Taking a bit of a break from my recent podcast recommendations, but kind of an extension of the previous post (see HERE) about the Mark Cuban CostPlus Drug Company, on October 11, 2022, Mark Cuban's startup known as the Mark Cuban CostPlus Drug Company ("MCCPDC", in different notices shared on Twitter, LinkedIn, Facebook, etc.) announced a partnership with Roche Diabetes Care to bring CostPlus Drugs patients access to buy Accu-Chek testing supplies through them at a lower price.
The cost of buying Accu-Chek test strips from CostPlus is $16.79 for a quantity of 50 test strips. That works out to a cost of $0.34 per strip. Price-wise, that's actually quite low in the grand-scheme of things.
They also sell an Accu-Chek Guide Me meter for $10.76. The meter isn't the item most patients struggle to pay for; it is the test strips used in the meter. Beyond that, it is also selling lancets, although those are a commodity product and are available for a low price at many pharmacies nationwide.
However, they limit the quantity patients can purchase to 150 test strips (3 packages of 50 test strips).
What happens if a patient tests their blood sugar more frequently than 5x per day?
For example, patients with hypoglycemia unawareness, or women with diabetes who are pregnant may test more frequently, and yet the quantity limit appears to be a key limitation. The answer to what happens to people who want more is unclear at the moment. Currently, there's simply no way for patients to order any MORE than that quantity right now. I suppose they could potentially refill the script immediately thereafter they receive their order, but that also means paying another $5 for shipping with each order, which reduces the cost advantage. I reached out to the company about it, but so far, haven't received a response (yet), so we shall see.
Some patients (myself included) have actually found buying test strips from third-party "generic" strips which work in Lifescan OneTouch Ultra meters from firms such as UniStrip Technologies, LLC http://www.unistrip-tech.com/unistrip1/ (which sells the Unistrip1 brand of testing supplies which work in the original OneTouch Ultra meter) to be marginally less costly, although not by very much, and it very much depends on exactly WHERE the patient ends up buying the product. Some retailers offer better deals based on quantity of test strips ordered. But with a branded testing product line (and meters which are still sold; OneTouch abandoned the Ultra meters to focus on the Verio product) so close in price, that could potentially be a lower-cost option than pharmacy private label brands.
Mark Cuban CostPlus Drug Company has carved a lucrative niche for itself as a nationwide operator of cash pharmacy, selling generics for prices which are frequently much less than insurance company PBM-provided pharmacy benefits charge for the same products. However, as I acknowledge in a recent podcast recommendation, that's a function of how broken the U.S. Rx drug market has become. However, it has become an opportunity for savvy patients to turn PBM price arbitrage on its head and use that to their own financial advantage
From Roche's perspective, it may prove to be a way of selling more test strips by avoiding insurance companies, with sales it would have to pay millions in kickbacks as "rebates" to PBM's. If bypassing insurance works well for the company, it may alter the monopoly PBM's have on discounting testing supplies, which is a big deal. In the insulin space, Lilly's now patent-expired unbranded prandial analogue now accounts for one-third of U.S. sales, up from nothing two years ago.
Still, the Roche Diabetes Care deal with the Mark Cuban CostPlus' is one of the company's first pharma partnerships, one in which Mark Cuban CostPlus Drug Company is now selling that company's Accu-Chek testing products, a leading brand in blood glucose monitors, test strips (and lancets), for less-than-the-average retail price. That's seen as a first step for the Mark Cuban CostPlus Drug Company to maybe potentially sell other branded prescriptions at lower prices than retail pharmacies, which tend to rely on PBM's to facilitate distributions and reimubursements hence prices are not within their control.
As of October 2022, the Mark Cuban CostPlus Drug Company lists more than 700 drugs (most generic; often at much lower prices than PBM's will enable patients to buy them for). The company says it hopes to have 2,000 medicines available by the end of 2022, and it is working to offer EpiPens and insulin, two of the most-heavily rebated prescription drugs (to PBM's) in existence.
The latter two products may depend on FDA approval of biosimilars, although not necessarily. For example, there are non-rebated, unbranded "authorized generic" versions of insulin already on the market from Lilly (lispro), Novo Nordisk (aspart and degludec), and Sanofi (glargine) on the market which the Mark Cuban CostPlus Drug Company could theoretically sell if they can acquire the products the right price. Currently, both Lilly and Sanofi, through manufacturer coupon programs, sell their insulins at a cost of $35/vial. But how willing will Lilly, Novo Nordisk and Sanofi be to simply bypass the PBM rebate-monster, even on unbranded insulins?
Biosimilars are coming (as I recently blogged about), too, which could change the underlying market dynamics. I know with absolute certainly that there are now biosimilar versions of Lantus, Novolog, Humalog and even old-school rDNA biosynthetic Regular and isophane/NPH "human" insulins in development from such companies as Biocon (already selling glargine and has a version of aspart now in development), Sandoz/Gan & Lee (glargine, aspart and lispro), Amphastar/ANP (glargine, aspart, rDNA regular and isophane/NPH), Lannett/HEC (glargine, U-300 glargine, and aspart), Civica/GeneSys Biologics (glargine, aspart, lispro) all currently working their way to receiving FDA approval (most of them have told investors they are pursuing FDA-designated "interchangeable" status with the innovator products). As of October 2022, there are a half-dozen Lantus biosims in development (including both U-100 and U-300 versions), and a comparable number of aspart products (Sandoz/Gan & Lee, Lannett/HEC, Amphastar/ANP, and Civica/GeneSys Biologics), at least two more lispro biosimiliars (from Sandoz and Civica, plus one already on the market from Sanofi), as well as at least one of Regular and isophane/NPH (the latter in development from Amphastar). My suspicion is its not a matter of if, but WHEN it will sell the products.
Anyway, with the MCCPDC/Accu-Chek announcement (see the following social media links):
https://twitter.com/costplusdrugs/status/1579890181246971906?s=20&t=8Nyv5L9NSR_DXZaKauUFKw
https://twitter.com/costplusdrugs/status/1579890327242276864?s=20&t=8Nyv5L9NSR_DXZaKauUFKw
https://www.linkedin.com/posts/costplusdrugs_cost-plus-drugs-now-offers-accu-chek-test-activity-6985655434346987521-yGVI
https://www.facebook.com/costplusdrugs/photos/a.404409049909907/1903332246684239/
Author P.S.: So, I reached out via social media to Mark Cuban Cost Plus Drug Company, but largely to no reply. Then I sent a direct message to the company, and was pleased to get a response to that, and the response was informative! Below was my dialogue:
So I have a practical question about the recently announced partnership with Roche Diabetes Care. I test 15x per day, which means I use a quantity of test strips of 450 test strips each month. Yet, your website says the maximum supply I can order is 150 test strips (3x50). Any suggestions on how to accommodate my needs?
I also included a link to their post in my direct message (see for https://twitter.com/costplusdrugs/status/1579890181246971906?s=20&t=goC5c0wnz-ZwMxOHmozSzw for the company's original Tweet announcing the Accu-Chek partnership)
Here was the very informative response I was given:
My team let me know we can supply up to 9 boxes every 30 days!
The doc needs to write 'test up to 15 times per day' on the directions or sig, however, so we can properly show a 30 days supply for 450 test strips.'
So you should be all set if your prescriber sends in a prescription for these.
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