We are assuming this will save money in the long run but that might not be true.
Seems the media is touting the stuff as a panacea for some other supposed problem every week, so soaring spending on the stuff is hardly a surprise.
Steve
1 Like
Not satisfied with the “Wegovy reduces risk of heart attack by 20%” that the media has been touting, tonight, ABC “news” reported that “drugs like Wegovy reduce risk of heart attack and stroke by up to 44%” That was it. No qualifiers, or what most people in the trial experienced, or the demographics of the participants in the trial. Just the hype.
Steve
1 Like
Article in Barron’s said that there won’t be generic competition for name brand GLP-1 drugs until well into the 2030’s.
The factory required to produce millions of doses of an injectable drug must be kept absolutely clean to prevent pathological contamination. The investment required rivals that of a semiconductor fab – multi-billion dollars.
intercst
2 Likes
Sounds like a good moat for LLY.
DB2
1 Like
I went to the web site for the ABC evening news this morning, to post a link to that tout of Wegovy from last night. Discovered that, now, if I am not paying for a streaming TV service, I can not access their “news” until it is a week old.
Steve
1 Like
Do other pharmaceuticals have lesser requirements than GLP-1 class of drugs regarding cleanliness and purity?
1 Like
It’s much cheaper to make tablets and capsules. Anything in liquid form that’s injectable is a problem because it needs to be absolutely pure. If GLP-1 was something like cough syrup that you could drink, your stomach acids would quickly deal with any impurities.
And that’s why “large molecules” need to be an injection or an IV drip. They’d never survive the trip through the stomach.
Lots of companies are working on a tablet form of GLP-1, but so far no success.
intercst
3 Likes
Rybelsus is a semaglutide tablet (7mg and 14mg).
Yea, but it doesn’t have the effectiveness of the injectable forms of GLP-1
Less than 1% of the active ingredient in Rybelsus is absorbed into your body after it passes through the stomach. And there’s quite a bit of variability in the absorption rate between people.
About 80% of the active ingredient is absorbed with the injectable forms of GLP-1, so it’s easier to maintain the desired level of the medication in the patient.
That’s the problem that the companies working on a tablet form of GLP-1 are looking at. How do you protect the molecule as it passes through the stomach, so that the proper dose is absorbed in the colon?
intercst
4 Likes
Suppository ???
I think people prefer oral tablets or capsules.
intercst
True. But if it is unreasonable/impractical to use a pill or tablet, then one must consider other means of delivery so the drug(s) can be absorbed.
They’ve actually done a study on that. People will choose an injection over a suppository 35 to 1. See Figure 1 at this link.
We would have lost 40 million people to COVID if the only treatment was a suppository.
intercst
Maybe a patch approach to get it directly into the bloodstream?
DB2
1 Like
For the wonky amongst us, here is a long form interview with Lotte Bjerre Knudsen, who worked on GLP-1 for decades, and at times was almost alone in the wilderness because a lot of people put it in the too hard pile.
On topic, there is a good bit of discussion why and how it became an injectable drug.
1 Like