Talk:Pyrimethamine

Wiki Education Foundation-supported course assignment

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Nishp14, MitraFazel, Hjkim1988, Piadizon. Peer reviewers: Chatleym, Rev20one, Mchernovsan.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 07:32, 17 January 2022 (UTC)

Why is it specific to protozoa

Why is Pyrimethamine use only to treat protozoal infections ? Presumably (from the mechanism) it also has antibacterial and anti-cancer properties ? Rod57 (talk) 19:15, 5 January 2009 (UTC)

Fansidar

Why is this not listed as a brand name, or as an alternative antimalarial? Certainly this packaging has relevance in terms of availability of the drug, no? Why is it relegated to a footnote in references, not even See Also? DAVilla (talk) 02:37, 20 September 2015 (UTC)

Beats me, DAVilla. I inserted Fansidar, so it doesnt need to be in a see also section. you could have done it too....many of these antibiotic articles are in less than desirable shape.--Wuerzele (talk) 03:04, 20 September 2015 (UTC)

Mixup in the synthesis scheme

In the synthesis scheme there is trimethyl orthoformate used for the methylation instead of diazomethane. Maybe the person who made the scheme could correct this? I guess this would be faster than drawing the whole thing new from scratch.129.206.54.17 (talk) 17:11, 21 September 2015 (UTC)

History?

Some news reports are saying this drug is 62 years old.

It could no longer be under patent then but some how the rights to it have been purchased in 2015.

What is the true timeline of this drugs development? — Preceding unsigned comment added by 23.119.204.117 (talk) 19:32, 21 September 2015 (UTC)

I have a found a report in The Times on 25 August 1953 which attributes the discovery of pyrimethamine to the Wellcome Foundation Ltd, specifically their laboratory at Tuckahoe in New York. It was then trialled by the Wellcome Laboratories of Tropical Medicine in London. The report also mentions that investigation and development took nine years in all. Emma May Smith (talk) 22:15, 21 September 2015 (UTC)

Are there any alternatives to this?

See subj. -Mardus /talk 13:14, 22 September 2015 (UTC)

• This nytimes article[1] has a good discussion of the current lack of any competition in the manufacture of this drug.--Milowent • ^hasspoken 16:18, 22 September 2015 (UTC)

• • I cannot remember where I read it now, but is sounded like a very knowledgeable source. They way they explained it is that Turing Pharmaceuticals owns, somehow, the monopoly to market the drug in the US. And the US had laws forbidding its citizens from shopping around for international drugs in some way. So defacto they have a American monopoly, but it is legal for other companies to manufacturing and sell it, they just cannot advertise to Americans. So the problem is not manufacturing, it is marketing, and only in America. 207.61.204.116 (talk) 13:30, 23 September 2015 (UTC)

Pyrimethamine is off patent, but in order to sell the drug, a generic manufacturer must get FDA approval. To get FDA approval, the generic manufacturer must do an equivalence test, comparing their pyrimethamine to Turing's pyrimethamine, with tests that include a controlled trial of patients randomized to the generic's drug or Turing's drug. Normally that's relatively easy. But Turing established a closed distribution system, which allows them to approve the sale of the drug to any customer. If a generic company ordered 100,000 doses for the trials, Turing could refuse to sell it. This procedure has gone to court a few times, but the drug companies have settled under confidentiality agreements, so nobody outside the companies knows how they turned out. --Nbauman (talk) 02:18, 25 September 2015 (UTC)

Moral?

"Call it censorship if you want, but I really don't think we should tell desperate people that they can get off-brand, bootleg medication if they just start Googling for sketchy international merchants"

Is it really Wikipedia's job to decide what information is immoral and should not be recorded and disseminated? If there exist companies selling copies of this drug, that is simply a fact that is worth mentioning. It should not be up to us what information should be deleted for the good of the people. 207.61.204.116 (talk) 17:09, 22 September 2015 (UTC)

Is Shkreli Fraud Relevant?

Is including the Shkreli fraud case at all relevant to this drug? It seems to add an unecessary and unwarranted bias to the section about the price increase. The article even notes that the fraud is not related to the price hike.

