In a recent LinkedIn post, Mark Cuban expressed strong criticism regarding the current pricing structures and organizational relationships within the pharmaceutical industry, particularly focusing on the role of wholesalers and Pharmacy Service Administrative Organizations (PSAOs).
Cuban argues that the existing system, where pharmacies are effectively beholden to wholesalers through PSAOs they own, is fundamentally flawed and detrimental to independent pharmacies and patients alike. He highlights the pricing model based on Wholesale Acquisition Cost (WAC) as a major point of contention.
“the idea that pharmacies are effectively banks for the drug industry is BAT SHIT CRAZY”
The entrepreneur, known for his business acumen and outspoken views, questioned the logic of pharmacies belonging to PSAOs that are controlled by the very wholesalers charging them inflated prices. He likened the situation to a coercive dynamic.
The Flawed PSAO and Wholesaler Relationship
Mark Cuban points out the inherent conflict of interest in the current structure. Pharmacies often rely on PSAOs to negotiate with drug manufacturers and wholesalers on their behalf. However, Cuban asserts that when these PSAOs are owned by the wholesalers themselves, the negotiation power is significantly skewed.
“the fact that pharmacies belong to PSAOs that are OWNED BY THE WHOLESALERS THAT CHARGE THEM WAC is just as NAT SHIT CRAZY”
According to Cuban, this arrangement forces pharmacies into a position where they are financially supporting the entities that are, in turn, extracting maximum value from them. He suggests that this model prevents pharmacies from operating independently and profitably, forcing them into a role akin to financial intermediaries for the drug supply chain.
Impact on Patient Costs
Beyond the implications for pharmacies, Cuban also stressed the negative consequences for patients. He noted that the WAC-based pricing model directly impacts what patients pay, especially during the initial phases of their health insurance coverage.
“To make matters worse , it also leads to patients paying full WAC during their deductible phase. which is BAT SHIT CRAZY”
In Cuban’s view, this means patients are often overpaying for their medications when they are most vulnerable financially, due to a pricing structure that benefits wholesalers and manufacturers rather than facilitating affordable access to medicine. He actively sought potential legal avenues to address this issue, posing a direct question to his network:
“does anyone have a legal approach to fix this ?”
Cuban’s post serves as a call to action, urging a re-evaluation of the established practices in pharmaceutical distribution and pricing, and seeking solutions to what he perceives as an exploitative system.
📝 About This Content
This article is based on insights shared by Mark Cuban on LinkedIn.
📅 Originally posted on December 30, 2025 | View original post on LinkedIn →