Wikipedia:Manual of Style/Medicine-related articles/RFC on pharmaceutical drug prices

These examples of drug prices for generic pharmaceutical drugs have been taken from the leads of articles. Do you think that this content complies with Wikipedia's standards for verifiability, due weight, no original research, what Wikipedia is not, and how to write a lead section? 23:02, 23 January 2020 (UTC)

The source:

All of these examples use the same source (chosen for simplicity and because it appears in many articles). The source, the International Medical Products Price Guide, is a database of prices voluntarily reported by some organizations and government agencies that buy or sell drugs in low and middle income countries. For example, a "supplier" price may be reported by a non-profit or a for-profit organization that sells drugs only to health organizations and government agencies in a single country, or one that sells drugs to buyers in many countries. The "buyer" price is most often reported by a government, and sometimes by a non-profit or medical missions organization. The "supplier" prices are usually more relevant than the buyer prices, as buyer prices do not include shipping, handling, insurance, or other costs, and some buyer prices involve unusual circumstances (such as atypical prices from local manufacturers). The database's website recommends the median supplier price as the most reliable option, assuming that enough data points are available. Read more about prices on the database's website.

Each database entry also includes some other information, such as the strength and dosage form of the specific drug for that entry (most drugs are available in different strengths; some are available in both liquid and pill forms; each strength and form gets a separate database entry, search here to find examples) and the defined daily dose (read the article). This database has not been updated since 2015. You can look at some statistics about entries in the MSH database.

Three examples:

• Ethosuximide:
  • What the lead says: The wholesale cost in the developing world is about US$27.77 per month as of 2014.[1]
  • What the source says about:
    • Suppliers: The cited database entry lists one supplier, which offered 250 mg tablets of ethosuximide for sale for US$0.1845 each (100 tablets per package) in 2014, only to organizations in the Democratic Republic of Congo.
    • Buyers: The database has no information about buyer prices.
    • The drug: Each pill contains 250 mg of ethosuximide. The defined daily dose is 1.25 grams. There are no other entries in the MSH database for this drug.
• Carbamazepine:
  • What the lead says: The wholesale cost in the developing world is about US$0.07 to US$0.24 per day as of 2015.[2]
  • What the source says about:
    • Suppliers: The cited database entry lists twelve suppliers that offered 200 mg tablets of carbamazepine for sale in packages ranging from 100 to 1,000 pills each in 2014. The lowest price reported by these 12 organizations was US$0.0138 per pill, and the highest price was US$0.0372 per pill, with a median price of US$0.0185 per pill, down 5%. The High/Low Ratio was 2.70.
    • Buyers: The cited database entry lists three governments plus the Central American Integration System. The lowest price reported by these four organizations was US$0.0155 per pill, and the highest price was US$0.0480 per pill with a median price of US$0.0202 per pill, down 9%. The High/Low ratio was 3.10.
    • The drug: Each pill contains 200 mg of carbamazepine. The defined daily dose is 1 gram. There are five other entries in the MSH database for this drug for 2015.[3]
• Diazepam:
  • What the lead says: The wholesale cost in the developing world is about US$0.01 per dose as of 2014.[4]
  • What the source says about:
    • Suppliers: The cited database entry has no information about supplier prices.
    • Buyers: The cited database entry lists two governments that reported buying 10 mg tablets of diazepam in 2014. Both governments report a price of US$0.0100 per pill, so the lowest, highest, and median price are identical, and the High/Low ratio is 1.
    • The drug: Each pill contains 10 mg of diazepam. The defined daily dose is 10 mg. There are two other entries in the MSH database for this drug in 2014,[5] and three for 2015.[6]

Background

Drug price availability

Drug prices vary according to a number of factors, including strength (e.g., how many milligrams per pill), formulation (e.g., pill or liquid), manufacturer, country, wholesale vs. retail, what the patient pays vs. what the health program pays, prices before rebates and subsidies, etc. Even within the category of wholesale prices, there are multiple measurements. Many prices are kept confidential, so there are few sources available. Additional information about drug prices can be found at Category:Drug pricing.

Example articles

You can see several hundred examples of how drug prices are being presented at User:Colin/ExistingPrices.

Related discussions

There was a previous RFC related to drug prices in 2016. Recent discussions on what advice we should give in guidelines include a long thread at Wikipedia talk:Manual of Style/Medicine-related articles#Product pricing and another at Wikipedia talk:WikiProject Medicine/Archive 130#MEDPRICE. This RFC was written at the direction of the community in this discussion and mostly developed at WT:MEDMOS.

This is a marathon, not a sprint

The next goal is to update the Wikipedia:Manual of Style/Medicine-related articles to include advice on when and how to present information about prices and pricing for drugs. It is likely that there will be at least one more RFC related to this subject area. Everyone's ultimate goal is to build great encyclopedia articles about pharmaceutical drugs.

Discussion

Main question:

Do you think that the content in the examples above complies with Wikipedia's standards for verifiability, due weight, no original research, what Wikipedia is not, and how to write a lead section?

This is a request for your comments, not just a vote! You don't need to "support" or "oppose" anything. Please feel free to ask questions and to respond to this RFC broadly. If you think the text in our articles could be improved, please tell us how you would improve it. If you think an example shows a good feature, please tell us why it's good. Understanding your thought process and what matters most to you will directly help us develop a solid proposal for updating WP:MEDMOS and will ultimately help us improve articles about drugs.

We're going to try to keep comments about the same general subject area together. Don't worry: you don't have to stick tightly to the subject! We know that these areas overlap significantly, so just put your comments in whichever section you think is closest. You can put all of your ideas in one section, or you can put different comments in separate sections.

Comments about verifiability and original research

• Unless there's some background I'm missing, the ethosuximide example appears grossly inappropriate. Is a single price from one supplier to one country really being given as the cost for the entire developing world? Is there some reason to believe that price is typical or representative? And why the four-figure precision? Even before we think about over-extrapolation, fluctuations in the US exchange rate alone make $27.77 misleading on account of overprecision. Adrian J. Hunter^{(talk•contribs)} 07:33, 24 January 2020 (UTC)
• I agree with Adrian. Unless the drug is specific to one or a small group of countries, or there is a negotiated price for a drug (eg a charity, producer or grouping has negotiated a wholesale price, which in itself is relevant to mention in my opinion), I think it's misleading and inappropriate to give a single number as the cost of a drug. It's misleading, because this is the wholesale price, which is not relevant to readers who will be expecting the consumer price. It's highly likely to vary between countries, and regardless of what a source may say I am extremely doubtful that there is a meaningful single stable price for drugs that should be included in the lead, particularly one that readers, who are likely from English speaking and therefore developing to developed countries. --Tom (LT) (talk) 21:56, 24 January 2020 (UTC)
• What calculation leads to the example for carbamazepine? Since the database appears to be a series of examples, unless it’s exhaustive I don’t think you can infer a range from that without original research (the extremes of a sample are not the extremes of the entire population). Also, "the developing world" is an ambiguous category, and even if a specific classification can be decided on, it will change as development status generally improves over time. Sunrise (talk) 00:40, 25 January 2020 (UTC)
  • Sunrise, the calculation used for daily prices is ${\textstyle (Defined\ daily\ dose\div pill\ size)\times price\ per\ pill}$, rounded the nearest penny. In this case, that means five times the price of the lowest price in the linked database record (a seller price) and the highest price (a buyer price). I don't know why this particular record was chosen and not the other five, but it might have been based upon professional experience (e.g., the most common pill size), or it might have been the record with the most buyer/seller prices listed (or maybe something else that I haven't thought of). I wonder, if some editors wanted to use this database, what advice would you give them on what to put in the article? WhatamIdoing (talk) 03:41, 28 January 2020 (UTC)

    I see, so it’s supposed to be the price of the defined daily dose. I don’t think calculating that is original research in itself, since it’s just determining the value for a different amount. But the conversion to a range is definitely OR as it suggests an assumption not supported by the source: that the minimum and maximum values in the database are the minimum and maximum values overall. After that, an even greater amount of OR is required to describe this information as “the wholesale cost in the developing world”.

    For your question, in general I’d say not to use it at all, and one of the minimum requirements for making an exception would be to use it in combination with a more reliable source. If you’re specifically asking what kind of statement the source is able to verify, without considering any issues outside V/OR, then it would be something much narrower. It would have to be indisputable and without containing any extrapolation, or in other words something closer to the sample quotation I gave as part of my comment in the “neutrality and due weight” section (which is admittedly somewhat exaggerated for effect, but not by much). It should probably include a direct reference to the defined daily dose as well. Sunrise (talk) 08:13, 31 January 2020 (UTC)

• I am confused why the first two entries in this section are nothing but blank starting statements. Are the originators of this RFC so insecure that they feel they must control the inputs of everyone who comments? Verifiability and original research have little in common as it pertains to the supposed examples. Are you asking whether we can verify original research or verify content or whether verifiable information is being used for original research. Also is there a particular reason you kept the one users's, who bludgeoned the discussion to start this RFC's, original research in the opening prose. Anyone thinking this RFC is a neutral representation of current content should look at the discussion that lead to this RFC. Be careful it will take hours.AlmostFrancis (talk) 04:47, 25 January 2020 (UTC)
  • @AlmostFrancis: your comment is a confusing mix of substantive comments and process complains. I suggest you separate the two. I am confused why the first two entries in this section are nothing but blank starting statements. Obviously, they are an attempt to encourage people to engage in discussion behavior, rather than in voting behavior. --JBL (talk) 02:18, 26 January 2020 (UTC) Addendum: AlmostFrancis cannot respond to this comment, having been topic-banned for incivility. --JBL (talk) 21:47, 27 January 2020 (UTC)
• About 25% of our articles give a developing world cost per dose. The source does not give a cost per dose, nor say what is a typical dose (the amount of a drug one takes at one time), so any such cost is unverifiable. Most drugs treat several conditions and there are lots of common doses, which vary with indication and patient characteristics (age, weight, health).

For example, with diazepam we give the cost for an untypical 10mg tablet dose, a tablet strength that isn't available from any suppliers to the developing world. The correct typical dose for diazepam for anxiety is 2mg three times a day taken long term. In the UK this costs the NHS £0.027 per dose, which is meaningless to our readers if you don't know the "2mg three times a day" treatment plan (forbidden by WP:MEDMOS). For emergency treatment of a prolonged seizure then the typical adult dose of 10mg is give and then repeated after 10 minutes if required. This is not a pill, but given either by injection or per rectum, costing £0.55 or £1.50 per dose. There is no one cost per dose. -- Colin°^Talk 11:41, 26 January 2020 (UTC)

• About 30% of our articles give a developing world treatment cost per day or month.. The source does not give the cost per day or month, nor does it suggest a treatment plan ("take two 50mg tablets twice a day for seven days", or "take one 100mg extended-release tablet a day and come back to see me in six months") so we are unable to verify which tablet strength to cite, how many to take, how often, and for how long.

These costs are derived by an editor using the defined daily dose (DDD) combined with an arbitrary choice of tablet strength and assumptions about dose frequency and treatment duration. The DDD is a calculated metric designed for drug usage statistics not treatment cost. It isn't guaranteed to divide by any available pill size, or correspond to a dose anyone is typically or ever prescribed. The WHO say that using this for detailed cost analysis is an abuse of the metric, and the only valid use they suggest is to compare the cost of two different formulations of the same drug. Our source does not use the DDD to give the treatment cost of a drug, so neither should we. -- Colin°^Talk 11:41, 26 January 2020 (UTC)

• We give a "wholesale cost in the developing world", an International Reference Price. The source Guide says "buyer" prices should not be used as reference prices. Instead, the WHO recommend taking the median of many "supplier" prices to make a reliable reference price. A third of our drug articles have no suppliers, and another third only have one or two suppliers: for these drugs, the majority, the Guide is not a reliable source of "wholesale cost in the developing world". -- Colin°^Talk 11:41, 26 January 2020 (UTC)
• See PriceMistakes for examples of drugs where original research, unsourced data and misuse of WHO metrics has led to clear errors. 20% of our prices are simply wrong, even ignoring all the other issues. -- Colin°^Talk 11:41, 26 January 2020 (UTC)
• Doing basic math isn't OR. But extrapolating from, say, wholesale price in one country to per-dose price globally obviously is OR.  — SMcCandlish ☏ ¢ 😼  20:51, 2 February 2020 (UTC)
• WP:NOTOR says simple calculations are not original research; the formula stated by WAID (above) seems like a relatively simple and direct mathematical calculation that reasonably educated readers can be expected to quickly and easily reproduce. I'd suggest that, if at the close of the RfC price information is to remain somewhere in the article, any agreed upon formula(s) should be stated within MEDMOS to allow for consistency and verifiability. Little pob (talk) 13:21, 3 February 2020 (UTC)
• In trying to figure out what to write about verifiability, it has come to my attention that prices in the U.S. vary vastly, even among similar people in the same location who merely have different insurance plans. Here is an example taken from a NextDoor.com poster. How can we purport that anything is verifiable when the facts are that the contracts are mutable without notice, and often are changed without notice to prey on the dependent in proportion to their ability to pay? EllenCT (talk) 21:46, 7 February 2020 (UTC)
• Just simple math isn't OR. It is certainly not OR to say that in the equation "x + 3 = 4", x must be equal to one. But this is well beyond basic math. It's taking wholesale database figures (which may or may not have any bearing on what a consumer actually pays), a listed average dose, and doing the math to say "Oh, this is the price." That goes far beyond basic math, into presuming that the price is worldwide, is static, that the wholesale price particularly matters on a per-dosage basis, that the "average" dose really is average and there isn't substantial variation, so on, so on.... That is OR. Seraphimblade ^{Talk to me} 02:09, 9 February 2020 (UTC)
• Yes, complies with verifiability and original research policies Adding medical price information in the demonstrated way is in alignment with Wikipedia's policies on verifiability and original research. In my view, the objections are not about Wikipedia presenting this information, but instead, the objections are critiques of the source material from the subject matter experts. We have identified the best drug pricing information that the world has to offer and we cite the sources. I acknowledge that the best sources in the world, including the governments of the United States, the European Union, The United Nations' World Health Organization, the entirety of the pharmaceutical industry, the best funded universities, and the sum of all NGOs and nonprofit organizations try to curate medical pricing information and frequently fail to produce quality data. However, it is not our place as Wikipedia editors to say that the best data sources in the world are too poor to include in Wikipedia. Instead, we recognize when we have found the best information which exists and then we find a way to include that in Wikipedia. I agree with critics that the best the world has to offer in this space is often low quality, but it is not our place to exclude the best available information on that basis. The fastest and most efficient way to become even better is to normalize the current practice, then in that context, consider the many options we have to present prices in ways that are even more integrated with the sources. Blue Rasberry (talk) 16:06, 11 February 2020 (UTC)

