Feb 8, 2022 · 30m · news

Cost Plus Drugs: EXPLAINED | Mark Cuban Full Interview · 20VC with Harry Stebbings

Mark Cuban · 23m spoken Harry Stebbings · 4m spoken
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Billionaire entrepreneur Mark Cuban joins host Harry Stebbings on the 20VC podcast to discuss how his venture, Cost Plus Drugs, is disrupting the pharmaceutical industry with transparent pricing. He shares deep insights into the systematic flaws of healthcare, his hands-on management strategies, and his optimistic view on emerging technologies.

How this conversation actually went

Every chapter scored 0–10 on four independent dynamics. Hover any point for the reasoning behind the score. Harry holds 15.4% of the talking time here. How this is scored →

Harry as informed peer 1.6 Guest teaching 5.0 Guest disagreement 2.4 Harry pushing back 1.4
05100:0010:0020:0030:000:10–2:18 · Harry as informed peer 1/10 What is Cost Plus Drugs? Harry asks straightforward introductory questions regarding what Cost Plus Drugs is and why nobody built it previously. Cuban educates the host on the economic constraints of venture-backed vs self-funded pharmacy models without any hostility.2:18–7:00 · Harry as informed peer 2/10 Inside the Pharmacy Ecosystem and the Origin of the Idea Cuban provides a deep dive into pharmacy benefit managers, operating costs between Toronto and NY hospitals, and legal limitations around drug giveaways. Harry maintains an open, listening stance while Cuban walks through the system mechanics.7:00–10:17 · Harry as informed peer 1/10 Overcoming Challenges, Team Assembly, and Hiring Lessons Harry presses Cuban on exact dollar amounts committed, which Cuban deflects with a generalized 'tens of millions' answer. Harry self-deprecates regarding his own hiring skill, allowing Cuban to share core management principles.10:17–16:35 · Harry as informed peer 2/10 Management Philosophy, Goal Setting, and Marketing Cuban repeatedly reframes Harry's binary premises on trust models and OKRs, rejecting formal business plans in favor of customer-centric price drops as a marketing strategy. Harry follows along as Cuban outlines his operational philosophy.16:35–21:11 · Harry as informed peer 3/10 Scaling, Systemic Healthcare Issues, and Policy Views Harry brings personal context regarding his mother's health condition and community virality. Cuban delivers a comprehensive breakdown of systemic healthcare flaws, including how the Medical Loss Ratio creates perverse incentives for insurers.21:11–23:34 · Harry as informed peer 1/10 Entrepreneurial Agility and the Future of Decoupled Tech When Harry asks for a five-year outlook, Cuban bluntly rejects long-term forecasting in favor of short-term agility, schooling the host on historical tech shifts from 1995 streaming to Web3 insurance protocols.23:34–30:38 · Harry as informed peer 1/10 Quick Fire Round: Insights, Climate Change, and Personal Values Harry conducts a quick-fire round with short prompts. Cuban offers candid, direct answers on Section 230, climate change probabilities, and family values in a relaxed and conversational tone.0:10–2:18 · Guest teaching 4/10 What is Cost Plus Drugs? Harry asks straightforward introductory questions regarding what Cost Plus Drugs is and why nobody built it previously. Cuban educates the host on the economic constraints of venture-backed vs self-funded pharmacy models without any hostility.2:18–7:00 · Guest teaching 6/10 Inside the Pharmacy Ecosystem and the Origin of the Idea Cuban provides a deep dive into pharmacy benefit managers, operating costs between Toronto and NY hospitals, and legal limitations around drug giveaways. Harry maintains an open, listening stance while Cuban walks through the system mechanics.7:00–10:17 · Guest teaching 4/10 Overcoming Challenges, Team Assembly, and Hiring Lessons Harry presses Cuban on exact dollar amounts committed, which Cuban deflects with a generalized 'tens of millions' answer. Harry self-deprecates regarding his own hiring skill, allowing Cuban to share core management principles.10:17–16:35 · Guest teaching 6/10 Management Philosophy, Goal Setting, and Marketing Cuban repeatedly reframes Harry's binary premises on trust models and OKRs, rejecting formal business plans in favor of customer-centric price drops as a marketing strategy. Harry follows along as Cuban outlines his operational philosophy.16:35–21:11 · Guest teaching 7/10 Scaling, Systemic Healthcare Issues, and Policy Views Harry brings personal context regarding his mother's health condition and community virality. Cuban delivers a comprehensive breakdown of systemic healthcare flaws, including how the Medical Loss Ratio creates perverse incentives for insurers.21:11–23:34 · Guest teaching 5/10 Entrepreneurial Agility and the Future of Decoupled Tech When Harry asks for a five-year outlook, Cuban bluntly