Donald Trump Jr., Executive Vice President of the Trump Organization, expressed agreement with Mark Cuban's critique of pharmacy benefit managers (PBMs) in healthcare. The statement was made on the social media platform X.
"Didn't think I'd be RTing Mark for a while," said Trump Jr., Business Executive. "he's 100% right on this issue."
Pharmacy Benefit Managers are facing increasing bipartisan scrutiny for their role in driving up prescription drug prices and controlling patient access. Trump Jr. responded to a tweet from billionaire Mark Cuban, who argued that PBMs "corrupt healthcare" by manipulating prices and negotiating over 90% of commercial insurance rebates to maximize their own revenue. Supporting these concerns, Empower Pharmacy founder Shaun Noorian said, "the most expensive part of your medication isn’t the drug—it’s the middleman," highlighting how PBM practices often inflate costs beyond the actual price of the drug itself. These voices underscore urgent calls for greater transparency and reform in the PBM industry, as reported by BenefitsPRO and American Pharmacy News.
According to the Federal Trade Commission’s July 2024 Interim Report, the six largest PBMs now process approximately 95 percent of U.S. prescriptions, with CVS Caremark, Express Scripts, and Optum Rx controlling over 80 percent of the market. The FTC found these top three PBMs amassed roughly $7.3 billion in markups on specialty generic drugs between 2017 and 2022, often inflating prices by hundreds or even thousands of percent. The breadth of PBM control over rebates and drug pricing in commercial insurance is significant, indicating a market dominated by intermediaries with substantial pricing power.
Medicare data show that PBM-driven pricing strategies result in severe geographic disparities in drug costs; for instance, the generic prostate cancer drug Zytiga costs $815 in northern Michigan but $3,356 along Lake Michigan—a difference exceeding 300 percent. As highlighted by The Wall Street Journal, this variation arises from different rebate negotiations and formulary management by PBMs across plans. Such inconsistencies emphasize how PBMs’ control over pricing architecture drives uneven and often inflated patient costs nationwide.
Donald John Trump Jr., born December 31, 1977, is an American businessman and political activist who joined the Trump Organization in 2001 after graduating from the University of Pennsylvania’s Wharton School. He currently serves as Executive Vice President and trustee of the Trump Organization, overseeing real estate, hospitality, and golf projects alongside his brother Eric.