Comments about neutrality and due weight

• I don't think this belongs in the lead, per WP:LEDE ("introduction to the article and a summary of its most important contents") and WP:UNDUE ("depth of detail...prominence of placement"). It's just one loose fact, not generally a defining characteristic of the drug or a summary of substantial article content (no secondary ref to help place this idea in context, etc.). If the topic of pricing of a certain drug is covered in substantial detail in the article (for example, highlighted as an example by secondary refs for differences of US vs foreign, or sudden markup by manufacturer, or in comparison to other treatments for a medical condition), I could envision mentioning that topic there (but again, probably not the single value). DMacks (talk) 09:43, 24 January 2020 (UTC)
• For anything but the most basic information, using only a database as a source isn’t much better than having no source at all. Even passing mentions in stronger sources are not generally sufficient to support inclusion, because they give no indication of the information’s importance; the price itself has to be the subject of discussion. A database contains no context or analysis, and is only usable in the first place if there’s no doubt about accuracy. However, to actually ensure that, the examples above would have to be much more specific, because these are prices for specific times and places, and even specific transactions ("in year A, according to the records in database B, company C sold D doses of drugs to group E for a price of F in currency G, which includes insurance and transportation charges but not handling fees or taxes"), and it rapidly becomes clear that the weight is insufficient. Considering only questions of weight, I suppose one could argue that a price is in fact basic information (similar to molecular weights or chemical formulas), meaning a database citation would be acceptable, although the argument is significantly weakened by the issues with inaccuracy and the fact that the value isn't constant. If it's accepted regardless, perhaps it might not be so out of place to include prices in an infobox entry attached to an appropriate caveat, but even then a sentence in the lead (or arguably even a sentence in the body) is far more weight than it should be given without support from stronger sources. Sunrise (talk) 00:40, 25 January 2020 (UTC)
• What does neutrality have to do with due weight in these examples? Are you claiming that the entries are not neutral in some way, and if so could that be pointed out? Due weight is a better question. Not the question that was asked but a better question. I think an RFC based on what would be due weight would be useful but based off of these three examples is pointlessAlmostFrancis (talk) 04:57, 25 January 2020 (UTC)

  Weight violations are a type of neutrality violation; WP:WEIGHT is a subsection of WP:NPOV. Sunrise (talk) 12:24, 25 January 2020 (UTC)

  Indeed. I think sometimes people forget it's not part of WP:NOR, since the phrase comes up there, too, as a cross-reference in a least a spot or two.  — SMcCandlish ☏ ¢ 😼  22:10, 3 February 2020 (UTC)

• Only rarely should something like prices be in the WP:LEDE. An exception would be if the price itself deserves much-higher-than-normal weight, such as a medication whose price was prominent in the news for an extended period of time, such as some new "you are cured of your chronic disease" medications that cost 6 figures for a treatment that takes less than a year, or some drugs whose price increases have put them in the news (insulin, emergency inhalers, to name two). Likewise, if a drug saves many lives because it is very cheap, that might be a reason to put the price, or at least the fact that it has a very low price ("because of its affordability, xxxx has been widely used in the developing world and has been estimated to have saved xxxx lives since it became available in year.") I'm sure there are other case-by-case situations where the price or change in price over time would belong in the lede, but those are the exceptions, not the rule. davidwr/(talk)/(contribs) 20:36, 27 January 2020 (UTC)

  Perhaps another way to put this is that "the price of X is Y" is not by itself encyclopedic, but sometimes there will be something encyclopedic to say about the price of X. --JBL (talk) 21:45, 27 January 2020 (UTC)

• This entire page is WP:TLDR ergo off-putting to many who are not into such exercises. As a spitball diagnosis though this info as well-meaning as it may be doesn’t seem neutral or lead-worthy as yet. It would need to be more global in presentation, and the prices likely compared to similar or even all drugs, “it is the most expensive foo”. Gleeanon409 (talk) 06:39, 28 January 2020 (UTC)
  • Don't feel that you need to read every comment to participate! Even if you don't have strong opinions about the examples, general comments on how you think our policies should handle pharmaceutical prices will be helpful in understanding the community consensus. Thanks for participating! — Wug·a·po·des​ 20:12, 28 January 2020 (UTC)
• Information about prices of medications are critical to human health. Médecins Sans Frontières (Doctors Without Borders) writes "Secret medicine prices cost lives" while the World Health Organization states "costs will always be important in managing policy related to drug supply, pricing and use" and lists cost per defined daily dose (DDD) as one possible cost metric. We contain plenty of information for different audiences such as "molar mass" and "melting point" and Simplified molecular-input line-entry system. Price is critical for an entire area of medicine (cost benefit analysis and public health) plus approximate prices are useful for both health care providers and patients. Doc James (talk · contribs · email) 06:23, 30 January 2020 (UTC)
  • I strongly prefer the Defined Daily Dose approach broken out by markets in which the drug is most and least expensive, optionally with historical trends, to attempts to try to pin down the cost of a single dose, which seems fraught with both NPOV and WEIGHT issues. But even then, wouldn't it be better to state the total cost of the drug over a typical course of treatment for drugs that aren't taken for the rest of the patient's life? EllenCT (talk) 08:28, 30 January 2020 (UTC)
  • James, the WHO do indeed list cost per defined daily dose as a metric. Your link says "the cost per DDD can usually be used to compare the costs of two formulations of the same drug" Most other uses they regard as "misuse", as explained in our Defined daily dose article and any research use of this metric should be done by experts who understand and explain its limitations, rather than by Wikipedians. It is ironic that the only use of the cost per DDD that the WHO encourage, is to compare the price of formulations of the same drug: different formulations have different treatment costs, and yet our articles all arbitrarily pick one formulation and strength and unspecified indication and claim this is representative of the treatment cost of the drug as a whole.

  EllenCT a "cost per day/month" or "treatment cost" are all valid costs to consider for presentation to readers, and I agree are more useful to our readers than the cost of a "dose" or a "tablet". But let's not call that the "the Defined Daily Dose approach", which is the original research method used by James to calculate this from database records that only give the costs of specific individual pills sold by individual suppliers. I agree that total treatment cost could be useful for certain indications, and also we should consider whether the disease article is more appropriate to discuss treatment cost if notable. -- Colin°^Talk 09:30, 30 January 2020 (UTC)

  • The importance of drug prices to human health sounds like a good reason for getting our content right. However, "it's important" doesn't necessarily seem to translate into obvious action about when and how to use the information in this database. Are we improving human health by saying that the price in the developing world is the single price that was reported by a seller that only reaches 1% of the world's population? Or are we maybe making things worse? WhatamIdoing (talk) 02:13, 31 January 2020 (UTC)

    These are not "single prices" but rather approximate prices. And yes approximate prices are useful. Doc James (talk · contribs · email) 09:54, 2 February 2020 (UTC)

    User:Doc James, the database record gave a single price. Not a single price in the article, but a single price in the source. I am asking you whether you think that claiming the price at which one (1) single non-profit organization offered a drug for sale, only during one year, and only to accredited healthcare organizations inside the Democratic Republic of the Congo, and (this is the important point) calling it the price "in the [entire] developing world" (rather than, e.g., "in the Democratic Republic of Congo" or "in one country in Africa") is good. I don't want you to tell me that WP:ITSUSEFUL to have some price in general. I want you to tell me whether you think it's okay for Wikipedia to claim that a price is "about $27.77 per month" for 80% of the people living on this planet, when the database record says that the listed price is only for 1% of the people living on this planet, and the only supplier listed is (according to my spot-check) consistently in the lower half of prices in that database. Are you happy just assuming that the price is the same for the other 79% of people, and that this single charitable organization is representative of all the suppliers? Or should we maybe adjust the text in that article to be a little more precise? WhatamIdoing (talk) 01:45, 3 February 2020 (UTC)

  User:WhatamIdoing we can adjust that one to that one country. Many of the prices apply to more than 130 countries in the developing world however.

  If the concern is around how we summarize this source, I imagine we can fairly easily come to a solution. However some appear to be proposing we remove all price information or all price information not covered by the Western popular press, well then we will continue to disagree.

  This database is a perfectly suitable source and one the many others reference. Doc James (talk · contribs · email) 01:48, 3 February 2020 (UTC)

  This RFC is about how/when to use this one database as a source, and not whether price information should ever be included. So far, people have pointed out some problems, but I don't remember seeing a single person saying that the carbamazepine record (which is one of the best in the database) is unusable, and absolutely nobody has said that the "Western popular press" is the only acceptable source of information about prices. Multiple editors have given examples of articles that they believe must include price information, which is the opposite of "proposing we remove all price information". If they are telling us that we have screwed up the ethosuximide information (and it appears that they are telling us that), then that doesn't mean that the only option left is a newspaper. That just means that we fix our mistakes. WhatamIdoing (talk) 16:53, 3 February 2020 (UTC)

• Agreed with several of the above that prices generally do not belong in the lead or infobox (i.e., I would support removing a parameter for this from any applicable i-boxes – WP:NOTPRICE basically demands it). Price-related information might belong in the lead only in cases where much of the notability of the subject surrounds real-world controversies about pricing.  — SMcCandlish ☏ ¢ 😼  20:54, 2 February 2020 (UTC)
  • User:SMcCandlish where is the consensus for WP:NOTPRICE? Or is it simple that someone added it one day and because it stuck? Prices are in the infoboxes of a lot of FAs such as Wii. Not in any medication articles that I am aware of. Doc James (talk · contribs · email) 04:54, 3 February 2020 (UTC)

    I have no idea what the origin is of this recently recurring fallacy (I've seen three editors try to use it this week alone, all to zero effect) that if you can't find an old RfC on something that's in a WP:P&G page that it must have no consensus and you can ignore or remove it. WP doesn't work that way, and we all (except, apparently, a handful of people) fully understand that. See WP:CONSENSUS. If something's been in a P&G page for years, it has consensus by definition. If you think consensus has changed and the P&G material hasn't been updated to reflect that shift, and thus the "rule" in question should be changed or deleted, you know where WP:VPPOL is, or can propose a change more locally at the talk page of the P&G page in question. P&G pages are not like obscure articles where someone can inject something for years without anyone noticing or caring. Policies are watchlisted by a zillion people, and are operationally used (and tested as to their sensibility, usefulness, agreement with other P&G material, etc.) on a daily basis.

    It's very unlikely that there hasn't been plenty of consensus discussion of NOTPRICE being included in WP:NOT; everything gets hashed over there; 57 archive pages worth of it. If there are other infoboxes that need cleanup to comply with NOTPRICE, then fix those, too. See WP:OTHERSTUFFEXISTS. Wikiprojects (the sources of most topical infoboxes) are notorious for ignoring policies they don't like (especially ones that get in the way of their topic-cruft geekery) until caught out and corrected. If it's so overwhelmingly common – despite all the arguments presented in this page – that WP as a community really does want to include lots of price/cost information (in infoboxes even), then a proposal or remove or change NOTPRICE would actually be called for (though I would wager real money on the outcome with confidence).
     — SMcCandlish ☏ ¢ 😼  05:57, 3 February 2020 (UTC); rev'd. 06:09, 3 February 2020 (UTC)

    Here you go: [7], and that's just a one-word search on prices; there will be other discussions found with other search terms. Cf. WP:You can search, too; it took about 20 seconds.  — SMcCandlish ☏ ¢ 😼  06:13, 3 February 2020 (UTC)

  Xbox articles mentions prices from various countries in various currencies. Wii is another example. These two consoles are not even available in most of the countries and are luxury products! Medicines are equally (maybe even more) important than gaming devices and affect people directly. --AbhiSuryawanshi (talk) 06:05, 3 February 2020 (UTC)

  WP:OTHERSTUFFEXISTS. That X number of other articles/infoboxes are making the same mistake (ignoring the same policy and its rationale) doesn't mean this one should be permitted.  — SMcCandlish ☏ ¢ 😼  06:09, 3 February 2020 (UTC)

  • I actually want to jump in here; video game consoles have price information because it's covered in RS and because RSs make a point of comparison between the varied hardware available, one item of which is always the price. (See also the generation series of articles e.g. Eighth generation of video game consoles.) That is not broadly true here (else we would not be having this discussion, I suspect). --Izno (talk) 15:25, 3 February 2020 (UTC)

    Sure, though that doesn't make it infobox and lead material at the console articles; we have a generalized problem of "tech gadget" boxes being totally festooned with almost every detail someone can find a way to cram into an infobox (cell phone ones a probably the worst). It defeats the purpose of infoboxes just from a "firehose of trivia" perspective, even before any V, NOR, NPOV concerns are examined.

