugs.com and put in a Matinib, if it's the lowest strength,

you're paying $13 and 50 cents, give or take. Wow. Yeah, I or take. Wow. Yeah, I mean, I can give you example after example after example. I mean, there are, you know, dozens if not hundreds of drugs where the disparity in pricing is that dramatic. You know, one of the other things that we did that was a true industry changer was we actually published our complete price list. It's shocking to think that there is not one other company that publishes a complete price list of the medications they sell. Not one. And so, you know, if you're

a company looking to save money on medications, we can send you our price list and you're able to compare. You know, there are researchers that have gone out there and said, okay, let's look at what Medicare is paying for specific medications, oncology medications, whatever it may be, and done studies where it said, okay, if the government bought these drugs through costplusdrugs.com, these nine oncology drugs, we could save $3.6 billion a year. Or these 11 drugs, we could save $3.6 billion or $6.3, or whatever the number is. The savings would be insane.

And those studies were never even possible prior to us promoting our price list. So it's that they just wanna make more money than you do. So it's just about the margins. Are you willing to work with the Trump administration, I guess Bobby Kennedy on MAHA? I don't care who. Look, we sell to anybody.

We don't judge and we don't care. Our price is the same for everybody. It could be the government, it could be, you know, Chris Cuomo, it could be Mark Cuban, it could be someone walking in off the street. I could care less. Our price doesn't change by the name of the customer. And so, yeah, and you know, the other thing is our volumes go up, our prices go down. We have literally reduced the price of at least one medication every single weekday for over a year now. And so we completely passed through,

which obviously for the government would be a big benefit. Do you think the government can do anything to make this situation better? And what should they do to make it better? Yeah, it's really simple. All they have to do is require that all contracts between government agencies and any pharmaceutical or any healthcare company for that matter are published.

The problem, the reason the cost of drugs have gotten so out of whack is because it's an open market where anybody can enter, but it's not an efficient market. There's no price discovery at all other than the price list that we publish. And so if the government were to say, look, any contract any state does, any federal agency does, it's all published. And if they're able to, to say any contract that any company does is also published, the

game's over. All the, you know, effectively all of healthcare right now is an arbitrage, where all the different players in the supply chain try to introduce some fee or some margin and it, to just grab their little piece of the pot. And if you make it transparent so that everybody sees what those pieces are and what the margins are, then people can negotiate and I'll clarify it further.

So let's just say you're a company that has a thousand employees and covers 2,000 lives, families and everything. You really don't know what your cost of medications are. You don't know what your healthcare costs are for that matter. So if Chris Cuomo, you get your insurance through, you know, whoever it may be, that entity does not know what they're paying for the medications that you take

or anybody in your family takes. That's just wrong and it makes it almost impossible for companies to negotiate the best pricing, whether it's medications or it's healthcare. So if it's that obvious and you've had Democrats and Republicans in power, why hasn't it changed? That's a good question. You know, we've been saying this exact same thing for the past four years.

I mean, it's just, you know, there's lobbyists, there's big companies called pharmacy benefit managers that don't want to see it change. There's big insurance companies, they call them the Bukkas, the largest insurance companies. They don't want to see it change. There's big insurance companies, they call them the Bucas, the largest insurance companies. They don't want to see it change because the more opaque it is, the more money they make. When you were first enlisted,

or really enlisting yourself to help the Harris campaign, I talked to one of her staffers and I was like, hey, is this about cost plus drugs for Cuban? Because, you know, you usually keep arms length. And she said, no, there's no quid pro quo. Mark just believes in it. So he wants to do it. So let me flip it. Why not? Why didn't you go to them and say, yeah, I'll help you. I'll lend you my cache, my platform, my reach. But I want to do it because of this. I never talked to you during the campaign about what we're talking about now.

Yeah, because I didn't need to, right? The tipping point for changing the healthcare industry isn't about what government does, honestly. The tipping point is educating CEOs. It's not the core competency of any CEO to truly understand their benefits, whether it's the healthcare side or the pharmacy side.

You know, they don't get into the details there despite the fact that it's the second largest expense item after payroll. And so my job, you know, going out and talking about political candidates, that really doesn't change that at all. But going and meeting with individuals, CEOs or groups of CEOs, that's led to significant change. So when I sit down and I talk to a CEO and I say, look, do you know how these costs came about or the breakdown of your healthcare or pharmaceutical costs? The answer is always no.

And then I just go through it with them step by step. The way the pharmacy side of the world has broken up, most of the scripts go through these things called pharmacy benefit managers. And there are three big ones that control 85% of the market. I won't name them. And most big companies deal with one of those big three companies.

