Cost Plus Drugs is an online pharmacy founded by Mark Cuban that sells generic medications at their actual manufacturing cost plus a flat, transparent markup. The formula is simple: the true wholesale price of the drug, plus a 15% markup, plus a $3 pharmacist fee, plus $5 for shipping. That’s it. No hidden fees, no opaque pricing layers, and no involvement from traditional pharmacy benefit managers inflating the cost along the way.
The company launched in 2022 as a direct challenge to the U.S. drug pricing system, where the same generic pill can vary wildly in price depending on your insurance, your pharmacy, and which middlemen are involved. It now serves over one million customers and offers nearly 1,000 generic medications.
How the Pricing Formula Works
Traditional pharmacies negotiate drug prices through a chain of intermediaries, including wholesalers, pharmacy benefit managers (PBMs), and insurance companies. Each layer adds costs that are rarely visible to the person paying at the counter. Cost Plus Drugs strips all of that out. Every drug on the site lists four numbers: the manufacturer’s price, the 15% markup, the $3 pharmacy labor fee, and the $5 standard shipping cost. You can see exactly what you’re paying for before you order.
This transparency is the core of the business model. A drug that costs $10 at wholesale would be listed at $16.50 total: $10 for the drug, $1.50 for the markup, $3 for the pharmacy fee, and $5 for shipping (if mailed). For expensive generics, the savings can be dramatic. A Vanderbilt University Medical Center study examined seven generic cancer drugs and found that if Medicare Part D plans had purchased them at Cost Plus Drugs prices, taxpayers could have saved a median of $661.8 million per year, a 78.8% reduction. One drug alone, abiraterone (used for prostate cancer), accounted for $338 million in potential savings.
What Medications Are Available
Cost Plus Drugs focuses exclusively on generic medications, meaning drugs whose patents have expired and can be manufactured by multiple companies. The catalog covers a wide range of common conditions: heart disease, diabetes, mental health, high cholesterol, infections, and cancer, among others. The inventory has grown steadily since launch and sits at roughly 1,000 medications.
There are some clear boundaries on what the pharmacy will and won’t dispense. It does not carry controlled substances, which includes common medications like Adderall, Xanax, and opioid painkillers. It also does not ship medications that require refrigeration or insulated packaging, which rules out insulin and certain injectable biologics. Brand-name drugs are not currently available through the platform, though the company has signaled interest in expanding into that market.
Mail Order and Local Pickup Options
The primary way to get your prescriptions is through mail order from the company’s own pharmacy. Standard shipping takes 5 to 7 business days, and expedited shipping (1 to 3 business days) is also available. After you place an order, the pharmacy typically emails shipping details within 48 to 72 hours.
But you’re not limited to mail. Cost Plus Drugs has built a network of over 2,300 affiliate pharmacy locations across 38 states and Washington, D.C., including independent pharmacies and major grocery chains like Kroger. At these locations, you can use what’s called the “Team Cuban Card,” which functions like an insurance card at the register. This hybrid model lets you choose mail order for maintenance medications you take every month and local pickup for prescriptions you need quickly, like an antibiotic for an infection.
How to Get Started
The process is straightforward. First, search for your medication on costplusdrugs.com to see if it’s available and what it costs. If it is, you have two options: ask your doctor to send a new prescription directly to Cost Plus Drugs, or request a transfer of your existing prescription. You’ll need to create an account on the site. Once the pharmacy receives and verifies your prescription, they’ll notify you that it’s ready to order. You place the order online, and it ships to your door.
If you have insurance through a participating employer or plan, you may be able to use your coverage at Cost Plus Drugs. The company has partnered with PBMs like SmithRx and insurers like Capital Blue Cross in Central Pennsylvania. In those cases, you enter your insurance information when creating your account, and the pricing may be adjusted through your plan. But one of the more striking aspects of Cost Plus Drugs is that many customers find the cash price is lower than their insurance copay, making it worth using even without coverage.
Their Own Manufacturing Facility
Cost Plus Drugs doesn’t just resell medications from other manufacturers. The company operates its own manufacturing and compounding facility in Dallas, Texas, which produces certain drugs in-house. FDA records show the facility has produced injectable epinephrine (used for severe allergic reactions) and miglustat suspension (used for a rare metabolic disorder called Gaucher disease). By manufacturing some drugs directly, the company cuts out yet another layer of cost and can potentially offer even lower prices on those products. The facility operates under FDA oversight and is subject to the same inspections as any pharmaceutical manufacturer.
How Much You Can Actually Save
The savings vary enormously depending on the drug. For inexpensive generics that already cost a few dollars at big-box pharmacies, the difference may be modest or even negligible once you factor in the $5 shipping fee. Where Cost Plus Drugs shines is on generics that remain inexplicably expensive in the traditional system, often because of PBM pricing dynamics rather than actual manufacturing costs.
The academic research on potential savings is striking. The Vanderbilt study on cancer drugs found that total savings could range from $228 million (56.1%) to over $2.15 billion (92.4%) per year depending on which Medicare Part D plan prices were used as the comparison point. A separate study estimated $1.29 billion in annual savings on just the nine most popular urological drugs based on 2020 Medicare Part D spending. These are population-level numbers, but they reflect real per-pill price gaps that individual patients experience at checkout.
For a practical sense of scale: the drug imatinib, a widely used cancer medication, showed potential median savings of $212 million at the 400 mg dose across Medicare Part D. That kind of gap between what the system pays and what the drug actually costs to produce is exactly the problem Cost Plus Drugs was built to expose.
Limitations Worth Knowing
Cost Plus Drugs is not a replacement for a full-service pharmacy. The restriction on controlled substances means it can’t fill prescriptions for many common medications used for pain, ADHD, anxiety, and sleep. The lack of refrigerated shipping excludes insulin and several injectable medications that millions of people depend on. And while the generic catalog is large, it doesn’t cover every generic on the market.
The mail-order model also introduces a time delay that doesn’t work for urgent prescriptions, though the affiliate pharmacy network helps close that gap. And because the company operates as a cash-pay pharmacy for most customers, your purchases won’t automatically count toward your insurance deductible or out-of-pocket maximum unless you’re on a participating plan. For people who are close to meeting their deductible, paying cash at Cost Plus Drugs could actually cost more in the long run by delaying when their insurance kicks in full coverage.