Talk:Ethosuximide

message: This book discusses affordability in prose form of anti epileptic medications in LMIC. As such it fulfills the RfC requirements IMO. Doc James (talk · contribs · email) 01:57, 30 March 2020 (UTC)
replies: text: This does not meet the RFC and WP:NOTPRICES requirement: "secondary sources discuss[ing] pricing extensively" [for that drug] or as policy states it "mainstream media sources (not just product reviews) provide commentary on these details instead of just passing mention". This is very much "passing mention" of ethosuximide and a single figure in a table in a 900 page specialist textbook on Epilepsy. That is not mainstream media. Further, the price in the source, is for Italy in 2001 (not 2011 -- the book was only published in 2008). A twenty-year-old Italian retail price has zero weight or relevance in an English encyclopaedia. The article text here juxtaposes wholesale prices in 2014/2019 for a month supply of a given daily dose, with a retail price in 2001 for a year's supply of approximately half that daily dose. This baffling mix of incompatible numbers is unacceptable. The RFC conclusion was clear. All these prices are unacceptable. -- Colin°Talk 09:02, 1 April 2020 (UTC)
thread_title: Affordability

message: Per the broad discussion here about Wikipedia:Manual of Style/Medicine-related articles/RFC on pharmaceutical drug prices, and specifically the issues raised about the use of 2001 data from one country to support price statements at Ethosuximide here, the pricing content here is disputed.  SandyGeorgia (Talk)  00:35, 31 March 2020 (UTC)
thread_title:  Disputed content 

message: *Support we have textbook by a well respect medical publisher. I have provided an exact quote of the text above. We have other sources that also describe it as inexpensive.(2005 textbook,2019 textbook) Doc James (talk · contribs · email) 00:38, 31 March 2020 (UTC)
thread_title: Support

message: First, I oppose the !voting rather than discussing format here.  Second, this is yet another RFC  to dispute the already held RFC (which is not a productive way to proceed IMO).  Third, the problems per the discussion about Wikipedia:Manual of Style/Medicine-related articles/RFC on pharmaceutical drug prices, specifically the issues raised about the use of 2001 data from one country to support price statements at Ethosuximide here, make this source obviously unsuitable for this text.  A thorough read of the source shows that the data for this drug is based on 2001 prices in one country only, Italy. As the data is two decades old, based on a decade-old source, WP:WEIGHT is not met for inclusion, per WP:NOPRICE. None of the cost data in this article is policy-compliant. SandyGeorgia (Talk)  00:54, 31 March 2020 (UTC)
replies: text: I also dislike this "please vote" style.  Can't we just talk about it?  Or have a ==Poll== section that doesn't treat supporters and opposers as the only possible responses, and as parties that need to be carefully segregated from each other?  My own view doesn't fall neatly into "Support" or "Oppose", but the (very) few editors who use this style tend to disregard comments in the "Discussion" section when they're trying to figure out what the conclusion is, so it doesn't even feel like it would be worth it to say what my view is.  WhatamIdoing (talk) 01:21, 31 March 2020 (UTC)
thread_title: Oppose

message: The Google Books hyperlink source the article refers to is to the 2004 second edition of "The Treatment of Epilepsy", not to a mythical 2008 edition that the citation claims. I think Google Books has got confused. I have managed to get hold of the second (2004), third (2009) and fourth (2016) editions of this book. While the 2004 text does list phenobarbital, phenytoin and ethosuximide as drugs that may be available at prices affordable by the general population in developing countries, the third and fourth editions only mention phenobarbital in that sentence. See this screenshot. There really couldn't be a clearer example that ethosuximide is not today considered by the authors of this textbook as being generally affordable in developing countries. I hope this, and the explanation below of the 40x price increase in the UK, put an end to claims this drug is generally affordable or low cost. Those later editions also remove the table of Italian retail prices from 2001, and surely Wikipedia should do the same here. Worth noting: this textbook on epilepsy treatment of 1000 pages discusses the cost of epilepsy drugs in general in 210 words without mentioning dollars or euros, and the extensive chapter on ethosuximide does not mention cost at all. -- Colin°Talk 11:37, 10 April 2020 (UTC)
thread_title: Update