    There are really four questions to ask in a let's-get-specific followup RfC. I think we need to be careful here to separate "Should we include price-related info in the article body at all?" from "Should we treat price info as vital lead-section information?" from "Should we treat price info as key tabular data for the infobox?" from "Should we build tables (as MOS:SALs or MOS:ELISTs) of comparative drug-price data?" They're four separate things that each have their own angels and devils. I think the answers are: to the first two, "It depends on the specific case in question, but generally only in unusual cases"; to the third, "Hell, no"; and to the fourth, "Probably not, unless we can come up with a way to do this without POV and OR problems", which is highly dubious. This topic area, as you point out, is simply not like video game consoles.  — SMcCandlish ☏ ¢ 😼  22:01, 3 February 2020 (UTC)

• Agree with the WP:LEAD arguments made about not having the only mention of price in the lead section (with the possible exception of stub articles). In my opinion, en.wikipedia should not be ignoring it's own policies just because it's of benefit to the other language wikis when they translate the lead sections of "our" content – I don't think even WP:IAR would support that argument. I'm not (yet) convinced by the other stuff arguments; as all the products mentioned so far have recommended retail prices. Little pob (talk) 13:36, 3 February 2020 (UTC)

  Sure, but that's already covered by MOS:LEAD. A lead section is a summary of the key points of the article, not a place to store unique facts not found elsewhere in the piece (at least not after the skeletal stub stage). Otherwise the lead is simply improperly written, and material needs to merge into the body, then the lead re-summarize the entire revised thing, with newly re-applied WP:DUE weight. That's true across all topics.  — SMcCandlish ☏ ¢ 😼  22:05, 3 February 2020 (UTC)

  I feel there may have been a miscommunication on my part; but for the sake of clarity, you're preaching to the choir on this point. Little pob (talk) 10:45, 4 February 2020 (UTC)

again I think adding the price of essential medicines is responsible because it's an important information for readers and with regard to the developing countries, I think adding the range of prices is helpful because the poverty is very common so many patients ask physicians about the price to decide whether they can buy that medication or they can search for a cheaper alternative and sometimes they refuse the treatment because it's unaffordable for them. For reliability of information we can use the formal resources in that countries. For example the website for Jordanian food and drug administration provides details about the prices of medicines. Regards--Avicenno (talk) 19:33, 6 February 2020 (UTC)

• Thanks for your comment, Avicenno. Would you use this database, which is wholesale prices (the patient usually pays much more), or would you recommend looking for other sources instead? If you used this source, what would you say in an article like Diazepam? Feel free to skip down the page to one of the sections on the three examples, and suggest the text that shows what you'd like to see in an article. Sometimes an example is worth more than a description. WhatamIdoing (talk) 00:42, 7 February 2020 (UTC)

  This RFC is difficult to parse. I guess what initially comes to mind is, what is our goal, it is to "provide the sum of all human knowledge". Do prices of essential medicines for those in the developing world advance this goal? Yes definitely. The rest can be figured out afterwards. Policies and guidelines are here to help us achieve this goal, nothing else. Can some of the wording of the current content be adjusted and improved? - sure certainly. However if we reach a decision where the price of insulin in the United States can be included as it is supported by newspaper articles but the prices of essential medicines cannot as it is only supported by an NGO affiliated with the World Health Organization we will have reached the wrong conclusion. EMsmile (talk) 01:54, 7 February 2020 (UTC)

  I agree with you, EMsmile, about what our policies should enable. I'm a little uncertain about saying that the price of a drug in one or two countries should really be considered the "sum", rather than the "addends", of human knowledge. Did you get a chance to look around at a few of records in this database? WhatamIdoing (talk) 00:04, 8 February 2020 (UTC)

• Only in tremendously exceptional cases should pricing information be in a lead. That's not "never" (there are indeed drugs for which the price of them is in itself a very notable factor about them), but it should be quite rare. To appear in the body, the price should be discussed, as opposed to mentioned, by reliable sources as something significant. In most drug articles, as with most articles about products, pricing should not appear at all. Seraphimblade ^{Talk to me} 02:12, 9 February 2020 (UTC)
• Pricing information defines the drug The main reason why we should include price information is because we know from thousands of sources that drug pricing is fundamental to understanding drugs. That should be sufficient reason, but the further explanation is that the price of a drug determines whether a patient can access it. There is room for discussing how we present price, but it would be a great error to omit price information entirely. The most essential part of price to communicate is whether a product is for typical people or only the rich. Wikipedia does not presume that its readers are all wealthy and able to access any option, and instead must anticipate that most readers live in an economy where prices define their choices. The sources we cite for prices publish the prices for this reason, which is why we cite them, and why Wikipedia should include prices.

The information which Wikipedia presents about what conditions a drug treats, etc., is irrelevant if the drug is not affordable to a person. In the case of Low and Middle Income Countries (LMICs), we know that a lot of households make less than US$1500/year, but in India for example, most people have access to high speed Internet and English language is ubiquitous. It is no longer a fantasy to imagine that Wikipedia is a global and universal encyclopedia, as the Wikimedia Foundation makes the claim that Wikipedia has more than 1 billion unique visitors every year. We also know that health information on Wikipedia is among its most popular content. It is not WP:Due weight to have a complicated explanation about the precision of prices. We have to decide what is the right way to report things, but one model might be to categorize and communicate drugs as roughly costing US$0.01, $0.10, $1, $10, or $100. Whether a drug is $0.01 or $10 will frequently mean the difference of whether a person can access it, and since we know people read Wikipedia to inform their general options, we can be sure that people will only talk with their doctors about the options they can afford to purchase. Even for a wealthy country like the United States, it is basic information to want to know whether a cancer treatment will cost $1000 or $100,000, and Wikipedia would be just as in error to not make that distinction. If Wikipedia neglects to include prices, then that would be a violation of neutrality, because in that case we would be designing Wikipedia for the small subset of wealthy people in this world who do not have to worry about the price of health care every time they have a health issue. Neutrality and matching source focus means including prices. Blue Rasberry (talk) 16:27, 11 February 2020 (UTC)

Comments about what Wikipedia should include

• I don't think WP:NOT per se should be used as an a reason to exclude pharmaceutical prices. To me, the approximate price of pharmaceuticals is self-evidently encyclopedic and a matter of public interest, as are the price of oil, the price of carbon, and even the price of a Big Mac. WP:NOTCATALOGUE has a vital maintenance role, preventing Wikipedia getting spammed with ephemeral information about which vendor sells what product for 10% less than the competition, or who's got a sale on right now!!!. Such practical concerns need not stop us citing globally relevant information from non-commercial secondary sources.

Obviously this is moot in cases where we cannot convey pricing information without contravening WP:VERIFIABILITY or otherwise misleading readers. Adrian J. Hunter^{(talk•contribs)} 07:36, 24 January 2020 (UTC)

• I do think the drug price is a notable topic deserving inclusion in an article. Additionally as I mention above, things related to drug prices can be notable and deserve mention, such as: notable agreements to lower or fix prices, notable criticism about price variation of a specific drug between countries or produces, notable coverage of extortionate increases or extortionate prices, or prices in relation to the prices of inferior or fake versions of the drug. Normal procedures should apply to this, ie. notability determined by coverage of these issues in reliable sources, and normal procedures should apply to coverage in the lead - viz. likely not in most cases --Tom (LT) (talk) 22:01, 24 January 2020 (UTC)
  • User:Tom (LT), would you recommend putting this kind of information in the ===Economics=== subsection of MEDMOS's suggested ==Society and culture== section? WhatamIdoing (talk) 04:43, 28 January 2020 (UTC)
    • My take on this RfC was that it was in general form soliciting feedback about drug pricing, which I have answered above, ie. notable information about price should be included, and very notable information in the lead. I worry getting too deep into the specifics will be a diversion from the intended RfC. My general feeling to your specific question is that if it's more than a sentence about the price, "price" should probably be the heading of that subsection (if it is indeed mainly about price), because it is the term most readers will be looking for as a heading, whereas "economics" is, to me anyway, quite obtruse and I am in favour of direct and simple headings where possible. However I do think this question is better addressed in a follow-up RfC or following comments where this can be discussed in more detail, rather than at this venue. Am happy if you or someone else refactors this comment somewhere else on the page. --Tom (LT) (talk) 08:10, 28 January 2020 (UTC)
• A price can be the direct subject of analysis, as described in Tom’s comment, in which case it is encyclopedic. However, the implication from the examples seems to be that the price should be included automatically, cited only to a database. Including these prices in such a manner, including the examples given above, makes Wikipedia seem more like a commercial catalogue and thus undermines our status as an authoritative reference work. One of the purposes of WP:NOT is to prevent this; in such cases the information should be included in Wikidata instead. Overcoming NOTPRICES in this sort of situation requires a strong overriding argument based in another policy, or otherwise WP:IAR.

As a separate point, in one part of the long pre-RfC discussion, I saw one argument regarding deaths caused by medical misinformation, which would certainly fit the criteria for a strong IAR argument. However, by the same analysis, damage to the encyclopedia’s reputation itself causes deaths because people have to be willing to believe the information in the first place (and that would affect all the rest of the information in the same articles, as well as everything else that has important implications anywhere on Wikipedia). So there is a potential "more harm than good" issue that needs to be resolved. Furthermore, while medical misinformation is certainly a major problem, I refer to the comments in the other sections: I'm not convinced that using prices in the manner described above wouldn’t just cause even more harm by contributing to that misinformation instead. Sunrise (talk) 00:40, 25 January 2020 (UTC)

• I am inclined to include pricing information for pharmaceuticals because unlike commodities they are routinely manipulated by manufacturers, sometimes in the same markets and geography, which makes them inherently noteworthy. However, I'd prefer that we cover the worst abuses in Medication costs, Prescription drug prices in the United States, and similar articles, rather than merely spreading noteworthy pricing information out only among individual drugs' articles. EllenCT (talk) 07:45, 30 January 2020 (UTC)
  • I think some of the generic small-molecule drugs function as commodities, or at least something similar. ("Biolgics", like insulin, aren't always interchangeable in the way that, say, aspirin is.) This is a bit outside the scope of this initial RFC, but one of the sources I've been interested in estimates the price to manufacture the active ingredient for a drug, giving the costs per kilogram and per pill for many generic drugs. For example, diazepam costs US$131 per kg to make, and when you make them up into pills, they think the manufacturers will generally charge in the vicinity of 1.2¢ or 1.3¢ per pill (depending on the amount of active ingredient in the two strengths). I have wondered whether manufacturing costs might have more utility (and be less subject to market manipulations) than "two governments got this price once" or "one non-profit sold for that price six years ago". It seems like the manufacturing costs would put a floor on a drug's wholesale price, because the manufacturers won't make a drug if they can't recoup their costs. WhatamIdoing (talk) 02:45, 31 January 2020 (UTC)
• "I don't think WP:NOT per se should be used as an a reason to exclude pharmaceutical prices." – More to the point, it can't, when they're encyclopedically relevant and they are accurate per WP:V and are not some editor's guestimations, per WP:NOR. However, WP:NOT#PRICE, WP:NOT#INDISCRIMINATE, WP:NOT#NEWS, and other aspects of that policy can certainly be used to disapprove of automatically including alleged price information. Price information that is actually reliable should be included when pricing is an integral part of the encyclopedic "story" of the drug in question.  — SMcCandlish ☏ ¢ 😼  20:57, 2 February 2020 (UTC)
• I think we need to be very careful in how we include drug prices. If we can accurately represent them with the important nuances and caveats to ensure the reader understands what the prices represent (and what they don’t), I’m okay with including them. But we do the reader a disservice by oversimplifying things just to come up with a convenient number or range. I completely understand the sentiment, and I don’t believe that we should be blanket-excluding prices, but providing the necessary context in a sentence or two within the lead will be exceedingly difficult (and any more than that would be violating due weight). Assuming we can adequately source one, I would prefer a pricing section; not all drugs will have enough data for this, and that's perfectly okay. If reliable sources don't discuss prices for a particular drug in enough detail to ensure we can cover it appropriately, perhaps it isn't significant enough to include. CThomas³ (talk) 05:28, 3 February 2020 (UTC)
  • +1--Pratik.pks (talk) 07:14, 3 February 2020 (UTC)
• Aside from the exact manner and location for their inclusion, I argue:
  1. Price information for drugs is both notable and valuable for an encyclopedia article (whether those prices are are uniform or varied across geography or time). there' a big difference between $2 per dose and $ 2000 per dose - and I think that is inherently notable.
  2. Four significant figures isn't relevant or useful (possibly even one sig fig would be appropriate), since such fine precision isn't the useful part.
  3. There are clearly reliable sources for such cost information and ways to paraphrase those in prose. Otherwise we're weirdly close to saying that no WP:RS exists to support an answer to the question "How much does this cost?"
  4. This sort of price info should also be on wikidata with locations, dates, level of approximation, and references.
  5. Peripherally-relevant: There's plenty of precedent for including price info in Wikipedia to give context, even in articles for which the price is less notable: example 1; example 2
• T.Shafee(Evo&Evo)^talk 10:12, 3 February 2020 (UTC)
  • Cthomas3, Pratik.pks, T.Shafee, these are great comments. WP:MEDMOS current recommends an ===Economics=== subsection (part of ==Society and culture==). Would you rather have a ==Prices== section?
    The OTHERSTUFFEXISTS examples aren't perfect analogies. The manufacturer's list price for cars and consumer electronics is extensively covered in the normal reliable sources for those subjects. Passing mentions are routine, but comparisons and categorizations are typical ("This Car is priced to compete against Their Car in the entry-level sports car category"). Sources about drugs usually aren't dealing with brand-name products that have a single manufacturer (and thus have no potential for a single list price), and they usually care more about whether it works than what the price is. OTOH, sometimes we have even better sources than one might expect, such as a UK NICE analysis that tells us not just what the UK price is, but also how many months of healthy life that money could buy. WhatamIdoing (talk) 16:45, 3 February 2020 (UTC)