--65.112.8.129 (talk) 05:32, 24 March 2016 (UTC)

While I do understand your point, I believe the information does say something about his general trustworthiness as a person. It illustrates his lack of moral and makes his other comments less valid, knowing the kind of person they come from. He plays the role of having done nothing wrong, but if the allegations are true, he clearly is morally corrupt. Therefore I personally find the information valuable.

Whether all the information should be in this article is another question though; maybe it could be moved to the article about him and only a shorter amount of information be kept here, with a link to the full information about the fraud case. I do believe it is relevant to mention it. --Jhertel (talk) 06:09, 24 March 2016 (UTC)

I would say, no. The information about Shkreli's involvement with the drug, including the price hike, does have to do with Pyrimethamine, the subject of the article. The information about Shkreli's arrest for activities unrelated to the drug do not belong in an article about the drug; it is completely off-topic, and this is a fine example of WP:COATRACK. That information should be (and is) discussed in Martin Shkreli, where it is on-topic, but not here. TJRC (talk) 22:54, 24 March 2016 (UTC)

It's the only reason why the drug is notable.2605:6000:6947:AB00:D031:C216:F0E1:58AC (talk) 01:59, 10 May 2018 (UTC)

However?

The use of the word "However" in the sentence beginning "However, New York Times journalist[...]" is unnecessary and appears to be an attempt to editorialize on the previous sentence. 66.194.85.162 (talk) 14:31, 13 April 2016 (UTC)

Changes to be Made by Pharmacy School Health Policy Class

We will be primarily editing the lead section, adverse effects and mechanism of action sections.

For the lead, we were going to structure it to be as the following: 1st paragraph: Class of drug (antifolate, antimalarial) 2nd paragraph: Summary of medical use 3rd paragraph: Common side effects 4th paragraph: History of medicine

For the adverse effect section, we were going to go over the most common adverse effects and separate those out based on organ system to enhance the readability of the section. We were also going to make the contraindications and interactions sections (currently as subheaders under the side effects section) into their own sections since they are different from adverse effects.

Lastly we will be editing the mechanism of action section for readability and add any necessary information that we find in our research. Nishp14 (talk) 02:25, 2 November 2016 (UTC)

This is a fairly decent reference [2]

Having the 1st paragraph cover medical uses and putting the mechanism after side effect would make the lead follow the body of the text. Doc James (talk · contribs · email) 08:47, 2 November 2016 (UTC)

Review from Group 24 Health policy class

Almost all the points included are verifiable, with a minor exception - I was unable to access the citations 5, 9 and 21, not sure weather there is a linking issue or some other type of malfunction. Possibly the sources are not accessible from the links provided anymore. — Preceding unsigned comment added by Mchernovsan (talk • contribs) 22:04, 15 November 2016 (UTC)

The article has a neutral point of view. Even in areas where it would seem natural to comment on efficacy and appropriate use, for example when discussing the pregnancy category, the authors stick to the facts. Chatleym (talk) 21:30, 15 November 2016 (UTC)

The article's flow is quite consistent with how the other medicine related articles are in Wikipedia. The summary is quite representative of what can be anticipated from the entire article. Gmsah (talk) 20:16, 15 November 2016 (UTC)

I did not find any evidence of plagiarism. All the evidence in the page appears to be cited correctly. — Preceding unsigned comment added by Rev20one (talk • contribs) 21:24, 15 November 2016 (UTC)

Response to Group 24's Peer Review

Thank you for your feedback. We reviewed citation #5 and found the link to the active and from a reputable source. Citation #9 is a reliable text book which is accessible via Google Books, and the ISBN is verifiable. We have removed citation #21 since the information and the source are both unable to be verified. Hjkim1988 (talk) 00:57, 17 November 2016 (UTC)

Good Faith Edit

My edit regarding clinical trail for CLL/SLL was reverted [3] by Doc James, citing " high-quality reliable sources as references". Does https://clinicaltrials.gov not meet the criteria for "high-quality reliable source"? If it does not, than should the entry regarding clinicial trials for amyotrophic lateral sclerosis also be removed, since they are both from the same source? Thanks! Jerry G. Sweeton Jr. (talk) 17:07, 13 March 2017 (UTC)

