Mark Cuban Critiques PBMs for Prioritizing Shareholders

Billionaire entrepreneur Mark Cuban criticized pharmacy benefit managers (PBMs) on Saturday, asserting that the industry's structure prioritizes shareholder returns over reducing prescription drug costs for employers and patients. Cuban's remarks were made in a post on X, where he emphasized that employers often lack the expertise to replace PBMs or navigate complex contracts. He stated,

Complexity and scale. They don’t have the internal people who can handle changing vendors, or that can manage the complexity.

Cuban also noted that human resources departments are overwhelmed by employee issues, such as denied medical care, which detracts from their ability to scrutinize PBM agreements.

Criticism of Industry Practices

Cuban described the current system as "It’s A Racket," highlighting that despite increasing legal and regulatory scrutiny of PBMs and health insurers, no companies have committed to reducing costs for employers or patients. He pointed out,

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 concluded that companies avoid making such commitments due to concerns over their stock prices, stating,

they know they would kill their stock prices. And that fiduciary responsibility comes first, middle and last.

Rising Healthcare Costs

Concerns over rising healthcare costs are not new. A report from Mercer projected that health benefit costs per employee would increase by 6.7% year-over-year in 2026, reaching at least $18,500. The report also indicated that employer health plan costs are expected to rise more than 6% for the fourth consecutive year, which is increasing pressure on both employers and workers.