I wonder how many other great medical innovations have disappeared because of such bureaucracy.

The proprietary injector mechanism like for Mounjaro makes it really easy for users. Even compounded versions of it use tiny insulin needles that have near zero pain when injected into the subcutaneous portion of like the stomach while pinched.

Source: I took compounded Mounjaro and compounded Ozempic/semaglutide.

Type 1 insulin user. One the alcohol should dry before the needle goes in. Two faster is better, within reason. Three about one in a few hundred shots hits a nerve bundle. That really hurts, but resolves after a short while. Both insulin and these GLP-1 injections are subcutaneous not intravenous which once a patient gets the skill it becomes like riding a bike, in that it becomes easier than imagined.

It really helps that the needles are hair-thin and short.

I concur, exactly the way I felt before and after.

Isn't there some long term harm to the skin if you do this often?

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The first generation of GLP-1 agonists are out of patent protection. Teva is producing a generic liraglutide (aka Victoza / Saxenda). Ozempic (semiglutide) and Mounjaro (tirzepatide) have protection until after 2031 in the US, I think it's less in other countries.

That’s usually the case for new classes of drugs.

You should always distrust politicians on science issues. Even if they come from a science background. Being a successful politician is orthogonal to being a brilliant scientist.

"It wasn't until much much later that it was discovered to be an obesity drug. It was a completely coincidental and accidental discovery."

Define "much much later"

It was known by the early 1990s that GLP-1 slowed stomach emptying, with a key study in 1993 demonstrating its effects on gastrointestinal functions like gastric emptying, leading to longer feelings of fullness, which is the central mechanism at work here. See, e.g., https://pubmed.ncbi.nlm.nih.gov/35635627/

It just took eons for someone to decide that therefore maybe it was worth thinking about for weight loss.

That part is due to lack of exec vision - the fact that weight loss was not commonly treated with drugs (amphetamines work, but ...) meant they never thought really that hard about it.

To be fair, that lackof vision is not unreasonable in the sense that they have both plenty of high value targets, and plenty of arrows to shoot at them. Most of the arrows miss of course, but that's okay.

There is not always tremendous incentive to try new targets until they start missing the target too much, or the value of existing targets drops.

They almost certainly give up on, or ignore/drop/whatever, a near infinite number of things that may have turned into life saving drugs, billion dollar blockbusters, you name it.

At least right now, that's how this kind of thing works, for better or worse.

However, this is quite separate from when x was discovered to be a y, as it is here.

FWIW - I'll offer another lack of vision in the same vein - by slowing stomach emptying significantly, GLP-1 also causes the same amount of alcohol to do significantly less damage, because it enters your small intestine in much smaller amounts and over a much longer period of time. So much so that is a very effective treatment for alcoholism because it both reduces alcohol craving, and causes significant amounts of alcohol to do less damage. See, e.g., newly published studies like https://pubmed.ncbi.nlm.nih.gov/37192005/ and https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

Again, this should have been somewhat obvious to study a long time ago, but it wasn't started until 2 years ago.

It also turns out to reduce drug cravings, which is more unexpected, but would have been discovered much earlier with better vision.

No. Not my angle. That is exactly what happened.

Injections are no longer a only-if-absolutely-necessary. The stigma is mitigated.