State-level differences that actually matter — setting out what I have, and where I think it stops being reliable.
A follow-up question about State-level differences that I did not know to ask the first time.
The earlier thread answered what I asked. What I should have asked is below, and I think it is the one that matters.
If you are new and reading this thread for the answer to State-level differences: the answer is conditional, the conditions are in the third reply, and the rest of the thread is worth skipping.
On the opening post — agreed on the reasoning, with one qualification.
Where the State-level differences discussion usually stalls is that nobody wants to say "I do not know" and everyone is willing to say "it varies". Those are the same sentence with different clothes on.
That is clearer than the version I had in my head. Thank you.
Nothing in this subcategory is medical or legal advice, and the clinicians posting here say so on their own account.
That is the practical version. The rigorous version is longer and says the same thing.
Where a manufacturer runs a direct supply route, that is a commercial arrangement rather than a regulatory change, and it can end.
That matches what I have seen, for whatever a single anecdote is worth.
Post #6 is right about the mechanism and I think understates the practical bit.
Second-hand on State-level differences, so weight it accordingly — someone whose method I trust told me this and I have not verified it myself.
Picking up post #6: that is the part I would want checked first.
State-level differences 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.
Formulary position changes on a schedule that is published in advance, which means a decision made now may be answering last year's formulary.
The documentation on State-level differences is better than this thread and I say that as someone who has posted in the thread.
Post #12 answers the question as asked. The question underneath it is different.
I have three months of notes on State-level differences and the honest summary is that the trend is real and the week-to-week numbers are noise. I nearly drew the opposite conclusion from the first fortnight.
Right — I had this wrong and I am glad to have read it before it mattered.
Prior authorisation criteria are usually published by the payer and reading them before the appointment changes the outcome more than anything else does.
A guess, clearly labelled as one.
I read post #15 twice before replying, because I had assumed the opposite.
The bit of State-level differences that nobody enjoys is that the answer changes depending on what you are trying to decide with it. Say what the decision is and the thread will converge.
Post #16 is right about the mechanism and I think understates the practical bit.
Offering a way to settle State-level differences rather than another opinion about it. Two measurements, taken the same way, a fortnight apart. If the difference is within the noise, the question was not answerable at this precision.
Say which country and which state or province. Regulatory position, availability and practical route can all differ within the same continent and frequently do.
Bookmarking this. I will come back when I have something worth adding.
Two sentences on State-level differences 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.
Small methodological point on State-level differences: repeating a measurement is cheap and resolves most of what is being argued about here at no cost to anyone.
Understood. Thank you for being specific about the limits of it.
The practical version of State-level differences is three sentences long. The rigorous version is three pages and reaches the same conclusion with the conditions attached.
I read post #24 twice before replying, because I had assumed the opposite.
State-level differences is worth one more sentence than it usually gets, and the sentence is the one about how the number was arrived at.
Having read the whole State-level differences thread before replying: the question in the first post has not actually been answered yet, and three of us have answered a nearby one instead.
Useful. I have added it to my own notes with the date on it.
The public assessment documents published at approval are free, detailed and largely unread here.
I would be interested in a counterexample if anyone has one.