The Ugly Truth Behind Soaring Drug Prices (And How To Fix Them) w/Dr. Alex Oshmyansky

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Parasitic middlemen and others in the healthcare industry are gouging patients who can't afford live-saving medications. Dr. Alex Oshmyansky of the Mark Cuban Cost Plus Drug Company teaches us who they are (oh yes, we name names) and how we can fight back to make meds affordable again. A must-watch for patients and caregivers struggling with the high cost of prescription drugs.
Our prior interview from 2021: zdoggmd.com/alex-oshmyansky/
Mark Cuban Cost Plus Drug Company: costplusdrugs.com
Podcast version and more here: zdoggmd.com/mark-cuban-cost-p...
Dr. Alex Oshmyansky is the Founder and CEO of the Mark Cuban Cost Plus Drug Company. He graduated from the University of Colorado at Boulder at the age of 18 with a BA in Biochemistry. He went on to earn an MD at the Duke University School of Medicine and a PhD at Oxford University in Mathematics as a Marshall Scholar. Alex completed a surgical internship at the Brigham and Women’s Hospital / Harvard Medical School. He went on to a residency in diagnostic radiology and a fellowship in pediatric radiology at the Johns Hopkins Hospital. Alex then served as an adjunct faculty member at the Stanford University School of Medicine and continues to practice as an emergency radiologist.
Topics & Timecodes
00:00 Intro
2:08 About Alex, the inspiration for Cost Plus Drugs
9:34 Why drugs cost so much, price gouging, parasitic middlemen (PBMs)
18:23 Who ultimately suffers?
25:29 Breaking the system, price transparency, the problem with “discounts”
31:18 Financing this model, negotiating directly with drug manufacturers, Mark Cuban, simple pricing
38:55 How providers can prescribe using costplusdrugs.com
42:12 Employer incentives, the Health 3.0 vision, building a new (less corrupt) system
51:06 Primary care, concierge care, importance of preventative care
1:07:03 Med expiration dates, working with Mark Cuban
1:11:52 Finding a sense of purpose (both personally & within your team), founder stress & burnout
1:20:30 Final thoughts
Video archive, audio podcast, music parodies, Supporter Tribe membership, merch, social media, and email: lnk.bio/zdoggmd
Support us with a 1-time donation and get a personal email thank you from me: paypal.me/zdoggmd
More about Dr. Z: zdoggmd.com/about-z

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1 июл 2024

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Комментарии : 129

@corgicuttie Год назад

Ambulatory Care Pharmacist here! Yes!!! Get rid of PBMS so that your community pharmacist can KNOW YOU and help you improve your health and reduce your medication burden. We know so much and want to help.

@kathytrawick3554 Год назад

What is the name of your pharmacy?

@kathytrawick3554 Год назад

Costplusdrugs?

@maggieg771 Год назад

I ♥️Pharmacists! When I was a new NP-C & was still learning the ropes beyond allergies- like copays & several other $ issues, the Pharmacists walked me through the steps. Several also told me I was welcome to call them even if it wasn’t their facility as long as it was a calc issue, we were colleagues! Nobody died! Funny how now I live next door to my favorite Pharmacist in my decade+ of being an NP! Initially, I thought he may have been doing drugs. NOPE! IDDM, not particularly stable. These days, I just happen to live next door to him. Am not standing around w/ binoculars but if his car doesn’t move for > a couple days, I ask his ex-in-laws who live on the other side of us if he’s OK (after I once told them that I knew him as a Pharmacist) & they give me a skinny. All three know am available, day or night. Grateful to be able to have his back in retirement as he had mine when I was a new NP.

@jopainting1668 Год назад

@@kathytrawick3554 find your local independent pharmacy and start talking with and learning from the pharmacists there.

@drbadia Год назад

I write about PBMs in my book, Healthcare from the Trenches. I hope that physicians could better collaborate to bring this type of information to the public eye. Thus far, it has not happened.

