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Access · Pricing · continued

List price versus negotiated price versus what you pay posts 91–116

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

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s.chowdhuryTL3Regular15 Apr 2026#91
i.grimaldi, post #26: 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

List price versus negotiated price 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.

1 like in reply to #26 3mo
MM
methods_marginTL3Regular16 Apr 2026 · edited#92
z.yildiz, post #6: 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. Go to post

Where a price is quoted per vial, the fill has to be stated for the comparison to mean anything.

It cost nothing to check and would have cost something not to.

0 likes in reply to #6 3mo
NK
n.kaufmannTL216 Apr 2026#93

Coming back to post #91, because the follow-up matters more than the original answer.

What I would check first on list price versus negotiated price is whether the thing being measured moved or whether the way of measuring it moved. Those look identical in a graph.

15 likes 3mo
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IRenaudinTL2Member16 Apr 2026#94

Post #91 is right about the mechanism and I think understates the practical bit.

A definition problem is doing most of the work in this list price versus negotiated price discussion. Once the term is pinned down I suspect the disagreement mostly goes away and what is left is small.

6 likes 3mo
NB
n.boatengTL216 Apr 2026#95
s.kravchenko, post #17: 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". Go to post

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

Not a strong opinion, just a consistent one.

3 likes in reply to #17 3mo
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g.pemberton_ukTL3Regional · UK16 Apr 2026#96

That is clearer than the version I had in my head. Thank you.

0 likes 3mo
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e.bakkenTL216 Apr 2026#97

Where a price includes consultation, device and follow-up, saying so makes a comparison possible. Most quoted figures do not.

Two sources, same conclusion, and I could not rule out that one copied the other.

22 likes 3mo
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crossover_reviewTL3Regular16 Apr 2026#98

Post #95 answers the question as asked. The question underneath it is different.

The number people quote for list price versus negotiated price is a central estimate presented without its interval, and the interval is wide enough that the estimate is nearly uninformative on its own.

10 likes 3mo
IB
i.balogunTL216 Apr 2026 · edited#99
h.karlsen, post #8: Summarising the list price versus negotiated price thread so far, since it is long and the answer is buried: the first reply has the method, the fourth has the correction to it, and the rest is people agreeing at length. Go to post

Post #95 put the caveat in the right place and I want to underline it.

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

5 likes in reply to #8 3mo
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r.mcalisterTL3Regular16 Apr 2026#100

An observation about list price versus negotiated price that I cannot explain and am posting anyway, on the principle that unexplained observations are more useful public than private.

0 likes 3mo
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m.adebayoTL216 Apr 2026#101

Where I part company with post #99, and it is a narrow parting.

Speaking only to list price versus negotiated price as I have actually seen it, rather than as it is usually described: the effect is real, it is smaller than the thread suggests, and the variance between people is larger than the effect.

0 likes 3mo
BP
bench_peakTL3Regular16 Apr 2026#102

Post #99 is the version of this I will quote in future. One addition.

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

25 likes 3mo
TB
t.batistaTL216 Apr 2026#103
Woodhouse, post #14: Taking post #11 at face value and following it one step further. Larger orders shift risk as well as price, because more of your material then comes from one lot. Happy to be corrected if someone holds better data than mine. Go to post

Good question, well framed, and I would like to see it answered properly.

8 likes in reply to #14 3mo
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IsaksenTL3Regular16 Apr 2026#104

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.

It is the sort of thing that seems obvious in retrospect and was not at the time.

1 like 3mo
TI
t.ibarraTL217 Apr 2026#105

Practical note on list price versus negotiated price: write down what you expect before you look. The number of times I have found what I went looking for is higher than chance would allow.

0 likes 3mo
TN
t.nardoneTL317 Apr 2026#106
NA
n.achebeTL217 Apr 2026#107
i.grimaldi, post #26: 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

On post #104 — agreed on the reasoning, with one qualification.

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.

4 likes in reply to #26 3mo
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footnote_entryTL3Regular17 Apr 2026#108

List price versus negotiated price is one of those subjects where the general answer and the answer for a specific case diverge, and the thread will go in circles until someone says which one is being asked for.

0 likes 3mo
KK
k.kuuselaTL217 Apr 2026#109

The most useful thing anyone has posted about list price versus negotiated price in this category was a table of what had been measured and by whom. That is what I would want again.

26 likes 3mo
NR
n.rowntreeTL3Regular17 Apr 2026#110
k.batista, post #74: Where a price is quoted per vial, the fill has to be stated for the comparison to mean anything. Go to post

Larger orders shift risk as well as price, because more of your material then comes from one lot.

Same conclusion as the reply above, reached differently, which is mildly reassuring.

13 likes in reply to #74 3mo
RS
r.szaboTL217 Apr 2026#111
s.bruun, post #90: Landed cost including shipping, fees and currency conversion is what you actually pay, and quotes that look identical frequently are not. Go to post

Picking up post #110: that is the part I would want checked first.

The failure mode on list price versus negotiated price is boring rather than dramatic. It is almost always the step everyone assumes was done correctly because it is too simple to get wrong.

17 likes in reply to #90 3mo
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g.pemberton_ukTL3Regional · UK17 Apr 2026#112
c.adebayo, post #5: Price variation between pharmacies: identical prescriptions can cost different amounts at different pharmacies because pharmacies negotiate individually with insurers and manufacturers. Reading it back, the second half matters more than the first. Go to post

On post #108 — agreed on the reasoning, with one qualification.

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

On reflection I would soften that slightly.

32 likes in reply to #5 3mo
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n.boatengTL217 Apr 2026 · edited#113

Price differences within a market are usually about scale, documentation and logistics rather than about anything mysterious.

Written from notes rather than memory, which is why the numbers are specific.

1 like 3mo
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crossover_reviewTL3Regular17 Apr 2026#114

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.

A modest claim, modestly supported.

6 likes 3mo
AI
a.iyerTL217 Apr 2026#115
e.iyer, post #81: Distinguishing three things in the list price versus negotiated price discussion that keep getting used interchangeably: the observation, the proposed mechanism, and the recommendation that gets attached to both. Go to post

Adding the measurement that post #114 says would settle it.

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

Worth one more sentence than it usually gets.

23 likes in reply to #81 3mo
RM
r.mcalisterTL3Regular17 Apr 2026#116
footnote_entry, post #108: List price versus negotiated price is one of those subjects where the general answer and the answer for a specific case diverge, and the thread will go in circles until someone says which one is being asked for. Go to post

Agreed, and I will stop repeating the version of this I had been repeating.

0 likes in reply to #108 3mo

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