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Dose ladders: how deep a published one actually goes

Publishing a dose ladder is the rare disclosure. Publishing one that reaches the dose you will actually end up on is rarer still — the median stops at four rungs.

Glenn Torres5 min read
105 sellers with a published ladder, by rungs shown38328418596277829111Rungs published. Median 4; deepest 11.

Publishing a dose ladder at all is the rarer disclosure, and we count how many sellers manage it in who publishes a dose ladder. This page asks the follow-up question: once a seller decides to show its rungs, how many does it show?

How deep they go

Of 105 rankable sellers publishing a ladder, the median shows 4 rungs. 66 stop at three or four, and 21 publish six or more. One publishes 11, which is a complete escalation schedule with a price against every step.

Three rungs is enough to establish that the price moves and not enough to plan a year against. A buyer starting at the opening dose and titrating upward will pass the end of a three-rung table well before treatment settles, and at that point is back to asking.

Why depth matters more than existence

A ladder is useful in proportion to how far it reaches. The disclosure that changes a purchase is not “the price rises” but “here is what it becomes at the dose you are likely to end up on”, and most of the real-world evidence suggests people settle in the middle of the range rather than at the bottom — which is what the dose comparison in what a higher dose actually adds implies about where climbing stops.

A three-rung table that stops before the middle answers the easy part of the question. A six-rung one priced to the top of the labeled range answers the whole thing, and the sellers doing that are a minority of a minority — roughly 20% of those who publish anything.

What to do with a shallow ladder

Treat the last published rung as the beginning of the unknown rather than the end of the price. If a seller shows three figures and your likely maintenance dose is above the third, the figure you will actually pay is not on the page — and that is a question to settle in writing before starting, not after.

Which sellers publish anything at all is listed in published dose ladders, and the wider pattern of what this market declines to write down is in what sellers will not tell you.

Frequently asked

How many rungs does a typical published ladder have?
The median is four. A minority publish six or more, and one seller publishes a complete escalation schedule with a price against every step.
Is three rungs enough?
Enough to establish that the price moves, not enough to plan a year against. A buyer titrating upward will pass the end of a three-rung table before treatment settles.
Could a seller be publishing more than you counted?
Yes. The test is distinct figures in one recorded note, which cannot see a table this desk captured only part of, so every count is a floor.

Sources

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