The source is being used differently. For ALS it is only used to confirm that trials are underway. Your edit also used it as evidence that "researchers have discovered that pyrimethamine may target the STAT3 protein", for which a review or other peer-reviewed paper would be more appropriate. If the information is sufficiently notable one shouldn't be that difficult to find. PriceDL (talk) 17:47, 13 March 2017 (UTC)

Thanks, I understand this issue now. I did come across something regarding STAT3. Let me try to find it again. Jerry G. Sweeton Jr. (talk) 19:48, 13 March 2017 (UTC)

WP:MEDRS runs through the recommendations. clinicaltrials.gov is generally not sufficient. This of course is not always consistently applied. Doc James (talk · contribs · email) 20:16, 13 March 2017 (UTC)

Found these with a quick Google search. I'll incorporate into my entry and re-submit.

• Targeting of MDS and AML Stem Cells Via Inhibition of STAT3 By Pyrimethamine
• A Chemical Biology Approach to Developing STAT Inhibitors: Molecular Strategies for Accelerating Clinical Translation
• Screening approaches to generating STAT inhibitors - Allowing the hits to identify the targets

Jerry G. Sweeton Jr. (talk)

A better explanation for the ability to block selling of generic drugs is missing

The average reader, especially if they come aren't Americans, would not understand what legal loopholes allow the selling of a drug regarding which the patent is long gone almost as if it was patented. I say that because... I don't understand it and I'd love to get a clear explanation. In particular: 1) Is it legal in the US for a company to refuse to sell their products to someone? The article says they can decide not to sell it to a rival company if they wish to. 2) If the answer to (1) is "yes", how come not all pharmaceuticals do that? I mean, hey, if Eli Lilly could continue forever to not have a generic drug competition to Fluoxetine (Prozac), wouldn't they have done it? 3) The formula of the active ingredient is known; why would a company need to get a hold of the "original pill" if it can prove (e.g. by mass spectrometry, I guess) that the formula they produced is identical, that the drug has good pharmacokinetic and pharmacodynamic properties etc.? 4) The drug is being sold all over the world for cheap prices by world-renown companies (e.g. GSK). Why can't they sell it in the US? 5) Are there any processes taking place to change the laws/procedures so as to avoid such situations in the future? — Preceding unsigned comment added by 85.180.174.208 (talk) 17:13, 14 September 2017 (UTC)

There are a couple of articles that go into it:

• Surowiecki, James (October 5, 2015). "Martin Shkreli Is Not the Problem". The New Yorker.
• Kliff, Sarah (September 22, 2015). "A generic pill's price just went up $700. Why doesn't another company create a competitor?". Vox.

Basically, as I understand it, the cost of entering the market is high, and if another company tried to enter the market to undercut Turing's inflated price, Turing can always drop the price again. And with only a few thousand prescriptions a year, a truly competitive market will not be very profitable, which makes entering a bad risk.

I may try to add something along these lines, or feel free to do so yourself based on the sources above. TJRC (talk) 00:30, 15 September 2017 (UTC)

Multiple problems

Discussion copied from WT:MED [4] SandyGeorgia (Talk) 06:31, 31 March 2020 (UTC)

Pyrimethamine

James added here moved but left existing pricing data specifically sourced to a press release from the manufacturer, which is directly addressed at WP:NOPRICE. SandyGeorgia (Talk) 01:57, 31 March 2020 (UTC)

WP:SOAP as well. --Hipal/Ronz (talk) 02:01, 31 March 2020 (UTC)

I was actually grouping content by country. The https://www.prnewswire.com was in the article before and I just moved it. Doc James (talk · contribs · email) 05:09, 31 March 2020 (UTC)

