LAS VEGAS, Nev.—The HLTH conference kicked off Sunday with investor and entrepreneur Mark Cuban taking center stage to blast pharmacy benefit managers, drug manufacturers and wholesalers for driving up prices for pharmaceutical drugs.
Characteristically blunt, Cuban also called out business leaders for being "complicit" in the broken system.
"If you're a CEO of a company, you're the one signing the contract with the PBM that allows this to happen. If you're in a state, you're the one that's approving the insurance plan that signs the deal with the PBM. If you're watching over the wholesalers and responsible for them, you're the ones allowing this to happen. They're doing what you expect them to do. They're trying to maximize their earnings. We're the ones that are the schmucks that are allowing it to happen," Cuban said during an on-stage interview Sunday.
The billionaire celebrity disrupted the prescription drug industry when he launched Cost Plus Drugs Company, a digital pharmaceutical marketplace, in 2022. Cuban's approach is focused on eliminating middlemen, markups and bureaucracy that drive up costs.
Cuban criticized the current system where manufacturers sell to wholesalers at list prices, leading to high costs for pharmacies and patients.
He emphasized the need for transparency and market competition to improve healthcare affordability.
"We started Cost Plus Drugs from the perspective that we wanted people to be able to go to a website, put in the name of the drug that they had a prescription for, not only see what we were selling it for, but see what our actual cost and markup was so that they would trust us," he said. "There's a formula I use all the time for my companies, and it's about how do you define trust. Trust equals transparency divided by self-interest. By showing all of our costs, all of our pricing, that's the transparency."
He added, "By showing that we only had a markup of 15%, that's the self-interest. That led people to trust us, and that's why we've been able to grow," he said.
Cost Plus Drugs works directly with drug manufacturers to bypass middlemen and lower prices. For consumers, the price of each drug includes a 15% markup. Cost Plus also transparently displays what it pays for its medicines.
The online pharmacy launched in January 2022 now carries over 2,300 prescription products. The company mostly offers generic drugs.
"We don't work with the biggest PBMs. We're on the outside of the healthcare system. So I don't need anything from them. I'm lucky where I am in my life. If I was 25, 35, 45, it might have been a different story. But my next dollar is not going to change my life. But, f**king up healthcare would make me very happy," Cuban joked.
The entrepreneur also joked that President Donald Trump's TrumpRx was "the biggest, best, most amazing, brilliant, phenomenal thing I've ever heard in the history of pharmacy."
The Trump administration announced in late September that it was rolling out a direct-to-consumer website where individuals can buy prescription medications at discounted prices rather than through insurance.
"We're going to be participating in it. TrumpRx, it's more a referral site," he said. "We saw really interesting deals from Pfizer and Amgen and others. And they'll put a link to their sites. So cash-paying patients could get the lower price from them."
Also on Sunday, Rob Lowe interviewed Eli Lilly's Jacob Van Naarden about innovation in clinical trials.
There was a noticeable absence of federal health officials on the final agenda this year, thanks to the ongoing government shutdown. Centers for Medicare and Medicaid Services Administrator Mehmet Oz, M.D., was initially slated to speak, as was Jim O'Neill, Deputy Secretary of the Department of Health and Human Services. They pulled out of the conference, along with CMS' Chris Klomp.
Amy Gleason, acting administrator of the U.S. DOGE Service and strategic advisor to CMS, is still scheduled to speak Tuesday morning about improving the patient experience.
The eighth annual HLTH conference plans to draw in 12,000 attendees to the Venetian Expo Center with an event that features more than 400 speakers tackling topics ranging from breakthrough therapies to weight management and the ongoing buzz around GLP-1s to longevity, women's health, healthcare policy and, of course, artificial intelligence.
Pharma companies have a big presence at this year's HLTH conference with executives from Novo Nordisk, Bristol Myers Squibb, Regeneron, GSK, Merck, Amgen and Novartis slated to speak, along with leaders from a handful of biotech companies such as Flagship Pioneering and Mammoth Biosciences.
Advances in AI, particularly generative AI and agentic AI, will likely dominate conversations at HLTH as AI adoption grows. Many attendees said they are keeping an eye out for new AI innovations and want to hear about how other organizations are using the technology.
“The hot topic is without question the role AI has played, and will continue to play in mental health care. I’m pro-AI, and feel 2026 is going to bring an exciting array of new solutions and the evolution of existing ones. However, everything in the AI and mental health space must be built with the utmost care given to oversight, clinical rigor and privacy. The industry can’t just release chatbots or care apps that aren’t underpinned by serious clinician oversight and governed ethically," Mark Frank, CEO of SonderMind, told Fierce Healthcare.
But healthcare executives are also interested in advances in other sectors of healthcare including primary care, employer health benefits, tech-enabled preventive health, food-as-medicine and digital solutions for mental health.
“I’m genuinely excited that we’re at a point where we can realize the outcomes from Advanced Primary Care that we’ve been talking about for so long. The challenge in healthcare has never been the ideas. This concept of Advanced Primary Care has been around for years. The issue has been in figuring out how to pay for it, how to deliver it at scale, and how to engage patients in using it. All of these pieces are starting to come together now, and it’s incredibly exciting," said Ami Parekh, Included Health's chief health officer, said.