Mark Cuban: Shark Tank, DEI & Wokeism Debate, Elon Musk, Politics & Drugs | Lex Fridman Podcast #422

Mark Cuban on Lex Fridman: how he made his first billion, Cost Plus Drugs vs. pharmacy cartels, and why healthcare CEOs are getting ripped off.

• Cuban and partner Todd Wagner sold Broadcast.com to Yahoo in 1999 for $5.7 billion in stock; Cuban owned ~30% pre-tax.
• Broadcast.com started as audionet in 1994 to stream Indiana University basketball games over a 128k ISDN line.
• Revenue model: used free consumer streaming as proof-of-concept, then charged corporations like Intel $2M per internal broadcast event.
• Cost Plus Drugs charges cost + 15% markup, publicly listed; a biosimilar to Humira ($8k/month) costs $594 through them.
• The big three PBMs (CVS Caremark, Cigna Express Scripts, United Optum Rx) exclude cheaper biosimilars from formularies to protect rebate income from branded drugs.
• Cuban found his Mavericks were paying $169k to a PBM for generic drugs that Cost Plus would have supplied for $19k.
• Community pharmacies are going out of business because PBMs reimburse them below their acquisition cost on Medicare Part D and Medicare Advantage scripts.
• Cuban argues Elon Musk’s personal engagement patterns on X disproportionately shape its recommendation algorithm toward right-leaning content.

Guests: Mark Cuban — entrepreneur, Dallas Mavericks owner, Cost Plus Drugs founder · 2024-03-29 · Watch on YouTube