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Access · Pricing

Coming back to: Why the cheapest option is often not the cheapest

DA
d.achebeTL213 Oct 2024#1

Why the cheapest option is often not the cheapest — that is the question, and I have not found it answered plainly anywhere I have looked.

Reading back through what has been written here about cheapest option, three questions come up every time and only one has ever been answered properly.

Listing all three, with what I think the state of the answer is for each, so the thread can start further along than the last one did.

14 likes 21mo
DV
d.vukovicTL24 Nov 2024#2

Coming back to the opening post, because the follow-up matters more than the original answer.

Taking cheapest option seriously for a moment rather than deflecting: the honest position is that the community has observations and no controlled comparison, and those two things support very different sentences.

18 likes 21mo
DB
dr_bhattacharyaTL3Physician19 Nov 2024#3

The most useful pricing posts here are the ones that show the arithmetic rather than the conclusion.

0 likes 20mo
RM
r.mensaTL23 Dec 2024#4

Cheapest option is well covered in the tag pages, and the older discussions are better than the recent ones because they were argued out properly. Worth twenty minutes before adding to this one.

1 like 20mo
MP
mira.patelTL4 Admin15 Dec 2024#5

Confirming post #4 from a second method, which matters more than confirming it from a second person.

My experience of cheapest option contradicts the reply above. I am posting it as a data point rather than as a refutation, because one person's experience is exactly that.

12 likes 19mo
CB
c.boatengTL227 Dec 2024 · edited#6

The cost of an independent submission is worth stating in these threads, because it is the main reason people do not do it.

25 likes 19mo
RA
r.aldana_pharmdTL4Pharmacist8 Jan 2025#7
d.vukovic, post #2: Coming back to the opening post, because the follow-up matters more than the original answer. Taking cheapest option seriously for a moment rather than deflecting: the honest position is that the community has observations and no controlled comparison, and those two things support very different sentences. Go to post

Fine by me. I had wanted a stronger conclusion and there is not one available.

0 likes in reply to #2 19mo
RZ
r.zielinskiTL219 Jan 2025#8

Nobody has said the unglamorous part of cheapest option yet, so: most of the variation is explained by things that are boring to write about and easy to check.

4 likes 18mo
GT
g.tanakaTL3Regular29 Jan 2025#9

A cheaper option that arrives slowly has a cost in the form of running out, and people rarely price that.

2 likes 18mo
MM
m.mwangiTL29 Feb 2025#10

Pharmacy acquisition cost: a pharmacy pays less than the patient pays, even at insurance rates. That margin is where the pharmacy's costs and profit live.

8 likes 18mo
TV
t.vasquezTL4 Moderator19 Feb 2025#11

On cheapest option, I would rather understate and be corrected upward than overstate and be quoted. That is a house style here and it is a good one.

1 like 17mo
VB
va.baptistaTL21 Mar 2025#12

Reading this cheapest option thread as someone who came in with a fixed view: the third and seventh replies moved me and the confident ones did not.

0 likes 17mo
SC
so.cardosoTL211 Mar 2025#13
m.mwangi, post #10: Pharmacy acquisition cost: a pharmacy pays less than the patient pays, even at insurance rates. That margin is where the pharmacy's costs and profit live. Go to post

Post #9 put the caveat in the right place and I want to underline it.

Nothing here is financial advice and none of it is a route to a transaction.

25 likes in reply to #10 17mo
SD
s.dziedzicTL220 Mar 2025#14

Building on post #13 rather than restating it.

Whatever the answer on cheapest option turns out to be, the method for getting there is the same: state the assumption, do the arithmetic in public, invite the correction.

12 likes 16mo
BN
b.nilsenTL230 Mar 2025#15

Filing a mild objection to the consensus on cheapest option. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit.

4 likes 16mo
NP
n.petrovTL28 Apr 2025#16
d.vukovic, post #2: Coming back to the opening post, because the follow-up matters more than the original answer. Taking cheapest option seriously for a moment rather than deflecting: the honest position is that the community has observations and no controlled comparison, and those two things support very different sentences. Go to post

Where somebody posts a comparison, the useful version states the date, the region and what was included.

0 likes in reply to #2 16mo
DB
d.barrosTL217 Apr 2025#17

Post #13 and I disagree about the size of the effect, not about the direction.

The number people quote for cheapest option is a central estimate presented without its interval, and the interval is wide enough that the estimate is nearly uninformative on its own.

0 likes 15mo
MI
m.ivaturiTL226 Apr 2025#18

Discount programmes and coupons: manufacturers often offer coupons that reduce out-of-pocket costs if insurance is not covering or is covering at a high copay. These have eligibility restrictions but can save money.

Old habit: I write down the expected answer before I calculate it.

18 likes 15mo
AS
a.silvaTL25 May 2025#19

The thing about cheapest option that took me longest to accept is that a plausible mechanism is not evidence of an effect. It is a reason to look, not a result.

0 likes 15mo
OC
o.cousineauTL3Regular14 May 2025#20

Adding the measurement that post #17 says would settle it.

What I want from this cheapest option thread is the list of things that would need to be true for the claim to hold. If we can write that list, we can check it.

26 likes 14mo
BP
baseline_peakTL2Member22 May 2025#21
c.boateng, post #6: The cost of an independent submission is worth stating in these threads, because it is the main reason people do not do it. Go to post

Insurance tier placement: a compound might be covered but on a higher tier (higher copay). Moving to a lower tier usually requires prior authorization or documented failure of cheaper alternatives.

The general case is well covered; this is the awkward specific one.

0 likes in reply to #6 14mo
BN
b.nwosuTL231 May 2025#22

Agreed on cheapest option, with one qualification that I think matters. The reasoning holds for the case as described. Change the starting assumption and it does not, and the starting assumption is the part nobody states.

4 likes 14mo
Z
ZieglerTL3Regular8 Jun 2025#23

This follows post #22 rather than contradicting it.

Cost per week at a maintenance dose is the figure most people actually want and least often calculate.

19 likes 14mo
BJ
b.jansenTL217 Jun 2025#24

Worth separating two things that post #20 runs together.

Pharmacy acquisition cost: a pharmacy pays less than the patient pays, even at insurance rates. That margin is where the pharmacy's costs and profit live.

0 likes 13mo
RG
r.girardTL225 Jun 2025#25
g.tanaka, post #9: A cheaper option that arrives slowly has a cost in the form of running out, and people rarely price that. Go to post

Marking my uncertainty on cheapest option explicitly. I am confident about the direction, much less confident about the size, and not confident at all that it generalises past the case in the first post.

2 likes in reply to #9 13mo
CS
c.silvaTL23 Jul 2025 · edited#26

I had written a reply contradicting post #24 and deleted it. Here is what survived.

If someone has run cheapest option properly I would rather read that than my own reconstruction of it. Posting mine only because the thread has gone quiet.

8 likes 13mo

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