    WhatamIdoing, I've been pondering your question off and on over the last several hours, and I'm not sure I have a definitive answer for you. I would endorse using the "Economics" (or perhaps "Economics and pricing") section if that's what the community ultimately opts for, but to me they seem like two different (albeit related) things. Economics feels to me like we should be getting into R&D, production costs, patient affordability, insurance coverage, etc., especially given that it is a subsection of "Society and culture". Pricing, on the other hand, should probably stick to a discussion of prices for particular formats, strengths, dosages, etc. in various countries/regions and any relevant history/comparison. Perhaps all this could be done in one section, but it does seem like potentially a lot of material for some well-covered drugs. CThomas³ (talk) 03:34, 4 February 2020 (UTC)

    Thank you for spending so long thinking about this, Cthomas3. There are some estimates of the cost of manufacturing the active ingredient for some drugs, and I could see that fitting into the ===Synthesis=== subsection of the recommended ==Chemistry== section (it would normally be a single sentence: "The manufacturing costs have been estimated at approximately $25 per kilo"). I agree with you that R&D costs are more ===Economics=== than ===Prices===. The WHO/Health Action International Project on Medicine Prices and Availability has a system for evaluating affordability. Many of these drugs, rather than being described as "wholesale price of US$3 per month" could be described as "considered affordable in most countries according to WHO/HAI metrics". (This would require some legwork, because there are sources for this, but the sources tend to be incomplete (like "Wonderpam is affordable in these 46 countries", rather than a database of all drugs × all countries). WhatamIdoing (talk) 21:25, 4 February 2020 (UTC)

• To me it makes no sense to have prices, in a global encyclopaedia. Prices are different from here (Portugal) to Spain, over the border, and both within the UE, how can we presente a "common price"?... Prices change fast(er than a article should be updated). Consumer price information is not any of WP's goals. Obviously we should have broad categories, wheter it cheap enough to be used without much restrictions, or a "luxury". - Nabla (talk) 18:44, 3 February 2020 (UTC)
  • Nabla (and anyone else), do you think that Wikipedia:External links to this database would be a better use for it, rather than trying to turn it into sentences/paragraphs in the article itself? WhatamIdoing (talk) 21:25, 4 February 2020 (UTC)

• Drug prices should be included in the lede and body. This is the same as including other content such as the safety of a drug. Readers want to know about this information and may want to compare prices to other similar drugs. Prices are critical context for understanding drugs and treatment. QuackGuru (talk) 14:57, 5 February 2020 (UTC)
  • QuackGuru. Which prices do you mean? Wholesale, retail, list or discounted? Per pill or per dose or per day or per month? WP:DIRECTORY says "Wikipedia is not a price comparison service to compare the prices of competing products, or the prices and availability of a single product from different vendors or retailers". Our treatment costs are calculated using the Defined daily dose, a WHO metric that WHO says: it is usually not valid to use this metric to compare costs of different drugs or drug groups". In displaying absolute prices, Wikipedia most becomes unstuck. Is diazepam really 40 times more expensive in the US than the developing world? At phenytoin we give the price of a dose in the developing world and a month's treatment in the US. This is common, mainly because our drug databases do not give treatment costs, only costs for 5mg pills or 20mg pills. Are our readers comparing patient (retail) prices or healthcare (cost effectiveness in a population) prices? Wouldn't it be better to find a source saying "Drug X is as effective as drug Y and much cheaper" or "Drug Y's greater expense is only justified for patients with Z", or "Drug Z is unaffordable in the developing world" than trying and failing to insert random numbers of dollars and cents into the leads of our articles. -- Colin°^Talk 15:32, 5 February 2020 (UTC)
    • We should include drug prices, especially when drug prices vary in different countries. I would try to at least include retail prices where available in the lede and body. If the lede gets too long a section in the body can include wholesale, retail, list and discounted prices. I would include drug prices in the lede first if it is only one short sentence. QuackGuru (talk) 15:52, 5 February 2020 (UTC)
      • QuackGuru We don't have a source of retail prices for developing world (except in rare circumstances for individual countries). The retail price in the UK is either £0 or £9 typically for a month's supply. For the US the Drugs.com retail price is a list price that nobody ever pays. The GoodRX site offers discounted coupon prices updated daily for a large set of possible stores and the price depends on how big a bottle of pills you buy and whether you have a Costco or Wallmart near you. Why should Wikipedia reproduce Drugs.com or GoodRX when those consumer sites already provide this information with accurate and up-to-date prices?

For diazepam, is this retail price for a treatment course, a monthly ongoing cost, a 10mg pill or a pack of 120 10mg pills? Should we include 2mg, 5mg, 10mg tablets; 2mg/5ml oral suspension in sugar and sugar-free; 10mg/2ml solution for injection ampoules; 2.5mg, 5mg, 10mg rectal tubes? Do we include the treatment costs for anxiety; muscle spasm; tetanus; insomnia; drug-induced dystonic reactions; acute anxiety and agitation; premedication; sedation in dental procedures carried out in hospital; conscious sedation for procedures, and in conjunction with local anaesthesia; status epilepticus... and many more. What about paediatric vs adult dose prices? There is no One Price for a drug. -- Colin°^Talk 16:20, 5 February 2020 (UTC)

It depends what each source states. I don't have an objection to including prices on different doses or on different age groups. If more than a few sentences are added to the lede then it should be repeated in the body. QuackGuru (talk) 21:11, 5 February 2020 (UTC)

Well, we're only here at this RFC to talk about one source, the IMPPG, so perhaps you would see what this source says about Diazepam, and then go down to #Diazepam section of this page, and write out what you think could be correctly written from that source, without any original research or undue attention at all (if anything; some editors think it's not the right kind of source to use at all). There are general information pages available from the website's home page if you need help figuring out what it says. WhatamIdoing (talk) 06:30, 6 February 2020 (UTC)

I agree with WAID that if QuackGuru wants developing world wholesale prices, they should explain and show how it should be done with this source in the other section. But this section is for "Comments about what Wikipedia should include" and we are "Wikipedia article writers", not "source factoid inserters". That involves discovering what the literature says about developing world prices for that drug, and thinking about what information might be useful to our readers wrt developing world access, affordability and cost-effectiveness compared to other options. It is only by doing that, that you can consider if this source (IMPPG) is offering anything usable or useful. Let's not put blinkers on and think only "I have this source, what facts can I insert from it". That's now how we write encyclopaedic articles our readers will enjoy reading and find useful. -- Colin°^Talk 08:11, 6 February 2020 (UTC)

Nuh-uh

• The policy "Wikipedia:What Wikipedia is not" does not apply here The main reason why that policy does not apply here is because we know many sources say that price is one of the fundamental characteristics of understanding a drug. Beyond that, Wikipedia has a policy, "What Wikipedia is not", WP:NOT, and a section in that policy, "Wikipedia is not a directory", and a paragraph in that section, "Sales catalogues". This does not apply because this text is about 15 years old, and was written by people in 2005 who were imagining the 1990s, and the context of this entire section is about the era when companies printed database data on paper and distributed them in paper books. That was just the state of media then, and the policy is talking about including that kind of content into Wikipedia, which of course makes no sense. Now, several generations of technology later, databases mean something other than paper guides. Admittedly, Wikipedia does not have policy on how to match with databases, or how we should manage our infoboxes, or what to do with 10,000 drugs with a range of prices in various geographical regions. However, just because technology is challenging to discuss does not mean we ignore generational changes. We could, for example, put price information into Wikidata, then have the price display in the infobox of a drug. From Wikidata we could update prices regularly as one dataset instead of as 10,000 individual edits to 10,000 Wikipedia articles, and Wikidata also has the ability to do currency conversion or even show different prices for different regions depending on user account settings. I am not saying this is easy or that we have a process in place, but if we agree that Wikipedia should show prices, then we have options for managing that which are more flexible than citing the paper books which established the text at WP:NOT. Also about WP:NOT - I know it is a "Wikipedia Policy", and policies are supposed to be our most established rules, but the reality is that most Wikipedia policies are whatever anyone drafted 15 years ago, and they never got discussed. If anyone checks the archives there, it is not the case that the "sales catalogue" policy had community discussion, and instead almost all of that entire ~10-pages of "What Wikipedia is not" text got adopted as a block without discussion. The Wikipedia policies are not dogma and we should not be using them to halt discussion when people want to talk through a practice. Blue Rasberry (talk) 16:43, 11 February 2020 (UTC)

Comments about the Manual of Style

• I think the complexity of drug pricing means, if it should be included, it should be as a section or subsection, certainly not in the lead. For comparison, coverage in articles about stable foods is inconsistent (eg milk - subsection, bread - no section; rice - section) --Tom (LT) (talk) 22:01, 24 January 2020 (UTC)
  • I agree that drug prices (unless exceptionally notable) should not be in the lead (if they appear at all). Kaldari (talk) 03:52, 26 January 2020 (UTC)
  • Any price mentioned in the lead should be a summary of a discussion/exposition in the body of the article. The discussion in the article should establish the notability of the price, complete with verifiable sources and enough context to establish due weight and ensure that the information provided is not ambiguous or potentially misleading, just like any other content in the lead. · · · Peter Southwood ^(talk): 06:00, 28 January 2020 (UTC)

    I think Kaldari means staple foods. But why would we include pricing information on such topics? We don't usually seem to do so. We're more likely to do so when the foodstuff is a major, globally traded commodity, like rice. Milk is an odd exception; "the price of a gallon [or liter or whatever] of milk" has a certain popular-culture usage as a barometer of local or regional economy, and whether a politician knows the average price in their region is taken as a sign of whether they are of-the-people or an out-of-touch aristocrat; and so on. When it comes to a one-size-fits-all prescription, I think we'd find it completely impossible to establish a convention that articles on foodstuffs should routinely be including price-related information.  — SMcCandlish ☏ ¢ 😼  21:31, 2 February 2020 (UTC)