And they just take it as, you know, standard issue that they're gonna deal with those companies because they always have. And those companies realize that they don't really get questioned much anymore. And so they just keep on adding incremental costs and, you know, excluding things and doing things that just add up the cost of care for those companies. So when I sit down with the CEO, I say, look, if you truly want to reduce the cost of your pharmaceutical benefits, then you need to know the actual price, the actual net price that you're paying. Do they give you a price list of actual net price?

No. Have you ever seen a price list? No. Would that benefit you in your analytics of pharmaceutical costs? Yes. Okay. Well, that's part one. Part two, there's this thing called the formulary, which is where companies choose what drugs are available

to the lives that they cover, the population they cover. And I asked the CEO, do you know what's allowed or not allowed in your formulary? No. Do you know which GLP-1 you can or cannot offer? No. That's a big issue, isn't it? What if there's a new drug that's more effective and less expensive? Are you allowed to just add it? I would presume so. No, you're not.

What about the claims data? When someone gets sick, I'm not saying down to the patient level, but you wanna know across the population that you covered whether a lot of people have a certain illness and you could put together a wellness program. You want to know how many people are using GLP-1 so you can get that claims data? No. We tried to get that. Well, what happens when you try to get it? Well, they want us to pay for it and it takes nine months to get it. Well, okay. So why are you

continuing to do these things? But wait, there's more. Are you allowed to discuss any of these contractual terms that you have with other companies to see if there's best practices? No. Are you allowed to even talk to pharmaceutical manufacturers to determine if there's a program that they may be able to work with you on to improve the wellness of your employees? No.

And so once you go through the list of elements that they're not getting access to, and that are detrimental to the wellness and the cost of their companies, they start to open their eyes. And then here's the kicker. There have been multiple lawsuits, what they call a RISA lawsuits,

where there's a fiduciary responsibility of the companies to make sure that they're taking the appropriate steps to keep costs down and optimize wellness for the lives they cover. Well, when you just work through these big PBMs and you don't have any of the information I just discussed, you're not living up to your fiduciary responsibility. So you've seen companies like Wells Fargo and JJ

and others getting sued and plaintiff lawyers are just waiting to see what happens with them. And then it's going to be Katie bar the door. I mean, there's going to be so many class action suits. And so when I tell this to them, all of a sudden they start getting nervous. And that's where we're at right now, going around and my talking to these CEOs and groups of CEOs and telling them, here's the solution. There are the biggest PBMs that are doing all these negative things

that we just discussed that aren't acting in your best interest. And there's about 25 of what they call pass-through PBMs. And what the pass-through PBMs do is they take the actual cost of the medications and they pass through that cost. They take all the data and they pass them through to you so you own all your own data. They take the formularies where drugs are chosen and let you set the formularies. They let you work with the manufacturers, et cetera, and then they just charge you either a transaction-based fee or they charge you a monthly fee to give you whichever you prefer, per employee per month.

That gives you complete control of all your data. So what I've been doing it to answer your question, why not politics? Well, if I can convince enough of these big companies, and they change over to these pass-through PBMs, and we're starting to see that start to happen, then the tipping point happens within the next two to five years. At that point, and things become truly transparent,

all of healthcare changes. And we're starting to do some of the same things on the healthcare side, but we're just getting started there. Support for the Chris Cuomo project comes from select quotes. Look, so much in life is uncertain. And the older I get, the more comfortable I am with my decision to have life insurance in place to take care of my family. Now, the problem is, it's complicated. You know, there's so many sales pitches, there's so much pricing, there's so much variability. That's why I'm so happy to partner

with Select Quote. It's one of America's leading insurance brokers, 40 years of experience. They've helped over 2 million people find over $700 billion in coverage since 1985. Head to SelectQuote.com and a licensed insurance agent will call you right away with the right policy for your life and your budget. Select Quote. They shop, you save. Get the right life insurance for you for less at selectquote.com slash Chris C. Go to selectquote.com slash Chris C today and you get started. Selectquote.com slash Chris C. Support for the Chris Cuomo project comes from Shopify. Listen my friends, Shopify. Listen my friends, success in selling comes from a business and how often that business behind the business gets it done for that business. What does that mean? It means that you need people to help you get your wares where you

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Shopify.com slash Chris C upgrades you're selling today. Where? shopify.com slash Chris C. With so many different things that you're invested in and passionate about, did you ever imagine that you would have this granular and understanding of something as recondite, as complicated as this, and what drives the passion? Yeah, the answer is no.

And the thinker part about the healthcare industry, particularly pharmaceuticals, is there are more acronyms than there are in all of professional sports combined. You know, in analytics and sports, there's all these acronyms and you gotta figure them out. In pharmacy, the number of acronyms and their meanings are insane. And there's even like duplicates, right? Where you got to know the context of which acronym that you're using.

