Cost per milligram, computed honestly across formats — the long version

Cost per milligram, computed honestly across formats — the long version Writing it up because I had to work it out twice and would rather nobody else did.

Documenting an access outcome, dated, because everything in this category expires.

As of May 2026, in my region, the position is as described below. I have linked the primary source rather than a summary of it, because the summaries are consistently a year behind.

If anyone can confirm or contradict this for their own region, please date your answer. An undated claim in this category is worse than no claim.

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

That is one dataset and I would not build a rule on it.

Where I part company with the opening post, and it is a narrow parting.

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.

Acknowledging rather than arguing. The reasoning holds as far as I can follow it.

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

I would put the burden of proof on the interesting explanation, not the dull one.

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.

I had written a reply contradicting post #5 and deleted it. Here is what survived.

Compute cost per delivered dose at your dose if you want a number you can act on. That requires knowing your dose, vial volume, and whether you are using a vial or a pen.

That is what the documentation says. What happens in practice is usually close.

Cost per milligram is the only comparison that survives format differences, but even then it needs care. A pen and a vial are not the same product and cannot be compared on price per milligram alone because dead volume, wastage, and number of doses actually obtainable differ.

Marking that as an opinion rather than a finding.

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

This follows post #9 rather than contradicting it.

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

The arithmetic in post #10 is right; the assumption feeding it is the part to check.

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

Answering the question post #8 raises rather than the one it answers.

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

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.

That is where I would start, not where I would stop.

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

Happy to be the one who is wrong here if it settles the question.