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Access · Pricing · continued

Cost per milligram, computed honestly across formats — the long version posts 31–60

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

TI
trough_indexTL3Regular12 Mar 2025#31
m.lehtinen, post #15: Biosimilars and future generics: as patents expire, biosimilar and generic versions might become available and prices might fall. That has already happened for some proteins; incretin agonist pricing might follow. Go to post

Compute cost per delivered dose at your dose if you want a number you can act on. That requires knowing your dose, vial volume, and whether you are using a vial or a pen.

5 likes in reply to #15 17mo
FN
f.novakTL2 Moderator13 Mar 2025#32

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.

14 likes 17mo
BR
buffer_reviewTL3Regular14 Mar 2025#33

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.

28 likes 16mo
AN
a.norgaardTL2 Moderator15 Mar 2025#34

On post #30 — agreed on the reasoning, with one qualification.

International pricing: the same compound costs very different amounts in different countries because healthcare systems and regulatory frameworks differ. Generally, US prices are higher than other developed nations.

0 likes 16mo
TN
t.ndiayeTL2 Moderator16 Mar 2025#35
n.broberg, post #13: Compute cost per delivered dose at your dose if you want a number you can act on. That requires knowing your dose, vial volume, and whether you are using a vial or a pen. Go to post

This follows post #32 rather than contradicting it.

Biosimilars and future generics: as patents expire, biosimilar and generic versions might become available and prices might fall. That has already happened for some proteins; incretin agonist pricing might follow.

9 likes in reply to #13 16mo
AF
a.friskTL2 Moderator17 Mar 2025#36
id.almeida, post #21: 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. Go to post

Subscription services and subscriptions: some online clinics bundle compounds into subscription models with different pricing. Understanding the terms before committing matters.

20 likes in reply to #21 16mo
K
KTurkingtonTL3Regular18 Mar 2025#37

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.

0 likes 16mo
SB
s.bergstromTL2 Moderator19 Mar 2025 · edited#38

Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive.

0 likes 16mo
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t.steenkampTL2Member20 Mar 2025#39

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.

13 likes 16mo
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ak.kravchenkoTL2 Moderator21 Mar 2025#40
a.frisk, post #36: Subscription services and subscriptions: some online clinics bundle compounds into subscription models with different pricing. Understanding the terms before committing matters. Go to post

Coming back to post #38, because the follow-up matters more than the original answer.

Two things before anyone answers the substance.

First, the context in the first post is clear and specific. Second, the question is framed so that an answer can actually address it. Both are the norm here and both matter more than they sound.

27 likes in reply to #36 16mo
FV
f.villalobosTL2 Moderator22 Mar 2025#41

Two things before anyone answers the substance.

First, the context in the first post is clear and specific. Second, the question is framed so that an answer can actually address it. Both are the norm here and both matter more than they sound.

1 like 16mo
TP
t.pereiraTL2 Moderator23 Mar 2025#42

This follows post #39 rather than contradicting it.

Biosimilars and future generics: as patents expire, biosimilar and generic versions might become available and prices might fall. That has already happened for some proteins; incretin agonist pricing might follow.

0 likes 16mo
BA
b.aaltoTL2 Moderator24 Mar 2025#43

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.

17 likes 16mo
EL
e.lehtinenTL2 Moderator25 Mar 2025 · edited#44
trough_index, post #31: Compute cost per delivered dose at your dose if you want a number you can act on. That requires knowing your dose, vial volume, and whether you are using a vial or a pen. Go to post

Compute cost per delivered dose at your dose if you want a number you can act on. That requires knowing your dose, vial volume, and whether you are using a vial or a pen.

7 likes in reply to #31 16mo
PW
PharmNotes_WhitfieldTL4Pharmacist26 Mar 2025#45

Coming back to post #43, because the follow-up matters more than the original answer.

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.

3 likes 16mo
SC
s.cabreraTL227 Mar 2025#46
DO
dr_okonkwoTL4 Moderator28 Mar 2025#47

Discount programmes and coupons: manufacturers often offer coupons that reduce out-of-pocket costs if insurance is not covering or is covering at a high copay. These have eligibility restrictions but can save money.

