The Big Bet Mark Cuban Is Betting Everything On (Exclusive Interview)
It was early June in Boston Common, and Mark Cuban was certain he’d fly under the radar. The day happened to coincide with the Boston Dyke March, an event billed as an “anti-capitalist intersectional gender liberation” gathering. Earlier that morning, outside his downtown hotel, the Dallas Mavericks minority owner had already been swarmed by basketball fans begging for selfies and autographs, who lit up the second they spotted him. But as we wandered the 50-acre expanse of America’s oldest public park, the billionaire capitalist was convinced this anti-capitalist crowd couldn’t care less about him.
“Mark Cubannnnn!” a young woman yelled right on cue. She rushed over, friends trailing close behind, all giddy with rainbow fabric strips tied into makeshift skirts around their waists. They wanted a selfie, and Cuban obliged, grinning like a proud dad.
Now 66, Cuban is at a major crossroads. Late last year, he announced the upcoming season of ABC’s Shark Tank—the reality show that turned him into a household name—would be his last. He also sold his controlling majority stake in the Mavericks. Had the serial tech entrepreneur and investor decided to slow down?
The suggestion rubs him the wrong way. This isn’t winding down—it’s clearing the deck for his biggest, most ambitious project yet. Back in 2018, a cold email landed in Cuban’s inbox that, to him, smelled like blood in the water: a once-in-a-lifetime opportunity. A 33-year-old radiologist named Alex Oshmyansky was pitching a new pharmaceutical startup out of the blue. His idea: sell generic drugs at prices barely above their manufacturing or wholesale cost. Cuban was intrigued, and cut a check for $250,000 to get in on the ground floor.
Within two years, Cuban had invested enough to take full ownership of the company. In January 2022, they launched to the public as Mark Cuban Cost Plus Drugs. The name is straightforward, matching its radical transparent pricing model: the base cost of the drug, plus a 15% markup, a $5 pharmacy service fee, and another $5 for shipping. Today, the company ships roughly 2,500 medications—covering everything from epilepsy and diabetes to birth control—to consumers and independent pharmacies across the U.S.
What hooked Cuban was Oshmyansky’s plan to cut out the exploitative middlemen that cripple America’s broken healthcare system. Pharmacy Benefit Managers, or PBMs, operate as the go-between for drugmakers, insurers, patients, and pharmacies. They control nearly every critical detail of how drugs are priced and accessed: which medications a patient’s plan will cover, how much patients pay out of pocket, and what cut pharmacies take home. The industry claims it saves consumers money, but a recent New York Times investigation found PBMs often tack hidden extra fees onto drugmakers and employers, drive up patient costs, and push independent neighborhood pharmacies out of business.
When I met Cuban for breakfast at a luxury Boston hotel—where soft jazz plays and gas fireplaces stay lit even on the muggiest summer days—he was already fired up ranting about PBMs. Their industry trade groups demonize drugmakers as viciously as “the Republicans demonized Hillary Clinton,” he tells me. Cuban says his mission isn’t rooted in personal healthcare trauma; he just saw a gaping hole to take down a dysfunctional, predatory industry.
Cuban hasn’t shied away from weighing in on tech platforms and national politics, either. He’s an active poster on X, and never hesitates to call out Elon Musk, accusing him of manipulating the platform’s algorithm to favor his own conservative views. He brushed it off easily when Musk clapped back by labeling him a poop emoji online.
When we met for breakfast in June, Joe Biden was still the presumptive Democratic nominee, and Cuban had a blunt warning for his campaign: relax your harsh stance on crypto taxes, or you’ll lose the election. When we caught up again in August, he said he’s been impressed by how Democratic nominee Kamala Harris has pushed back against Donald Trump’s aggressive campaign rhetoric, and the approachable “Bring Your Dad to Work Day” energy running mate Tim Walz brings to the ticket. He likes that the pair can win over moderate voters and dial back the political chaos America has weathered over the last eight years.
That said, Cuban has always thrived in chaos.
Full Interview
Lauren Goode: You’ve had a lot of big changes lately: leaving Shark Tank, selling your majority stake in the Mavericks. Is this a midlife crisis?
Mark Cuban: No, not even close—it’s the exact opposite. This is just clearing the deck for the next chapter. I don’t look at my age and think, “I’ve got to switch things up because I’m older.” It’s just that I love disrupting broken industries, I love competing in business, and Cost Plus Drugs could end up being the biggest, most impactful thing I’ve ever done.
LG: Why is that?
MC: If I told you, Lauren, that you could fundamentally change American healthcare for the better, would you say no?
LG: I would say yes, for sure—just from my own recent experience booking doctor’s appointments. Everything’s so opaque, I never know what my bill will be when I walk in.
MC: Nobody does. Back in 2017, Republicans were pushing to repeal the Affordable Care Act, and I talked to so many people who had no clue how they’d get coverage after that. So I decided to dig into the system myself. I worked with the RAND Corporation to brainstorm solutions.
