Analysis
Billionaire entrepreneur Mark Cuban criticized pharmacy benefit managers and health insurers, arguing that the industry’s structure rewards shareholder returns over reducing prescription drug costs for employers and patients.
PBMs Face Cuban’s Criticism Over Drug Costs On Saturday, Cuban shared his criticism in a post on X, saying employers often lack the expertise and resources to replace pharmacy benefit managers (PBMs) or navigate complex contracts.
"Complexity and scale. They don’t have the internal people who can handle changing vendors, or that can manage the complexity," Cuban wrote, adding that consultants frequently recommend "more of the junk they already got."
He also said human resources departments are overwhelmed by employees facing denied medical care, leaving little time to scrutinize PBM agreements.
"The calls from that employer whose cancer treatment just got denied takes precedence over focusing on finding typos in their PBM contract," he wrote.
Calling the system "It’s A Racket," Cuban argued that despite increasing legal and regulatory scrutiny of PBMs and health insurers, none have pledged that reforms would reduce costs for employers or patients.
"All you need to know is that after all the legal changes and scrutiny thrown at PBMs and insurance companies, NOT A SINGLE ONE has said they will result in lower costs for employers or patients," Cuban wrote.
He concluded that companies avoid making such commitments because "they know they would kill their stock prices. And that fiduciary responsibility comes first, middle and last."
Complexity and scale. They don’t have the internal people who can handle changing vendors, or that can manage the complexity. And their consultants know they can’t handle it, so they recommend more of the junk they already got.
Their HR people are struggling just to keep up… https://t.co/hXMVwv2zJ7
— Mark Cuban (@mcuban) July 18, 2026
Rising Healthcare Costs In June, Market commentator The Kobeissi Letter warned that rising U.S. healthcare costs were increasing pressure on employers and workers, citing a Mercer report that projected health benefit costs per employee would climb 6.7% year-over-year in 2026 to at least $18,500.
The report also found employer health plan costs were expected to rise more than 6% for the fourth consecutive year, with many companies considering higher deductibles, copays and employee premium contributions.
Earlier, Cuban said "most insurers aren’t insurers" and promoted a healthcare model focused on personal savings, catastrophic coverage and routine care.
Trump Targeted PBM Fees President Donald Trump unveiled a healthcare plan targeting PBMs, arguing that their rebate and fee structures increased prescription drug costs.
The proposal aimed to eliminate certain PBM payments and lower drug prices, with healthcare experts also criticizing the model as a costly middleman system.