Struck and corrected above, with my apologies. I am curious why you did not remove the text, since that sort of content (company press release) is quite specifically addressed in the policy page, WP:NOPRICE, and as far as I know was never disputed during the RFC. Could you clarify whether you also consider the PRnewswire source to be usable for price content? Also, this is another example where an edit summary would be helpful. Many (most?) editors when moving content, indicate that in edit summary. Because you used the same edit summary (adjusted) [5] that you used when reinstating other price content (in the articles above), I mistakenly assumed this was another reinstatement. SandyGeorgia (Talk) 05:22, 31 March 2020 (UTC)

I did not look at the sources. That source sucks. I was just grouping content about price by country. Removed it. Doc James (talk · contribs · email) 05:37, 31 March 2020 (UTC)

Glad to hear that!(Oops, I see a problem there, added below). Ok, there are other problems there. We have an ungrammatical sentence in the lead, so I went to the sources to try to figure out what it meant to be saying.

• In the United States in 2015, when it was not available as a generic medication, and the price was increased from US$13.50 to $750 a tablet ($75,000 for a course of treatment), resulting in criticism.

Sources

I don't know what is in the first source (request quote). The second source is a Forbes contributor opinion piece, which are generally considered unreliable for ANY text on Wikipedia. The third source does not verify the content; it mentions the cost of treating one patient at one hospital, as an example, and does not state that $75,000 is generally the cost of treatment. So, even in a case where there may be reason to include price data in the lead, we haven't done it in a policy-compliant way. This is why a systematic approach to checking all of these problems is needed; it appears that there has been too much very hurried editing of price content. SandyGeorgia (Talk) 06:04, 31 March 2020 (UTC)

And there's another problem with the text you deleted here. As I mentioned above, the source (a company press release) was not reliable compliant with WP:NOPRICE, but instead of tagging or replacing or removing the citation (the press release), you also removed the entire content, which does seem to be relevant to the pricing problem that happened there. It is not good practice to remove text that can be cited, as in this case, that text can be cited to CNBC. The edit summary was "trimmed press release" which might better have been "removed text cited to press release", as that would trigger other editors to know that an alternate source might be (in fact, should be) sought. SandyGeorgia (Talk) 06:47, 31 March 2020 (UTC)

So is it that you consider the content to be incorrect? Or that you do not like the source? Took me a couple of seconds to find a NYTs article that supports. Have provided direct quotes.

If you wish to return the content that was previously based on the press release supported by another source feel free. Doc James (talk · contribs · email) 19:48, 31 March 2020 (UTC)

IF refs are easy to find, what I am pointing out is that should be done comprehensively as drug price content on each article is addressed … slow and steady wins the race. We don't want all of us checking and re-checking and finding this number of issues. SandyGeorgia (Talk) 20:06, 31 March 2020 (UTC)

This looks good now, [6] but the body of the article still contains the same issues. SandyGeorgia (Talk) 20:12, 31 March 2020 (UTC)

The price per a typical course of treatment at 75,000 is here[7] among other places. Doc James (talk · contribs · email) 19:51, 31 March 2020 (UTC)

Are you familiar with that source (I am not)? My concern is that it seems to be an opinion piece and they may be misquoting the NEJM piece, just as the other did, particularly if you look at the dates. And, they may also be using Wikipedia as a source (circular reasoning). When we get into this drug pricing, we need to apply not MEDRS, but the same methods we use to look more generally at RS. Unless a stronger source is found, I am more comfortable with the original NEJM, rephrasing to the correct context they gave. This source looks pretty dubious. SandyGeorgia (Talk) 20:04, 31 March 2020 (UTC)

So to clarify you do not believe "a typical course of treatment costs 75,000"? And you think the source got it wrong? Or am I misinterpreting your concern? Doc James (talk · contribs · email) 17:23, 1 April 2020 (UTC)

Huh? Source-to-text integrity is never about "what one believes". Do you know the source, it appears to be an opinion piece, it could be using circular data (mirrored from Wikipedia), and since we have a superior source (NEJM), why not use them, and edit the text to conform to what they say (which is not what we say now)? Alternately, find a better source backing the notion that $75,000 is a typical course of treatment, not just one hospital, one example as stated by the NEJM. SandyGeorgia (Talk) 17:39, 1 April 2020 (UTC)

