Estrogen Patch Shortage: Who Profits From Your Prescriptions with Mark Cuban

In this episode of unPAUSED, Dr. Mary Claire Haver sits down with entrepreneur Mark Cuban, cofounder of the Mark Cuban Cost Plus Drug Company, to unpack the estrogen patch shortage and why so many women in perimenopause and menopause struggle to find and afford hormone therapy. Holding up her own patch, Dr. Haver asks the question her patients keep asking: why is this so hard to get? Mark explains why the shortage hit so hard — patches require specialized manufacturing that pills don't, demand surged after the black box warning was removed, and supply couldn't keep up — plus how Cost Plus Drugs has worked to buy every patch manufacturers can produce, what the FDA can actually do, and who gets served first when a generic drug runs short. Then they take apart how prescription drug prices are really set in the United States: how pharmacy benefit managers (PBMs) build the formularies that decide what your insurance covers, how manufacturer rebates drive list prices higher, and why a handful of conglomerates now own the insurer, the pharmacy, the PBM, and the physician practice all at once. Using a hypothetical testosterone therapy for women, Mark traces where every dollar goes — and together they pull up the Cost Plus Drugs website live to compare what a generic estradiol patch costs to make against what many women pay at retail. They also cover Dr. Haver's case for vaginal estrogen as one of the most affordable, effective treatments in all of menopause care, why there's still no FDA-approved testosterone for women, how untreated symptoms push experienced women out of the workforce, and the practical playbook for lowering your prescription costs: ask about a 90-day supply, learn how your medications are tiered, compare cash prices with your copay, and use AI to decode your own coverage. Guest links: Mark Cuban Companies https://markcubancompanies.com/ Cost Plus Drug Company https://www.costplusdrugs.com/ Mark Cuban (Instagram)   / mcuban   Mark Cuban (X) https://x.com/mcuban Mark Cuban (Facebook)   / markcuban   Mark Cuban (LinkedIn)   / mark-cuban-06a0755b   Recommended Books: "The New Perimenopause," by Dr. Mary Claire Haver https://thepauselife.com/pages/the-ne... "The New Menopause," by Dr. Mary Claire Haver https://www.amazon.com/New-Menopause-... Other Resources:: Menopausal Hormone Therapy Use Among Postmenopausal Women (JAMA) https://jamanetwork.com/journals/jama... Withings https://www.withings.com/en-us?utm_so... For full show notes, please visit: https://bit.ly/4s6v4zY 00:00:00 – Why prescription drug pricing is broken 00:00:54 – Why women pay different prices for the same medication 00:03:06 – How Cost Plus Drugs is tackling estrogen patch shortages 00:05:23 – Why estrogen patch demand is outpacing supply 00:09:36 – Breaking down the real cost of an estrogen patch 00:11:36 – Why Mark Cuban started Cost Plus Drugs 00:13:02 – How insurance determines what you pay for prescriptions 00:16:22 – How transparent pricing makes medication more affordable 00:18:35 – Why patients pay wildly different prices 00:19:53 – How healthcare conglomerates profit from prescriptions 00:21:25 – What pharmacy benefit managers actually do 00:24:25 – Why your insurance can suddenly stop covering medication 00:27:52 – How hidden rebates drive up brand-name drug prices 00:32:46 – Making vaginal estrogen affordable 00:35:28 – Who decides which medications are specialty drugs 00:36:54 – How Mark Cuban would fix the healthcare system 00:37:50 – Why women's health remains underfunded 00:40:11 – The investment opportunity in menopause and women's health 00:44:55 – Why investing in women's health makes economic sense 00:47:12 – What to do when you can't afford medical care 00:50:15 – How to find more affordable prescription medications Never miss an episode—sign up for The 'Pause Life Newsletter: https://thepauselife.com/pages/newsle... Medical Disclaimer: The information, including opinions and recommendations, on this platform is meant for informational and educational purposes only. Mary Claire Media, LLC, the unPAUSED podcast, and The 'Pause Life are not medical organizations. Medical advice or medical diagnosis cannot be provided to you through the platform, any associated website, or customer portals. Using this platform does not establish a patient-physician relationship.