This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
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.
Post #61 put the caveat in the right place and I want to underline it.
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.
The number is defensible. The precision I gave it is not.
The cost of an independent submission is worth stating in these threads, because it is the main reason people do not do it.
The strength of my opinion here exceeds the strength of my evidence.
Taking post #66 at face value and following it one step further.
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 distinction has done more work for me than anything else in this category.
I read post #66 twice before replying, because I had assumed the opposite.
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 disagreement above is smaller than it looks once the terms are fixed.
Cost per milligram is the only comparison that survives format differences, and even then it needs care.
Nothing above should be read as advice about what anyone else should do.
Nothing here is financial advice and none of it is a route to a transaction.
The most useful pricing posts here are the ones that show the arithmetic rather than the conclusion.
Post #70 put the caveat in the right place and I want to underline it.
The cost of an independent submission is worth stating in these threads, because it is the main reason people do not do it.
Anyone with a larger sample, please post it.
The most useful pricing posts here are the ones that show the arithmetic rather than the conclusion.
I read post #74 twice before replying, because I had assumed the opposite.
Wastage from a concentration choice that leaves an unusable remainder is a real cost and is invisible in a per-milligram figure.
Second-hand, so weight it accordingly.
Taking post #76 at face value and following it one step further.
A cheaper option that arrives slowly has a cost in the form of running out, and people rarely price that.
Posting it because the silence on this was starting to look like agreement.
Nothing here is financial advice and none of it is a route to a transaction.
It reads as pedantry until the day it does not.
Post #76 is right about the mechanism and I think understates the practical bit.
Where somebody posts a comparison, the useful version states the date, the region and what was included.
I would want a second opinion before relying on that.
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.
That holds under the stated conditions and I have stated them.
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.
Same conclusion as the reply above, reached differently, which is mildly reassuring.
Post #83 is the version of this I will quote in future. One addition.
The most useful pricing posts here are the ones that show the arithmetic rather than the conclusion.
Take the reasoning and check the arithmetic; I do not always get it right.
Post #83 describes the usual case. This is about the unusual 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.
Nothing here is financial advice and none of it is a route to a transaction.
I have changed my mind on this once already, so take it as current rather than settled.
Thank you — that answers what I came here to find out.
On post #88 — agreed on the reasoning, with one qualification.
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.