But to answer your question, no, I never possibly imagined. But you know, the whole genesis of what happened was, going back to 2017, when there was discussion of the ACA being overturned, I talked to some folks here in Texas and I started geeking out on healthcare. Okay, that's pretty cool. What if I can come up with an alternative and see what happens? I worked on this thing called the 10 plan that had some traction, but not enough. Went and even met with the White House and talked to people there,

Brooke Rawlings, Donald Trump, you name it. But they really didn't get any traction because the ACA didn't go anywhere. But that got me into healthcare. And then in 2018 or early 2019, I got a cold email from a Dr. Alex Osmianski. And he wanted to create a compounding pharmacy for generic drugs that were in short supply. And I said to him, you're thinking too small. You know, let's think of something bigger that can impact more people. And that was right around the time the farmer bro was going to jail. And I asked him the question, how is it that this one individual can completely distort the pricing of this one drug, DeraPrim.

And we went through it and it was obvious to me that the problem was a lack of transparency. The industry was opaque, like we discussed. But that led into me saying, you know what? This industry may not be all that hard to disrupt. And the reality is we started shipping January 19th of 2022. And here we are a little bit more than two and a half years later. And I think we've had a major impact. And truly, this has been the easiest industry

to disrupt of any I've ever worked in. Because it's just a matter of publishing our price list and making the data available. And you're seeing the head of CBS talking shit about us. I mean, it's just we don't even have 60 employees, and we're literally changing this industry by just introducing transparency. What have you learned in your time and your exposure

about what is going on in America in terms of how much medication we take versus what we actually need? No, it's a great question, right? Because there's always that push-pull, trying to find that equilibrium about being over-medicated with prescription drugs versus eating the right food and getting exercise

and doing all the things we need to to try to optimize our health. On one hand, we don't try to judge a cost plus drugs.com. We wanna carry every FDA approved medication we're legally allowed to and trust doctors to do what they do. We're not going to try to think for them. On the other hand, my partner from broadcast.com and so many other things, Todd Wagner, has been just an amazing advocate for the elimination of ultra processed foods. He's got a, he released the movie Food Fight USA too, and has an organization Food Fight USA. And so I'm a big advocate there. We partnered with a group called Yuka, who is, which is an app. If you've never seen it, it's amazing. You go to the store and you scan the barcode and it tells you how processed it

is, how processed the ingredients are So like, you know my family we really try to stick to all ultra non ultra processed foods Despite having three teenagers who you know vehemently disagree with that approach. Um, and so I that's important to me I created a site called food guides comm where people can go in who have GERD and acid reflux and get all kinds of information and recipes and access to good products. So it's not like we're just saying, let's just medicate everybody for everything.

It's saying, you know, when the doctor decides medication is a necessity, we'll trust them and we'll do the best pricing that we possibly can so that people don't have to make the choice between rent and Food and daycare etc But we're also going to try to create options where people can best educate themselves to optimize their health Have you ever found a bag of talkies in your house?

So many that I can't even begin. I mean that stuff is like crack No, let me just tell you, there's Reese's Pieces sitting in the kitchen and I took one, that was like my gift, I took two. Two little Reese's, you know how hard it is to only eat two Reese's Pieces? That is impressive. And that, no, cause that thing's gonna be sitting there

cause my kids aren't home from school and I can't move it, they get pissed off. You know how it goes, right, with kids. And so, like, this is gonna be my dilemma for the rest of the day. I'll be looking at that box of Reese's Pieces. But you get how it goes, right? When kids, and so like this is gonna be my dilemma for the rest of the day. I'll be looking at that box of Reese's Pieces. But you get how it works, man. You see how we get seduced by salt and sugar

and processed foods. For sure. Bill Maher the other night said to me on the show, we were talking about this. And Dr. Casey Means, who's got the number one New York Times bestseller right now called Good Energy. And she was talking about how, look, I'm not about politics, but I'm for Bobby Kennedy doing what he wants to do

and looking what's in our food, just like you're saying right now. And of course she got trashed by some for supporting Bobby, but she only supports this one thing. And Bill says, well, we know why this stuff's in our food. And I'm like, you know, the industrial complex. And he's like, no, it tastes good. He's like, this stuff tastes amazing.

So how do we deal with that? So Todd Wagner, again, I'll keep on name dropping him. He went to Gavin Newsome and he showed him a list of chemicals that are in foods that our kids are eating that are not in European foods. There's a term for it and I don't recall it, but they're not legal in Europe for the most part. And he showed him the list and got him to sign the legislation that removed it. That was step one. And now he's extending that to other things as well with the hope that California,

the People's Republic of California, usually is the first to take action on these things. And then other states, once they realize that it's the right thing to do, follow, follow through. Look, I'm not the world's biggest fan of Bobby Kennedy Jr. for a lot of different reasons, but it really comes down to what activity is actually going to happen. And that's where I give Todd credit. He wasn't out there making it political at all. He was going out there and actually doing the meetings, giving the data to show, here are the food elements that may extend the shelf life of bread, as an example.