message: OK, here's how I work with pings. Processing through them hurts, as it just gives my fingers more clicks to deal with (see the top of User talk:SandyGeorgia)-- early in the day and I am already headed for the Tylenol bottle.  When I'm following a page, I don't need pings, but I hope I would never be so arrogant as to demand or expect other people to remember that, or to remember every editor's preference with respect to a feature of the website.  IMO, if someone doesn't want to be pinged, it is their responsibility to alter their user preferences. My other practice is to let the talk page know when I am unwatching, and request that THEN I please be pinged if my feedback is needed.  It is apparent that no matter how clearly Colin types, if his posts aren't being read, we won't make progress towards consensus.  Colin, Ronz, SandyGeorgia and WAID are all clear on the V, WEIGHT, NOT and LEAD issues here, and yet this page has turned into walls of misunderstanding, misreading and misinterpreting requiring lengthy explanation.  Asking for clarification would be so much shorter. It looks like this: "Colin, I see you said X, but I see Y: could you clarify?"  Response, "When I said X, I meant this; is it more helpful if I lay out the full math?" It appears that the text will remain tagged disputed, as most of us don't routinely edit war, and there is no way to resolve this, although consensus is darn clear that most of the text in the article now should be removed.  Ping me back if people want to honestly start reading and digesting posts with the good of the Project in mind.  Bye for now. SandyGeorgia (Talk)  15:29, 7 April 2020 (UTC)
thread_title:  Pings 

message: I have managed to get hold of a bunch of BNF paper copies. These are not as detailed in their price coverage as the current online edition, but do cover the major brands and the generic prices and the formulations available. There were two major brands: the originator Pfizer brand Zarontin and Chemidex's brand Emeside.
BNF	Year  	Genericcapsules	EmesideCapsules	Zarontincapsules	GenericSyrup	EmesideSyrup	ZarontinSyrup
52 	2006.2	               	38.23          	                	            	6.60        	4.48
54 	2007.2	38.23          	               	                	            	6.60        	-
58 	2009.2	38.23          	               	                	            	6.60        	4.31
61 	2011.2	38.23          	               	                	            	6.60        	4.22
68 	2014.2	48.20          	               	                	            	6.60        	4.22
69 	2015.1	48.20          	               	                	            	6.60        	4.22
70 	2015.2	48.20          	               	                	            	6.60        	4.22
73 	2017.1	173.00         	               	                	173.00      	6.60        	4.22
74 	2017.2	173.00         	               	                	173.00      	            	
76 	2018.2	173.00         	               	                	173.00      	            	
78 	2019.1	173.00         	               	                	173.00      	            	
79 	2019.2	173.00         	               	                	173.00      	            	
Predating the above table, Emeside capsules were discontinued in October 2005 and Zarontin capsules discontinued in 2006. This left the market for tablets/capsules only for generic manufacturers.
The Emeside and Zarontin syrup branded formulations were both discontinued in April 2017..  The market for both tablets and syrup was then left only for generic manufacturers.
Today's BNF offers many generic suppliers.
*A pack of 56 250mg capsules is available for £173 from Essential Generics Ltd, Neuraxpharm Arzneimittal GmbH and Strides Pharma UK Ltd, at £180.71 from Alliance Healthcare (Distribution) Ltd, and at £203.81 from AAH Pharmaceuticals Ltd.
*The syrup or sugar-free oral solution is available at £173 for 200ml (equivalent to 40 250mg capsules) from Alliance Healthcare (Distribution) Ltd, Aristo Pharma Ltd, Neuraxpharm Arzneimittal GmbH, AAH Pharmaceuticals Ltd and Essential Pharma Ltd (though AAH's sugar free formulation is £203.81).
It seems that once the brand-name manufacturers pulled out, the generic manufacturers chose not to offer the drug at a similarly cheap price, but to hike the price up enormously. We can see this price hike for the syrup and I suspect it also occurred for the capsules, though I don't currently have BNF data going back to around 2005/6.
Although we have secondary sources commenting that certain brand formulations have been discontinued, we haven't got such sources commenting on the price changes. -- Colin°Talk 12:23, 1 June 2020 (UTC)
thread_title:  Price in the UK