My position on comparing prices across jurisdictions is current rather than settled. I have revised it once already and I expect to again, so treat it accordingly.
Comparing prices across jurisdictions without misleading yourself — setting out what I have, and where I think it stops being reliable.
Working notes on comparing prices across jurisdictions rather than a conclusion. I would rather post the reasoning while it can still be corrected than post the answer once I am committed to it.
Everything below is checkable. Where I have taken a figure from somewhere else I have said where; where I have estimated, I have said that too.
The arithmetic in the opening post is right; the assumption feeding it is the part to check.
Where the comparing prices across jurisdictions 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.
Where I part company with the opening post, and it is a narrow parting.
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.
My position on comparing prices across jurisdictions is current rather than settled. I have revised it once already and I expect to again, so treat it accordingly.
I have three months of notes on comparing prices across jurisdictions 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.
I had written a reply contradicting post #3 and deleted it. Here is what survived.
Second-hand on comparing prices across jurisdictions, so weight it accordingly — someone whose method I trust told me this and I have not verified it myself.
Confirming post #6 from a second method, which matters more than confirming it from a second person.
Prices in old topics are historical records and are frequently wrong now. Every post here carries its date for that reason.
Where somebody posts a comparison, the useful version states the date, the region and what was included.
That is all I can say without guessing.
Fine by me. I had wanted a stronger conclusion and there is not one available.
Answering the question post #10 raises rather than the one it answers.
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.
I have changed my mind on this once already, so take it as current rather than settled.
Post #12 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 comparing prices across jurisdictions, because it is the sort of subject where it matters.
Practical answer on comparing prices across jurisdictions, since the theoretical one is upthread: do the simplest check first, write down the result, and only then decide whether the complicated explanation is needed. It usually is not.
Adding the measurement that post #12 says would settle 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.
That is what I would do. It may not be what is correct.
Post #14 describes the usual case. This is about the unusual one.
The version of comparing prices across jurisdictions 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.
Agreed on comparing prices across jurisdictions, with one qualification that I think matters. The reasoning holds for the case as described. Change the starting assumption and it does not, and the starting assumption is the part nobody states.
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.
Since comparing prices across jurisdictions keeps coming up, it should probably be a maintained page rather than a recurring thread. I am happy to draft it if someone with more direct experience will review it.
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.
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.
I would hold that lightly until someone with a larger sample weighs in.
Post #23 is right about the mechanism and I think understates the practical bit.
The site carries no prices, no payment routes and no supplier links beyond the documented storefronts on vendor pages.
That is the practical version. The rigorous version is longer and says the same thing.
That is the distinction I keep failing to hold on to. Written down now.
I read post #23 twice before replying, because I had assumed the opposite.
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.
I would not lead a decision with this, but I would not ignore it either.
Post #27 answers the question as asked. The question underneath it is different.
The reason comparing prices across jurisdictions is hard to answer is that the obvious measurement and the relevant quantity are not the same thing, and substituting one for the other is silent.