@wilyliam Год назад

I would happily watch this entire video twice just for the part about complex financial products being scams. I have been trying to tell my friends for years: Remember back in our 20's, when you'd go out for drinks and dinner with 6 or more people, you're trying to split the check and there's always one person who takes everyone's cash and then distributes everyone's change? The "math" was always insanely complicated and, if anyone feels they didn't get the right amount of cash back the answer is always: "Oh no, that's right, you just aren't getting the math ... don't worry it's fine!" That was, of course, complete bullshit - and so are super complicated financial products and PBMs and any other obvious shell game financial schemes.

@charleskraft781 Год назад

I may never watch TV again! The world these smart well-informed people bring to me is fascinating.

@angieworks5890 Год назад

Just spent half my work day appealing denied PAs… I’ll just have the PCPs send the Rx here. Thank you 🙏🏼

@dupzales Год назад

The US has an incredible distribution system (local independent pharmacies) that provide healthcare across the country, down to small towns that the big box chain pharmacies would never open in, and the PBMs are crushing them, putting them out of business. It is way past time for this madness to stop, before these “pharmacy deserts” become the norm, and the average person had very limited access to the healthcare they deserve.

@david2049 Год назад

I just checked at work and sure enough it pops up as an option in EPIC

@dawnwerby5807 Год назад

I can speak to the primary care situation. Just recently I lost my PC of 25 years to being overworked, she carried a load of 1,800 patients and never saw her family. She has switched over to concierge medicine now with a load around 300 patients. Trying to find a PC with an appointment that isn't 6 months out is impossible, we are in desperate need. Thank you for this video today very insightful.

@robertfox4524 Год назад

TRUTH. I work ER as a PA. The ER is often utilized for primary care by people. I'm really not trained for that, don't enjoy it, and don't do a good job of it. The system desperately needs to change.

@dawnwerby5807 Год назад

@@robertfox4524 I just sat in ER for 6 hours waiting for my Mother to be seen, we were seated by check-in and I was so angry over the crap that came to ER 60% of the people could have gone to Urgent care, made and appt with a Dr or taken a damn Tylenol! Sometimes PCP's are guilty because they send people there just for tests and scans too. Change needs to happen without taking away patient care.

@griffshark Год назад

ZDogg, this is amazing and amazingly depressing. Thanks for Bringing Dr. Alex to us.

@sheriquintana2543 Год назад

Don’t fight the old, create something new ✨

@darlafitzpatrick8770 Год назад

Please tell me they are reaching out to state governments and their self-insured health plans. There's nothing sexier to voters than state governments saving a shit-ton of taxpayer money while still attracting and retaining quality government workers by offering good health benefits. I know, I'm one of those government workers with past work experience in health insurance.

@richardhoskins1894 Год назад

Great overview and commentary as an American in Australia it provides insights to the systems here also

@sarahbreisch4750 Год назад

"It's amazing how much of life is just what your elementary school teachers tell you." That one little line fro you guest had me in tears. I'm doing my best to advocate for my kids with their teachers, especially my 9 year old right now. See them as individuals, for the love of God. I'm so glad I was homeschooled. I wish I could offer that to my kids. But at least I can be in their corner.

@BigOrangeMountain Год назад

Would you guys consider talking with members of Congress about this? It is a bipartisan issue and should be topic #1 in our elections; it involves our own healthcare as well as our national economics. Congressman Khana from California and Congressman Gaetz from Florida are both very reasonable people from opposite sides of the aisle known for responding to those with good ideas that would be potential resources for federal advocacy. We need to change this, it is unacceptable.

@ronaldthomas7221 Год назад

I shared this immediately. Thank you. Just thank you. Zdogg, Alex and The big M.C. God bless you all

@brighteyes1016 Год назад

Thank you both! I will be sharing this with my lovely, local pharamacist!

@user-gn2yq2gg5c 9 месяцев назад

Just found this video. Thank you for what you guys are trying to do. I'm a Superficial Siderosis sufferer with medication that costs $9k per month in U.S. Something needs to be done.

@tallleprechaun1318 Год назад

Great to see a follow up on this company. I believe that the last one came out just before the pandemic

@lindabruce2295 Год назад

Thank you, thank you, thank you!

