In this episode of unPAUSED, Dr. Mary Claire Haver sits down with entrepreneur Mark Cuban, cofounder of the Mark Cuban Cost Plus Drug Company, to unpack the estrogen patch shortage and why so many women in perimenopause and menopause struggle to find and afford hormone therapy. Holding up her own patch, Dr. Haver asks the question her patients keep asking: why is this so hard to get? Mark explains why the shortage hit so hard — patches require specialized manufacturing that pills don't, demand surged after the black box warning was removed, and supply couldn't keep up — plus how Cost Plus Drugs has worked to buy every patch manufacturers can produce, what the FDA can actually do, and who gets served first when a generic drug runs short. Then they take apart how prescription drug prices are really set in the United States: how pharmacy benefit managers (PBMs) build the formularies that decide what your insurance covers, how manufacturer rebates drive list prices higher, and why a handful of conglomerates now own the insurer, the pharmacy, the PBM, and the physician practice all at once. Using a hypothetical testosterone therapy for women, Mark traces where every dollar goes — and together they pull up the Cost Plus Drugs website live to compare what a generic estradiol patch costs to make against what many women pay at retail. They also cover Dr. Haver's case for vaginal estrogen as one of the most affordable, effective treatments in all of menopause care, why there's still no FDA-approved testosterone for women, how untreated symptoms push experienced women out of the workforce, and the practical playbook for lowering your prescription costs: ask about a 90-day supply, learn how your medications are tiered, compare cash prices with your copay, and use AI to decode your own coverage. Guest links: * Mark Cuban Companies https://markcubancompanies.com/ * Cost Plus Drug Company https://www.costplusdrugs.com/ * Mark Cuban (Instagram) https://www.instagram.com/mcuban/ * Mark Cuban (X) https://x.com/mcuban * Mark Cuban (Facebook) https://www.facebook.com/markcuban/ * Mark Cuban (LinkedIn) https://www.linkedin.com/in/mark-cuban-06a0755b/ Recommended Books: * "The New Perimenopause," by Dr. Mary Claire Haver https://thepauselife.com/pages/the-new-perimenopause-book * "The New Menopause," by Dr. Mary Claire Haver https://www.amazon.com/New-Menopause-Navigating-Through-Hormonal/dp/B0CKBZ4K1Z Other Resources:: * Menopausal Hormone Therapy Use Among Postmenopausal Women (JAMA) https://jamanetwork.com/journals/jama-health-forum/fullarticle/2823976 * Withings https://www.withings.com/en-us?utm_source=unpaused_podcast&utm_medium=podcast&utm_campaign=audacy_2026 For full show notes, please visit: https://bit.ly/4s6v4zY Never miss an episode—sign up for The 'Pause Life Newsletter: https://thepauselife.com/pages/newsletter Medical Disclaimer: The information, including opinions and recommendations, on this platform is meant for informational and educational purposes only. Mary Claire Media, LLC, the unPAUSED podcast, and The 'Pause Life are not medical organizations. Medical advice or medical diagnosis cannot be provided to you through the platform, any associated website, or customer portals. Using this platform does not establish a patient-physician relationship.