• If there are many reliable sources focusing on the drug's prices (e.g. insulin) then a summary should appear in the introduction. If the drug is successfully on the generics market and uniformly inexpensive, then the price probably isn't noteworthy at all. If the drug is only expensive in some markets but not others, that's worth a mention in the article body. EllenCT (talk) 07:48, 30 January 2020 (UTC)
  • EllenCT, the three examples here are common generic drugs. The first isn't exactly cheap (a retail price of maybe $50–75 after insurance/discounts in the US), but the other two are fairly cheap ($10–20 retail in the US). Would you include any information about prices for those drugs anywhere in the article? WhatamIdoing (talk) 02:27, 31 January 2020 (UTC)
    • @WhatamIdoing: I like the way the intros for ethosuximide and diazepam conclude with coverage of their prices, because they are so different -- around an order of magnitude between prices in the US compared to the developing world, which is absolutely noteworthy but not really a matter of style. For carbamazepine since the article doesn't have that disparity, I probably wouldn't put it in the intro. However, the question of which of the sections price information should go in is certainly a style guide issue and might be part of the underlying problem here, because, well, it doesn't go into any of the sections prescribed (sorry) by the style guide -- so maybe we need to add a section on "Availability" to the style guide for medications? And that also brings up the fact that all three of those articles are in violation of WP:LEAD because their pricing information is in the lede but not the body of the article. Frankly I've always been a little suspicious of that requirement, but heaven knows plenty of editors have yelled at me for violating it over the years. EllenCT (talk) 06:32, 31 January 2020 (UTC)
      • I like unexpected and counter-intuitive findings, too. The bigger story with ethosuximide seems to be that it's not usually available for purchase in developing countries. The price claimed there was from a single supplier, offering the drug for sale only to one country in Africa, for one year. They didn't claim to sell it in other years, and nobody else in this database claims to have either sold or bought it at all in recent years. The US "wholesale" prices are actually Medicaid National Average Drug Acquisition Costs, which are not exactly normal, unbiased, unmanipulated wholesale prices. GoodRx says that people can buy that drug at retail for less than the NADAC price. I suspect that you're as suspicious as I am when the retail price is cheaper than alleged wholesale one. WhatamIdoing (talk) 07:31, 31 January 2020 (UTC)
      • EllenCT, I thought I'd list a few datapoints on ethosuximide:
        • https://www.goodrx.com/ethosuximide gives a US retail cost of US$45 to $85 for 120 pills ($2 to $4 per day retail, if we stick with the defined daily dose).
        • https://www.drugs.com/price-guide/ethosuximide gives a US retail cost of US$160 for 100 pills ($8 per day retail).
        • NADAC (here; then filter) says that the US wholesale price is about US$0.65 per pill ($3.25 per day).
      • So that looks like a retail price that's the same as, or sometimes cheaper than, the wholesale price; a retail price that's 2.5x the wholesale price (approximately the markup you'd expect from everyday retail establishments: the price of food in a sit-down restaurant is usually around 3x what the ingredients cost, and clothing stores aren't losing money when they run "50% off" sales); and a for-profit wholesale price in the US that's 3x the wholesale price from a single non-profit selling to recognized hospitals and clinics in the Democratic Republic of Congo. I don't think it's unreasonable to expect that US prices (for most things) will be higher than prices in the developing world. I'm a little uncertain that we should be reporting the Drugs.com price rather than the GoodRx price, and the juxtaposition of a wholesale price against the higher retail price might mislead readers into thinking that the US prices were 8x the developing world prices, when they're probably "just" 3x different (and that difference might be largely explained by differences in cost of living and differences in what's being reported [i.e., before vs after all discounts and rebates are accounted for]).
        Finally, I just found the article on the median price ratio, which might also interest some editors here. WhatamIdoing (talk) 18:35, 31 January 2020 (UTC)
      • EllenCT, you are not the first to comment on the 40 cent US price of diazepam compared with the low 1 cent cost in the developing world. Wikipedia has been misleading readers since this edit in December 2015. The US price is actually a retail list price for 30 tablets from Drugs.com. The NADAC as of 2014 filtered for diazepam has a wholesale price of 2.2 cents for 10mg, which isn't IMO nearly so notably different from 1 cent. GoodRx offers me a coupon price for 120 10mg tablets from Costco for less than 10 cents each. -- Colin°^Talk 20:45, 31 January 2020 (UTC)
• Almost all of the above is off-topic for the section it is in. To address it anyway: I concur with EllenCT's "If there are many reliable sources focusing on the drug's prices (e.g. insulin) then a summary should appear in the introduction. If the drug is successfully on the generics market and uniformly inexpensive, then the price probably isn't noteworthy at all." As for "If the drug is only expensive in some markets but not others, that's worth a mention in the article body." – That's only going to be the case when multiple independent reliable sources, with a global perspective, are covering the matter in-depth. It's not sufficient that, say, 4 newspapers in Bolivia complain about the price of something in Bolivia. There could be all sorts of reasons for a price being unusually high or low somewhere, most often governmental interference. If The Times of London, The New York Times, Al Jazeera, The Times of India, Le Monde, and Asahi Shimbun all devote coverage to the pricing of that drug in Bolivia and their coverage converges on at least a semblance of a consistent account, then we have a good reason to include it.  — SMcCandlish ☏ ¢ 😼  21:31, 2 February 2020 (UTC)
• On-topic: If I may provide actual comments about the Manual of Style, I'll say that while whether to include pricing information is, on a case-by-case basis, mostly going to be a factor of the interplay of other WP:P&G pages (NOT, NOR, V, RS, MEDRS, NPOV, etc.), it's entirely reasonable for MEDMOS to summarize the gist, and to [probably – I can't 100% predict the outcome of this RfC] discourage including pricing information without good reason, especially in the lead and double-especially in a context-devoid infobox. It's common and well-established that topical MoS pages are not 100% confined to style and grammar matters, but also include topically specific elements of content guidelines, naming conventions, good versus poor sourcing guidance, and other "rules". WP:NOT#BUREACRACY, WP:WIKILAWYER, WP:CREEP and other principles apply here. We do not want a sprawling, confusing proliferation of stand-alone style, naming, content, sourcing, and other guidelines on every topic category! We may have a compelling rationale to have, say, WP:MEDRS and WP:MEDMOS as separate pages (for length alone, if nothing else), but if we needed stand-alone "NCMED" and "MEDCONTENT" pages we would have evolved them a long time ago. And in fact the opposite is happening; various unnecessarily topical guidelines have been merged, and others are slated for merger (e.g. WP:NCCOMICS into a section at WP:MOSCOMICS). Such a merger is already in the case in medicine; WP:NCMED redirects to MOS:MED#Article titles. The only sphere in which the community is routinely tolerant of additional topic-specific guidelines is WP:SNG, and even that is rare (there are only 12 of them). Frankly, it would be completely harmless and probably helpful to merge these into their respective topical MoS pages for centralization (and I would bet real money that any attempts to create new ones would either fail outright or lead to such a merger). So, the existence of some of them as separate pages isn't a strong rationale for creating more things like a medicine-specific content guideline. If this RfC concludes with anything concrete, MOS:MED is where to put it, probably with a cross-reference at WP:MEDRS and where ever else pertinent, like WP:WPMED.  — SMcCandlish ☏ ¢ 😼  21:31, 2 February 2020 (UTC)

Comments about drug prices or statistics

This is the section for comments that are more focused on the subject matter than on Wikipedia's policies and guidelines.

• The prices of pharmaceuticals vary over several orders of magnitude. Just in the US, Kalydeco apparently costs $25,000/month, while aspirin costs <$25/month. Perhaps much conflict could be avoided if the proponents of including pricing could focus on conveying the order of magnitude of a drug's cost. Is it in the same ballpark as Kalydeco or as aspirin? Trying to give exact pricing runs into issues with overprecision and whether particular known prices are representative. From this perspective, I think the example given for diazepam is fine, being an order-of-magnitude estimate to one significant figure. Adrian J. Hunter^{(talk•contribs)} 07:38, 24 January 2020 (UTC)
  • Also drug prices vary even in the same country on the same drug Dq209 (talk) 13:43, 24 January 2020 (UTC)
    • Agree with your point; a single number is almost meaningless. That is because what is discussed above is the wholesale price which is the price of the drug sold to businesses. As I mention above it is confusing and misleading to use the wholesale price without any context, for the very reason you mention. There is usually a lot of variation between this and the prices charged by businesses or end distributors to consumers.--Tom (LT) (talk) 22:08, 24 January 2020 (UTC)
• As far as I can tell, the prices are more likely than not to be misleading. Adding specific qualifiers or putting together numbers from several different places or times doesn’t materially change this, because there are at least hundreds of possibilities. Per Adrian, a "which order of magnitude" estimate is reasonable, but nothing more precise than that. Also, I'll repeat that all of this has the same exception that sources that directly analyze the price are a separate issue. However, if e.g. certain medicines are important specifically because of their low (or high) price, which I can certainly believe, then it should be easy to find a source that simply says that and use it directly. A generic statement about medicines from a certain category would probably work for that and could be copied across multiple articles. Sunrise (talk) 00:40, 25 January 2020 (UTC)
• would be ok with just reflecting the "order of magnitude"...the price has been stable over the last 20 years, the one supplier IDA Foundation sells to more than 130 LMIC at the stated price...IMO--Ozzie10aaaa (talk) 02:29, 26 January 2020 (UTC)
• The most obvious cost to offer readers is treatment cost for a named indication. Either for complete treatment or an idea of ongoing costs for lengthy treatment. Giving the cost of an arbitrary pill or dose isn't meaningful if you don't know how many pills to take, how many times a day to take that dose, and for how many days. The problem is, our drug database sources simply do not contain the information needed to work this out, and our medical guideline forbid giving dose or treatment plan information to our readers. And that's assuming it even makes sense to talk of one treatment cost, for a drug with multiple indications and multiple patient types.

Even if we were able to source a single treatment cost for a drug, some have suggested offering a ballpark figure (Adrian J. Hunter). The $0.01 for diazepam is an illusion: it isn't a ballpark figure but just the result of the two buyer prices being the same "$0.0100" price. Rounding to 1 significant figure, for example, still gives the illusion of precision to a tenth of the price: $0.06 appears twice as expensive as $0.03 when in fact both prices may have huge error bars and fluctuate by that amount in a few years. Newspapers can collapse multiple prices into one by saying "cost as much as $25,000" or "cost as little as $0.20" or cherry pick with "can cost $100" and do so to make a case about how expensive or cheap a drug is. Unless citing such a source, we can't do that, so how could Wikipedia give a ballpark figure that the reader knows is a ballpark and understands how imprecise it is? -- Colin°^Talk 11:50, 26 January 2020 (UTC)

• I agree with some of the above responses that the best thing for a medication article to do is give the reader a general idea of price: cheap, expensive, etc. A Wikipedia article is not really good at giving actual prices at the granularity that would be needed to be relevant to the reader. I think it might be feasible to provide links to good sources for medication prices, to aid the reader if they do want to get an idea of what cost they'd pay for a medication. And of course if there is encyclopedic stuff to discuss about a medication's price (like "this drug is really expensive and people have complained about that") that should be discussed in the article body. --47.146.63.87 (talk) 21:31, 26 January 2020 (UTC)
• Again, I would strongly prefer that we focus on expanding articles such as Medication costs and Prescription drug prices in the United States to show industry patterns and practices rather than merely including a price in each drug's article. If inclined to do the latter, editors can be far more helpful to the reader by providing more information, such as the locales where the drug costs the least and the most, and historical price trends, than a single price. EllenCT (talk) 07:58, 30 January 2020 (UTC)
• How often is such data available? Am I wrong to think that a lack of data on prices may sometimes reflect less a lack of interest by MEDRS/RS sources than a lack of solid information, in some cases caused by purchasing confidentiality agreements? I have heard of transparency initiatives seeking the prices paid for medications by major (government) buyers. If, in a few years/decades' time, there is more reliable data of this sort, and more discussion of it, this may be grounds to change what we present. I understand that cost ranges for generic drugs are sometimes researched and discussed by the WHO; certainly for some vaccines this is the case (for some vaccines, the cost per dose may even be extensively reported it the general media over time; polio vaccines, for instance). Exceptionally expensive medications must be specially approved in some countries (like the UK), which may generate large amounts of media coverage. I don't think, subject to correction, that anyone is arguing that the prices of medications is never of encyclopedic importance, or that any source can be cited for it, or in favour of generalizing beyond available data. So more solid discussion of prices in reliable sources might resolve much of the contention. HLHJ (talk) 07:42, 31 January 2020 (UTC)
• I have to agree with "the prices are more likely than not to be misleading. Adding specific qualifiers or putting together numbers from several different places or times doesn’t materially change this, because there are at least hundreds of possibilities" (i.e. the opening points that prices for different drugs vary to widely in the same country, prices for the same drug vary too widely by country and even, at the retail level, within a country). Some kind of order-of-magnitude data seems reasonable, yet how easily with average reader make sense of it? I'll return to my consistent theme throughout: if the RS are not dwelling on the pricing, then WP should not either; if they are, then they're already providing the sourced information for us to present. Whether that magically produces as cross-article system of comparable figures (hint: it won't) is completely immaterial. WP is not a price-comparisons database.  — SMcCandlish ☏ ¢ 😼  21:37, 2 February 2020 (UTC)
  • SMcCandlish (and anyone else), about your sources "dwelling on the pricing", I wonder whether you think it's enough to have source dwell on the price of pharmaceuticals in general, or specifically on that drug. Consider a (very) common drug for cardiovascular health: Do I need to find a source that dwells on:
    • the price of a (specifically) 20 mg simvastatin pill?
    • Or the price of simvastatin?
    • Or the price of statins?
    • Or the price of lipid-lowering drugs (e.g., statins plus fibrates and others)?
    • Or the price of drugs for cardiovascular conditions?
    • Or the price of drugs in general?
  • What's the most general category that you'd consider appropriate in that list, if I wanted to add some content about price to Simvastatin? (I'm talking about "price" here, as in dollars-and-cents; if you think of "pricing" as having more to do with gross profit margins, then that's a conversation for another day.) WhatamIdoing (talk) 02:01, 3 February 2020 (UTC)

    I would say "the price of simvastatin", since that's the subject. It need not be specific pill sizes, per the principle that basic math isn't OR. All the rest, though, appear to be highways straight to OR land, and it would be pretty much gaming the system to conclude that "the price of drugs in general" or a broad class of them is sufficient, when the general consensus in here seems to be that there's an OR problem in even leaping from wholesale prices of a particular drug to retail dosage prices. A source that focused on "the price of statins" and explicitly included simvastatin would appear to be good enough; if it did not, we cannot be certain that the research behind that article included that specific drug or even knew of it its existence, so we're right back to OR. Anyway, I also addressed this in my comment at #Other concerns, below.  — SMcCandlish ☏ ¢ 😼  03:51, 3 February 2020 (UTC)

    Okay, it sounds like you might accept one source that says what the price is (e.g., this database) plus another source that says something like "The price of statins, including simvastatin, is Terribly Important™", and use those to both verify (the first/database source) and justify (the second/non-database source) the inclusion of a statement like "Simvastatin costs US$1 per fortnight" (or whatever the price actually is). I think User:Doc James is also willing to combine sources (i.e., the source saying that it's terribly important doesn't have to be the same source used to get the numbers) but is suggesting that we could use a more general source (towards the other end of the spectrum, somewhere in the vicinity of "drugs for cardiovascular conditions" or "drugs in general") to as the "justifying" source. But it sounds like that wouldn't work for you. Am I understanding your view correctly?

