Evaluation of Potential Urologic Prescription Drug Savings With Mark Cuban Cost Plus Drug Company.

INTRODUCTION: Mark Cuban Cost Plus Drug Company (MCCPDC) launched in 2022 with a goal to decrease prescription drug costs. Thus far, research has focused on possible savings if Medicare purchased its annual volume of drugs at MCCPDC prices. The aim of this study is to analyze if MCCPDC can offer savings directly to urologic patients compared with other mail-order pharmacies, local pharmacies, and with patients using health insurance. METHODS: Twelve drugs used to treat urological diseases available on MCCPDC were analyzed. Pricing data of 30-tab and 90-tab prescriptions from MCCPDC, other mail-order pharmacies, and local in-person pharmacies near our zip code 40508 (Lexington, Kentucky) were compiled. To compare if MCCPDC could offer savings to patients using health insurance to fill their prescriptions, out-of-pocket drug costs for patients from the 2020 and 2021 Medical Expenditure Panel Survey and the 2021 Medicare Part D spending data were extracted. RESULTS: Greater savings at MCCPDC were found at 90-tab prescriptions, but overall variability in prices existed. When comparing without health insurance, 9 of 12 drugs at MCCPDC were cheaper at 90 tabs with solifenacin and tadalafil saving $20 and $12 per prescription. When considering patients using insurance, abiraterone, sildenafil, and tadalafil offered savings on out-of-pocket costs at 30- and 90-tab prescriptions. CONCLUSIONS: MCCPDC may offer cheaper prices for patients filling urologic medications, especially at 90-tab prescriptions. This study is the first to show patients could save money using MCCPDC and has implications for physician counseling when prescribing common urologic drugs.

Near-Miss Diagnoses of Solitary Bladder Tumors Highlight the Importance of Immunohistochemical Staining.

We report three cases of prostate adenocarcinoma appearing as bladder masses and misdiagnosed as muscle-invasive bladder cancer (MIBC). Patients were referred for consideration for radical cystectomy after initial pathological diagnosis suggested poorly differentiated bladder cancer. Pathological review of tissue samples and subsequent immunohistochemical (IHC) staining confirmed advanced prostatic adenocarcinoma. Systemic therapy for prostate cancer was then initiated. These cases highlight the importance of patient history, physical exam, and IHC staining in consideration of a bladder mass, as these patients may have been subject to undue morbidity and surgical intervention without accurate pathologic diagnosis.