Follow-up: State-level differences that actually matter posts 61–90
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
Building on post #59 rather than restating it.
I have been on both sides of the State-level differences argument in this category within eighteen months, which should tell you how strong the evidence for either side is.
One caution on State-level differences: everything above assumes the underlying documentation is what it claims to be. That assumption is doing real work and is rarely stated.
Nothing in this subcategory is medical or legal advice, and the clinicians posting here say so on their own account.
I would treat the number as indicative rather than as a measurement.
Whatever the answer on State-level differences turns out to be, the method for getting there is the same: state the assumption, do the arithmetic in public, invite the correction.
On State-level differences, 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.
Everything in post #63 holds. The case it does not cover is the one I have.
Both are useful and different. The account tells you what happens in practice; the criterion tells you what to write.
This is the version I would want a new member to read first.
Worth separating two things that post #67 runs together.
State-level differences was covered in the wiki last year and the page has a review date on it, which is a better starting point than my memory of a thread.
I read post #72 twice before replying, because I had assumed the opposite.
Source for the State-level differences figure, since it was asked for. It is in the discussion rather than the abstract, which is why the version circulating is stronger than the paper is.
Reading the surrounding paragraph is worth the two minutes. The authors are more careful than their summarisers.
Post #72 put the caveat in the right place and I want to underline it.
Two claims get bundled together under State-level differences and they need separating. The descriptive one — this is what was observed — is usually well supported. The causal one — this is why — usually is not.
Almost every disagreement in threads like this one dissolves once you say which of the two you are making.
Date every claim in this subcategory. Positions here have moved repeatedly and old posts are read as current.
Caveat: everything above assumes the paperwork is what it says it is.
A note on scope: what I am saying about State-level differences applies to the case in the first post and I would not extend it further without checking.
Collapsed as off-topic by two members at trust level 3 or above
Post #77 describes the usual case. This is about the unusual one.
Compounded preparations and authorised products are different regulatory categories with different oversight, and conflating them produces most of the confusion here.
Adding the boring version of State-level differences, because the interesting version keeps getting posted and the boring one is usually right.
Check the ordinary explanations, in order, and stop when one of them accounts for what you are seeing. Most of the time the second one does.
Cross-border purchasing raises both a legal question and a practical one, and the legal one is yours to establish for your own jurisdiction.
This is where my knowledge stops and I would rather mark the edge than blur it.
Small correction to my own earlier position on State-level differences. I had the units the wrong way round, which changes the conclusion by an order of magnitude and therefore changes it entirely.
Picking up post #85: that is the part I would want checked first.
The confident answers on State-level differences and the well-sourced answers are not the same answers, which is the most useful thing I have learned reading this category.
Prior authorisation criteria are usually published by the payer and reading them before the appointment changes the outcome more than anything else does.
I would want a second opinion before relying on that.
Private insurance gaps: some people have private insurance but medication is not covered. Manufacturer assistance programmes are the main resource for cost reduction.
It reads as pedantry until the day it does not.
Collapsed as off-topic by two members at trust level 3 or above
The question underneath State-level differences is usually "how would I tell?" rather than "what is true?", and that one has a method attached to it.
Write down what you would expect to see under each hypothesis before you collect anything. If they predict the same observation, collecting it will not help.