rejects long-term forecasting in favor of short-term agility, schooling the host on historical tech shifts from 1995 streaming to Web3 insurance protocols.23:34–30:38 · Guest teaching 3/10 Quick Fire Round: Insights, Climate Change, and Personal Values Harry conducts a quick-fire round with short prompts. Cuban offers candid, direct answers on Section 230, climate change probabilities, and family values in a relaxed and conversational tone.0:10–2:18 · Guest disagreement 1/10 What is Cost Plus Drugs? Harry asks straightforward introductory questions regarding what Cost Plus Drugs is and why nobody built it previously. Cuban educates the host on the economic constraints of venture-backed vs self-funded pharmacy models without any hostility.2:18–7:00 · Guest disagreement 2/10 Inside the Pharmacy Ecosystem and the Origin of the Idea Cuban provides a deep dive into pharmacy benefit managers, operating costs between Toronto and NY hospitals, and legal limitations around drug giveaways. Harry maintains an open, listening stance while Cuban walks through the system mechanics.7:00–10:17 · Guest disagreement 3/10 Overcoming Challenges, Team Assembly, and Hiring Lessons Harry presses Cuban on exact dollar amounts committed, which Cuban deflects with a generalized 'tens of millions' answer. Harry self-deprecates regarding his own hiring skill, allowing Cuban to share core management principles.10:17–16:35 · Guest disagreement 4/10 Management Philosophy, Goal Setting, and Marketing Cuban repeatedly reframes Harry's binary premises on trust models and OKRs, rejecting formal business plans in favor of customer-centric price drops as a marketing strategy. Harry follows along as Cuban outlines his operational philosophy.16:35–21:11 · Guest disagreement 1/10 Scaling, Systemic Healthcare Issues, and Policy Views Harry brings personal context regarding his mother's health condition and community virality. Cuban delivers a comprehensive breakdown of systemic healthcare flaws, including how the Medical Loss Ratio creates perverse incentives for insurers.21:11–23:34 · Guest disagreement 4/10 Entrepreneurial Agility and the Future of Decoupled Tech When Harry asks for a five-year outlook, Cuban bluntly rejects long-term forecasting in favor of short-term agility, schooling the host on historical tech shifts from 1995 streaming to Web3 insurance protocols.23:34–30:38 · Guest disagreement 2/10 Quick Fire Round: Insights, Climate Change, and Personal Values Harry conducts a quick-fire round with short prompts. Cuban offers candid, direct answers on Section 230, climate change probabilities, and family values in a relaxed and conversational tone.0:10–2:18 · Harry pushing back 1/10 What is Cost Plus Drugs? Harry asks straightforward introductory questions regarding what Cost Plus Drugs is and why nobody built it previously. Cuban educates the host on the economic constraints of venture-backed vs self-funded pharmacy models without any hostility.2:18–7:00 · Harry pushing back 1/10 Inside the Pharmacy Ecosystem and the Origin of the Idea Cuban provides a deep dive into pharmacy benefit managers, operating costs between Toronto and NY hospitals, and legal limitations around drug giveaways. Harry maintains an open, listening stance while Cuban walks through the system mechanics.7:00–10:17 · Harry pushing back 3/10 Overcoming Challenges, Team Assembly, and Hiring Lessons Harry presses Cuban on exact dollar amounts committed, which Cuban deflects with a generalized 'tens of millions' answer. Harry self-deprecates regarding his own hiring skill, allowing Cuban to share core management principles.10:17–16:35 · Harry pushing back 2/10 Management Philosophy, Goal Setting, and Marketing Cuban repeatedly reframes Harry's binary premises on trust models and OKRs, rejecting formal business plans in favor of customer-centric price drops as a marketing strategy. Harry follows along as Cuban outlines his operational philosophy.16:35–21:11 · Harry pushing back 1/10 Scaling, Systemic Healthcare Issues, and Policy Views Harry brings personal context regarding his mother's health condition and community virality. Cuban delivers a comprehensive breakdown of systemic healthcare flaws, including how the Medical Loss Ratio creates perverse incentives for insurers.21:11–23:34 · Harry pushing back 1/10 Entrepreneurial Agility and the Future of Decoupled Tech When Harry asks for a five-year outlook, Cuban bluntly rejects long-term forecasting in favor of short-term agility, schooling the host on historical tech shifts from 1995 streaming to Web3 insurance protocols.23:34–30:38 · Harry pushing back 1/10 Quick Fire Round: Insights, Climate Change, and Personal Values Harry conducts a quick-fire round with short prompts. Cuban offers candid, direct answers on Section 230, climate change probabilities, and family values in a relaxed and conversational tone.