I am not sure the issue you are having. Do you or do you not accept that the medication costed $750 per tablet at the time? Doc James (talk · contribs · email) 23:52, 1 April 2020 (UTC)

Well I don't know how else to state this. It's not what I believe. It's whether we are reflecting what the source says. The source says "in one hospital". If we don't like that, we should find a different source. Anyway, I fixed it myself. But I don't understand why we have a five-year-old price in the article at all, when it seems that particular controversy is resolved now (see next section). SandyGeorgia (Talk) 00:41, 2 April 2020 (UTC)

And you looked for sources for 750 USD per tablet and could not find any sources that meet your requirement? What was wrong with the NYTs that says "The drug, called Daraprim, was acquired in August by Turing Pharmaceuticals, a start-up run by a former hedge fund manager. Turing immediately raised the price to $750 a tablet from $13.50, bringing the annual cost of treatment for some patients to hundreds of thousands of dollars." It does not say this is for one hospital.

That appears to still be true in the USA in 2018.[8][9] Doc James (talk · contribs · email) 03:18, 2 April 2020 (UTC)

I am not looking for anything. I am asking for source-to-text integrity for whichever source is used: say what the source says. Right now, the article cites the NEJM, which says "Recently, at our hospital ... the price for 100 pills was $75,000." One hospital only (which is why I added that to clarify). If we'd rather switch to a different source that says more broadly, hundreds of thousands of dollars, we can do that too. Or some combination of both. But the statement before was that annual treatment cost was $75,000 (not specifying that the source said this was at one hospital only... demonstrated to not be broadly true for all treatment costs, since you now have a source that says hundreds of thousands). At any rate, it's old data, and not even relevant to the lead, so once Hipal finishes sorting more general text (below) it can be rewritten and incorporated. SandyGeorgia (Talk) 03:30, 2 April 2020 (UTC)

Here is a textbook from Cambridge University Press. 100 pills costs $75,000 which can easily be required for a course of treatment.[10] Doc James (talk · contribs · email) 04:03, 2 April 2020 (UTC)

So we could probably combine the two sources (this book and NEJM) to settle on $75K as (then) cost of treatment, but better, this source may provide the context Hipal is looking for, with ... there was a time when it was ... by weight 700 times more valuable than gold and half as valuable as diamonds. The context could be more useful than the (then) price confirmation! Will see what Hipal says on how to craft the entire construct with all the pieces. SandyGeorgia (Talk) 04:28, 2 April 2020 (UTC)

That book looks like a rather poor source, possibly WP:CIRCULAR. It looks like a student case study. I'd rather not use it if we can find better. --Hipal/Ronz (talk) 15:59, 2 April 2020 (UTC)

Thanks, Hipal; I was actually afraid of that, and thought twice about posting from my iPad after I had gone to bed, when my iPad link to the book curiously could not pull up the actual book, and only that page. Since Wikipedia was for many years misreporting the 75K (relative to what the NEJM actually said), I am concerned that all subsequent references to 75K lead back to Wikipedia. This is why we should take greater care in our editing :) Glad you got to the bottom of that. When we are dealing with normal RS text (as opposed to our more typical MEDRS), we have to carefully examine sources, as we can't rely on PubMed as our basis for integrity. SandyGeorgia (Talk) 16:18, 2 April 2020 (UTC)

Lede

I did some cleanup to the lede per the RfC and policy. I think a better description than "resulting in criticism" is needed and due. --Hipal/Ronz (talk) 17:32, 1 April 2020 (UTC)

What do you propose? Doc James (talk · contribs · email) 23:52, 1 April 2020 (UTC)

It's rather odd that the lead mentions a five-year-old pricing scandal, which is now somewhat resolved. Couldn't the lead be more along the lines of ... When Turing Pharmaceuticals bought the production rights from CorePharma in 2015, there was controversy when they increased the price in the United States by 5,500 percent, but it is now available worldwide as a generic at lower prices. Why is the 2015 actual price still relevant? Also, price info is repeated in History and United States sections. SandyGeorgia (Talk) 00:02, 2 April 2020 (UTC)