Then in 2018, I got that cold email from Alex. He wanted to launch a pharmacy focused on generic drugs that were in short supply—there are all these critical meds, like pediatric cancer treatments, that people can’t access, and it’s insane that no one was stepping up to make them.
I told him, that’s a great idea, but you’re thinking too small. This was around the time Martin Shkreli—you know, “Pharma Bro”—was going to jail for all his garbage. He’d bought the rights to a life-saving antiparasitic drug and jacked up the price from $13.50 a pill to $750. I asked Alex, why can’t we buy a full year’s supply of these scarce drugs ourselves? He told me it’d cost about $250,000. I said, are you kidding me? Only $250k? Let’s do it. The only catch was, we couldn’t buy it—someone had already cornered the entire supply.
LG: Locked it up through intellectual property laws?
MC: No. They just bought up the entire year’s production. [Our waiter stops by to offer coffee. Cuban turns to him.] Can I get an oatmeal with just raisins? No other add-ins, please.
LG: That’s very specific—just raisins.
MC: Yeah, I have zero willpower. If there’s anything else in front of me, it’ll be gone before I know it.
LG: Speaking of gone—so someone had already locked up the drug supply.
MC: Exactly. They went to the manufacturer and got a de facto monopoly. If there are only 100 people a year who need the drug, they can jack the price up to whatever they want. I thought it was completely messed up that that’s even allowed. So I dug deeper.
The biggest problem isn’t the care itself, it’s not even the drug companies most of the time. Everyone points to pharma as the bad guys because they hold the patents, but generally speaking, they’re not the problem.
LG: What do you mean by that?
MC: Because whatever insurance company you use works through a PBM. The PBM negotiates reimbursement rates with pharmacies, and it’s completely one-sided. They just tell you, “This is what we’ll pay you, take it or leave it.” [His Apple Watch buzzes.]
LG: No rush, go ahead.
MC: It’s my son. [He speaks into the watch.] We’ll do a late lunch, don’t worry about it. Go have fun. [Back to the interview.] He’s playing basketball today.
LG: Nice. So back to PBMs.
MC: Right, there’s no negotiation at all, especially for small independent pharmacies. On top of that, they’re barred from even talking about the terms of their contracts. The number one rule of healthcare contracts is you don’t talk about healthcare contracts. So instead of breaking even on a prescription, a pharmacy might lose $20 to $30 on every brand-name drug they fill. They’re supposed to make that money back selling toilet paper and other convenience goods. That model doesn’t work.
What about the drug manufacturers? They lose out too. PBMs negotiate with them, but pharma has no real data on who’s using their drugs, what the patient demographics are, how often people actually take their meds as prescribed. So PBMs offer to sell that data back to them, for a fee. The whole system is so convoluted and opaque, and the PBM trade group just points the finger at everyone else.
[Greg Lopes, a spokesperson for the Pharmaceutical Care Management Association, the PBM industry trade group, told WIRED: “PBMs have a proven track record of securing savings on prescription drugs for patients.” He added that drug companies “are solely responsible for setting and raising prescription drug prices.”]
LG: You saw how bad actors corner drug supplies and manipulate the market. Why didn’t you, as a billionaire, take that same approach to corner critical drugs like insulin? Why not buy up all the insulin supply in the U.S. and undercut the market?
MC: We did look into manufacturing our own insulin. We developed our own synthetic glargine insulin, I spent more than $5 million on that project, I don’t even remember the exact number. But that was right around when Biden capped insulin copays for Medicare patients at $35 a month. That made our project pointless at the time.
LG: You told Texas Monthly you don’t care if you never make a huge fortune off this. Is that still true?
MC: I want it to be self-sustaining. I don’t want to have to subsidize it forever. But I don’t need to profit off it.
LG: Do you see Cost Plus Drugs as an altruistic project?
MC: No. I see it as fun, with massive impact. Altruism is just, “I feel good because I gave money to help people.” Disrupting an industry everyone hates? That’s fun. I get emails or letters every week or two from people saying things like, “You saved my grandma’s life.” I just got a note from someone who told me, “You saved me $15,000 a year on my cancer meds. I’d be dead if it weren’t for you.”
LG: It’s interesting—whether you call it a midlife crisis or not, it does feel like you’re thinking more about your legacy right now.
MC: But if this opportunity had come when I was 25, I’d still do it. The only difference is I’d be trying to make as much money as possible back then, because I was still building my career. Now I don’t need the money. My next dollar isn’t going to change the life of my kids, or my kids’ kids, or their kids after that.
But this does take a ton of time and emotional energy. A lot of people are surprised I’ve learned the entire industry in just a few years, enough to take it on. I walk into meetings with the CEO of a major pharma company and tell them they’re getting it wrong, because I’ve studied their business inside and out. [The waiter drops off our food.]
Thanks. For what it’s worth, I track every single thing I eat in MyFitnessPal. My current streak is up to 3,600 days.
LG: How big do you want Cost Plus Drugs to grow? How do you think about scaling?
