Don Jr. Joins Mark Cuban in Criticism of Drug Middlemen

Donald Trump Jr. expressed agreement with Kamala Harris supporter Mark Cuban on X yesterday on the issue of combating high drug prices. 

Cuban critiqued Sen. Elizabeth Warren, D-Mass., on social media over her characterization of why drug prices are so high for Americans compared to the rest of the world. 

“Big Pharma companies like Johnson & Johnson and Pfizer charge Americans the highest drug prices in the WORLD while often paying ZERO dollars in federal taxes themselves. Why? Because our tax system is rigged. Now, Republicans want to make it worse. I’m fighting back,” the Massachusetts senator posted on X and linked below it to a CNBC piece about the legislator’s grilling of drug company executives. 

The Shark Tank star who recently left the show after 15 seasons was sharp in his response to the progressive senator.

“No. It’s because PBMs [pharmacy benefit managers] corrupt health care,” he said on X. 

Pharmacy benefit managers, or PBMs for short, are third-party administrators of drug prescriptions who negotiate between the groups that pay for the drugs, drugmakers, and pharmacies. They have become the target of increasingly bipartisan regulation.

“Big Pharma wishes they could set their own pricing. They don’t. PBMs control formularies and manipulate prices, in exchange for providing pharma access to patients. It’s how they maximize rebate revenue,” Cuban continued.

“In fact, 3 PBMs NEGOTIATE MORE THAN 90% OF REBATES for commercial insurance plans. That’s your area of expertise, and you have done nothing,” the billionaire concluded. 

According to a 2024 report from the Federal Trade Commission, “the three largest PBMs now manage nearly 80% of all prescriptions filled in the United States.”

The president’s son, Trump Jr., then jumped into the debate.

“Didn’t think I’d be RTing Mark for a while, but he’s 100% right on this issue,” Trump Jr. said.

“Agreed,” Silicon Valley venture capitalist Joe Lonsdale added. 

In April, Arkansas Gov. Sarah Huckabee Sanders signed into law first of its kind legislation, which banned PBMs from also owning, managing, or controlling pharmacies licensed in the state of Arkansas. 

“For far too long, drug middlemen called PBMs have taken advantage of lax regulations to abuse customers, inflate drug prices, and cut off access to critical medications. Not anymore,” Sanders said in a press statement released for the signing. 

“Pharmacy benefit managers can still operate in our state; they just can’t continue to mistreat patients and box out other pharmacies,” Sanders added in an op-ed. 

The Pharmaceutical Care Management Association, a trade organization that represents major PBMs, promptly sued the state over the law.

“Our lawsuit aims to protect patients in Arkansas from the implementation of this dangerous, misguided policy. If implemented, the Arkansas legislation mandating forced closures of pharmacies would have a devastating impact on patient access to critical medications and pharmacy services,” the association said in a press statement. 

Sanders, a Republican who served as White House press secretary during the first Trump administration, attributed the successful passage of the law to the elder Trump holding office now. 

“If you’d asked me a year ago if we could change these entrenched interests, I’m not sure I would have thought it possible. But with President [Donald] Trump in office, everything is changing,” the governor explained. 

Indeed, the president has promised to “cut out the middlemen,” and he may get his chance if Congress holds steady and includes provisions to regulate PBMs in the budget reconciliation bill.

One proposed provision would seek to regulate spread pricing, the practice of a PBM charging “payers like Medicaid more than they pay the pharmacy for a medication.”

The provision would prohibit the ability to claim federal matching funds for spread pricing where “the PBM charges the state or a managed care organization an amount for the dispensing of a drug that exceeds the amount paid to the pharmacies or providers, net of all pricing concessions,” according to the Bipartisan Policy Center.

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