    If you (or anyone else who's willing to share an opinion) don't mind taking it one step further, does the "justifying" source need to specifically say "the price is Terribly Important™ to _____ population" or "in these countries", or do you think it would be fair, once we've got a source saying that it's important, to provide a reasonably full description of the price. For example, if the source says the price matters in Africa, does that only justify mention of African prices, or would it be enough to provide a more comprehensive description (e.g., "the price in Africa is approximately X, and the price in industrialized countries is approximately Y". WhatamIdoing (talk) 20:18, 3 February 2020 (UTC)

    Right; the specific figure (a moving target over time anyway, thus requiring different sourcing over time) and the importance-to-the-world of the price (which may itself be a moving target – controversies usually are not perpetual) are discrete facts. My larger theme here is that WP:NOTPRICE and various other concerns indicate that just a source saying "The price of statins, including simvastatin, is Terribly Important™" probably isn't good enough. If we have a policy of avoiding price information (never mind that various wikiprojects mostly into technology products like cell phones and video games have been skirting it), then we'd need in-depth coverage of the matter is multiple sources that aren't just advocacy pieces (primary sources). Is there a real world consensus that an injustice is be? Is there a real-world consensus that there's a big controversy going on? Is there a real-world consensus on anything about the pricing and its importance, that rises to an encyclopedic level? One of the main issues here is that a lot of people (including organizations) are convinced that pretty much all drugs are overpriced, so it's probably not going to be the case that for any given drug we can't find some source somewhere making noise about its cost.

    We need to be certain we're dealing with signal not noise. And even if we are, that still doesn't make it an infobox matter or necessarily a lead-section matter (at least as to specific numbers). There's a slice of editors here who are just intent on getting numbers into the lead and infobox, and they're not providing a good rationale for doing so. It's generally going to be sufficient to note that orphan drug X has attracted controversy and media attention because various people are going to die or be miserable without it, insurance generally won't cover it, and no one but the rich could afford it themselves. That's an encyclopedic point; what the exact price was this month is trivia. Another encyclopedic poinpt might be that the cost of a drug is subsidized in, say, the US, but is up around orphan drug prices in some other places. Follow that with details like: "For example, in Zimbabwe as of 2015, the wholesale cost of the drug was 700% higher than in Canada. Between 2000 and 2011, a scandal in Ecuador involved the government and national pharmacy chain Drogomatico colluding with Germany-based XYZ GmbH, sole supplier of the patented drug, to fix consumer prices around around 4 times the cost to Americans and Europeans". Or whatever. But it's tied to particular time frames and reported facts, and blurred out to broadly comparative estimations, not specific dollar/pound/yen/whatever numbers. The data need not be directly comparable, and not something we build a table out of, but just what the sources are actually telling us, and telling us consistently and in enough depth that we know it's WP material, which we then massage into WP material that doesn't need monthly updating.

    That's my take on it. I'm being too wordy and general in this for it to translate easily into "The guideline should say exactly 'foo'", but this is a rather sprawling discussion that seems aimed getting to some general principles, so I'm hoping this contributes to a directional push, to drafting something specific we can !vote on in a followup RfC. This isn't a topic I gnash my teeth over; I'm just approaching it like any other with a high risk of PoV and OR problems (and maybe in this case some MEDRS ethical concerns, like whether we could be unduly affecting patient decisions).
     — SMcCandlish ☏ ¢ 😼  21:10, 3 February 2020 (UTC)

Comments about the specific examples

Ethosuximide

What the lead says: The wholesale cost in the developing world is about US$27.77 per month as of 2014.

What the source says about:

• Suppliers: The cited database entry lists one supplier, which offered 250 mg tablets of ethosuximide for sale for US$0.1845 each (100 tablets per package) in 2014, only to organizations in the Democratic Republic of Congo.
• Buyers: The database has no information about buyer prices.
• The drug: Each pill contains 250 mg of ethosuximide. The defined daily dose is 1.25 grams. There are no other entries in the MSH database for this drug.

• This information does not look useful to me. There is no indication in the text of how the specified value is derived, the price seems over-precise at four significant figures, particularly when one knows it is based on a single and possibly out of date value.
  If a price is quoted for a defined daily dose this must be specified, and linked, as most readers will not have heard of the concept. · · · Peter Southwood ^(talk): 18:45, 28 January 2020 (UTC)
  • Peter thanks. FYI out of 25 years data, the MSH database only records a single supplier for ethosuximide in 1999 and in 2014 (not 2015). I have read several WHO/HAI reports on price/availability in developing countries and all of them mention that ethosuximide has zero availability. Zero. It simply is not available in the developing world, despite being on WHO's list of essential medicines and a primary choice for treating childhood absence epilepsy. This seems a more important point for the lead, than claiming a four-significant-figure "developing world price" based on that offered six years ago by a non-profit working in the north of the Democratic Republic of Congo. -- Colin°^Talk 20:44, 28 January 2020 (UTC)
    • A price for something that is not available is exceptionally useless and misleading. The fact of non-availability is far more important. · · · Peter Southwood ^(talk): 06:11, 29 January 2020 (UTC)
      • Peter Southwood, I just got an edit conflict, and discovered that you'd made my question for you irrelevant. ;-) It sounds like you would recommend not using this database record at all. There has been relatively little support for this particular use so far. The Carbamazepine example seems to have more potential than this one. Would you (or anyone) like to hazard a list of key features by which editors could identify which records are usable, and which we don't recommend? "Availability" isn't directly mentioned in this database, although a record with a lot of suppliers or suppliers that cover many countries could perhaps be used as a proxy. We could also simply say that it's good to report availability, regardless of anything else we might (or might not) be able to say about prices. (I'm still hoping to get your thoughts about the third example, too.) WhatamIdoing (talk) 06:21, 29 January 2020 (UTC)
        • This particular databate record does not appear to provide anything usable in isolation. I cannot judge whether it might have value in combination with other data as part of a deeper commentary. Availability is relatively tricky. If there is a reliable report discussing availability, as Colin claims for this drug, then it can be mentioned using that source. In other cases it may be a problem of absence of evidence rather than evidence of absence. I have seen some complex maneuvers to work around original research problems on Wikipedia, and a common one is to list the evidence and leave it to the reader to do the math. For drug prices this may not be generally desirable, and certainly not in the lead. I cannot say there will never be a situation where this type of information would be appropriate, but it should not be default include. · · · Peter Southwood ^(talk): 08:00, 29 January 2020 (UTC)
          • Peter, User:Colin/MSHData provides some analysis and data showing the proportion of records and number of suppliers. Also some stats on the number of suppliers for small number of core drugs that WHO/HAI researched. It seems reasonable to assume that a low number of suppliers to developing world is likely to correspond with low availability, but low availability can occur even without this. Currently, this database has been used everywhere it has a record, whereas I think any continued use needs to be guided by some community-agreed level of the number of supplier records needed to be a reliable reference price. IMO we should, like the source demands, ignore buyer prices. And we should take the median of many supplier prices, rather than quoting the outlier min/max which also has other problems, and then we are at least in agreement with WHO advice. How many suppliers are required? I would say three is a very low bar and should preferably be higher. Do you have a feel for where a threshold might be?

I would encourage the use of other sources such as WHO/HAI studies to get real-world prices and availability instead of this academic value. We also need to remember that every professional publication using this guide only uses it to get the reference price of a specific formulation and strength of a drug to treat a specific indication. We do not do that. -- Colin°^Talk 10:58, 29 January 2020 (UTC)

I don't have strong feelings about a specific bar. What one can say depends on the specific information provided by a source, and whether that information is appropriate to the article. More sources may make more information worth including, but not necessarily. There is much greyness in the area. Three suppliers only just allows a median to be identified, and my feeling is that in most cases we would reasonably expect the number of suppliers to be specified, so that the reader is aware of the level of approximation. It is theoritically possible that only three suppliers exist for a drug. That in itself might be worthy of mention. If there is only one manufacturer it would almost always be worthy of mention. Some competence and discretion is required. Minimum, maximum and median may all be encyclopedic in some cases, but probably not in many others. Information that has lasting value is usually more valuable than information that will be out of date in a few months. · · · Peter Southwood ^(talk): 13:37, 30 January 2020 (UTC)

Peter thanks. I agree that this source must be used with a great deal more care than the current approach, and I think mostly (nearly always) it is probably unsuitable for direct use by Wikipedians. Just to clarify the "suppliers" in this database are are mostly NGOs, are not drug companies or generic manufacturers, and are drawn from a list of 35 suppliers who make their price lists available to MSH. There will be other suppliers who don't have a relationship with MSH, or where manufacturers deal more directly with government agencies. Limited or missing set of records in the MSH database doesn't prove there are no suppliers, just that the guide doesn't list many/any. Similarly the min/max are only the min max of MSH database records for that one pill and year, not for all formulations/strengths and not for the entire developing world and not for all indications and circumstances. A WHO/HAI report into availability, treatment cost and affordability is likely to be more directly useful to us and to our readers, though they are relatively rare and narrow in scope. -- Colin°^Talk 15:08, 30 January 2020 (UTC)

That information was not obvious, and makes the use of the data without explanation potentially misleading. · · · Peter Southwood ^(talk): 09:06, 31 January 2020 (UTC)

Peter, I'm looking at Sunrise's comment at 00:40, 25 January 2020, which suggested (perhaps only half-seriously) that a less misleading formulation might look like "in year A, according to the records in database B, company C sold D doses of drugs to group E for a price of F in currency G, which includes insurance and transportation charges but not handling fees or taxes".

For ethosuximide, I think Sunrise's example sentence would sound like this: In 2014, according to the International Medical Products Price Guide, one organization offered this drug for sale to accredited healthcare agencies in the Democratic Republic of the Congo at a price of about $28 per month." (Actually, does that make any sense? It's not a hospital's worth amount for US$28 per month. Maybe it should say something like "at a price equivalent to a month's treatment for about US$28, assuming the dose was the same as the defined daily dose". Or eliminate the monthly calculation, and say "at a price that would cost them about US$1 per patient per day, using the defined daily dose".)

Does that sound about right? Do you think that's a fair representation of that source? (We don't have many sources for the price of this drug.) And does the list price of a drug, in one year, in one country, from one specialized supplier, feel hopelessly WP:UNDUE, or would you keep it in the article? I'll work out equivalents for the other two examples, and post those below in a bit. WhatamIdoing (talk) 17:24, 31 January 2020 (UTC)

You said it best: hopelessly undue. SandyGeorgia (Talk) 17:56, 31 January 2020 (UTC)

That seems to be about what we could say using that record as the source. Why would we want to? · · · Peter Southwood ^(talk): 18:49, 31 January 2020 (UTC)

The specific examples both point out the general nature of the problem (i.e., why MOS:MED / WP:MEDMOS should advise against including pricing info except in unusual cases where price controversy is usually part of the RS coverage), yet also are WP:SURMOUNTABLE problems in their specifics (if someone is doing OR at a particular article, undo the OR). So, I'm not sure that dwelling on them one-by-one below will be productive for the overall discussion, which is about the systemic problem that including drug prices in our articles is almost always a poor idea for multiple reasons.  — SMcCandlish ☏ ¢ 😼  21:42, 2 February 2020 (UTC)

These three examples seem to be pretty typical, and thus show the general nature of what can/can't be sourced right now. I hope that by the end, we'll have two outcomes:

1. a clear, very concrete idea of what to do with these three specific examples.
   • Simply to illustrate – and not necessarily the current consensus for any article, much less the one we'll end up with! – I'd be happy if at the end, editors had agreed that the first should be removed entirely because it would be UNDUE even if the other problems were corrected [or that it's okay, and we just need to round to $30 and swap in "in the Democratic Republic of Congo" where it currently says "in the developing world"], that the second is basically okay but should use the median supplier price instead of a range and round more aggressively, and that the third needs should be switched to a record with more datapoints.
2. some general ideas about what's needed to support prices, so that we can use those to propose a new section in MEDMOS. Those ideas might say things like "databases deal with WP:V but you have to have a non-database source to demonstrate DUE" or "if your price is for a single country, then you have to name that country" or "focus on availability and affordability, rather than prices" or "don't put it in the lead unless you have hundreds of words in the article about prices", but they're general ideas that apply to all articles rather than just these three (or just the several hundred sourced to this database).

