Mark Cuban steps in to cut heart transplant drug cost

Billionaire entrepreneur Mark Cuban has helped Payton Herres, a 26-year-old heart transplant survivor, obtain her anti-rejection drug at a fraction of the cost after her insurer stopped covering it. Herres, who received a donated heart at age 11, had relied on everolimus since 2013 but was told in February that the drug was no longer medically necessary by her insurer, Elevance Health (Anthem). After a social media appeal, coverage was restored but the price rose to $1,000 for a 90-day supply from $180 earlier, leaving her unable to afford it.

The story reached Cuban through posts on LinkedIn. His Cost Plus Drug Company now supplies the medication for about $300 for 90 days, with costs covered by a nonprofit linked to startup Claimable. Elevance Health stated the initial denial "did not fully account for" Herres' medical history and apologised, approving the drug. A recent IQVIA study found 70% of commercially insured US patients faced initial denials for a newly prescribed branded medicine in 2024, highlighting broader insurance access issues.