Mark Cuban Cost Plus Drug Company launched in January 2022 with a direct challenge to the US prescription drug pricing system. The company, founded by radiologist Alex Oshmyansky and investor Mark Cuban, strips out pharmacy benefit managers (PBMs) and sells generic medications at a fully disclosed formula: the manufacturer's acquisition cost, plus 15% markup, plus a $5 pharmacy service fee, plus $5.25 shipping. Nothing is hidden.
By 2026, the company carries more than 2,200 generic drug products, shipping to all 50 states. The savings on some drugs are extraordinary. Imatinib, a cancer drug with a traditional pharmacy list price near $2,500 for a month's supply, costs $13.40 at Cost Plus Drugs. Common generics such as metformin, lisinopril, and atorvastatin run $3 to $8 per month. The model works best for people paying cash, those without drug coverage, and those whose insurance copays for specific drugs are higher than the Cost Plus Drugs total price.
There is a key limitation: Cost Plus Drugs does not accept Medicare Part D or most standard insurance plans. Payments are out-of-pocket and do not count toward insurance deductibles or annual out-of-pocket maximums. Medicare beneficiaries can choose to use it alongside their Part D coverage, paying out-of-pocket, if the Cost Plus price beats their plan copay for a specific drug. In May 2026, the service was incorporated into the federal TrumpRx.gov platform alongside Amazon Pharmacy and GoodRx, giving patients a single comparison point across discount options.
What Cost Plus Drugs Guide Costs by Point of Pay (2026)
The price you pay depends almost entirely on WHERE you pay. The same cost plus drugs guide can cost many times more at a hospital than at your local pharmacy:
2026 Cost Plus Drugs Guide Price by Point of Pay| Where you pay | Typical cost | Notes |
|---|
| Retail pharmacy (no insurance) | $25 - $300/month | Standard cash price at CVS, Walgreens, Rite Aid for common generics |
| Cost Plus Drugs (out-of-pocket) | $3 - $14/month typical generics | Manufacturer cost plus 15%, $5 pharmacy fee, $5.25 shipping. Does not count toward insurance deductibles. |
| Medicare Part D (2026) | Varies by plan and tier | $2,100 annual OOP cap. Cost Plus Drugs does NOT accept Part D; use for comparison only. |
| Medicaid | $1 - $4/prescription | For income-qualified enrollees; lower than Cost Plus Drugs if you qualify |
Cost Plus Drugs pricing: manufacturer acquisition cost plus 15% markup, $5 pharmacy service fee, $5.25 shipping. Prices vary by drug and quantity. Does not accept Medicare Part D or most insurance.
Source: Cost Plus Drugs pricing model (costplusdrugs.com), CoverRight Medicare analysis 2023
Why Hospitals Charge So Much
Traditional pharmacy pricing in the US runs through pharmacy benefit managers (PBMs) -- middlemen who negotiate between drug manufacturers, insurance companies, and pharmacies. PBMs collect rebates from manufacturers and spread the difference across complicated fee structures that mark up the base drug cost by multiples. A generic drug with a $0.10 ingredient cost can reach $20 to $50 at retail after PBM fees, dispensing fees, and profit layers are stacked in.
Cost Plus Drugs eliminates the PBM layer entirely. The company negotiates directly with generic manufacturers for the lowest acquisition price, then applies a fixed 15% markup (the same across all drugs), a flat $5 pharmacy dispensing fee, and a flat $5.25 shipping fee. Every component is disclosed at checkout. For patients comparing Cost Plus Drugs against their Part D copay on a specific drug, the math is often compelling. For patients comparing it against Medicaid copays of $1 to $4, Medicaid wins on price -- but Cost Plus Drugs has no income requirements and no enrollment process.
Hospital inpatient drug charges follow a different markup logic: hospitals apply "facility rates" that bundle drug acquisition cost with nursing administration, storage, and overhead. Generic drugs that cost a hospital $1 to $5 to acquire can appear on a patient bill as $50 to $200 per dose. Cost Plus Drugs is relevant only for outpatient prescriptions filled at home -- it has no role in what a hospital charges during an inpatient stay. Patients who receive hospital bills for drugs like imatinib should use the 2026 Medicare ASP rates as a benchmark for disputing inflated charges.
Patient Assistance Programs
Cost Plus Drugs itself functions as a direct savings pathway for the uninsured and underinsured. For patients who need further assistance beyond what Cost Plus Drugs offers, manufacturer patient assistance programs (PAPs) may provide free drugs for income-qualified patients:
Patient assistance programs for Cost Plus Drugs Guide| Manufacturer program | Cost / Benefit | How to apply |
|---|
| Cost Plus Drugs Direct (any drug in formulary) | Manufacturer cost plus 15% plus $5 plus $5.25 shipping. No income requirement. | costplusdrugs.com |
| NeedyMeds Drug Assistance Database | Free or low-cost drugs from manufacturers for income-qualified patients (varies by drug and manufacturer) | needymeds.org |
| RxAssist Patient Assistance Directory | Database of manufacturer PAP programs; free for patients who meet income thresholds (typically up to 200-400% FPL) | rxassist.org |
Cost Plus Drugs has no income requirement. Manufacturer PAPs require income verification and are best for uninsured patients with income below 400% FPL.
