This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1 · go to the accepted answer.
This follows post #118 rather than contradicting it.
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 rather this thread reach "we do not know" about Price changes than reach a confident answer that nobody can support when asked.
What would change my mind on Price changes is a second dataset collected by someone with no stake in the first. Until then I hold it loosely and I would rather say so than pretend to more.
Taking post #122 at face value and following it one step further.
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 note on scope: what I am saying about Price changes applies to the case in the first post and I would not extend it further without checking.
Adding a null result on Price changes. I looked, carefully, and found nothing, and null results deserve posting precisely because they never are.
Nothing to add, except that this is the answer I would give if asked.
I disagree with the framing of Price changes above, and I think it is a substantive disagreement rather than a terminological one. Setting out why, so it can be checked.
The reasoning depends on an assumption that is doing a lot of work and is never stated. If the assumption holds, the conclusion follows. I do not think it holds generally.
Where a price includes consultation, device and follow-up, saying so makes a comparison possible. Most quoted figures do not.
Reading this Price changes thread as someone who came in with a fixed view: the third and seventh replies moved me and the confident ones did not.
Everything in post #131 holds. The case it does not cover is the one I have.
Adding a small correction to the Price changes summary above rather than a disagreement with it. The substance holds; one of the figures is out by a factor that matters.
Nothing here is financial advice and none of it is a route to a transaction.
Understood, and I withdraw the assumption I opened with.
Post #134 is the version of this I will quote in future. One addition.
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.
I keep a log of this specifically because memory is unreliable about it.
What I want from this Price changes thread is the list of things that would need to be true for the claim to hold. If we can write that list, we can check 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.
Confirming post #139 from a second method, which matters more than confirming it from a second person.
Two sentences on Price changes and then I will stop, because the rest is speculation and the thread is better without mine.
What is documented is narrow. What is inferred from it is broad. The gap between them is where every argument here lives.
I will take the caveat as seriously as the claim, which is the point of putting it there.
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.
Post #140 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.
Where I part company with post #142, and it is a narrow parting.
The honest answer on Price changes is that it depends, and the useful part is the list of what it depends on. Four items, in rough order of how much they matter.
Most people get the first two right and then argue about the fourth.
The most useful reply I ever got about Price changes was a request to state my units. It sounds like pedantry and it has saved me twice.
The cost of an independent submission is worth stating in these threads, because it is the main reason people do not do it.
Marking that as an opinion rather than a finding.
Where a price includes consultation, device and follow-up, saying so makes a comparison possible. Most quoted figures do not.
I had written a reply contradicting post #146 and deleted it. Here is what survived.
Counterpoint on Price changes, offered without confidence: the same observation is consistent with a much duller explanation, and nobody has ruled the dull one out.
This follows post #147 rather than contradicting it.
The most useful pricing posts here are the ones that show the arithmetic rather than the conclusion.
A partial answer, offered because a partial answer beats none.