WhatamIdoing (talk) 02:26, 3 February 2020 (UTC)

I can buy all that; I guess I just don't much care about any but the last part; individual articles can be patched up without a site-wide RfC, but preventing a constant stream of articles in need of patch-up in this kind of regard is going to need site-wide attention and a decision on guideline wording. FWIW, I support all of your suggested guidance in principle, though some policy wordsmithing would be needed.  — SMcCandlish ☏ ¢ 😼  04:00, 3 February 2020 (UTC)

• This well illustrates the OR and misrepresentation problems. First off, that is not the price "in the developing world"; it is the price in a single country. Also, the "defined daily dose" may or may not be reflected in actual usage. Finally, what good does it do most readers to know the wholesale price? That may or may not mean anything in regards to what they pay at the pharmacy counter. Seraphimblade ^{Talk to me} 02:17, 9 February 2020 (UTC)

Carbamazepine

What the lead says: The wholesale cost in the developing world is about US$0.07 to US$0.24 per day as of 2015.

What the source says about:

• Suppliers: The cited database entry lists twelve suppliers that offered 200 mg tablets of carbamazepine for sale in packages ranging from 100 to 1,000 pills each in 2014. The lowest price reported by these 12 organizations was US$0.0138 per pill, and the highest price was US$0.0372 per pill, with a median price of US$0.0185 per pill, down 5%. The High/Low Ratio was 2.70.
• Buyers: The cited database entry lists three governments plus the Central American Integration System. The lowest price reported by these four organizations was US$0.0155 per pill, and the highest price was US$0.0480 per pill with a median price of US$0.0202 per pill, down 9%. The High/Low ratio was 3.10.
• The drug: Each pill contains 200 mg of carbamazepine. The defined daily dose is 1 gram. There are five other entries in the MSH database for this drug for 2015.

• My assumption on reading a cost per day with a range, is that the dose is variable or the cost is variable, or both, so the information appears ambiguous. All I get from this is that it was reasonably affordable at wholesale price in my part of the developing world five years ago. I cannot deduce from the available information what it is likely to cost me over the counter today. It is not clear how this information is intended to be of value to me as a reader. If I saw this in a section about pricing or economics it would not bother me too much, though I would expect more detail. In the lead it seems undue. · · · Peter Southwood ^(talk): 18:45, 28 January 2020 (UTC)
  • Peter, I agree that we need to ensure the cost is both honest and meaningful. This paper on developing nations brings the price of carbamazepine into perspective. Availability in public sector is about 45% (in low income developing nations, about 33%) and 58% in the private sector. Public sector procurement price is about 1.5 times the international reference price (IRP -- median supplier price in MSH Guide), which is actually pretty good. For prices patients pay, in the public sector, this is 5 times higher than the IRP, and 11 times higher in the private sector. The multipliers for phenytoin are even worse (18 and 25 times higher). A month's treatment "cost the lowest‐paid government worker 2.7 and 5.2 days' wages in the public and private sectors, respectively". That's for generics; for originator brands the price is 30 times the IRP. If we are concerned with prices people pay in the developing world, the IRP is simply not remotely representative, and worrying about how many significant figures to show is the least of its problems. Price, availability and affordability are all linked and complex.

Before we excited about using the WHO/HAI research on wiki (and we could use it to make a general point) the data from this paper is from 2003-2010 and only looked at 5 epilepsy drugs for the journal Epilepsia. There are 530 articles with database-sourced drug prices. Only a tiny portion have been analysed to this degree. -- Colin°^Talk 20:44, 28 January 2020 (UTC)

For carbamazepine, I'll note that Peter, Sunrise, and HLHJ have expressed some opposition to using a range, so I'll drop that, and use the median price (which the database's website recommends). Using Sunrise's model sentence above, it might sound like this:

In 2015, according to the International Medical Products Price Guide, the median wholesale list price for 200 mg pills of carbamazepine was about US$0.02 per pill in the developing world." (or ...at a cost equivalent to about US$0.10 per day, using the defined daily dose..." or ...at a cost equivalent to about US$3 per person per month, using the defined daily dose...").

This database record is one of the best in the database, so I'd like to see how much we can get out of it without being misleading or crossing any policy lines. It includes one supplier selling to more than 100 countries (at a price very close to the median), so I think "developing world" isn't an unreasonable summary in this case. (Do you agree or disagree?) I'm still not sure what to do about the other five records, each of which have many fewer datapoints. Perhaps just ignore them, because we're using the best? WhatamIdoing (talk) 17:32, 31 January 2020 (UTC)

Does the source mention the "developing world", and does the source define the developing world for this context? Our article on the developing world (a redirect) says thet the "devloping world" is not unambiguously defined. · · · Peter Southwood ^(talk): 19:02, 31 January 2020 (UTC)

In practice, I suppose it's really "countries sold to by the orgs listed at http://mshpriceguide.org/en/price-sources/?menuNo=6 ". WhatamIdoing (talk) 22:03, 31 January 2020 (UTC)

I assume WAID is referencing my statement about extrapolating beyond available data, with Sunrise's statement that the data are inadequate for giving a range. This is reasonable, but I'd like to be clear that I don't object to giving ranges per se. It won't be possible or desirable in all cases, but ranges can capture useful information. Of course, we could auto-generate drug-price violin plots with a sensible selection of labeled datapoints, to convey more information concisely . I'd think the difficulty of expressing the incompleteness of datasets, without adding cumbersome numbers of qualifications to the text, might be met with something like "according to/in limited [sourcename] data", with the details in the reference statement. HLHJ (talk) 20:31, 1 February 2020 (UTC)

• This is another case where the data is too limited, too ambiguous, too old, and too far removed from actual price paid to be of any practical value, as well as representing some OR in extrapolating to the entire "developing world" from a subset which may or may not be representative. Something like this should not appear in the article at all. Seraphimblade ^{Talk to me} 02:20, 9 February 2020 (UTC)

Diazepam

What the lead says: The wholesale cost in the developing world is about US$0.01 per dose as of 2014.

What the source says about:

• Suppliers: The cited database entry has no information about supplier prices.
• Buyers: The cited database entry lists two governments that reported buying 10 mg tablets of diazepam in 2014. Both governments report a price of US$0.0100 per pill, so the lowest, highest, and median price are identical, and the High/Low ratio is 1.
• The drug: Each pill contains 10 mg of diazepam. The defined daily dose is 10 mg. There are two other entries in the MSH database for this drug in 2014

• Two buyers' prices is not very representative of the developing world, which is not defined in this context, and is ambiguous at best, making reliability of the information open to question. Dose is undefined. Is it a one dose fits all applications drug? (I doubt it). Is the 10mg tablet representative of common prescription? Without knowing how many doses are likely in a course of treatment, the cost of a single dose is not very useful. Is all this clarified in the body of the article? Why would this information be considered due in the lead? · · · Peter Southwood ^(talk): 08:21, 29 January 2020 (UTC)
  • I've mentioned diazepam elsewhere here, and the answer to all your questions is no. But more importantly, the information you ask is not in the source, which is a big problem. -- Colin°^Talk 10:58, 29 January 2020 (UTC)
    • The questions were largely rhetorical, but thank you for answering them anyway, as the answers may provide inspiration leading us to a solution. · · · Peter Southwood ^(talk): 13:37, 30 January 2020 (UTC)

Following on from the above, for diazepam:

Taking into account all the advice on this page, and the advice from the database about preferring the median supplier price, I think we're back to Sunrise's very narrow suggested formulation again, or omitting it entirely. So with this record, the result might be "The Ministry of Health of Peru and the Essential Medicines Unit of the Dominican Republic reported that they bought 10 mg pills of diazepam for US0.01 each in 2014". Does that sound like a fair description of that source?

However, I'd really like to switch to another record. 2015's 5 mg record has a lot more datapoints, and the suppliers include UNICEF as well as other large organizations. We could then write something that looks more like the carbamazepine example, with a DDD-based daily price of about two cents. WhatamIdoing (talk) 17:42, 31 January 2020 (UTC)

• Again, extrapolation from dated and ambiguous database figures, without backing secondary sources. Should not appear in the article. Seraphimblade ^{Talk to me} 02:23, 9 February 2020 (UTC)

Other concerns

• The problem I see with this is WP:NOTPRICES. Neutral view or not, it cannot override policy.

"An article should not include product pricing or availability information unless there is an independent source and a justified reason for the mention. Encyclopedic significance may be indicated if mainstream media sources (not just product reviews) provide commentary on these details instead of just passing mention. Prices and product availability can vary widely from place to place and over time. Wikipedia is not a price comparison service to compare the prices of competing products, or the prices and availability of a single product from different vendors or retailers."

Accordingly, I don't see a reason to override policy here. If we're going to include prices (which is an inherently political issue when it comes to medicine with WIDELY varying standards), it's just plain too unclear to be accurate. I can't see a single instance where such a quote wouldn't have to have an in-depth explanation. The only instance I can see its inclusion would be where the price was in the news for some reason (very high or very low). Without addressing this issue at Wikipedia Talk:What Wikipedia is not, neutrally phrased or not, such a change to this guideline cannot override a policy. Buffs (talk) 16:54, 24 January 2020 (UTC)

(Above quote from the general conent policy page section Wikipedia:What_Wikipedia_is_not#Wikipedia_is_not_a_directory item 5:Sales catalogues)

If this RfC establishes that it is desirable to change the policy, a further RfC can be held for that purpose. If there is no such consensus, there will be no need. This discussion has value in establishing whether there is good reason to consider changing the policy, and what, if any, those good reasons would be. · · · Peter Southwood ^(talk): 08:42, 29 January 2020 (UTC)

• Comment. [COI statement: I used to do consultancy work for the pharma industry in the area of HIV & antivirals.] Commenting generally here as I find the attempt to channel comments into areas unnecessarily limiting. I have not read any of the previous discussions. Some drug prices are, in my experience, of huge interest to patients and in particular patient advocate groups. They are often the subject of considerable discussion in news-type sources. I don't see why they should be excluded because they are not sourced to meet the medical project's idiosyncratic definition of reliable sources for medical articles, as they are not themselves medical information. There again, there is a problem with the amount of detail that is necessary to convey any real understanding of the real price of a drug. Point information in the infobox is likely to be misleading, and will date rapidly. A couple of sentences in the lead, as in say nevirapine, whilst not precisely undue weight, feels less critical than much of the other information in the lead. In general, a section in the body on pricing might be a better way of conveying the issue, unless there is a cogent reason for including it in the lead. Espresso Addict (talk) 23:20, 25 January 2020 (UTC)
  • Espresso Addict, just to note that nobody has suggested politico/economic data like drug costs should meet WP:MEDRS. Meeting basic core policy WP:V, WP:OR and WP:WEIGHT and not misleading our readers would be a start. The notability requirements of WP:NOTPRICES are very much "mainstream media sources" and not specialist journal papers, drug database records, or documents in the WHO archives, for example. -- Colin°^Talk 11:57, 26 January 2020 (UTC)
• I agree with Buffs: I think that WP:NOTPRICES is the relevant policy and that it applies cleanly to the particular case of drug pricing. There may be individual drugs whose pricing in encyclopedically notable (insulin is clearly an example), but for those drugs one should expect to find many sources addressed to a broader audience, allowing for meaningful coverage on WP; these exceptions are already allowed for in the relevant policy. --JBL (talk) 02:26, 26 January 2020 (UTC)
• Re overprecision Just a side point, but giving figures like $27.77 is silly; what in the world is the reader supposed to do with the 77 cents? Round everything to two significant figures. EEng 17:30, 26 January 2020 (UTC)

  User:EEng#s agree that is perfectly reasonable. Doc James (talk · contribs · email) 12:15, 28 January 2020 (UTC)

• Generally: Please don't put price data into Wikipedia. That's not what an encyclopaedia is for. Also generally: I suspect the RfC drafters have indulged in some over-thinking here. The attempts to channel input into predefined areas is inappropriately constraining and the page notice is needlessly hostile.—S Marshall T/C 18:23, 29 January 2020 (UTC)
• I am astonished that Prescription drug prices in the United States doesn't cover the situation with insulin, although it does briefly discuss epi-pens. EllenCT (talk) 09:02, 30 January 2020 (UTC)
• Another side point, but if routine calculations are made, it would be good to give the numbers from which they are calculated in the citation, to make them easier to verify. Own essay here, but WP:Contort the citations. HLHJ (talk) 05:58, 31 January 2020 (UTC)
  • User:HLHJ that is a perfectly reasonable request and would be happy to provide all the calculations. Doc James (talk · contribs · email) 09:56, 2 February 2020 (UTC)
• I'm going to object somewhat also to the structure of this RFC. That said, I agree that WP:WEIGHT is relevant, and that WP:NOTPRICE is relevant, and that the use of databases to source this data is not in keeping with the expected minimum standards of reliable sourcing on Wikipedia. Never mind inclusion in the lead, unless that's a natural part of the summary of the article (with some decent amount of discussion in the article-proper, attached to reliable sources). Pricing information is okay in some cases, but almost always (and only) because of inclusion in reliable sources noting the price. --Izno (talk) 03:37, 2 February 2020 (UTC)
• I'm not doing to object to the structure of the RfC, since it's a general discussion to draw in editorial brainpower to work toward consensus (what RfCs technically are actually for, even if we've bent them over time into a yes/no or support option 3 out of options 1–4 voting mechanism). Anyway, WP:NOTPRICE is rather hard to surmount here, when it comes to "auto-including" pricing info in drug articles. NOTPRICE, however, makes explicit allowance for including this information when it's a major factor in the reliable sourcing. So, we basically already have the answer to this entire RfC: don't include drug prices except in the unusual case that the reliable independent sources spend a lot of time on pricing-related coverage of that paticular drug. The policy certainly and obviously militates against the idea of working up a comparative pricing system to include by default in our drug articles, and per WP:CONLEVEL policy, a gaggle of MOS:MED and WP:WPMED and WP:MEDRS regulars cannot override that policy for their pet topic. The NOTPRICE policy itself would have be changed, and we all know where WP:VPPOL is. This is basically irrelevant: "Some drug prices are, in my experience, of huge interest to patients and in particular patient advocate groups". WP isn't written as a tool for NGO lobbyists, nor as a determiner for patients in deciding which treatments they can afford.  — SMcCandlish ☏ ¢ 😼  21:51, 2 February 2020 (UTC)

WP:PRICE says "An article should not include product pricing or availability information unless there is an independent source and a justified reason for the mention." So as there is an independent source AND a justified reason for mention the criteria are filled. Nothing needs to be changed to include these details.