5,500 percent is less useful than $13.50 to $750 per pill IMO. Doc James (talk · contribs · email) 03:20, 2 April 2020 (UTC)

I agree that the exact historical prices for this controversy are useful to have, but in the body of the text, not the lead, since the data is now five years dated and the situation has changed. Hipal is looking for a source to give context (below), but in the lead for a historical controversy, all we need is relevant context. One easier way to express it may be that there was a 50-fold increase. SandyGeorgia (Talk) 03:37, 2 April 2020 (UTC)

I lost a bunch of edits to this article and talk page due to an emergency. The edits to the article included removing most of the pricing information [11].

I was looking for a reference to use for some perspective on how to summarize the pricing scandal, something that has a historical perspective on the entire episode. I also wanted to search for any information on how the generic came to be.

Is this actual price relevant enough for the lede? Probably not, but some good references would help us decide.

Here's one, but there's not as much detail as I'd like: https://www.npr.org/sections/health-shots/2019/12/31/792617538/a-decade-marked-by-outrage-over-drug-prices --Hipal/Ronz (talk) 02:20, 2 April 2020 (UTC)

Can anyone access https://www.wsj.com/articles/fda-approves-generic-version-of-drug-featured-in-shkreli-suit-11582928802 ? --Hipal/Ronz (talk) 02:24, 2 April 2020 (UTC)

Yes, there are only a few sentences beyond the preview you can see, and they say not a thing you don't already have. There is an apparent contradiction, though, in "When Turing Pharmaceuticals bought the U.S. rights to Daraprim in 2015, it raised the price of the drug to $750 per tablet from $17.50." The other sources say $13.50? Way to go, WSJ ! I do like some of the context given in the NPR piece (too expensive for hospitals to stock, etc.) SandyGeorgia (Talk) 02:40, 2 April 2020 (UTC)

Maybe some from this? SandyGeorgia (Talk) 02:49, 2 April 2020 (UTC)

• Turing to Cut Price of Drug Daraprim After Increase Sparks Outcry; Small pharmaceutical company had come under fire after raising price of Daraprim to $750 from $13.50 Rockoff, Jonathan D. Wall Street Journal (Online); New York, N.Y. [New York, N.Y]23 Sep 2015: via ProQuest

A small pharmaceutical company that has come under fire for a more than 50-fold hike in the price of a drug used to fight a parasitic infection will cut the price, though it is still working out by how much, according to a person familiar with the matter. The drug, Daraprim, had cost $13.50 a tablet before Turing Pharmaceuticals AG bought the U.S. rights in August from Impax Laboratories Inc. and raised the price to $750. The increase became a poster child for high drug prices, which have been attacked by drug-benefit managers and some Democrats. ... The price hike was the latest example of how some drug companies are buying rights to medicines they view as underpriced and then charging significantly more... Daraprim's higher price prompted an outcry from some patient advocates, especially those representing people infected by the HIV virus.

• New pharmaceutical start-up raises Daraprim prices, holds medicine hostage Eickhoff, Maggie. University Wire; Carlsbad [Carlsbad]23 Sep 2015. via ProQuest

Apparently, compared to other lifesaving drugs for cancers and other infectious diseases, Daraprim is a veritable steal at $13.50, despite the fact it only costs about $1 to produce. ... Shkreli has stated in multiple interviews that Turing Pharmaceuticals is merely using the extra profits from Daraprim to research and eventually create a safer, better alternative to the drug.

• Drug CEO lowers prices of Daraprim after outrages Spindler, Nicole. University Wire; Carlsbad [Carlsbad]01 Oct 2015. via ProQuest

Although Shkreli raied the price in August, the issue is gaining attention due to Hillary Clinton's comments on it on her social media accounts. ... Shkreli said since the drug is so rarely used, he believes that the impact on the health system would be minuscule ... he stated the money from the increase would be used to develop better treatments for AIDS that have fewer side effects. This spontaneous hike in the price of the much-needed medication has sparked enormous outrages. It caused several lawmakers and even presidential candidate Hillary Clinton to consider possible measures of controlling the rising cost of medicines.

