Government bias and billionaires shouldn’t decide who gets affordable medicine

The Louisiana Pharmacy Benefit Manager Monitoring Advisory Council met last month with an unusual guest — one who came with a clear conflict of interest.

Dr. Alex Oshmyansky, founder and CEO of the Mark Cuban-backed Cost Plus Drug Company, was invited to brief the council on PBMs. But his company directly competes with them. No PBM representatives were invited to speak or respond. What could have been an informed policy discussion turned into an unbalanced promotional session for a single competitor — and that does not serve patients.

The one-sided hearing

Pharmacy benefit managers have long been in Mark Cuban’s crosshairs. He claims PBMs create “an inefficient market” and lack transparency. Those complaints underpin his partnership with Oshmyansky to form Cost Plus Drug Company, a business designed to bypass PBMs entirely.

If Louisiana’s leaders want real reform, they must start by restoring fairness — and remembering who the system exists to serve.

At the hearing, Oshmyansky presented his company’s views on PBMs without challenge or rebuttal. The absence of PBM voices left the council with a distorted view of the system it’s supposed to oversee.

That imbalance creates two serious problems.

First, it deprives the council of a complete understanding of how PBMs work — what services they provide, how they negotiate lower drug prices, and how Louisiana’s new PBM regulations are already being implemented. Without hearing from the industry itself, policymakers risk forming conclusions based on partial information and advocacy, not evidence.

Second, when public bodies accept one-sided testimony, patients lose. PBMs manage drug coverage for millions of Americans, ensuring access to affordable medicines and stable pharmacy networks. When their perspective is ignored, regulations may raise costs, reduce access, or disrupt care for the very people the state claims to protect.

Political hostility and government bias

The broader political context in Louisiana makes this even more troubling. Gov. Jeff Landry (R) has pushed to ban PBMs entirely — an extreme measure that would upend how prescription coverage operates in the state. Meanwhile, Attorney General Liz Murrill has sued CVS, one of the nation’s largest PBMs, for warning consumers about the potential fallout of such a ban.

These moves reveal a pattern: State leaders are treating PBMs not as partners with critical expertise but as enemies. That approach replaces policymaking with politics and undermines public confidence in fair regulation.

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Reform through balance, not bias

The PBM industry isn’t above reform. Greater transparency and accountability are necessary. But good policy starts with balance. The council should convene a second meeting — this time with PBM representatives at the table alongside Cost Plus Drug Company. The proceedings should be public and transparent.

Patients deserve policies based on facts, not billionaire-backed bias. Regulation shaped by evidence, not resentment, is how states protect health, affordability, and trust.

If Louisiana’s leaders want real reform, they must start by restoring fairness — and remembering who the system exists to serve.