A Radiologist with a Better Idea

Alex Oshmyansky, MD, PhD is 33 years old and a mild-mannered radiologist.

He is going to war with the big drug companies.

His partner in the battle is Mark Cuban, owner of the Dallas Mavericks and star of Shark Tank.

Their strategy is to buy generics from the manufacturer and sell them direct.

Oshmyansky grew up around Denver with parents from Ukraine and Moldova. He started college at age 13 while still in high school and graduated from the University of Colorado at age 18 with a degree in biochemistry. He thought he wanted to be a particle physicist but changed his mind to pursue a field that had more real-world opportunities to help people. Four years later, he founded his first company, which sold door handles that dispensed hand sanitizer. While working at his company (that he later sold), he kept pursuing his education and went on to receive his MD from Duke University and a PhD in Mathematics from the University of Oxford. In his fourth year of residency at John Hopkins University, he had his first distaste for drug companies that denied two patients requiring urgent drug treatment for pulmonary arterial hypertension because they could not afford the $10,000 treatment. Both applied for financial assistance but died while waiting for approval. That event set him on the path to figure out how to challenge the status quo.

He moved from Denver to Dallas and founded Osh’s Affordable Pharmaceuticals where he attracted $1 million in investment funding. He sent an email to billionaire Mark Cuban describing what he hoped to achieve. Mark Cuban receives as many as a thousand of these types of emails per day (and most end up in his trash folder). Oshmyansky was asking for investment monies in his concept. Over a series of weekly emails an agreement was reached, and Mark Cuban said Oshmyansky did not sell him, Cuban sold him on “doing more and thinking bigger.”

The company changed its name to Mark Cuban Cost Plus Drug Company and emerged publicly in January of 2020. With big plans, they will buy, package, distribute, and manufacture low-cost versions of expensive generic drugs. Only one drug was in the portfolio in the beginning, but in November, plans for ninety-three additions were added. A September 2022 opening for a 23,000 square-foot manufacturing facility in Dallas is on target. The first drug to market was albendazole, a treatment for parasitic worms, such as the hookworm. This poses problems in rural and low-income parts of the world, even the United States. A simple one-time treatment of two tablets will rid the patient of the parasite and the associated infection in the small bowel. Cost without insurance is approximately $225 per tablet (or $450 per treatment). That leads patients who cannot afford it to get medicine from Mexico or to use treatment designed to treat animals. Cost Plus offers albendazole at a wholesale price of $15 per tablet and recommends pharmacies sell it for $20 per pill.

Overcoming the complicated drug business, the middlemen suppliers, and the pharmacy benefit managers (PBM) will be difficult. Nothing in the drug business is straightforward. Regulations and markups are the rule rather than the exception. Cost Plus Pharmacy will operate an online pharmacy and sell directly to patients with an additional $3 pharmacy charge. One cancer drug, Imatinib, will cost $47.40 without insurance for 30 pills of 400 mg in the planned expansion. The average retail price of this dosage is $9,600.

Can they change the course of medicine and drugs in the United States? I certainly hope so. We need them to succeed.

Oshmyansky works telehealth shifts on Saturday nights interpreting scans sent to his home in Dallas.

For more information and the full article, the Source is:

Shinneman, Shawn. Texas Monthly, “Dunking on Big Pharma.” December 2021



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