Abstract Body (Do not enter title and authors here): Introduction
Medicare Part D represents a significant portion of government drug spending, underscoring the importance of efforts to pursue potential cost savings through alternative drug purchasing models. In this study, we aimed to determine how alternative drug pricing models, including Mark Cuban Cost Plus Drugs (MCCPDC) and Costco Member Prescription Program (CMPP), exhibit cost reductions for common cardiology drugs compared to Medicare Part D purchasing.

Methods
We evaluated the drug costs of 74 commonly prescribed cardiology medications across MCCPDC, CMPP, and Medicare Part D provider drug claims. Drugs were selected based on high-volume cardiology claims and availability through MCCPDC and CMPP as of May 2025. To conservatively estimate savings, we used the dosage strength and quantity associated with the highest cost per unit through MCCPDC and CMPP. We obtained total spending, unit price, and units dispensed from 2023 Medicare Part D Spending by Drug data. Total Medicare Part D spending for each drug was adjusted using the U.S. Bureau of Labor Statistics’ Producer Price Index for pharmaceutical preparations to account for changes in cost from 2023 to 2025.

Results
Table 1 summarizes estimated savings or losses for commonly prescribed cardiology drugs when priced through MCCPDC or CMPP, compared to Medicare Part D spending. Using MCCPDC purchasing prices, 36% (27/74) of the sampled drugs displayed savings, totaling $3.4 billion. Of the drugs that demonstrated savings, the average percent savings was 42%. The top 3 drugs in our sample by potential savings with MCCPDC pricing were: dapagliflozin propanediol ($1.5 billion; 34% savings), icosapent ethyl ($794 million; 78% savings), and ezetimibe ($221 million; 73% savings; Table 2). Using CMPP purchasing prices, 16% (12/74) of the drugs displayed savings, netting $2.2 billion. For these drugs, the average percent savings was 20%. The top 3 drugs by potential savings with CMPP pricing were also dapagliflozin propanediol ($1.8 billion; 40% savings), icosapent ethyl ($130 million; 13% savings), and ezetimibe ($68 million; 22% savings; Table 2).

Conclusions
Our analysis found that a notable subset of cardiology drugs demonstrated substantial cost reductions through MCCPDC and CMPP purchasing, potentially representing meaningful savings when compared to Medicare Part D.