Like, he'll tell the story all the time. Bread lasts three days in Europe, and it lasts a week or more here. How does that happen? And we've all heard the stories about the food intolerances and et cetera, and the differences there and here. And he always makes the point very clearly that when you extend shelf life, that's money in the bank.

When you put more sugar, it tastes better. Whatever all those chemicals are, they're there for a reason. And so by going after the ingredients themselves and making the data case that they're more harmful than good, sure, there's gonna be opposition from the big food companies, but hopefully the data does support,

and hopefully the politicians on, or the data does support, and hopefully, you know, the politicians on a state by state basis, and maybe even a federal basis will take these steps. One step sideways on this, and then I wanna ask you about something that's a passion project for me. Sure. The step sideways is help me understand

as you wade into the political waters. How is it that the guy who eats fast food all the time, and that is Trump, I mean, I don't care what anybody says, the guy eats it all the time, is the campaign that wound up being about this issue. How? How did he get ownership of this issue? You know, who knows? You know what? We're gonna find out.

Until the season starts on January 21st. It's all hype It's all hype and we don't know and so I'm just gonna hold on and wait to see what happens, you know I'm not gonna guess I'm not gonna make projections because it's all masturbation Yep, and so it is just no point and so we'll see what happens. Well, it's a huge point of masturbation, but I agree This is masturbatory. But you get my point, right? I'm staying away from it. To me, it's like sports, right?

In the preseason, you have the draft picks and your draft picks are the best picks ever until they're not, until they play in the actual games. So we'll see what happens when they play in the actual games. Can they produce? All right. Now here's and I think it's very cool. And I hope the audience picks up on the fact that even though Mark Cuban was an outspoken critic of the campaign, he says, I'll work with him in a second. That's very cool, and we need more of that.

So long COVID, what have you observed in terms of clinicians trying to use drugs off label to deal with this monster of an emerging reality of long COVID and vaccine injuries? You know, I don't have any data one way or the other on long COVID or vaccine injuries. I just read the same things from JAMA and others that everybody else reads.

And so I really can't add anything to the discussion. I know a lot of people who feel like they have long COVID, so to me it's real. The data seems to say that it's real. So I'm not going to question it. And vaccine injuries, you know, I don't have any data at all. You know, I played around with bars and downloaded the database. And, you know, you could say that, you know, a Martian gave you this illness and people aren't gonna know, so it's hard for me to say. Yeah, theirs is not the solution. Are you open to that avenue of revenue and access though,

that like long COVID and vaccine injuries, there are gonna be things that get solved through a concoction, like a cocktail of different medicines that obviously weren't made for that. And there's gonna be an opportunity to platform what clinicians come up with, and they're gonna need a home. Is that something that Cost Plus Drugs is open to?

Yeah, I don't see us really, I don't want us to get in the picking winners and losers business. You know, that's a whole different game. But I get your point that, you know, I don't see us really, I don't want us to get into picking winners and losers business. That's a whole different game. But I get your point that, but I'm a believer in science and the scientific method, that if there are clinicians that come up with combinations of drugs, just like ivermectin was, HCQ were options, and then the studies were done and we saw the results.

And I think the same thing will happen here. You know, we don't try to invest in new drugs or discovery of drugs. We just, you know, like I said, we have 60 employees and we try to stay lean and mean because that's how we're going to offer the lowest cost. That's how we're going to be the lowest cost option. And so I don't want to get into a whole different business. I just really want to stay focused because in my mind, if we can bring transparency, if we can reduce costs as much as we think we can, then that changes healthcare enough

for people to be able to afford other options for more money to be spent on research for new things or to do the analytics to determine if this, this, or this, you know, that works. You were talking about the TENT program earlier as a supplement to the ACA. The propaganda, I would call it, of getting rid of the ACA has died down in Trump land.

Now he's talking about fixing it. If anything, he hampered it in his first administration, cutting marketing money, getting rid of the individual mandate through the court system. Do you believe the ACA is a sustainable model and what does it need? Yeah, it's certainly a sustainable model. You can tweak it in a lot of different ways. What's the medical loss ratio?