MC: We’ll sell every drug we’re legally allowed to sell. But scale isn’t just about getting bigger—it’s about creating disruption. If I do my job right, we’ll cut those PBMs out of the system entirely.
LG: Will you expand the manufacturing side of your business?
MC: We manufacture drugs that are on the FDA’s shortage list, especially injectables. Hospitals can’t get them, so existing suppliers jack up the price as high as they want.
LG: How are you approaching GLP-1 drugs like Ozempic and Wegovy?
MC: That’s an interesting question, because GLP-1s have been on the FDA shortage list. As long as a drug is on the shortage list, the rules let you manufacture it even if the patent is still valid. That’s why you’re seeing other companies start to sell cheaper generic versions already.
But that’s also why brand-name GLP-1 makers are pouring billions into expanding their production capacity—they don’t want to stay on the shortage list. It’s unlikely those drugs will be scarce for long, so we’re not making them.
LG: Building your own manufacturing from scratch sounds a lot like making silicon chips—it’s a multiyear, multibillion-dollar investment to build new production facilities. Is that right?
MC: It is multiyear, but it’s not multibillion. It’s all run by robots, right now our annual capacity is about 2 million vials.
LG: How long will you stay on this mission?
MC: Until the system is fixed. I want to be able to say I fixed American healthcare. Can I pull that off? Maybe. Will it be 100% fixed? No. But is there more than a zero percent chance we can make a real difference? Absolutely.
(The full interview continues below, covering politics, AI, billionaires, and more)
LG: On the Trevor Noah podcast, you said you’d have been successful at anything just because of your work ethic and curiosity, but you’ve also been incredibly lucky.
MC: And I’ll be incredibly lucky here too.
LG: Do you think billionaires should even exist?
MC: Yeah, of course they should.
LG: Why?
MC: Everything is relative. Being a millionaire used to be unthinkable for most people. When I became a billionaire, a company valued at $5 or $10 billion was huge. Now we have trillion-dollar companies. And I guarantee you, the people who build those companies are a lot smarter than the government when it comes to creating value.
LG: You mean billionaires are?
MC: The 1 percent of people who figure it out and build something that matters to people, yes. There’s a reason Atlas Shrugged is still talked about. The question “Who is John Galt?” exists for a reason. There’s a point where you hit diminishing returns for how much money one person can use, but people who are in a position to build something new aren’t just going to walk away because they can’t keep all the reward for their work.
As an entrepreneur, I can create new things, get rewarded, and reinvest that money into other projects—like I did with Cost Plus Drugs. Yeah, the amount of money I have looks obscene, and I get that— I could never spend all of it even if I tried. But without that wealth, I couldn’t invest in the things I invest in, the hundreds of entrepreneurs I’ve backed, I couldn’t have built Cost Plus Drugs at all.
LG: Do you think billionaires should be taxed more than they are now?
MC: Not on unearned income or capital gains.
LG: A huge majority of Americans support a wealth tax on the ultra-wealthy—it’s one of the most broadly popular policy ideas out there.
MC: If we had a net worth tax, Cost Plus Drugs would never exist, because I’d never know what my tax bill would be from one year to the next.
LG: Couldn’t you afford to pay it either way? You tweeted back in April that you owed $275.9 million in taxes this year.
MC: I couldn’t. Who carries that much cash around?
LG: Are you still a libertarian?
MC: Not so much anymore.
LG: Why the change?
MC: Things change. This country has 110 million more people than it did in 1980, and we’ve built up all these layers of policy over decades. Would I still prefer less government? Yeah, I would. I’d even more prefer a smarter government. I’d love to see government work as a service, so we don’t have people doing the same bureaucratic work over and over again. Do I think AI can do a better job than 99 percent of the people doing that rote bureaucratic work? Yes, I do. Do I wish any politician in power got that and was trying to implement that change? Yes. That part of me is still libertarian.
But you can’t go straight from where we are now to that smaller, smarter government overnight. It’s impossible.
LG: And you’ve said repeatedly you won’t run for office.
MC: No, hell no.
LG: Why not?
MC: Who would put themselves through that? I can get way more done from the private sector. You can’t be president and fix healthcare. You have to get Congress on board, jump through a hundred hoops. As an entrepreneur, I can change anything I want. Look at Jensen Huang at Nvidia—he’s basically shaping the entire future of AI just by the choices he makes for his company.
LG: Do you think Nvidia’s stock is at its peak right now?
MC: Not yet.
LG: I know you don’t shy away from talking about Elon Musk, you’ve been very open about disagreeing with his takes on DEI. What makes you speak up, even when you know what kind of reaction you’ll get on X?
MC: The whole point is that it wasn’t ever just about Elon—it was about the platform.
LG: Explain that.
MC: Whoever controls the algorithm controls the platform, controls that whole community. Elon built X into a very strong right-leaning community. They’re fun to push back against.
LG: That doesn’t sound like the full reasoning for speaking up about diversity and inclusion.
MC: I’m not just taking a position to rile them up. It’s something I actually believe in. But at the same