Found a vendor with insanely cheap prices - too good to be true?

CarlaRPh_TPA said:

Prices dramatically below market are the strongest single signal, and the reason is arithmetic rather than suspicion.

I disagree that testing history is decisive. It tells you what a supplier did when they were being watched. Continuity of behaviour under stress — a late shipment, a failed test, a complaint — is more predictive than any run of good results.

SkepticalSean said:

Eight months with one supplier, then a change in how they communicate that I noticed before I noticed anything about the product.

Shipping damage protocol for vendor vetting orders: if your package arrives with visible damage, temperature excursion, or broken vials:

• Photograph EVERYTHING before discarding packaging
• Note the temperature of the cold pack (liquid = possibly too warm)
• Contact the vendor within 24 hours with photos
• Request a replacement shipment or refund
• Do NOT use potentially compromised medication

Reputable vendors will replace damaged shipments without argument. If they push back, that's a red flag about the vendor.

julia.endo said:

I disagree that testing history is decisive.

Coming at julia.endo’s question from a different direction. Denials are usually procedural rather than clinical, and the order that works reflects that. Get the denial reason in writing, because it names the criterion you failed. Then supply the documentation that criterion asks for — usually documented BMI with a comorbidity, or a failed prior therapy. Then appeal, and ask for a peer-to-peer review, because a prescriber talking to a reviewing clinician resolves a large fraction of denials that written appeals do not. Manufacturer copay assistance is separate and applies mainly to commercial insurance, and patient assistance programmes are means-tested rather than a discount.

A narrower follow-up, since the general answer is now clear:

What a vetting checklist should actually contain, as opposed to a list of things that are easy to fake?

Reporting back.

Went back through my own correspondence with an earlier supplier and the warning signs were all there in the replies, weeks before the quality changed. I was reading the product and not the behaviour.