How is it accomplished? What's included or not included? I think you can deal. I think the more important thing though is when you bring the challenge with the ACA and any solution is if you don't have good pricing data, you don't really know how well it could work with any tweaks or changes. You know, you can say the same thing with single payer. If I know what the cost of every single medication is on a net basis, no rebates, no nothing,

just an absolute cost. Well then, there's no reason why we couldn't replicate what Canada does to a certain extent and say the city of Dallas says, you know what, we're going to pay for all the medications on this list for the entire city because we can actually determine how much it's going to cost us on an annual basis and we can afford it. Or a company can just say, look, no cost for drugs, zero co-pay because now we know the actual costs and we've been able to negotiate them down.

And the same to a certain extent on healthcare. Once you know definitively what something is going to cost, then you can come up with a budget. And if you can afford to cover that budget, whether it is in a household, in a company, in a state, or the entire country, you can talk about single payer as an option. I'm not saying it's the best option, but you can consider it. You can't do that without transparency and prices on the pharmaceutical and the health

care side. Without transparency, there's always going to be uncertainty about the ACA because the underpinning of the uncertainty is the cost. The cost of premiums, the cost of the deductible, who's subsidizing what and for who. If you push the price down, the cost down, all those discussions become far easier. So I should have asked you this question like third, but why is that?

Most service industries, of course, you have to show your pricing structure with your prospective buyers. Why isn't that the case here? Just the way the industry has evolved. You've got players that have come in and they've become vertically integrated. And the number one rule of pharmacy benefit contracts,

the number one rule of all healthcare contracts is you don't talk about healthcare contracts. They literally say right at the beginning, you cannot disclose any of this. And going back to politics, maybe that is the solution. Take out non-disclosures from any healthcare contract. And my preference is they're published because why would you not publish it? Because it's in the best interest of the consumer, It's the best interest. You know, if I'm with my companies, why not publish, right? That helps your marketing. So, you know, I think the reason why it's been distorted like this is because it's economically viable. It really helps the big companies. And the more they vertically integrate, the more control they have over contracts. And if there's non-disclosures in those contracts,

you can introduce anything and nobody knows. You know, I don't know about you, but I am very non-conspiratorial. I believe that that's intellectually lazy. On the same way. Big Pharma's getting close. And just the other day, the idea that they buy up over 70% of the commercial time on

cable television or whatever it was, I had no idea. And I'm on cable television. And I had no idea. Is it naive to think that with the, you know, literally nine digits of lobbying that they spend on a regular basis that you will see anything that changes their profit model? Well, there's a lot to unpack there. When I talk about the pharmacy benefit managers, not only are patients and the companies that pay their insurance bills for those patients disadvantage, but so are the manufacturers.

And the rebate system that these pharmacy benefit managers have implemented, they push up the retail price of medications and they obfuscate the net pricing of those medications to the self-insured companies and self-insured or uninsured patients. And so part of the response is why are they spending so much in advertising is a lot of it's because they have to because they have to generate as much sales as possible because the net revenues they get aren't nearly what you believe them to be. I'm not saying I'm not pleading poverty for them at all. All I'm saying that this system is so convoluted and back-ass half-words that it also negatively impacts the

manufacturers. And I've seen that firsthand from the pharmacy benefit managers. Now those pharmacy benefit managers also intimidate those farmer manufacturers. And I'll give you the example, and that's costplusdrugs.com. There's a lot of branded medications that we can't sell, not because the farmer manufacturers don't want to sell through us, but because they know that if they work with us and our pricing is transparent, those big pharmacy benefit managers that control access for drugs to hundreds of millions of people, they're going to take them off their formularies

or de-emphasize them on the formularies and that's going to cost them hundreds of millions if not billions of dollars. And so when they go out there and advertise all the time, I kind of get it and why they're doing it, but it also says that there's a lot of margin there, right? And so if they pull that back, so if we can fix it from top to bottom, starting with the pharmacy benefit managers, starting with the vertical integration

with insurance companies and get down to net pricing so it's transparent, then there's a lot of foundation to go to the pharmaceutical companies and say, look, we know what your net price is now. We know what you're able to sell because all this data is now readily available. The fact that you're marketing it, why? You know, why is that margin dollar there? And part two to that, this is probably if we were on Shark Tank and I was pretending to work for a pharmacy manufacturer, they

don't see their claims data. They don't know who they're selling to, not individually, but the types of sales. They don't have access to all their claims data. So even with GLP-1s, where everything is focused right now, they don't really get access to data. They try to buy through the PBMs. PBMs don't sell them everything. So in a lot of respects, they're flying blind.

And then there's these other 340B programs where certain providers will double dip and charge them twice. It's such an opaque industry that all of these costs add up for everybody. And the primary beneficiaries are the pharmacy benefit managers. You don't want to pick winners and losers.

How do you balance that with any concerns that you or the team has with you talking about GLP ones, the idea of Ozempic and that whole class of drugs that are very fatty right now, pun intended, that, ooh, wow, are we selling something or making it easier to buy something that a lot of people are using that shouldn't?