@venesaingold9390 Год назад

Retired anesthesiologist here..The pharmacist in hospital told my husband and I that his chemotherapy would be $10,000 each dosage every 6 weeks but with our insurance , it is $20! My response to him was that it is really sad for the uninsured who have to die early. He agreed.

@katdunleavey Год назад

Or an uninsured patient may qualify for charity care and get the treatment for free. Another option is paying a reduced cash price, though this could bankrupt a middle-class family.

@RevAnakin Год назад

Shared with all my physician friends and internal network. Thank you!

@benjaminkelser138 Год назад

Great video, learned a lot. Thank you both!

@mercedeswarrenash5929 Год назад

Thank you both! Ill soon be searching for every med I don’t have to get from PBM’s! I spent so many years and $$$ for meds that make my life with fibromyalgia bearable. My disdain for PBM’s began 11 years ago when my rheumatologist’s PA wrote the Rx for lyrica in the wrong format & they charged me $400 for a month supply rather than the 90 days I normally received.

@lee-kazz 9 месяцев назад

great interview you both rock 👍

@SuperFrankieKimm Год назад

astounding. thanks you guys.

@victorialoven2645 Год назад

This is so so so awesome!! Health 3.0! Let’s do it!

@natalievancouver8188 Год назад

Depending on which province in Canada you like in we pay way less. Where I am people over 60 never pay more than $21 a month, kids from 0-25 pay $0 and everyone else pays up to $94.00 a month deductible and that’s it. All Cancer meds are free I get the bill but the total to pay is $0 but each injection is $4740.70 but I pay zero. Why can all other countries figure this out except the USA? Every other country has universal or socialized healthcare. No one here has to ration their insulin or skip days.

@richardcrocker8048 Год назад

Oligarchy

@yvonnemiller418 Год назад

greed

@richardcrocker8048 Год назад

@@yvonnemiller418 Greed has destroyed the Country …. Brand Name Pharmaceutical Companies , with their huge profit reserves , have gotten what they wanted from Congress, to the detriment of the public, since the 80’s. So don’t expect a bribed Congress to do anything in this Oligarchy.

@monicamolloy5105 Год назад

Great job. Thanks again. M

@thor800 Год назад

average taxpayers are beyond fed up with broken systems and even worse the lack of political will do change them because the companies own the politicians

@camilleroland2923 Год назад

This is my SOAP BOX as a graduate student provider in Mental Health my patients who can not get medications suffer terribly...

@natalievancouver8188 Год назад

In Canada the Pharma companies aren’t allowed to advertise on tv or magazines & newspapers so people aren’t persuaded to like one med or another. They don’t want people going to their doctors and demanding a med because they’ve seen more adds of a particular medicine.

@richardcrocker8048 Год назад

Only 2 countries allow DTC advertising …. US and New Zealand

@natalievancouver8188 Год назад

@@richardcrocker8048 yep I usually write that too🤙🏻

@leilanisimmons8431 Год назад

Great information. Thank you!

@quirkykindalife2948 Год назад

I had a prescription for Tetracycline in my 20's and remember it being less than $10, fast forward 25 years and my son's prescription was around $300 (at CVS). I couldn't understand how it could have gotten so much more expensive. This answers my question, thank you.

@rberks5 Год назад

Tetracycline is a bad example. It went completely off market for a while. When it came back, it was much more expensive. Doxycycline and minocycline are much less expensive.

@sdjohnston67 Год назад

Fantastic! I hope this flourishes and inspires additional much-needed reforms.

@embee7434 Год назад

Great conversation. I work for a rural community health insurance company (read small, non-profit) and the cost of these genetic treatments and could literally bankrupt us and the other prices are already breaking everyone's back. Something must change. Disclaimer: my opinions are my own and I am not speaking in behalf of my employer. Also: pay attention algorithm.

@karmicpower 5 месяцев назад

Two questions: (1) why pharmaceutical companies don't sell direct? and (2) why insurance companies don't try to lock pharmaceutical companies into selling at RRP?

@deliamillanes7141 Год назад

🎉interesting podcast.

@nightsky4132 Год назад

You guys are cute. I am non-stop trying to fill patient's meds. I have frustration levels you would not believe. Haha. I once wound up crying in the HR office with my DON like, "I'm just trying to get my patients their meds!"