24 likes 16mo
CG
c.grimaldiTL2 Moderator29 Mar 2025 · edited#48
t.steenkamp, post #39: 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. Go to post

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.

11 likes in reply to #39 16mo
KK
k.kimaniTL2 Moderator30 Mar 2025#49

I read post #47 twice before replying, because I had assumed the opposite.

Price variation between pharmacies: identical prescriptions can cost different amounts at different pharmacies because pharmacies negotiate individually with insurers and manufacturers.

6 likes 16mo
SE
septum_entryTL2Member31 Mar 2025#50

International pricing: the same compound costs very different amounts in different countries because healthcare systems and regulatory frameworks differ. Generally, US prices are higher than other developed nations.

1 like 16mo
SO
s.oyelaranTL2 Moderator1 Apr 2025#51
KLindqvist, post #26: post #25 is right about the mechanism and I think understates the practical bit. Price variation between pharmacies: identical prescriptions can cost different amounts at different pharmacies because pharmacies negotiate individually with insurers and manufacturers. Go to post

Thank you for the correction. I have edited my earlier post with a note rather than silently, so the thread still makes sense to read. The error was mine and it was the kind that comes from remembering a figure instead of looking it up.

4 likes in reply to #26 16mo
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OTeixeiraTL3Regular2 Apr 2025#52
s.bergstrom, post #38: Practical note that does not fit anywhere else. Whatever you conclude from this topic, write down what you did and when. The single most useful thing in your own records is not any individual result; it is that they are dated and consecutive. Go to post

Subscription services and subscriptions: some online clinics bundle compounds into subscription models with different pricing. Understanding the terms before committing matters.

12 likes in reply to #38 16mo
IO
i.oseiTL2 Moderator3 Apr 2025#53

Picking up post #50: that is the part I would want checked first.

Compute cost per delivered dose at your dose if you want a number you can act on. That requires knowing your dose, vial volume, and whether you are using a vial or a pen.

0 likes 16mo
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OkaforTL3Regular4 Apr 2025#54

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.

0 likes 16mo
ID
il.dumitruTL2 Moderator5 Apr 2025#55
a.norgaard, post #34: On post #30 — agreed on the reasoning, with one qualification. International pricing: the same compound costs very different amounts in different countries because healthcare systems and regulatory frameworks differ. Generally, US prices are higher than other developed nations. Go to post

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.

2 likes in reply to #34 16mo
GH
g.haalandTL3Regular6 Apr 2025 · edited#56
dr_okonkwo, post #47: Discount programmes and coupons: manufacturers often offer coupons that reduce out-of-pocket costs if insurance is not covering or is covering at a high copay. These have eligibility restrictions but can save money. Go to post

Worth separating two things that post #52 runs together.

Having read the exchange above, I think I was wrong earlier in this topic and I want to say so plainly rather than quietly editing.

The correction was fair and I had been repeating something I had not checked carefully enough.

8 likes in reply to #47 16mo
SB
s.beaulieuTL2 Moderator7 Apr 2025#57

Biosimilars and future generics: as patents expire, biosimilar and generic versions might become available and prices might fall. That has already happened for some proteins; incretin agonist pricing might follow.

26 likes 16mo
FA
f.abrahamsenTL2Member8 Apr 2025#58

Subscription services and subscriptions: some online clinics bundle compounds into subscription models with different pricing. Understanding the terms before committing matters.

0 likes 16mo
ER
e.roosTL2 Moderator9 Apr 2025#59

post #58 answers the question as asked. The question underneath it is different.

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.

11 likes 16mo
SG
s.grahameTL2Member9 Apr 2025#60
s.beaulieu, post #57: Biosimilars and future generics: as patents expire, biosimilar and generic versions might become available and prices might fall. That has already happened for some proteins; incretin agonist pricing might follow. Go to post

On post #56 — agreed on the reasoning, with one qualification.

Discount programmes and coupons: manufacturers often offer coupons that reduce out-of-pocket costs if insurance is not covering or is covering at a high copay. These have eligibility restrictions but can save money.

25 likes in reply to #57 16mo