Yeah, I can't, I gotta trust doctors at some point. You know, if we wanna have a conversation of are doctors doing what they're supposed to do? Is there self-interest? Are too many of the big companies, big insurance companies, or big hospital networks buying up too many private practices and doctors and literally controlling them? That's a conversation to be had. But from my position, I can't be in the job of trying to pick winners or losers or second-guess doctors. To me, that just complicates things even more and adds cost to the system, makes it more

opaque. Why did you make this decision, Mark? Well, let me explain it. Well, I don't agree with you, yada, yada, versus, okay, if there's a doctor like we saw in the opioid crisis, if there's a doctor that's a pill mill or a GOP-1 mill, then if we're transparent and the data is readily available to the sponsors, the people paying for it, then we have a path with which to deal with it.

If it's opaque like it was with the opioid crisis, then you may recognize it, but it's much more difficult to deal with. Do you have the ability to crunch data and let public officials know, hey, people are buying a lot of oxycodone in this one place? We don't because we don't sell controlled substances yet.

We've made the choice not to because like we've only been doing this two and a half years and we've got to really get organized and be able to scale. But at some point when we do, we'll be able to, and it won't be because, well, we'd be able to see the scripts that were coming from all from one doctor or two doctors or three doctors

or this practice. And so yeah, we'd be able to call attention to it. And I think legally we'd be required to. Oh, I wonder if you would. I wonder if you'd be... I believe so, but I'm not positive. Ethically you would. Yeah, ethically we would for sure.

But we're not selling those controlled substances yet. After this is, this has been your most high profile political activity to date, may not be in the future. I'm a big buyer of more Cuban on the national landscape. You know this well. But what were the three lessons? I mean, it doesn't matter. I'm you know, I'm not going to it's like last season's last season. The minute the Mavs lose the last game, if we don't win a championship, all everything changes by the next season, new draft picks, trades, etc. And there's no reason to relitigate last season. And that's the way I'm looking at this. You know, I'm

gonna go in with an open mind. I'm gonna go in, you know, with a positive attitude and come January 1st, we'll see what happens. You know, we'll learn lessons. I can guess, but we don't really know. You know, like I said before, I just don't want to add myself to the pile of people who are guessing and relitigate what happened. What matters is what starts on January 21st, and when they play the games, to use the metaphor, we'll see what his draftees do, and we'll see how they perform. And then it's fair game, just like they took shots, deservedly, many times at Biden and Kamala Harris. Well, we'll have the same opportunity and come 2026,

we'll know a lot about how people feel about the first two years of this upcoming administration and we'll go from there. I get it in terms of the autopsy of the campaigns. I don't want you on that pile either. Personally to you, what do you know now about that game that you didn't know before you stepped up? That it's not as brutal as sports is.

You know, I got a lot of crap from a lot of people about a lot of things, but that's nothing compared to when the Mavs lose. It is nothing, you know? I mean, people are very emotionally invested in politics and sports, but the level is far greater in sports.

And part two to that is it really depends on where you go look for information and where you get feedback from. If you're on Twitter, I'm public enemy number one, or at least top 10. I'm on the FBI's most wanted list, Twitter's's most wanted list but anywhere else that's not the case in real life The same people who might bash me, you know and comment about my classes Aren't saying anything to me face to face 230 pounds. No, no, no, no. That's why.

I'm 62, but yeah, I get your point. But if I go on Blue Sky, which I really like now, it's a completely different tenor. If I go on Threads, it's a little bit, but it's a completely different tenor. All I have to do is stay off of Twitter, and life is grand. And that's actually the lesson, if you will, that we live in a social media environment. And when you're on the biggest social media platforms, your algorithm is geared uniquely to you. What you see on YouTube, what you see on Instagram,

what you see on Facebook, what you see on Twitter, those platforms define their feeds what you see on Instagram, what you see on Facebook, what you see on Twitter, those platforms define their fees based off of how you flip through and how you scroll through. And if there's a lesson to be learned, not from me personally, but from a more general perspective, I think companies, not just candidates, have to recognize that, particularly now in a more AI-driven

world, you have to create an unlimited number of advertising or limited number of content so that you hit the feed that you're trying to hit. And all those pieces of content have to be uniquely or have to be different and in some cases unique. And that's where AI will play a big part. We've seen, you know, the funny videos that show Trump and Biden together, smoking a cigar or bowling or whatever, you know, imagine millions of those. Tens of millions of those.

