Built overnight as a working demonstration for Mark Cuban Cost Plus Drug Company  →
The Markup Index30-day supply
Imatinib 400mgleukemia — gen. Gleevec
$34.50
$9,657.30 listed retail
Abiraterone 250mgprostate cancer — gen. Zytiga
$19.23
$1,093.20 listed retail
Tadalafil 20mgED / BPH — gen. Cialis
$6.68
$1,300.50 listed retail
A Letter Leverage demonstration

The drug-pricing index

Know what your medicines actually cost.

One pharmacy in America publishes its true cost plus a fixed 15% on every drug it sells. What America Pays tracks what everyone else charges against it — drug by drug, source by source.

Built in one night. Every number links to its source. See the methodology →

Evidence drawn from
FTCAnnals of Internal MedicineJ. Clinical OncologyCMSPenn LDIDrug Channels
How it reads

See the cost. Track the markup. Name the middleman.

Prices captured live from costplusdrugs.com and drugs.com on July 7, 2026. Two comparators, never blended: an independent discounted-cash floor, and the retail figure Cost Plus itself publishes.

01 · The cost

Cheaper than the coupon floor, 10 times out of 12.

The conservative comparison: the lowest published discounted cash price — the coupon floor, not the counter price — as a multiple of the Cost Plus price for the same 30-day supply. Every multiple is a lower bound.

1× = PARITY Tadalafil 20mggen. Cialis — ED / BPH5.8× Sildenafil 20mgED / pulmonary hypertension4.3× Abiraterone 250mggen. Zytiga — prostate cancer3.9× Imatinib 400mggen. Gleevec — leukemia3.4× Atorvastatin 20mggen. Lipitor — cholesterol3.2× Esomeprazole 40mggen. Nexium — acid reflux2.3× Rosuvastatin 10mggen. Crestor — cholesterol1.7× Lisinopril 10mgblood pressure1.7× Escitalopram 10mggen. Lexapro — depression1.4× Metformin 1000mgtype 2 diabetes1.0× Aripiprazole 5mggen. Abilify — schizophrenia0.96× Mesalamine 800mg DRgen. Asacol HD — colitis0.96× The index cuts both ways. Two drugs land below parity against the couponed floor — and we print that too. An index that only cuts one way is an advertisement.

Comparator: lowest published discounted cash price, drugs.com Price Guide, normalized to a 30-count supply; gray bars sit below parity. Both sources captured July 7, 2026.

02 · The index

Twelve drugs, three prices, every source linked.

Each row links to the exact product page and price guide it was pulled from. The right-hand column is the retail figure Cost Plus itself publishes — reproduced with attribution, not independently verified. Beyond these twelve, 583 of the 1,032 catalog prices are now benchmarked against an independent source — federal NADAC acquisition-cost data or this index (see methodology). Browse it as a dataset — search, sort, filter, CSV →

DrugSupply Cost Plus¹ Cash floor² vs. floor Retail at other pharmacies³
Tadalafilgen. Cialis — ED / BPH20mg × 30$6.68$38.925.8×$1,300.50
SildenafilED / pulmonary hypertension20mg × 30$6.74$28.714.3×$183.60
Abirateronegen. Zytiga — prostate cancer250mg × 30$19.23$74.093.9×$1,093.20
Imatinibgen. Gleevec — CML leukemia400mg × 30$34.50$117.003.4×$9,657.30
Atorvastatingen. Lipitor — cholesterol20mg × 30$5.46$17.643.2×$68.70
Esomeprazolegen. Nexium — acid reflux40mg × 30$5.86$13.622.3×$216.60
Rosuvastatingen. Crestor — cholesterol10mg × 30$5.67$9.601.7×$134.10
Lisinoprilblood pressure10mg × 30$5.39$8.981.7×$33.90
Escitalopramgen. Lexapro — depression / anxiety10mg × 30$6.25$9.021.4×$47.70
Metformintype 2 diabetes1000mg × 30$5.57$5.581.0×$39.90
Aripiprazolegen. Abilify — schizophrenia / bipolar5mg × 30$6.93$6.680.96×$685.50
Mesalaminegen. Asacol HD — ulcerative colitis800mg DR × 30$97.40$93.470.96×$245.10

¹ Live costplusdrugs.com product-page price, July 7, 2026; excludes the flat $5 pharmacy fee and $5.25 shipping per order.  ² Lowest published discounted cash price, drugs.com Price Guide, July 7, 2026, normalized to 30-count where the listed quantity differs (see methodology).  ³ "Retail Price at Other Pharmacies" as displayed on each costplusdrugs.com product page — the company's own comparison, reproduced with attribution, not independently verified.

03 · The use

Built to be cited.

The real version of this index updates weekly and is written to be quoted — the same signal, packaged for the person reading it.

For a journalist

Embeddable rows and charts with the source one click away — so a drug-pricing story starts from the index instead of a press release, and the fact-check is already done.

For a policymaker

Testimony-grade fact sheets per drug and per middleman, footnoted to the FTC record and the peer-reviewed studies — ready for the next hearing on PBM reform.

See the full methodology  →
Briefings

The stories the index keeps telling.

Data-driven reporting, every figure footnoted.

Oncology · The index, ranked

The widest gaps are on cancer drugs.

A month of generic imatinib costs $34.50 to sell profitably. Its listed retail is $9,657.30. Researchers put Medicare's overpayment on seven generic oncology drugs at $661.8 million a year.

Briefing 01Open briefing  →
PBMs · The middlemen

The $7.3 billion middleman.

The FTC counted what the three biggest pharmacy benefit managers made by marking up specialty generics at their own pharmacies: $7.3 billion above cost in six years.

Briefing 02Open briefing  →

Turn a price list into the reference publication.

What America Pays is a working demonstration by Letter Leverage — researched, verified and shipped in one session. The real version updates weekly and gets cited by default.

nils@letterleverage.com Why this exists