[toomuchtodo]

The pill version is showing similar safety and efficacy profiles as the injectable (leveraging higher dosage to get through the gut to the bloodstream), so runs to Canada and Mexico are probably in consumer futures to evade patent regulatory capture until 2030 (or getting it mailed from India, I have had personal success with this for other non controlled pharma products).

[Someone1234]

> The pill version is showing similar safety and efficacy profiles as the injectable

The pill, Rybelsus, barely works. They've having to put 700%+ more than the injections to still get a lower overall effectiveness. They're actively working on alternative delivery methods to resolve this.

A daily pill GLP-1 will be a massive commercial success. Rybelsus isn't very good for either the manufacturer or the consumer. You're burning a lot of expensive peptide to get a worse outcome at every dose level.

[toomuchtodo]

Perfect is the enemy of good enough. I agree with your assessment, that a pill is not ideal current state of the art, but if a pill format improves compliance and delivery vs injectables, and the cost of the pill can be driven down to where it is similar to Metformin, the outcome is still the same (even if there is waste from a suboptimal delivery mechanism).

An efficient drug delivery mechanism you can’t get into the hands of a broad population cohort is not efficient. We are optimizing for accessibility for everyone who needs access to this drug family (imho).

[Someone1234]

Rybelsus is harder on compliance (1-per-day, rather than 1-per-week), and the cost of the pill will always be high due to the excessive amount of peptide it wastes (700% more per day * 7-days = 7000% more wasteful than a single injection per week).

At some point it isn't "perfect Vs. good" it is "effective Vs. ineffective." Rybelsus is an ineffective medication. Even with the eye watering waste set out above, it is reported as being less effective as a GLP-1 too. There is no upside.

A pill GLP-1 is an absolute game-changer. We just aren't there yet.

[Integrape]

Oral medications are much cheaper to manufacture than injectables. The Apis Bull is working on a drug combination that prevents the digestive system from burning up all the semaglutide.