All the sources used are independent of the manufacturer AND lots of sources support the critical nature of pricing information surrounding medicines. Sure how we present the prices can be changed / improved. Doc James (talk · contribs · email) 11:27, 3 February 2020 (UTC)

NOTPRICE cannot be read in isolation of our other policies and guidelines on sourcing, some of which include the requirement for reliability. "Justified reason" in context is just code for WP:NPOV, which is one such PAG. Databases do not fall in the scope of reliable sources, especially given the context of WP:MEDRS and WP:RS. --Izno (talk) 15:26, 3 February 2020 (UTC)

WP:PRICE is an essay. BTW in 2016, there was an RFC on the talk page, WT:Prices#RfC: why no prices at all?, which concluded with, "Consensus is clearly that detailed price information should not be included in most cases, including the Mitsubishi Magna page. Most commenters agree there can be exceptions, such as if reliable sources state a specific price was specifically important, but commenters do not believe that is the case here." I note that our articles about cars do not include the MSRP.

Anyway, the language DJ is quoting is not just in the essay WP:PRICE but also in the policy WP:NOTPRICES, but the very next sentence in NOTPRICES is "Encyclopedic significance may be indicated if mainstream media sources (not just product reviews) provide commentary on these details instead of just passing mention." The IMPPG database (subject of this RfC) is "passing mention". It contains no commentary. Also, it's not a "mainstream media source".

The next two sentences in WP:NOTPRICES are: "Prices and product availability can vary widely from place to place and over time. Wikipedia is not a price comparison service to compare the prices of competing products, or the prices and availability of a single product from different vendors or retailers." So putting the drug prices into the lead, or body, or infobox, of every drug as a routine matter, cited to a source that only contains a "mention" without "commentary" (meaning, a primary source like a drug price database), directly violates the longstanding global consensus documented at NOTPRICES.

The words on the page at NOTPRICES specifically say that our articles on products should not include pricing of products unless the product pricing has "encyclopedic significance", as shown through "commentary" (i.e., secondary sourcing), rather than "mention' (i.e., primary sourcing).

Sourcing price information to IMPPG violates NOTPRICES. Levivich 19:08, 3 February 2020 (UTC)

Levivich, thanks for your note about "mainstream media sources". Do you see any reason that an academic journal article should be considered worse than a mainstream media source? I don't, and if you don't either, then perhaps we should (separately from this RFC) propose a little adjustment to NOTPRICES to say something like "academic or mainstream sources". There have been whole books written on the price of bread. WhatamIdoing (talk) 20:31, 3 February 2020 (UTC)

WhatamIdoing, wholeheartedly agree. Levivich 20:44, 3 February 2020 (UTC)

To answer WAID, yes there is a reason: the vast majority of academic-journal article material is primary sourcing (it's original research in the root sense of the phrase). If you have a systematic review, that's one thing, but most of the rest of it isn't material we can ever legitimately use for WP:AEIS claims, nor for any claims that may be controversial (which is likely to be the case when it comes to drug pricing). We have a long-standing problem on WP with sciences (including med) editors stubbornly refusing to absorb the fact that their professional preference for primary material (the hot new research results) and disdain for secondary material as either professional-grade but dull and derivative "homework" to slog through, or crappy layman's stuff in things like newspapers, is the exact opposite of how WP is written. The main use WP has for primary research material is providing backup citations for specifics, mostly for the benefit of our more academic readers, after we already have secondary citations for any non-trivial claims made in that same material. (The main additional use for it is providing WP:ABOUTSELF details of research claims that are themselves controversial and reported as such in secondary sources; that is, there is no better source for what exact claims such a paper made than the exact claims published in the paper, just as the best proof of what Trump said in a tweet is Trump's actual tweet). Too many of our articles still violate our sourcing policies and cite damned near nothing but primary research papers, for all sorts of claims never substantiated by anyone else's followup research, much less a scientific consensus in systematic reviews. This is a problem to correct, not a model to emulate. (in quasi-behavioral policy terms, it's a WP:CONLEVEL failure; some sci/med wikiproject people cannot declare their own "counter-consensus" on how to properly source "their" articles, against site-wide policies and consensus about them.) In the end, primary journal pieces may be able to tell us with relative certainty – in the absence of any controversy at all about the claim – some really specific number in a very tight context, but they cannot demonstrate that including that isolated datum passes WP:NOT#INDISCRIMINATE. Only secondary sources can do that, or provide the analysis, evaluation, interpretation, and/or synthesis to relate discrete bits of data like that into a "picture", an "issue", to cover.

To work back up the thread a bit: Izno is correct that databases of drug data are not secondary sources, either; they're tertiary (cf. WP:TERTIARYNOT). This really nailed it: 'NOTPRICE cannot be read in isolation of our other policies and guidelines on sourcing .... "Justified reason" in context is just code' [for those other WP:P&G pages]. Aside from V, NOR, and NPOV, several sections of NOT in addition to NOTPRICE clearly steer us away from programmatically including drug-price information on Wikipedia.
 — SMcCandlish ☏ ¢ 😼  21:41, 3 February 2020 (UTC)

Most mainstream media articles are primary sources, too, but that doesn't seem to stop NOTPRICES from recommending them.

Perhaps more relevantly, there are secondary sources that discuss prices among academic publications (not all of which appear in journals; books are the esteemed form factor for some disciplines). It might be embarrassing for Wikipedia's policies to say "No academics, because they're all just primary" and then be shown something like ISBN 9781108476386 (an entire book, published by a university press, on the economic history of trade regulation and its effects the price of bread in the Netherlands) or review articles such as PMID 29169476 (compares the price of two classes of drug treatment and declares one to be a poor value), PMID 30464416 (criticizes the cost-effectiveness of a drug), and PMID 31669499 (says prices have gone down for a class of drugs). If we want secondary source (not just independent ones?), then it should say "secondary" (or independent, or high-quality, or whatever). I don't think it should exclude academic sources just because some of them are primary sources. WhatamIdoing (talk) 01:43, 4 February 2020 (UTC)

Waid, what is it with you and the price of Dutch bread? Craving groninger koek or something? – Levivich 02:27, 4 February 2020 (UTC)

Levivich, I think I want something more like Volkorenbrood this morning. Something with seeds on the top so it looks a bit like this, gently toasted with lots of butter. :-D WhatamIdoing (talk) 16:51, 4 February 2020 (UTC)

I think that PMID 29169476 justifies an article on the class of drugs (PCSK9 Inhibitors) noting that their list price in 2017 was more than 100 times the cost of generic statins. But the danger of inserting factoids based on discovering a random article is emphasised by your PMID 31669499 which says that by 2019 they "are now a reasonable or even good value following over 60% reductions in their acquisition price, and the identification of high risk patient groups most likely to benefit". We've seen with the drug prices that they have been inserted automatically to all drug articles, and have not been maintained or even fact-checked by other WP:MED folk for five years. So really we need to encourage editors to research the literature on the relative cost, cost-effectiveness, availability and affordability of a drug or treatment and then write about those aspects to the degree the narrative literature supports such commentary. Not to do OR with drug pill price databases. Because that route leads to what we see on Diazepam where we have for five years wrongly claimed the US price is 40x the international wholesale price. Or Aciclovir where we compare the cost of an unspecified "dose" with the cost of "treatment" and nowhere explain what this is for (it is tablets for shingles, not for cold sore cream). We get that sort of unencyclopaedic mess when editors insert factoids robotically rather than researching the literature on the topic, and judging what should be said, and where, and how.

Assessing the cost-effectiveness of new drugs is routine and with Google and PubMed one can find a paper noting the cost merits of any modern drug. I don't think those papers are sufficient justification to give a price in dollars and cents, or even dollars, and certainly not doing so using OR from a drug database of pill prices to claim a treatment cost. So I don't think that extending NOTPRICES to include academic literature is warranted. NOTPRICES does not prevent us discussing relative cost or discussing affordability of drugs or drug groups or disease treatments using general terms drawn from our sources. And this is all far more encyclopaedic than the routine addition of essentially random-number dated and irrelevant wholesale prices presented as treatment costs. -- Colin°^Talk 09:05, 4 February 2020 (UTC)

Colin, How is cost-effectiveness defined in this context? is it in comparison with a specified set of alternative prescriptions or treatments? Something else? Cheers, · · · Peter Southwood ^(talk): 08:51, 9 February 2020 (UTC)

Peter, I'm not sure exactly what you are looking for. I'm not suggesting editors assess cost-effectiveness according to some definition, and certainly don't want us to tempt readers to compare treatments based on some statistically incompetent wholesale cost figures. I've seen many papers discussing new treatments vs existing ones and most times the new treatments are more expensive (still on patent; no generic) so naturally there will be pressure to consider whether they really are so much more effective or better tolerated to justify that. There's also the extensive work done by bodies like NICE (e.g. Cost-effectiveness analysis) to decide what is first-line or second-line choices, or what expensive life-saving drugs get approved for the NHS. Part of that judgement may include the wealth of a country to afford treatment, and it is likely that adjectives such as "inexpensive" and "affordable" are country-specific. But we could do more to discuss cost (without giving $$.cc figures) in both the drug and the disease (treatment section) articles.

Colin, I wasn't sure myself, which is one of the reasons I was asking. but if with Google and PubMed one can find a paper noting the cost merits of any modern drug, I thought it might have some relevance. What you describe makes sense, and I fully agree that editors generally are not competent to make such analyses, particularly with the database under dicussion. · · · Peter Southwood ^(talk): 11:51, 9 February 2020 (UTC)

Our example drug Ethosuximide isn't cheap despite being an old drug, but the US and UK still recommend it and can afford it for a relatively rare illness. I assume the developing world can't justify its greater cost over e.g. sodium valproate and therefore it appears to be essentially unavailable. We may not find sources discussing that, though. -- Colin°^Talk 10:04, 9 February 2020 (UTC)

• I see nothing wrong with an RfC which just requests comments; indeed that is their purpose. They do not have to be up or down "support or oppose" exercises. That being said, I agree with the above in that simply following WP:NOPRICES is sufficient, and we don't need any special guidance other than that. If secondary sources extensively discuss (note, that does not mean "often mention") the price of a product, there is a plausible case for inclusion of information about that price in the article. If sources just briefly mention such prices, or especially if one must resort to extrapolating from a simple database or directory entry, leave pricing out entirely. Seraphimblade ^{Talk to me} 02:26, 9 February 2020 (UTC)
• Comment: I commented before that "It seems to me that prices of medications are a[n] important fact about medications." I still feel that way. Flyer22 Frozen (talk) 00:22, 10 February 2020 (UTC)

It's not something I want to debate. My feelings are in that section I linked to. Flyer22 Frozen (talk) 00:25, 10 February 2020 (UTC)

Notices

As of RfC launch Wugapodes has agreed to act as a closer. Depending on the nature of the conversation it might or might not make sense to do a three editor panel. Best, Barkeep49 (talk) 23:02, 23 January 2020 (UTC)

It looks like Ymblanter should also be available as a closer, based on their most recent comment at AN. Advertising the discussion early at ANRFC might help with finding additional closers as well. Sunrise (talk) 00:49, 25 January 2020 (UTC)

I had missed that. Thanks. Best, Barkeep49 (talk) 01:15, 25 January 2020 (UTC)

So far, I only volunteered to close this RfC. This might or might not make me involved, but I am not yet prepared to make statements now on the RfC at which talk page we are now in.--Ymblanter (talk) 07:52, 25 January 2020 (UTC)

My mistake, I hadn't realized your comment was about the other RfC. Sunrise (talk) 12:34, 25 January 2020 (UTC)

No problem. Let us do it step by step. First I need to close that one.--Ymblanter (talk) 18:07, 25 January 2020 (UTC)

Now I closed that one, and I do not feel myself involved in the topic, so I can be a closer of this one. However, if there are objections (if users feel that I am involved) I will obviously recuse. I still have no interest in the topic, and I have not read this RfC.--Ymblanter (talk) 19:36, 28 January 2020 (UTC)

No problem here (other than feeling bad that you had to close that mess). SandyGeorgia (Talk) 19:37, 28 January 2020 (UTC)

IMO none of the admin who have helped here in an admin capacity (BK, Ros, Wug, Ymb, sorry if I'm forgetting anyone) are involved, and thanks to all of you for chipping in. Levivich 17:24, 29 January 2020 (UTC)

Agree and thanks. -- Colin°^Talk 17:32, 29 January 2020 (UTC)