Access · Pricing · continued

Cost per milligram, computed honestly across formats — the long version posts 31–60

Access › Pricing cost per milligram compounding formulary data table

This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.

trough_indexTL3Regular12 Mar 2025#31

m.lehtinen, post #15: 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. Not the whole picture, but the part of it I can speak to. 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.

I am not the right person to answer the follow-up to this.

5 likes in reply to #15 17mo

f.novakTL213 Mar 2025#32

Landed cost including shipping, fees and currency conversion is what you actually pay, and quotes that look identical frequently are not.

The mechanism is plausible, which is not the same as established.

14 likes 17mo

buffer_reviewTL3Regular14 Mar 2025#33

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

The answer changed when I changed how I was measuring, which was informative.

28 likes 16mo

a.norgaardTL215 Mar 2025#34

I read post #30 twice before replying, because I had assumed the opposite.

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.

0 likes 16mo

t.ndiayeTL216 Mar 2025#35

n.broberg, post #13: 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. Go to post

Taking post #32 at face value and following it one step further.

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

9 likes in reply to #13 16mo

a.friskTL217 Mar 2025#36

id.almeida, post #21: Cost per milligram is the only comparison that survives format differences, and even then it needs care. This is the sort of thing that ought to be settled and apparently is not. 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.

20 likes in reply to #21 16mo

KTurkingtonTL3Regular18 Mar 2025#37

Wastage from a concentration choice that leaves an unusable remainder is a real cost and is invisible in a per-milligram figure.

I would be glad to be shown a cleaner way of putting this.

0 likes 16mo

s.bergstromTL219 Mar 2025 · edited#38

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

A single observation, in a thread that deserves better than single observations.

0 likes 16mo

t.steenkampTL2Member20 Mar 2025#39

Compute cost per delivered dose at your dose if you want a number you can act on. Everything else is a comparison of packaging.

The short answer was in the first line; everything after is the working.

13 likes 16mo

ak.kravchenkoTL221 Mar 2025#40

a.frisk, post #36: 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. Go to post

Post #38 put the caveat in the right place and I want to underline it.

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

27 likes in reply to #36 16mo

f.villalobosTL222 Mar 2025#41

Reading back through, this was answered upthread and I missed it. My fault.

1 like 16mo

t.pereiraTL223 Mar 2025#42

Picking up post #39: that is the part I would want checked first.

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

Adding it because I spent an afternoon working it out and nobody should have to twice.

0 likes 16mo

b.aaltoTL224 Mar 2025#43

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 would not lead a decision with this, but I would not ignore it either.

17 likes 16mo

e.lehtinenTL225 Mar 2025 · edited#44

trough_index, post #31: 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 am not the right person to answer the follow-up to this. Go to post

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

7 likes in reply to #31 16mo

PharmNotes_WhitfieldTL4Pharmacist26 Mar 2025#45

Post #43 describes the usual case. This is about the unusual one.

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

Happy to be corrected if someone holds better data than mine.

3 likes 16mo

s.cabreraTL227 Mar 2025#46

Collapsed as off-topic by two members at trust level 3 or above

Adding the measurement that post #43 says would settle it.

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

A guess, clearly labelled as one.

dr_okonkwoTL4 Moderator28 Mar 2025#47

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.

24 likes 16mo

c.grimaldiTL229 Mar 2025 · edited#48

t.steenkamp, post #39: Compute cost per delivered dose at your dose if you want a number you can act on. Everything else is a comparison of packaging. The short answer was in the first line; everything after is the working. Go to post

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

11 likes in reply to #39 16mo

k.kimaniTL230 Mar 2025#49

Post #47 and I disagree about the size of the effect, not about the direction.

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 would rather post the uncertainty than round it away.

6 likes 16mo

septum_entryTL2Member31 Mar 2025#50

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.

1 like 16mo

s.oyelaranTL21 Apr 2025#51

KLindqvist, post #26: Taking post #25 at face value and following it one step further. Where somebody posts a comparison, the useful version states the date, the region and what was included. Go to post

Landed cost including shipping, fees and currency conversion is what you actually pay, and quotes that look identical frequently are not.

Not the answer, but possibly the question that gets there.

4 likes in reply to #26 16mo

OTeixeiraTL3Regular2 Apr 2025#52

s.bergstrom, post #38: Cost per week at a maintenance dose is the figure most people actually want and least often calculate. A single observation, in a thread that deserves better than single observations. Go to post

Independent testing is a real cost and belongs in the comparison. A cheaper supplier tested every lot may cost more in total.

I have kept the units in throughout, for the obvious reason.

12 likes in reply to #38 16mo

i.oseiTL23 Apr 2025#53

Building on post #50 rather than restating it.

Cost per milligram is the only comparison that survives format differences, and even then it needs care.

0 likes 16mo

OkaforTL3Regular4 Apr 2025#54

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

Adding a source would improve this post and I do not have one to hand.

0 likes 16mo

il.dumitruTL25 Apr 2025#55

a.norgaard, post #34: I read post #30 twice before replying, because I had assumed the opposite. 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. Go to post

This is the first time the answer has come with its own limits attached. Appreciated.

2 likes in reply to #34 16mo

g.haalandTL3Regular6 Apr 2025 · edited#56

dr_okonkwo, post #47: 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. Go to post

Post #52 describes the usual case. This is about the unusual one.

Price variation between pharmacies: identical prescriptions can cost different amounts at different pharmacies because pharmacies negotiate individually with insurers and manufacturers.

8 likes in reply to #47 16mo

s.beaulieuTL27 Apr 2025#57

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.

This has been discussed before and I could not find the thread, so, again.

26 likes 16mo

f.abrahamsenTL2Member8 Apr 2025#58

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

It is a small point and it changes the answer, which is an awkward combination.

0 likes 16mo

e.roosTL29 Apr 2025#59

Picking up post #58: that is the part I would want checked first.

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

11 likes 16mo

s.grahameTL2Member9 Apr 2025#60

s.beaulieu, post #57: 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. This has been discussed before and I could not find the thread, so, again. Go to post

On post #56 — agreed on the reasoning, with one qualification.

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

25 likes in reply to #57 16mo