‘Those Billionaires and Rich Execs Have No Clue’: Mark Cuban Says If Healthcare Is Too Expensive, Cash ‘May Be Cheaper Than Your Out-of-Pocket’

"Those billionaires and rich execs have no clue," Mark Cuban wrote on Bluesky on July 28, 2026. "They bitch about costs going up as much as you do." Then he added the part that is actually worth acting on: that "you may be better off looking for cash prices" and that cash "may be cheaper than your out of pocket".

Replying to somebody, Cuban said, "My insurance changes constantly — company layoffs, 'cost saving measures,' DOGE idiocy — employees have about zero control. Multimillionaire and billionaire execs call these shots AND prop up the obstructionist pols. I don't recall ever being asked what I want." Cuban's first two sentences are agreement with that.

Cuban has co-founded and bankrolled the Mark Cuban Cost Plus Drug Company, which sells generics at a published formula of manufacturer cost plus a 15% markup plus a $5 pharmacy fee, and he has said he personally subsidizes prescriptions sold through it.   

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So we priced six of the most commonly dispensed generics at a 30-day supply, three ways: Cost Plus, Costco's own posted cash prices, and Walmart's $4 generic program. I checked every figure below on September 22, 2026, and pharmacy prices move. At Cost Plus, atorvastatin 20mg runs $5.41, lisinopril 10mg $5.38, metformin 500mg $5.31, sertraline 50mg $5.69, amlodipine 5mg $5.21, and levothyroxine 50mcg $5.93, before a $5.25 shipping charge applied once per order.

The same six at Costco's own cash counter, the prices it publishes for people not using insurance, are a different world: atorvastatin $50.60, lisinopril $33.35, metformin $33.39, sertraline $23.80, amlodipine $45.80, and levothyroxine $34.26. That spread is the actual finding here. A cash price isn't a single number. Depending on where you pay, the same atorvastatin costs $5.41 or $50.60.

Walmart's $4 list is the counterweight to Cuban's own pharmacy. Lisinopril 10mg, amlodipine 5 mg, and levothyroxine 50mcg are all $4 there for a 30-day supply, and metformin 500mg is $4 for 60 tablets. On those, Walmart beats Cost Plus before shipping is even counted. Sertraline 50mg and atorvastatin are not on the list at all. A reader following Cuban's advice literally would need to check more than one counter, which is, to be fair, what he said to do.

Now the benchmark. KFF's 2025 employer survey puts the average copayment for a generic drug at $12 for covered workers. Against $12, cash at Cost Plus wins on every one of the six, and Walmart's $4 wins by more. Against Costco's posted cash price, insurance wins on all six. The more useful number in that survey may be the deductible: the average general annual deductible for single coverage was $1,886 among workers who have one, and until a worker meets it, many plans have them paying the full negotiated price rather than a $12 copay at all. For those months, the comparison is not cash against $12. It is cash against whatever the plan has negotiated, which the patient usually cannot see in advance.

The one caveat being, money spent outside your plan generally doesn't count toward your deductible or out-of-pocket maximum. Which means, for somebody on one or two cheap generics who will never come close to a deductible, paying cash is likely cheaper, and the lost accumulator credit costs nothing. For somebody with high annual drug spend who will hit their out-of-pocket maximum, every cash fill is a payment that does not move them toward the cap, and the low price today can be the expensive choice by December.

The thing Cuban and the person he was replying to actually agreed on was smaller and harder to price: that the people choosing these plans are not the people living inside them. Cuban has argued elsewhere that the system makes patients pay the highest price of anyone in the chain. Neither person has to take the argument on faith, and neither do you. The prices are published. CVS Health and every other chain will quote you a cash price if you ask for one, and the only way to know whether it beats your plan is to ask.

On the date of publication, Caleb Naysmith did not have (either directly or indirectly) positions in any of the securities mentioned in this article. All information and data in this article is solely for informational purposes. For more information please view the Barchart Disclosure Policy here.