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Access · Pricing · continued

Price changes over 2025 and 2026, tabulated and dated — does this still hold? posts 61–90

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.

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g.ekstromTL213 Jan 2026#61

I have no financial interest in anything named in this thread and I want to say so before I comment on Price changes, because it is the sort of subject where it matters.

3 likes 6mo
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LeitermanTL3Regular15 Jan 2026#62
h.bhattacharya, post #44: Narrowing post #43, because the general version has more than one answer. The cost of an independent submission is worth stating in these threads, because it is the main reason people do not do it. Go to post

Reading rather than contributing, but this is the most useful thread I have found on it.

0 likes in reply to #44 6mo
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k.okaforTL216 Jan 2026#63

Everything in post #61 holds. The case it does not cover is the one I have.

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

29 likes 6mo
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BBramleyTL3Regular17 Jan 2026#64

Practical answer on Price changes, 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.

15 likes 6mo
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f.fontaineTL218 Jan 2026#65

Where I part company with post #61, and it is a narrow parting.

Agreed on Price changes, 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.

5 likes 6mo
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g.valckenaereTL3Regular19 Jan 2026#66

Post #65 is the version of this I will quote in future. One addition.

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.

0 likes 6mo
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n.serranoTL220 Jan 2026#67
Ridgeway, post #32: Everything in post #30 holds. The case it does not cover is the one I have. Where a price is quoted per vial, the fill has to be stated for the comparison to mean anything. Go to post

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

Happy to be corrected if someone holds better data than mine.

0 likes in reply to #32 6mo
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r.marsdenTL3Regular22 Jan 2026 · edited#68

A methods point on Price changes rather than a substantive one: if the comparison is not like for like, the difference you are measuring is the difference in method.

21 likes 6mo
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mi.almeidaTL223 Jan 2026#69

I had written a reply contradicting post #65 and deleted it. Here is what survived.

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

None of the above is medical advice and I am not qualified to give any.

9 likes 6mo
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s.poulsenTL3Regular24 Jan 2026#70

Since Price changes 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.

2 likes 6mo
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s.kuuselaTL225 Jan 2026#71

My understanding of Price changes is a few years old and may have been superseded. If it has been, I would genuinely like to know rather than keep repeating it.

6 likes 6mo
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two_year_lineTL3Regular26 Jan 2026#72

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

The honest answer is that it depends, and here is what it depends on.

16 likes 6mo
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j.iyerTL227 Jan 2026#73
CSagredo, post #45: Post #43 put the caveat in the right place and I want to underline it. Something worth flagging about Price changes: the strongest-sounding claims in this thread are the ones with no source attached, which is the usual pattern and not a coincidence. Go to post

Post #72 answers the question as asked. The question underneath it is different.

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

That has held every time I have looked, which is not the same as always.

31 likes in reply to #45 6mo
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batchlogTL328 Jan 2026#74
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k.pereiraTL230 Jan 2026#75

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

10 likes 6mo
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r.venkatesanTL3Wiki editor31 Jan 2026 · edited#76

Clear enough that I do not think I have a follow-up, which is unusual.

22 likes 6mo
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g.radichTL21 Feb 2026#77
c.bakker, post #39: Price changes came up in a thread eighteen months ago and was answered well. I cannot find it, which is itself the problem, so here is the reconstruction. Go to post

Price changes: I would want to see the raw numbers rather than the summary before agreeing. Summaries lose exactly the information that would settle this.

0 likes in reply to #39 6mo
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maintenance_modeTL3Regular2 Feb 2026#78
PSundberg, post #57: Post #54 is the version of this I will quote in future. One addition. Where I would push back on the Price changes consensus is the confidence, not the direction. The direction looks right. The confidence is borrowed. Go to post

Everything in post #75 holds. The case it does not cover is the one I have.

The reason Price changes 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.

1 like in reply to #57 6mo
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p.trevinoTL23 Feb 2026#79

Building on post #77 rather than restating it.

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

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

15 likes 6mo
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RodriguesTL3Regular4 Feb 2026#80
c.bakker, post #39: Price changes came up in a thread eighteen months ago and was answered well. I cannot find it, which is itself the problem, so here is the reconstruction. Go to post

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

30 likes in reply to #39 6mo
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r.szaboTL25 Feb 2026#81

I read post #79 twice before replying, because I had assumed the opposite.

One caution on Price changes: everything above assumes the underlying documentation is what it claims to be. That assumption is doing real work and is rarely stated.

8 likes 6mo
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dexa_twice_yearlyTL3Regular6 Feb 2026#82

Post #79 answers the question as asked. The question underneath it is different.

The version of Price changes that I was taught turned out to be a teaching simplification. Useful, and not true in the way I had assumed it was.

2 likes 6mo
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m.balogunTL28 Feb 2026#83
m.perrin, post #8: Picking up post #5: that is the part I would want checked first. Where a price includes consultation, device and follow-up, saying so makes a comparison possible. Most quoted figures do not. Adding it in case it saves somebody the afternoon it cost me. Go to post

The most useful pricing posts here are the ones that show the arithmetic rather than the conclusion.

It is one reading of the data and not the only reasonable one.

0 likes in reply to #8 6mo
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a.lindholmTL29 Feb 2026#84
j.iyer, post #73: Post #72 answers the question as asked. The question underneath it is different. Where a price includes consultation, device and follow-up, saying so makes a comparison possible. Most quoted figures do not. That has held every time I have looked, which is not the same as always. Go to post

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.

19 likes in reply to #73 6mo
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f.yildizTL210 Feb 2026#85

Coming back to post #83, 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.

Worth one more sentence than it usually gets.

0 likes 6mo
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WendelboeTL211 Feb 2026#86
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ai.vukovicTL212 Feb 2026#87
journalclub_wren, post #17: 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. Scoping that to what I have actually seen rather than what I have read. Go to post

Price changes is a good example of a question where the honest answer is boring and the interesting answers are unsupported. I would go with boring.

0 likes in reply to #17 5mo
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g.pemberton_ukTL3Regional · UK13 Feb 2026#88

This follows post #87 rather than contradicting it.

I have been on both sides of the Price changes argument in this category within eighteen months, which should tell you how strong the evidence for either side is.

0 likes 5mo
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cannula_driftTL3Regular14 Feb 2026#89

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.

This is the sort of thing the wiki should carry and currently does not.

2 likes 5mo
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l.dialloTL215 Feb 2026#90
o.vukovic, post #10: Larger orders shift risk as well as price, because more of your material then comes from one lot. Reading it back, the second half matters more than the first. Go to post

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

Reading it again, the caveat matters more than the finding.

0 likes in reply to #10 5mo