Story perspectives

Exposé Reveals Risks of Unregulated Drug Funding Programs

11/18/2025

Summary

AFP Accountability Issues

The CNBC exposé highlights concerns about PriceMD and Rx Valet, alternative funding programs (AFPs) accused of bypassing FDA regulations by sourcing drugs from unverified suppliers.
The report notes this practice causes delays and confusion for employers and beneficiaries.
It also states some plans exclude specialty drugs from formulary, leaving patients without coverage.
The exposé calls for accountability for AFPs and highlights the risks they pose in drug supply chain.

Summary

Cuban Disrupts Drug Pricing

Cuban's Cost Plus Drug Company has introduced Starjemza, a biosimilar priced 99% lower than Stelara.
Cigna's Quallent Pharmaceuticals is under scrutiny for high generic drug prices, with some products showing a 2.00 AWP to WAC ratio.
Net drug spending in the U.S. accounts for 9% to 21% of total healthcare costs, placing it mid-range globally.
The context highlights drug pricing complexity and the need to reevaluate current reimbursement strategies.

History

Historical Context

The Medicare Prescription Drug Improvement and Modernization Act, enacted in 2003, aimed to enhance drug access and affordability, resulting in a 20% rise in prescription drug spending. This reflects ongoing challenges in drug pricing regulation, similar to the scrutiny faced by PriceMD and Rx Valet, as rising drug costs necessitate accountability measures to ensure patient safety and equitable access to medications.

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AFP Accountability Issues

The CNBC exposé highlights concerns about PriceMD and Rx Valet, alternative funding programs (AFPs) accused of bypassing FDA regulations by sourcing drugs from unverified suppliers.
The report notes this practice causes delays and confusion for employers and beneficiaries.
It also states some plans exclude specialty drugs from formulary, leaving patients without coverage.
The exposé calls for accountability for AFPs and highlights the risks they pose in drug supply chain.

1 / 3