@Epiphora11 Год назад

definitely really cool!

@sabrinalavdisarnold825 Год назад

We need something like this for labwork. Even a holistic clinic I tried had a $50 draw fee.

@BenTanner-th7uy Год назад

Preach

@robinnovak7457 Год назад

Thanks!

@ZDoggMD Год назад

Thanks Robin!

@georgeshepherd3381 Год назад

Thank you! My dimensions go to 11!

@sandrat66 Год назад

Truly enjoyed learning this update; thank you. (catching up Tue 14-Feb)

@cherylshort5005 Год назад

Every year I go to war to get Lantus pens. I have MS si hands tremor. The pens are key. Also basal glar does not control my sugars, like iver 209 fasting. But every year I do get it!

@nightsky4132 Год назад

My pharmacology teacher in nursing school half-owns a small pharmacy. (This is irrelevant but interesting.) My 3yo granddaughter got a UTI. (Supposedly) the bacteria was only susceptible to ONE ABx. We called every pharmacy in town and they did not have it. We drove out of town, to Ty's pharmacy, to get liquid cefdinir. I told him when I got there, "I'm kind of in a hurry because we have to get back to pick up my older granddaughter from kindergarten." I had that antibiotic QUICKLY. Some people care.

@nightsky4132 Год назад

You mentioned labs. There is a doctor in my area who does not accept medical insurance. He draws his own blood and charges like*almost nothing* for labs. Some people CARE.

@nightsky4132 Год назад

I love you guys. You are saying what needs to be said.

@davidwatkins8016 Год назад

There can be problems with generic drugs and their bioavailability. Will any trade name drugs become available?

@JCResDoc94 Год назад

*53:00** i wonder what the actual price point is in m4a single payer systems* , i mean it is still betr for pts. but i bet the "negotiated price is still some bs. _JC

@JCResDoc94 Год назад

*always an important topic to hamr.* but i wonder how many direct pharmacies can open before "suicides" start hapng in rooms locked from the outside. _JC

@novakdjokovis 10 месяцев назад

lol the changing background defocuses the camera

@susanbizeau9936 Год назад

Thank you! Thank you! So wonderful to see 2 physicians who are willing to tackle this greedy system.

@tammydise2340 Год назад

How about the price of biologics!!!! $14K a dose. People need these to stop their autoimmune diseases in their tracks. It is so incredibly sad to hear these people's stories.

@annefischer3530 Год назад

He is not suicidal! 😳😯 Truth!!!

@DezertDana Год назад

So big pharma is not causing the high cost issue, it's the distribution?

@meganswan143 Год назад

Thank you for all your hard work.

@mogoreanu Год назад

The US medical price model and "discounts" never made sense to someone who isn't raised in the US.

@janarn6887 Год назад

It’s been painfully obvious for many many years pts and their well being are not priority… it’s greed !!!

@BurtNLaurie Год назад

Get insulin and use a returnable cooler box.

@jeffk3734 Год назад

Have any name brand manufacturers expressed interest in joining your system?

@BurtNLaurie Год назад

What about pet meds?

@gary100dm Год назад

Greed. Systemized and institutionalized

@richardcrocker8048 Год назад

Goes beyond greed to Govt/Political corruption.

@rohypnotist6263 Год назад

As an EU citizen I have been amazed whenever I heard or read about your American healthcare system and drug prices .It's hard to conceive for us that this is allowed to not only continue but worsen over the years .The New Zealanders have it figured out even better than we do , the Kiwi model should be applied worldwide .If politicians ever dare to destroy our system my country would see a national strike within a week .I live in Belgium btw

@sadem1045 Год назад

It's embarrassing

@tdogmoney1 Год назад

Many of us have been indoctrinated to believe that our system is better than yours because you have to wait months to see a doctor, you have death panels that refuse care to really sick people and your doctors and technology are far below our standard. Only recently am I starting to see the sad reality