Source: costplusdrugs.com, NeedyMeds.org, RxAssist.org
Medicare Part D
Cost Plus Drugs does not accept Medicare Part D. If you are enrolled in Medicare, you cannot use your Part D drug benefit to pay at Cost Plus Drugs. However, you can still choose to pay out-of-pocket at Cost Plus Drugs if its cash price for a specific drug is lower than your Part D plan copay. That payment will not count toward your 2026 annual Part D out-of-pocket cap of $2,100. For Medicare beneficiaries with high drug costs who qualify for Extra Help (Low Income Subsidy), the program sets Part D copays at $5.10 for generics and $12.65 for brand-name drugs in 2026 -- which is often lower than Cost Plus Drugs on a per-drug basis once shipping is included.
Common Cost Plus Drugs Guide Billing Errors
When using Cost Plus Drugs, watch for these common issues that can affect your final cost or your insurance coverage:
- Assuming Cost Plus Drugs purchases count toward your insurance deductible or out-of-pocket maximum. They do not -- payments at Cost Plus Drugs are out-of-network cash payments.
- Using Cost Plus Drugs for a drug that is on your insurance formulary at a low copay. Always compare the total Cost Plus price (ingredient cost plus 15% plus $5 plus $5.25 shipping) against your plan's copay for the same drug and quantity before ordering.
- Expecting Medicare Part D to reimburse a Cost Plus Drugs purchase. Part D does not reimburse out-of-network cash pharmacy purchases.
- Ordering a brand-name drug through Cost Plus Drugs when a generic equivalent is available and listed separately. Cost Plus Drugs' savings come entirely from the generic formulary -- brand-name drugs offered there still carry list-price-level costs.
Frequently Asked Questions
How does Cost Plus Drugs calculate its prices?
Cost Plus Drugs uses a fully transparent formula: the manufacturer's acquisition cost for the drug, plus a 15% markup, plus a flat $5 pharmacy service fee, plus $5.25 for shipping. Every component is disclosed at checkout. There are no PBM rebates, no hidden fees, and no coupon gimmicks. The total for many common generics runs between $3 and $15 for a 30-day supply before shipping.
What drugs are available at Cost Plus Drugs in 2026?
As of 2026, Cost Plus Drugs carries more than 2,200 generic drug products shipped to all 50 states. The catalog includes common generics across diabetes (metformin), blood pressure (lisinopril, amlodipine), cholesterol (atorvastatin, simvastatin), psychiatric medications, antibiotics, and cancer drugs (imatinib, gleevec generics). The company has a Texas manufacturing facility producing some injectables. The full up-to-date list is at costplusdrugs.com/medications.
Does Cost Plus Drugs accept Medicare?
No. Cost Plus Drugs does not accept Medicare Part D. Medicare beneficiaries can still use the service, but they pay fully out-of-pocket and those payments do not count toward their annual Part D out-of-pocket cap ($2,100 in 2026). The only case where using Cost Plus Drugs makes financial sense for a Medicare enrollee is when the out-of-pocket Cost Plus price for a specific drug is lower than the Part D plan's copay for that same drug.
What is the imatinib price at Cost Plus Drugs versus retail?
Imatinib (generic for Gleevec, used to treat chronic myeloid leukemia and other cancers) costs approximately $13.40 for a 30-day supply at Cost Plus Drugs. The traditional retail pharmacy price for the same supply is approximately $2,500. That is a savings of roughly $2,486 per month on a single drug. Research published in peer-reviewed journals has confirmed these savings figures for imatinib and other generic oncology drugs.
Can I use Cost Plus Drugs if I have insurance?
Yes, but there is a trade-off. If you have private insurance or Medicare Part D, you can still use Cost Plus Drugs -- you just pay cash and your insurance is not billed. Patients do this when their insurer's copay for a drug is higher than the Cost Plus Drugs total price including shipping. The downside: those payments do not count toward your deductible or annual out-of-pocket maximum.
How does Cost Plus Drugs compare to GoodRx in 2026?
Both reduce prescription costs, but through different mechanisms. GoodRx works by negotiating discount codes you present at a participating pharmacy; those transactions still run through a PBM. Cost Plus Drugs bypasses the PBM entirely and ships directly from its own pharmacy. For common generics, prices are often similar. For specialty generics like imatinib, Cost Plus Drugs is dramatically cheaper. As of May 2026, both are part of the federal TrumpRx.gov comparison platform.
Does Medicaid pay less than Cost Plus Drugs?
Yes, in most cases. Medicaid enrollees typically pay $1 to $4 per prescription regardless of the drug. Cost Plus Drugs' minimum total -- ingredient cost plus 15% plus $5 pharmacy fee plus $5.25 shipping -- is generally $10.25 or more. If you qualify for Medicaid, use Medicaid first. Cost Plus Drugs is most valuable for people who are uninsured, underinsured, or whose insurance copay for a specific drug exceeds the Cost Plus price.
Who founded Cost Plus Drugs and how does it work?
Cost Plus Drug Company was founded in January 2022 by radiologist Alex Oshmyansky and entrepreneur Mark Cuban. Oshmyansky serves as CEO. The company is headquartered in Dallas, Texas, and operates its own 22,000-square-foot manufacturing facility in Deep Ellum, Dallas. It ships medications in all 50 states. The business model eliminates pharmacy benefit managers by purchasing directly from generic drug manufacturers and selling at a disclosed cost-plus formula.