speaking balance: gold is Harry, purple is the guest (3 minute bins)

0:00 · Harry 27.8% · guest 72.2%0:00 · Harry 27.8% · guest 72.2%3:00 · Harry 12.4% · guest 87.6%3:00 · Harry 12.4% · guest 87.6%6:00 · Harry 11.1% · guest 88.9%6:00 · Harry 11.1% · guest 88.9%9:00 · Harry 21.5% · guest 78.5%9:00 · Harry 21.5% · guest 78.5%12:00 · Harry 9.8% · guest 90.2%12:00 · Harry 9.8% · guest 90.2%15:00 · Harry 18.7% · guest 81.3%15:00 · Harry 18.7% · guest 81.3%18:00 · Harry 8% · guest 92%18:00 · Harry 8% · guest 92%21:00 · Harry 19.4% · guest 80.6%21:00 · Harry 19.4% · guest 80.6%24:00 · Harry 7.3% · guest 92.7%24:00 · Harry 7.3% · guest 92.7%27:00 · Harry 15.1% · guest 84.9%27:00 · Harry 15.1% · guest 84.9%30:00 · Harry 29.9% · guest 70.1%30:00 · Harry 29.9% · guest 70.1%
Sharpest disagreement ▶ 22:05 Cuban dismisses five-year planning horizon

Cuban directly rejects the premise of Harry's question, stating he looks forward a month rather than five years when building innovative companies.

Hardest push from Harry ▶ 7:52 Harry presses Cuban for specific capital figures

Harry explicitly asks Cuban to disclose the exact amount of personal capital allocated and planned for Cost Plus Drugs.

Biggest teaching moment ▶ 18:40 Cuban explains Medical Loss Ratio dynamic

Cuban educates the host on how Medicare's 85% rule incentivizes insurance companies to prefer higher overall care costs to increase absolute profit dollars.

Harry holds his own ▶ 16:35 Harry connects patient community virality to healthcare adoption

Harry demonstrates domain insight by highlighting how online communities around specific medical conditions drive viral word-of-mouth adoption.

the scores for every segment, with the reasoning behind each
ChapterTopicHarry as informed peerGuest teachingGuest disagreementHarry pushing backWhy
What is Cost Plus Drugs? 1411 Harry asks straightforward introductory questions regarding what Cost Plus Drugs is and why nobody built it previously. Cuban educates the host on the economic constraints of venture-backed vs self-funded pharmacy models without any hostility.
Inside the Pharmacy Ecosystem and the Origin of the Idea 2621 Cuban provides a deep dive into pharmacy benefit managers, operating costs between Toronto and NY hospitals, and legal limitations around drug giveaways. Harry maintains an open, listening stance while Cuban walks through the system mechanics.
Overcoming Challenges, Team Assembly, and Hiring Lessons 1433 Harry presses Cuban on exact dollar amounts committed, which Cuban deflects with a generalized 'tens of millions' answer. Harry self-deprecates regarding his own hiring skill, allowing Cuban to share core management principles.
Management Philosophy, Goal Setting, and Marketing 2642 Cuban repeatedly reframes Harry's binary premises on trust models and OKRs, rejecting formal business plans in favor of customer-centric price drops as a marketing strategy. Harry follows along as Cuban outlines his operational philosophy.
Scaling, Systemic Healthcare Issues, and Policy Views 3711 Harry brings personal context regarding his mother's health condition and community virality. Cuban delivers a comprehensive breakdown of systemic healthcare flaws, including how the Medical Loss Ratio creates perverse incentives for insurers.
Entrepreneurial Agility and the Future of Decoupled Tech 1541 When Harry asks for a five-year outlook, Cuban bluntly rejects long-term forecasting in favor of short-term agility, schooling the host on historical tech shifts from 1995 streaming to Web3 insurance protocols.
Quick Fire Round: Insights, Climate Change, and Personal Values 1321 Harry conducts a quick-fire round with short prompts. Cuban offers candid, direct answers on Section 230, climate change probabilities, and family values in a relaxed and conversational tone.

