Three services, one lot, and a spread of two and a half points
Two years ago we ran an anonymised version of this comparison and promised a named one. This is it, with every method printed in full.
The Ledger in 2025
Page 4 of 10 of this archive, newest first.
The Netherlands declines to reimburse dulaglutide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
The supply gap as a clinical event
A supply interruption is a discontinuation with no notice, no taper and no plan. That is a distinct clinical situation.
Canada declines to reimburse tirzepatide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
Norway caps tirzepatide prescribing to 15 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
We split six vials four ways and posted them
The Journal submitted split samples from single lots to three assay services, under names unconnected to this publication, and published each method alongside each result.
Poland caps tirzepatide prescribing to 22 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
The supply gap as a clinical event
Why the reason for stopping changes what happens afterwards.
New Zealand caps liraglutide prescribing to 17 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
What the placebo arms of the withdrawal trials actually tell us
What was withdrawn, from whom, after how long, and what was measured afterwards.
Portugal declines to reimburse semaglutide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
South Korea caps tirzepatide prescribing to 11 specialist centres
Efficacy was never the question in this appraisal. Duration of treatment was.
Six words a verification badge would need to mean anything
The Journal does not treat a badge as evidence and states so wherever it reports one.
Nigeria declines to reimburse tirzepatide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
Canada declines to reimburse semaglutide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
The lowest effective dose is a real concept with almost no data behind it
A survey of the maintenance evidence, which is shorter than the survey of the withdrawal evidence.
Portugal declines to reimburse exenatide outside a specialist service
Efficacy was never the question in this appraisal. Duration of treatment was.
The supply gap as a clinical event
Cost is the modal reason for discontinuation in every dataset we have seen, and it is absent from the clinical literature.
Six words a verification badge would need to mean anything
What a verification mark would have to carry to be checkable: a date, a lot, a method, a submitter and a link to the report.
The badge economy, and what it is actually certifying
Lot-level verification with a public report is a real and achievable thing. It exists in this market, on a minority of listings.