Mark Cuban’s pharmacy has shown there is no silver bullet to disrupting the pharmacy value chain

Pharmacy hours interviewed Yoona Kim, PharmD, PhD, co-founder and CEO of Arine, about how Mark Cuban’s Pharmacy can help change the Medicare paradigm.

Alana Hippensteele: Hi, I’m Alana Hippensteele with Pharmacy hours. With me is Yoona Kim, PharmD, PhD, pharmacist, health economist and co-founder and CEO of drug intelligence company Arine, who is here to discuss some of the information that can be gleaned from the pharmacy of Mark Cuban and his potential for change. the health insurance paradigm.

So what do you think are the main lessons we learned from the launch of Mark Cuban’s pharmacy, Mark Cuban Cost Plus Drug Co?

Yoona Kim: Well, first of all, I think that’s huge progress. If patients can have a more affordable solution to getting key chronic medications, especially for those who are underinsured and uninsured, that’s a big step forward, and if Mark Cuban can put his name on it and spread the word , it’s also great.

When it comes to medication, of course, medication and medication management and everything that goes with it is an ongoing and complex issue. What we have learned is that there is no magic bullet. There are so many parts of the pharmacy value chain that need to be disrupted, from ensuring patients get the right drugs, to a low-cost solution like Mark Cuban’s pharmacy, to solutions for and commitment that ensure patients take their medications correctly. . Again, huge progress, but there is still a long way to go, especially since most Mark Cuban pharmacies are dispensing more generics today.

Alana Hippensteele: Right. Media coverage has been both positive and negative regarding the impact of Mark Cuban’s pharmacy on the healthcare market. Why do you think there were such mixed reactions to the launch of his pharmacy?

Yoona Kim: I think there are mixed reactions, probably because right now they’re focused on generics, and probably because that concept exists – Walmart offered $4 generics many years ago. But again, the good thing here is that Mark Cuban has hundreds of generics that he offers for less, and there’s price transparency around that. He also talks about having brand name drugs on board which would be huge. We know that almost 10% of our population is already uninsured. That’s over 30 million people. So, this presents a good option for those who need an affordable solution.

However, when you think of the patient populations who seek low-cost options and who suffer from these chronic conditions, they need ongoing clinical care. They probably have comorbidities, probably have trouble getting the right medications for their condition. So I think the first step is to make sure the right drugs are prescribed and then to make sure that patients have access to the drugs.

Then another concern that I know Scott has raised in the media is that with this new pharmacy we are potentially fragmenting care because now patients are getting some drugs from one pharmacy, other drugs from another pharmacy , and we all know that patients develop relationships with their community pharmacies. And so, it can be confusing. As pharmacists, we often talk about medication synchronization as a key intervention to improve adherence and continuity of care.

Then there is no data feedback in this case from Mark Cuban’s Pharmacy to payers or providers, as it is usually a cash payment option today. So great option, but still some limitations.

Alana Hippensteele: Right. Cuban said he aimed to disrupt the country’s drug market. How effective was it in achieving this goal?

Yoona Kim: It remains to be seen whether he will be able to upset the market. There has been talk that it could change the way payers cover prescription drugs, and it will be interesting to see how this model will disrupt the PBM model, where there are many loopholes and ways PBMs make money by distributing drugs.

There was an intriguing article that was published in Los Angeles Time by a group of health economists, Peter Newman being one of them, and the headline was “Mark Cuban won’t solve our drug price problem”. And the thing was that it was mostly generic drugs and not brand name drugs which are even more expensive and really lead to high drug costs. The authors ask policy makers to instead consider value-based pricing models, which tie pricing to drug benefits, and call for cost-effectiveness studies that compare drug costs to drug benefits.

I think that makes a lot of sense and is a great idea. But when I look at the problem in general, we compartmentalize the drugs. And it’s not just about the cost of drugs, but also about how giving patients the right treatments can affect the total cost of care. Most of us as pharmacists are probably familiar with the Scripps article, which talks about the cost of non-optimized drugs as a $530 billion problem. Most of this is on the medical side of the equation. Patients who don’t take the right drug treatment unnecessarily lead to 33 million hospitalizations a year and 275,000 deaths a year, and all of this is 100% preventable. And that’s why I created Arine to address this fundamental problem of getting patients to take the right medications by considering the overall picture of the patient.

Alana Hippensteele: Right. What are some of the other existing technologies that can help reduce drug costs? And are these technologies fully utilized by Medicare?

Yoona Kim: There are many AI-based technologies that are revolutionizing all aspects of healthcare, but especially around medicines. There’s AI drug discovery, companies that can help identify drug targets faster and really speed up the drug development process. There are precision medicine solutions, using AI, that can help identify the right therapies without too much trial and error, as is the case with pharmacogenomics companies. And then there are technologies like Arine, which ensure safe and effective drug therapy, which is not just focused on reducing drug costs, but looking at the big picture and reducing the total cost of care by giving patients the right medicine. So there are many interesting technologies that can really advance the quality and cost of care.

Alana Hippensteele: How can pharmacies tap into existing systems to help reduce costs not only for patients, but also for pharmacies?

Yoona Kim: I feel sorry for pharmacies, because I think the current margins on the pharmaceutical business are already slim. I think the way pharmacies can benefit from this is actually to increase their revenue streams and go beyond distribution. I also believe that payers are beginning to see the benefit of this and to reimburse pharmacists for these kinds of solutions. We have a paying customer who reimburses community pharmacists for using Arine’s platform, performing comprehensive medication management services when a patient picks up their medications at the pharmacy. Thanks to this, we have shown enormous improvements in health: 40% reduction in hospitalizations, savings on the total cost of care. Arine’s platform is really helping to scale these clinical services because in a busy distribution environment, it’s difficult to do these clinical programs at the same time as drug distribution, but having an approach based on a platform that automates the delivery of recommendations and turns data into actionable recommendations, this allows the pharmacist to then do what they do best and spend time advising patients instead. I think even within the pharmacy framework there are many opportunities to go beyond distribution.

Alana Hippensteele: What are your predictions about the impact of Mark Cuban’s pharmacy on the long-term healthcare economy?

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Yoona Kim: Again, if I look at the numbers, as a health economist, I think that article indicated that Mark Cuban’s pharmacy could save up to $3.6 billion a year, and when I look at the cost of unoptimized drugs is a $530 billion problem. Just getting patients on the right drugs, again, I think that’s what can move the needle even more. When you think about drugs in general, I mean, they’re powerful. They have the ability to control almost any medical condition. Some drugs even lead to cures, but it’s about getting patients on the right drugs and then, secondarily, increasing access and providing patients with access to those drugs. I think ultimately it’s going to have to be all of these different parts of the solution coming together, from ones like Mark Cuban’s Pharmacy that’s focused on an affordability angle, to ones like grip solutions like GlowCaps, and those like Arine, who are looking for safe and effective solutions. drug therapy and other companies performing remote monitoring to continue to monitor disease progression. I think all of these pieces together will move the needle in the long run.

Alana Hippensteele: Final thoughts?

Yoona Kim: I am very optimistic about the future, especially with pharmacists. I believe that pharmacists play a key role in all of this. They know how to advise patients to take their medications, they know which medications are the right choices, and how to speak with prescribers to ensure that the correct medication choices and dosage are made. Pharmacists have many patient touch points, especially in settings like community pharmacy, and it’s with the help of different technologies that will help make these types of clinical services more scalable, and that’s the passion that I have that inspired me to launch Arine and motivated me to start Arine, and I see many other innovations in pharmacy as well to elevate the role of the pharmacist. I think the future is very bright.