And they're put out there and loaded and advertising is bought with the goal of Chris getting the video that's designed for Chris, Mark getting for Mark, the 16 year old kids each getting their own. It's scary in some respects, but that for me from a candidate and a corporate perspective, that's the lesson. That's part one. Part two is communities drive everything. And you saw a Trump community on Twitter that grew and grew and grew, a lot of it because of Elon and him pushing the algorithm

that direction and him being the largest account. But again, even for corporate programs, whether it's talking about cost plus drugs, talking about selling cars, whatever it is, communities are stronger now because people use social media for so much of their time that they connect to people more strongly on social media because it's easier. It's the path of least resistance to find common interests for better or worse. And so I think that is going to be the lesson that candidates and parties and products

all take from the lesson. And then finally, and I said it wasn't gonna get too political, but finally- This isn't political, this is citizenship that you're talking about. Well, no, yeah, but still, you gotta be a good salesperson. You gotta be able to sell your product. This is no law, people are like,

oh, it's the Republicans and it's the Democrats. Neither party really matters anymore. They're fundraising mechanisms. But Donald Trump took over the Republican Party and made it a family business. Kamala Harris did her best in 120 days or whatever it was to take over the Democratic Party and make it about her. And it was really those two candidates against each other. And who do people trust more?

And they trusted Trump a little bit more. And those 240,000 votes across those seven swing states, that's all it took. We can argue about why, but Donald Trump was the better salesperson. He built a better community and they trusted him more for because he, in my mind, because he was a better salesperson. And because, you know, going back to the tech side of it, they're still learning how to use, candidates and companies are still learning how to use social media

and that the uniqueness of every feed to their advantage. Yeah, it's so, it's so, it's so comical to me. The media loves to eat itself, loves to criticize itself, right? Loves to criticize other people even more. But the latest round of that, in my opinion, is the impact of the podcast.

There's no question that podcasting is a thing, digital media is a thing. But the idea that Rogan is now the new place where every candidate has to go. Well, he has amazing reach. People go on Rogan, not so much for him, but because of his reach, right? And he has his reach because of time and him.

And he's earned that reach, his credit. He's earned that reach. Absolutely. He wouldn't have me on. I DM'd him twice, multiple times. Have me on, he won't have me on. He doesn't want to have you on because he is in the open-ended

conversation business with people that he largely agrees with. And you are a tough interview. Oh, I am? Yeah, oh yeah. I'll tell you why. You have a ton of information coming out of you. You can dominate a space if you want to. I mean, I've found you fairly collegial, but you are not a joke.

You know what you're talking about. And you have a very definite point of view. So if someone, you know, the way that the, well, yeah, but isn't that kind of weird? Like what you're doing, isn't that kind of weird? You know, you are a- Yeah, I'm gonna think you're, go, go, go, go, go, go. Yeah, you are like, no, it's not weird. What's weird is that the, well, yeah, but isn't that kind of weird? Like what you're doing, isn't that kind of weird? You know, you are a- Yeah, I mean, you're like, go, go, go, go, go, go, go. Yeah, you are like, no, it's not weird.

What's weird is that you said that. And I'm gonna give you three reasons. And there is a compliment in him not wanting you on. I interviewed, I sat down with Tucker Carlson and I said to him, man, why, why'd you tear into my ass so much when I was at CNN? I didn't even know you. And he goes, well, you were the big dog over there.

And I'm a dick, but you were the big dog, so we went after you. And I realized that you had arrived in that way within the campaign dynamic when Megyn Kelly who you know did what they're all doing now, which is bowing to Trump, right? Because you need his audience if you want to be on that side of the line.

And she said, I love owning Mark Cuban. And I was like, I don't even remember this. So I went back and looked, and obviously they were taking something you had said out of context, but I don't even know what she was referring to that she had owned Mark Cuban. And I'm going back and looking for interviews

and looking for things, because I've never seen that happen to you, because you never go into a place not knowing. They can't twist your contacts. Well, I'll tell you what happened with Megan Keller. Yeah, what happened? I'll tell you what happened with Megan Keller. So like four years ago, she started her podcast or interview program,

whatever it was, and she had me on. And I had a nice relationship with Megan. And so I thought, sure, I'll come on just to be nice. And the interview started off very cordial, my family, my background, business, this and that. Then all of a sudden, and it was like, well, what about the NBA and you and China? And that was a very dicey issue because that was when Darrell Murray had said something about Taiwan and he created all these issues. And I had to talk around it a little bit. What about the Uyghurs?

I talked around a little bit, but gave her an answer that, you know, I'm against all human rights violations. And she didn't go for it. And that got picked up a lot. But what she didn't say, and this is probably the first time anybody's hearing it, is she had asked me questions in that interview, starting off, and I don't remember it verbatim, starting off talking about Nazis and Hitler. I'm like, are you sure you want to go in this direction and ask me questions like that?

