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, and who gets served first when a generic drug runs short.

Then they take apart how drug prices are really set: how pharmacy benefit managers (PBMs) decide what your insurance covers, how 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. They compare what a generic estradiol patch costs to make against what many women pay at retail, cover Dr. Haver's case for vaginal estrogen as one of the most affordable treatments in menopause care, why there's still no FDA-approved testosterone for women, how untreated symptoms push women out of the workforce, and the playbook for lowering your prescription costs — from 90-day supplies to comparing cash prices with your copay.

Guest links:
Mark Cuban Companies https://markcubancompanies.com/
Cost Plus Drug Company https://www.costplusdrugs.com/
Mark Cuban (Instagram) https://www.instagram.com/mcuban/
Mark Cuban (X) https://x.com/mcuban

Books:
"The New Perimenopause," by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book
"The New Menopause," by Dr. Mary Claire Haver https://www.amazon.com/dp/B0CKBZ4K1Z

Articles:
Menopausal Hormone Therapy Use Among Postmenopausal Women (JAMA) https://jamanetwork.com/journals/jama-health-forum/fullarticle/2823976