@tallleprechaun1318 Год назад

The issue comes down to size and ability to get stuff done. If I’m not mistaken your nation/s are fairly United are they not? Unfortunately the US is about as far from united right now as can be without being in an active civil war. To make matter worse, we have such a huge area to cover and many conflicting cultures who disagree on what medicine should provide. To put it into perspective, Texas is more than twice the size of modern day Germany. There has also been a cultural issue of most Americans want a simple solution (usually a pill) to solve everything. I hope this helps as an explanation. Don’t fully take my word though as I’ve only just seen my 18th spring in a few weeks

@allycat9044 Год назад

PBM’s have created a whole job industry to get meds covered by pharmacy insurance now. Also, optum has different branches of pharmacy benefits + specialty pharmacy + they are venturing into diagnostics (like MRI’s). It is absolute madness.

@orubenvaldez Год назад

Love these 2 guys exposing their own corrupt field.

@karenkaren3189 Год назад

It’s not exactly their field. Zdogg is a hospitalist ( Internal Medicine) and the other gentleman was a surgical resident. They are part of the solution, not the problem

@orubenvaldez Год назад

@@karenkaren3189 sorry, but for me, they are part of the cozy relationship with big pharma. And actually c19 revealed a LOT about this cartel.

@peter5149 Год назад

The PBMs simply exist to extract money

@robfreeman5783 Год назад

Can we get cards or pamphlets of some kind to give patients about this? email me.

@mklite Год назад

Someone get this man on Joe Rogan.

@annetsoukalas1162 Год назад

Yes, this is evil incarnate.

@FL-dv7tq Год назад

Acquiring Taylor Swift tickets is a lot like acquiring medicine.

@richardcrocker8048 Год назад

Except nobody really needs Taylor Swift

@FL-dv7tq Год назад

But don’t say that when you are outnumbered by women ages 15-21! Lol

@talega1 Год назад

All meds used to be made in the US..., you couldn't even go to Canada to get the same stuff cheaper. Walmart started $4 Rx....made in India, Israel and so .....; the they all turned around and NOW you pay top dollar for all these crappy generics.....God forbid you want the Brand name..... $cam galore ......

@tonyc223 Год назад

Why not start shaming these company,s. Put names on the scam.

@paddy3622 Год назад

this should be broadcast on every tv station. i want older folks who take 10 different medications to watch this. It' amazing that no cable news station will touch this. hope i'm wrong. do one on medical devices. it's the wild west.

@kensavoie8211 Год назад

If congress would get rid of pharmacy benefit managers , they wouldn’t need his company because your local independent pharmacy can take care of all of your pharmaceutical needs but their hands are often tied beyond their control. Example - getting paid by insurance company $40-50 below cost so that the PBM can make billions on rebates on brand names when there are generic drugs available

@rohypnotist6263 Год назад

Pharma is a major ,if not the major sponsor of cable tv ...

@paddy3622 Год назад

@@rohypnotist6263 yep. look at 60 minutes a few weeks ago. they did a segment on wegovy. A drug, i believe, for diabetes and now used for weight loss. the cost i think was 26k a year or more. ozempic is the same drug just dosed differently. zero pushback from leslie stahl.

@suzit3237 Год назад

Agreed!!! Great information and video.

@johnhancock8213 Год назад

Can't believe I was only "Like" 29. Great Podcast

@katdunleavey Год назад

I try spreading the word about Cost Plus Drugs to everyone!

@dupzales Год назад

Also, Mark Cuban’s model is what independent pharmacies always provided until the PBMs corrupted the system. They can still provide this service, just ask what the cash price is.

@patmonahan6844 Год назад

Actually, they cannot legally tell you the cash price once you have established you have insurance Messed up, but true

@dupzales Год назад

In Louisiana, we got legislation that says we can with no repercussions from the PBMs. I know, goes against common sense to think you can’t help the patient.

@katdunleavey Год назад

@@patmonahan6844 you’re absolutely correct! I always advise people to call pharmacies and ask for the cash price first.

@rberks5 Год назад

His model is unsustainable. He is not charging enough because he doesn't have a minimum dispensing fee to ensure you won't lose money. You can find pharmacies which use an acquisition plus method for cash prescriptions. You just need to make sure the price is above Medicare and medicaid reimbursement.