By Erin Albert, MBA, PharmD, JD, DASPL
Chief of Pharmacy Relations, Network and Privacy at Mark Cuban Cost Plus Drugs, PBC
12/18/25
Healthcare policy debates often center on billion-dollar budgets, national systems, and complex reimbursement structures.
But as Mark Cuban reminded lawmakers in his testimony before the U.S. Senate Special Committee on Aging, the most important
part of healthcare delivery happens much closer to home — within the last five feet between a patient and their pharmacist.
“Modernizing Health Care: How Shoppable Services Improve Outcomes and Lower Costs” — Mark Cuban testimony begins at 1:31:33:
U.S. Senate Special Committee on Aging video
In that hearing, Cuban emphasized that this final interaction is where medication errors are prevented, adherence problems are uncovered,
and patient trust is built. When pharmacy economics fail, he warned, that “last five feet” disappears — replaced by mail order,
call centers, and fragmented care. For community and independent pharmacies planning for 2026, the Cost Plus Drugs Affiliate Pharmacy Network
offers a way to protect that clinical advantage while restoring economic sustainability.
1. The “Last Five Feet” Is a Clinical Advantage — and a Business One
During the Senate hearing “Modernizing Health Care: How Shoppable Services Improve Outcomes and Lower Costs,”
Cuban explained that the final interaction between pharmacist and patient may be the most consequential moment in the medication-use process.
It’s where contraindications are caught, dosing confusion is resolved, and patients feel safe asking questions they would never raise with a call center.
Yet traditional PBM reimbursement models treat this interaction as a cost to be minimized. Below-cost reimbursements, retroactive fees,
and unpredictable adjustments force pharmacies to reduce staffing or exit networks altogether. When that happens, patients lose access — not just convenience.
The Cost Plus Drugs Affiliate Pharmacy Network is structured around the opposite philosophy:
value the pharmacist, pay transparently, and preserve in-person care.
2. Transparent Pricing and Defined Dispensing Fees
One of the most destabilizing aspects of pharmacy operations today is reimbursement uncertainty. Pharmacies often do not know their true payment until weeks after dispensing,
once DIR fees, network adjustments, and reconciliation processes are complete.
The affiliate network replaces that uncertainty with clearly defined, transparent economics, including a dispensing fee structure that recognizes pharmacist labor and complexity:
This structure allows pharmacies to plan staffing, invest in services, and forecast cash flow with confidence — instead of gambling on opaque reimbursement formulas.
3. New Plan Volume Through Employer and PBM-Leased Networks
As employers and PBMs look to control drug spend without sacrificing access or safety, many are adopting alternative pharmacy networks and wrap programs aligned with transparent pricing models.
Starting in 2026, more commercial and employer-funded plans are expected to lease or include Cost Plus Drugs–aligned pharmacy networks.
For participating pharmacies, this means access to new patient volume that might otherwise be directed exclusively to large chains or mail order.
Importantly, these prescriptions remain in-store, preserving patient relationships and the opportunity for clinical intervention.
Joining the affiliate network positions pharmacies to participate in these arrangements rather than be bypassed by them.
4. Patient Loyalty Built on Clear, Honest Pricing
Patients are increasingly “shopping” for healthcare. Prescription prices are compared online, and frustration with unpredictable copays is growing.
The Cost Plus Drugs ecosystem — including the Team Cuban Card (www.teamcubancard.com) and cost-plus messaging — gives pharmacies a straightforward, credible pricing story.
When patients understand what a medication costs and why, trust grows. That trust drives loyalty, adherence, and repeat visits.
Pharmacies benefit not only from prescription volume, but from expanded use of services such as MTM, chronic disease support, and immunizations — all delivered within that critical five-foot space.
5. Smarter Operations and Access to the Cost Plus Drugs Marketplace
Operational efficiency is just as important as reimbursement. Independent pharmacies often struggle with fluctuating acquisition costs, limited buying power,
and pressure to dispense drugs at a loss to satisfy plan requirements.
Affiliate pharmacies have the option to purchase medications through the Cost Plus Drugs Marketplace,
acquiring select drugs at Mark Cuban Cost Plus Drugs pricing — the same transparent cost-plus model used nationwide.
- A reliable way to avoid negative-margin dispensing
- A transparent acquisition benchmark to evaluate wholesaler pricing
- Improved inventory planning and cash-flow predictability
- Confidence that reimbursement aligns with acquisition cost and dispensing fees
For pharmacies without massive scale, marketplace access creates a more level playing field — especially when paired with the network’s defined dispensing fees.
6. Keeping Care Local in a Mail-Order-Dominated Landscape
Mail-order pharmacies remove the pharmacist from the last 5 feet equation entirely. No counseling, no real-time safety checks,
no opportunity to intervene when something doesn’t look right.
The affiliate network preserves local care by ensuring pharmacies remain the front door for medication access — even as employers and PBMs pursue lower costs.
Patients receive affordable medications and professional oversight, rather than having to choose one or the other.
7. Collective Strength Without Sacrificing Independence
Independent pharmacies often negotiate alone. By joining an affiliate network, pharmacies gain collective leverage while maintaining local ownership and autonomy.
Negotiations become centered on demonstrated value — transparent pricing, adherence, safety, and access — rather than hidden spreads and retrospective fees.
This strengthens the pharmacy’s position while aligning incentives across patients, employers, and payers.
8. Built-In Credibility and Reduced Marketing Burden
Explaining pharmacy pricing is hard. Being part of the Cost Plus Drugs ecosystem simplifies that conversation.
Patients already recognize and trust the brand’s commitment to transparency.
Instead of defending prices, pharmacies can focus on what they’ve been trained to do…care.
Conclusion: Five Feet That Defines the Future of Pharmacy
Mark Cuban’s Senate testimony underscored a truth that pharmacists have always known: the most important work happens face to face.
That last five feet between pharmacist and patient is where safety, trust, and outcomes converge.
The Cost Plus Drugs Affiliate Pharmacy Network protects that space by pairing transparent drug acquisition through the Cost Plus Drugs Marketplace with clearly defined dispensing fees —
$12 baseline, $14 for cold chain and complex REMS drugs, and $25 for vaccine administration on the network drug list.
For pharmacies that want predictable margins, expanded plan access, and the ability to keep care local in 2026 and beyond, joining the network isn’t just a financial decision —
it’s a strategic commitment to the future of pharmacy.
Learn more by completing this form:
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