And she cut the whole thing out. Why was she talking to you about that? I don't remember specifically what the reference was to. And right afterwards, I asked the producer for a copy of the entire interview and they wouldn't give it to me. And they cut it out of the final interview. So, you know, if she wants to think she owns me, that's great.

I don't take anything away from Megan. You know, that's, there's more money on the right in terms of podcasts and advertising, despite what a lot of people think or say, and more subscribers to things. so more power to her. She's doing the best she can, she's had her ups and her downs, and she's fighting her way back.

So nothing personal against Megan. Okay, now here's the question that you hate, and I ask you it all the time, in full disclosure, I do it in private as well as personal. I think that one of the problems we have in our country, okay, not just our politics, we have so many amazing people in this country, and they don't get into service

because it's so ugly because of people like me. And tearing up and finding out the one time that you got a shot pinned in a basketball game and whatever stupid thing I can find. So it's not worth it. It's not worth it to the family, it's not worth it to the business, it's not worth it. It's not worth it to the family. It's not worth it to the business. It's not worth it to the legacy,

even though you'd like to serve. I put you very high on that list of proof of concept that we got Mark Cuban in this country finding all kinds of ways to do shit. He can't be running for office. What's the answer? Ranked choice voting. Ranked choice voting because you get away from the polar

opposites. Correct. And so you have to get through a primary system where doesn't require a lot of votes. And the most extreme candidates gets the most attention and enough money to put them over the top to be the candidate in the general. And with ranked choice voting, you know, it's just like, you know, you can have four, five, six, seven, ten candidates and you get to pick your best candidate. And if that candidate doesn't get 50%, then the next year vote goes to your second choice until one of the

candidates gets more than 50%. It's simple. It's easy. It works. And what's crazy, like if you look at Maine and Alaska, the two senators from Maine and Alaska, they're able to, you know, when the whole impeachment thing with Trump, they were able to vote against them. You see them going against other Republicans all the time because in a rank choice world, you don't worry about being primaried

by somebody who's extreme. And so, I'm a huge proponent of rank choice voting. The incumbent parties don't like it because it takes away a lot from the power structure. It reduces the impact of money. It opens the door for people outside the parties to run and succeed. And so it makes sense that they wouldn't be for it.

They come up with all, oh, it takes too long to calculate. Well, damn, California still hasn't finished calculating. It can't take that long. So the resistance is kind of ridiculous, but to me, that is the delta. Because you can't, when the focus is on two candidates, you get one level of attention when you have to really address five

and you don't really know. And just think about it, right? If there were, you know, five, if you could pick, if there were two more candidates and you could rank your votes just in the presidential election, right? We might have a completely different outcome. 100%.

Mark Cuban, I appreciate you taking the opportunity. I want the audience to know, I chase after Cuban on a regular basis. And thank God he doesn't have an Apple phone because I thought he had blocked me like three years ago because the messages were growing green. I got one of everything. I've got an iPhone, I got an Android, you name it.

But I'm a big fan and I'm a big believer in what you do. Thank you. And you always have an opportunity on any platform I'm on at any time. And if you need anything, I'm a call away. Yeah, I appreciate it. And when you were chasing me, you were nice about it. And I always responded.

Always. Most of the time, most of the time responded. Maybe a couple of times I missed, but because I respect you, Chris, and I respect the work you do. And know, you keep on grinding and that's always important because you have something to say and you do the work. That's the more important part. I like how you're prepared. Thank you very much, Mark Cuban. If there's anything I can do as you guys go to the next phase with cost plus drugs.com. Let me know because it's part of the solution. Please, everybody go check out no matter what medication you have, go to costplusdrugs.com, put in the name of the medication and if we carry it, compare it to the price you pay, compare it to your deductible because there's a really, really good chance, particularly

if it's a generic medication, which is 92% of prescriptions, there's a really good chance we're less than your deductible. I'm not saying this should be the tagline, but a friend of mine uses, uh, this service. And I was like, why that one? He goes, Cuban doesn't need the money. That's what he said. He's like, Cuban doesn't need the money. So if he's doing this, my next dollar is not going to change my life, but it feels really fucking good to turn this industry upside down. Well, I appreciate you. Good luck. And I'll talk to you again.

Thanks, Chris. Take care, buddy. I really do believe that you may not vote for them, but isn't that the caliber of people that we should have leading us in America, or at least competing to? I mean, I don't know. I think talent is a big thing. But I have to tell you,

the idea that they don't have to show their prices before our insurance plans decide what we're going to pay for the drugs and medicines that we need is cray cray. What did you think? Let me know. Thank you for subscribing and following here at The Chris Cuomo Project. I'll see you at NewsNation every night, 8p Eastern, weekday nights of course. I don't work weekends. Work on my tan. Hey, I like the podcast, but I wish there hadn't been those ads. I love my advertisers.

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