Mark Cuban is known for many things, including his role on the long-running ABC reality show Shark Tank and his ownership of the Dallas Mavericks. At the Entrepreneurship and Health Care Innovation event, hosted by the Johns Hopkins Carey Business School, he focused on his pharmaceutical venture, the Mark Cuban Cost Plus Drugs Company.
The company, launched in January 2022, makes and sells about 2,300 medications, promising transparent prices and an across-the-board 15% markup.
“We go straight to consumers,” Cuban said. “The smartest thing we did was publish a price list. No other pharmaceutical company does that.”
Cuban was a featured speaker, along with venture capitalist Bill Gurley and Optum CEO Patrick Conway, at the Johns Hopkins University Bloomberg Center in Washington, D.C.
Cuban talked with Gurley about the difficulties of disrupting the healthcare industry, and challenged Conway on his company’s strategies for negotiating pharmaceutical prices.
Sparks occasionally flew, but the three high-profile panelists also agreed on many things, including that improving the healthcare system is hard, mainly because a few large players dominate both payments and care, and have little incentive to lower costs for consumers.
“What I found over the years is that a lot of well-intentioned business founders say they’re getting into healthcare because it’s broken, and they get in year three or four and they make a flip, and end up becoming part of the problem,” said Gurley, general partner at Benchmark Capital and author of Runnin’ Down a Dream: How to Succeed and Thrive in a Career You Love, due out in February 2026.
Gurley spoke about the book, and the insights it offers, in a conversation with journalist David Epstein, author of the similarly themed 2019 book Range: Why Generalists Triumph in a Specialized World.
Drawing on insights from other successful people, as well as his own experiences leaving an enviable job as design engineer in the early days of Compaq Computer Corporation and moving to venture capitalism, Gurley argued in favor of pursuing passions and ignoring nay-sayers.
“Some people once they get in on a career, they stop external learning,” he said. “The test is, do you love it so much that the external learning feels like fun? We’ve trained the kids to persevere, to grind. One day, they wake up stressed and realize they don’t love what they do.”
His book, he said, is “for people who need that little push to go chase that dream, chase that occupation that well-meaning parents would tell them not to do. I really want to give people a shove and permission.”
After that conversation wrapped, Cuban joined Gurley to talk about whether entrepreneurs can disrupt and innovate in healthcare.
It’s a topic Cuban is actively pushing. He decided to start Cost Plus Drugs around 2016, inspired by political chatter about replacing the Affordable Care Act and the negative spotlight on “pharma bro” Martin Shkreli for dramatically raising prices of life-saving drugs. Cuban wanted to offer lower prices, particularly on generic medications, while also forcing the industry to comparison-shop.
“If you have a deductible and you’re paying for a medication we carry, there’s a good chance we’ll save you money,” Cuban said. However, many insurance companies don’t include his medications on their formularies and don’t count the purchase of those meds toward an individual’s deductible.
Cuban reserved particular ire for pharmacy benefit managers, or PBMs—third-party companies that negotiate the drug prices that are paid by insurers and consumers.
“We’re the only country that uses PBMs,” he said. “They say they protect patients by negotiating better prices. When I respond to that, I say, look at your deductible. Why are patients who need the medication paying retail price while working down their deductible?”
Optum Health CEO Patrick Conway, MD, took Gurley’s seat for a lively discussion on payment and delivery innovation in healthcare. Cuban argued that Conway’s Optum Rx, the company’s PBM, is harming patients who can’t afford the medications in its plans.
Conway noted that Optum Rx serves more than 61 million people, and saved them some $50 billion last year. Individuals and smaller companies lack the time, insights, and sheer negotiating heft to secure similar prices, he said.
"You have a niche solution, largely in generics,” he said to Cuban. “We have a comprehensive solution, for employers or unions, for the entire population. We negotiate prices and we have clinical programs. We use AI to look for low prices. I recently got an email from a real customer, not an employer, who said, ‘I have cancer, and my median co-pay went from $80 to $5. I’m now on my cancer drug and I’m doing well.’”
Guided by Ge Bai, professor of accounting at Carey, Cuban and Conway did find common ground, both noting that they want to lower prices and improve access to medications and healthcare in general.
The event was free and open to students and the general public, although advance registration was required. Students were seated in front and encouraged to participate during the question-and-answer period.
Some of the audience members said they appreciated the passion and energy of the discussion, which seemed to sum up the frustrations of tackling a healthcare delivery system in dire need of improvement.
“The energy in the room was electric,” said Carey Professor of Practice Steven D. Cohen, who organized and hosted the event with Bai. “It underscored a deep interest in reshaping the future of healthcare and healthcare delivery.”