Is that the sort of thing you're after? I can search newspapers online via my library. SandyGeorgia (Talk) 03:04, 2 April 2020 (UTC)

The WSJ article looks like a version of Reuters https://www.reuters.com/article/us-cerovene-fda/us-fda-approves-first-generic-version-of-750-daraprim-drug-idUSKCN20M36L . Not much there, unfortunately. It does link to another Reuters article about an FTC lawsuit: https://www.reuters.com/article/us-drugs-shkreli-ftc-ny/new-york-ftc-sue-pharma-bro-shkreli-others-over-daraprim-price-hikes-idUSKBN1ZQ2D8 . --Hipal/Ronz (talk) 15:59, 2 April 2020 (UTC)

Just to be clear, I think we should be avoiding references published around the time of the scandal (2015-2016) where it comes to determining how to best summarize (and other issues of weight). --Hipal/Ronz (talk) 16:01, 2 April 2020 (UTC)

OK, I wasn't sure what you were after. Will try some more later today... SandyGeorgia (Talk) 16:19, 2 April 2020 (UTC)

Hipal I haven't had time yet to sort through any of this, but have you tried scholar.google.com … eg … https://scholar.google.com/scholar?hl=en&as_sdt=0%2C24&q=daraprim+price&btnG= There is a lot there. SandyGeorgia (Talk) 17:34, 2 April 2020 (UTC)

PS, I struck out at books.google.com SandyGeorgia (Talk) 17:35, 2 April 2020 (UTC)

Thanks. No, I've barely looked at all, and don't expect to have much time to do so in the near future. --Hipal/Ronz (talk) 17:47, 2 April 2020 (UTC)

@Hipal:, what is in the lead now is no longer dreadful, because the 75K is clarified and the other issues I listed above have been fixed. But in the longer run, we need to update the lead, and correct the issues in the body. I am not urgently worried about this, since most of the serious issues have been somewhat corrected and it's good enough for now. Ping me when/if you have time or want to work on updating the lead and fixing the rest? SandyGeorgia (Talk) 17:54, 2 April 2020 (UTC)

Added the starting price of 13.50 and the fact that approval is not the same thing as availability. Otherwise I am fine with the changes to the lead. Other than it could also use the price in other areas of such as India and the fact that has not changed. Doc James (talk · contribs · email) 22:41, 2 April 2020 (UTC)

And that kind of excess numerical detail in the lead is not how WP:LEADs are written. So why add an outdated price to the lead at all, when the 50-fold covers the issue? SandyGeorgia (Talk) 23:18, 2 April 2020 (UTC)

A 50 fold increase from $US0.01 to $0.50 is sort of meh. A 50 fold increase from 13:50 is a completely different matter, so yes the starting point is important for the relative increase to be meaningful. Doc James (talk · contribs · email) 07:26, 3 April 2020 (UTC)

This isn't logical math. The exact same thing is accomplished by giving the endpoint of the 50-fold increase (750), rather than the beginning point (13.50). But by giving all three numbers, we are unnecessarily overburdening the lead with excess detail. SandyGeorgia (Talk) 08:33, 3 April 2020 (UTC)

I think we have the exact same problems as I brought up months ago, excessive pricing detail over more notable aspects. --Hipal/Ronz (talk) 16:06, 3 April 2020 (UTC)

I am having a hard time understanding what the reasoning is here for ignoring our lead guideline, and why these numbers are helpful in the lead. (And another problem I have is the idea that an increase from .01 to .50 "is sort of meh", when we relate that to a days' wages for a month's supply in much of Africa, but that is besides the point here. I am just not understanding any of the logic being employed here. I am just accustomed to writing leads that accord with our lead guideline, and this one does not ... and we haven't even dealt with the body.) Here we have an example where the price controversy was notable, and yet we still can't seem to follow guideline and policy. SandyGeorgia (Talk) 16:46, 3 April 2020 (UTC)