On the subject in the title: List price versus negotiated price versus what you pay Working notes rather than a conclusion.
List price versus negotiated price — I have the observation and I do not trust my interpretation of it, so I am posting the observation and holding the interpretation back.
Numbers, method and the conditions under which they were collected are below. Interpret them however they warrant.
Post #2 is the version of this I will quote in future. One addition.
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.
A price well below the rest of the market is a fact rather than a finding, and it is worth noting without concluding from it.
Post #4 describes the usual case. This is about the unusual one.
List prices versus negotiated prices: the price a pharmaceutical company publishes and the price an insurance company or pharmacy actually pays differ substantially. List price is not what anyone pays.
I would want to see it done twice before believing it once.
One more thing on list price versus negotiated price that took me far too long to see: the two figures people quote are not measuring the same quantity. Once you notice that, the apparent contradiction disappears.
That is the distinction I keep failing to hold on to. Written down now.
List price versus negotiated price has a well-known answer and a correct answer, and the interesting work is establishing that they are the same. Nobody has done that here yet.
The documentation on list price versus negotiated price is better than this thread and I say that as someone who has posted in the thread.
Where somebody posts a comparison, the useful version states the date, the region and what was included.
The claim about list price versus negotiated price upthread is stronger than its source supports. I have read the source. The source says "associated with" and the post says "causes".
Agreed on all of that, and I have nothing to add to it.
Comparing a licensed product's price to a research-use-only preparation's price is comparing two different things, and the difference is most of the explanation.
That is what the documentation says. What happens in practice is usually close.
Where a price includes consultation, device and follow-up, saying so makes a comparison possible. Most quoted figures do not.
This is the sort of thing the wiki should carry and currently does not.
Confirming post #20 from a second method, which matters more than confirming it from a second person.
Price differences within a market are usually about scale, documentation and logistics rather than about anything mysterious.
This has been discussed before and I could not find the thread, so, again.
Helpful, and short, which on this subject is harder than long.
The most useful pricing posts here are the ones that show the arithmetic rather than the conclusion.
Adding a reference point for list price versus negotiated price. Mine is a single case, collected without controls, and I am posting the method alongside it so it can be discounted appropriately.
Post #24 is the version of this I will quote in future. One addition.
I have no financial interest in anything named in this thread and I want to say so before I comment on list price versus negotiated price, because it is the sort of subject where it matters.
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.
Answering the question post #26 raises rather than the one it answers.
The version of list price versus negotiated price that circulates here is a simplification of a simplification. It is not wrong, but it has lost the conditions under which it holds, and those conditions are where the interesting cases live.
Fine by me. I had wanted a stronger conclusion and there is not one available.