How we count
Every number on this site traces to a source you can open. This page is the rulebook.
The Markup Index uses Mark Cuban Cost Plus Drug Company prices as its baseline because they are the only pharmacy prices in America constructed transparently: the manufacturer's actual cost, plus a fixed 15% markup, plus a flat $5 pharmacy labor fee, plus $5.25 shipping per order. All Cost Plus prices in the index were pulled from live costplusdrugs.com product pages and are date-stamped. Where we cite a price, we link the exact product page it came from.
The 12-drug index shows two comparisons and never blends them. The first is independent and deliberately conservative: the lowest published discounted cash price on the drugs.com Price Guide — the coupon-card floor, not the undiscounted counter price — so every multiple in the chart is a lower bound. The second is the "Retail Price at Other Pharmacies" figure Cost Plus publishes on its own product pages; it is reproduced with attribution as the company's comparison, not as an independent audit. We never estimate a retail price and never reconstruct one from memory. If no published comparator existed for a drug (one of thirteen candidates, an inhaler with no form-matched listing), the drug was dropped rather than approximated.
For the full 1,032-drug catalog we add a third, independent comparator: NADAC — the National Average Drug Acquisition Cost, CMS's weekly survey of the invoice prices US retail pharmacies actually pay to acquire each drug (weekly CSV, as of July 8, 2026). Each catalog drug is matched to FDA product codes via the openFDA NDC directory on ingredient set, strength and dosage form; only exact-tier matches — all three confirmed — are shown on the site. That yields 583 federally benchmarked drugs; together with the 12-drug hand-verified index (a few drugs appear in both, and five index supplies sit outside the drug-level catalog) that makes 595 independent price checks. The remaining 422 catalog drugs show only Cost Plus's own listed retail and are labeled "pending independent verification" — the label is the standard, not a footnote. Package-level cost comparisons appear only where the package math is unambiguous (single-count packs, per-unit pricing), and extreme ratios are held back pending row-level review rather than published.
A comparison appears only when drug, strength and quantity match. Where a source quotes a different quantity, we either normalize per-unit and label it, or mark the row "approximate" and say why. The markup multiple is retail price divided by Cost Plus price for the same supply — before insurance, coupons or discount cards, because the point of the index is the list price the system starts from.
It is not medical advice, and it is not a claim that any particular patient pays the retail figure — insured patients usually pay less, and occasionally more, than either number. It measures the gap between a transparent cost-based price and the prevailing retail one. Studies of insured populations measuring actual out-of-pocket gaps are cited separately in our briefings.
Federal Trade Commission interim staff reports on pharmacy benefit managers (July 2024, January 2025); CMS National Health Expenditure data; Lalani et al., Annals of Internal Medicine (2022); Cortese et al., Journal of Clinical Oncology (2023); University of Pennsylvania Leonard Davis Institute claims analysis (2025); Drug Channels Institute market-share data (2026). Full citations appear as footnotes on each briefing.
If a number is wrong, we correct the row, note the correction at the bottom of the page, and keep the original visible. A price index that quietly edits itself is not an index.