Statements from this episode (15)

Assertion Partly supported
Mark Cuban: Cost Plus Drugs charges a 15% markup plus $8 fees
“The goal for us is to take generic drugs and be very transparent in what our costs and operation costs are and sell everything at a 15% markup. And from there, we add a three dollar handling fee and a five dollar shipping fee.”
Mark Cuban Feb 8, 2022 ▶ 0:38
Assertion Not checkable as stated
Cuban: Cost Plus Drugs prices beat market rates 99% of time
“And just the way the industry is set up, that price, not always, but 99% of the time ends up being lower than what you're probably already paying. And most likely, It's lower than your insurance copay.”
Mark Cuban Feb 8, 2022 ▶ 0:59
Disclosure
Mark Cuban: Cost Plus Drugs has no outside investors and is self-funded
“I didn't bring on any investors I'm financing it all myself”
Mark Cuban Feb 8, 2022 ▶ 1:29
Assertion Partly supported
Cuban: Cost Plus Drugs does not accept health insurance payments
“You can't pay using insurance on costplusdrugs.com. You have to, you know, put in your credit card and pay that way.”
Mark Cuban Feb 8, 2022 ▶ 3:34
Prediction Not checkable as stated
Cuban: Big pharma will match Cost Plus Drugs' pricing as scale grows
“A lot of them will match. Some of them will ignore us. It depends on how big we get. You know, if we have ten million customers, they'll pay attention to us. If we have a million customers, maybe not. You know, and there'll be times when there'll be PR and, yo…”
Mark Cuban Feb 8, 2022 ▶ 3:54
Disclosure
Mark Cuban has invested tens of millions into Cost Plus Drugs
“It's, you know, it's tens of millions of dollars and growing.”
Mark Cuban Feb 8, 2022 ▶ 8:13
Disclosure
Cuban: Tolerating key employees' underperformance backfires 90% of the time
“So there's going to be times when you've got to bite your tongue because there's somebody that's in a position that you really, really need. And that, you know, honestly, that's, 90% of the time that's come back to bite me.”
Mark Cuban Feb 8, 2022 ▶ 11:04
Insight
Cuban: 75% of underperforming employees know they are underperforming
“When somebody is not doing the job, 75% of the time, they know it, right? And, you know, the other 25%, those are the people who just love to create stress anyways, and then they try to tell you they're solving the stress, right?”
Mark Cuban Feb 8, 2022 ▶ 11:37
Assertion Open
Cuban: Cost Plus Drugs adds over 10,000 accounts per day
“We're adding 10,000 accounts Plus a day, and we're already past 50”
Mark Cuban Feb 8, 2022 ▶ 16:59
Assertion Supported
Cuban: Administrative expenses represent 21% of US healthcare costs
“Effectively about 21% of all health care costs in the United States are for administration”
Mark Cuban Feb 8, 2022 ▶ 20:37
Opinion
Cuban opposes Medicare for All in favor of a hybrid healthcare model
“I'm not a huge fan of Medicare for all or single payer simply because there's a variety of issues. I'm more a fan of a hybrid system where lower income people get single payer and higher income people like me pay for what they use.”
Mark Cuban Feb 8, 2022 ▶ 20:45
Insight
Mark Cuban rejects five-year planning, focusing on short-term business execution
“I don't look forward five years. I look forward a month. You know, I look forward two years, maybe in terms of what drugs are available or coming off a patent or that we can add, but I'm not like, okay, five years.”
Mark Cuban Feb 8, 2022 ▶ 22:07
Assertion Not checkable as stated
Cuban: Hospitals lie about losing eight to nine percent on Medicare
“It's a shit show. You know, you don't need, you know, all these, building all these new buildings and buying all this real estate, and there's no, you know, lying about your cost to do something. Oh, our Medicare, you know, we provide Medicare. We lose eight, …”
Mark Cuban Feb 8, 2022 ▶ 24:13
Opinion
Cuban: Algorithmic content amplification is protected under First Amendment
“They made a really, really good argument while that it's still protected under the first amendment in the United States, whether it's algorithmically derived or some comes out of someone's mouth. And so I went from saying, okay, algorithmic amplification shoul…”
Mark Cuban Feb 8, 2022 ▶ 25:28
Disclosure
Cuban buys crypto carbon offset tokens like BCT, Klima, and MCO2
“I mean, there's this, these crypto tokens I'll buy that are carbon offsets, BCT and climate and others, MCO two, and just, you know, to try to reduce my guilt.”
Mark Cuban Feb 8, 2022 ▶ 29:55

Shorts cut from this episode

▶ Mark Cuban’s 4 life lessons 🔑 · 20VC with Harry Stebbings (@27:15) ▶ Mark Cuban: Best purchase I ever made 💸✈️ #shorts · 20VC wi (@29:42) ▶ Mark Cuban: What I HATE most about healthcare · 20VC with Ha (@23:58) ▶ Four Sayings #MarkCuban Gives His Kids @20VC #VentureCapita (@27:15)
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