Fuld transskription af Introducing The Journal: Trillion Dollar Shot

the medicine and his decision to stop 75 00:04:46.600 --> 00:04:52.040 taking it stirred up a lot of feelings. Surprise, anger, uncertainty. 76 00:04:52.060 --> 00:04:56.230 It was a lot. So after Brad took his last shot, 77 00:04:56.730 --> 00:04:58.939 he and I decided to report on the impact of 78 00:04:58.980 --> 00:05:02.660 these drugs. We set out to understand, are they a 79 00:05:02.699 --> 00:05:06.579 true turning point for America's struggle with obesity? And if so, 80 00:05:07.339 --> 00:05:11.699 are we ready for everything that would mean? Because people 81 00:05:11.740 --> 00:05:15.439 who've taken these medications told us the same things over 82 00:05:15.620 --> 00:05:18.649 and over again. All of a sudden, just the weight 83 00:05:19.069 --> 00:05:21.990 starts falling off. You know, eight pounds the first month. 84 00:05:22.170 --> 00:05:24.209 I felt like it was a miracle. Three pounds the 85 00:05:24.269 --> 00:05:24.750 second month. 86 00:05:24.949 --> 00:05:26.199 Life-changing for sure. 87 00:05:26.319 --> 00:05:30.720 Ten pounds the third month. That's how powerful this medication is. 88 00:05:30.980 --> 00:05:33.180 Then it just was like, how is this happening? 89 00:05:33.379 --> 00:05:36.009 I could tell it was working and I could tell 90 00:05:36.069 --> 00:05:39.850 that it was changing my relationship with food and I 91 00:05:39.949 --> 00:05:40.569 liked that. 92 00:05:41.930 --> 00:05:45.730 This type of success has meant huge windfalls for drug makers. 93 00:05:46.069 --> 00:05:49.310 We said, oh, Jesus, this can become a big, big drug. 94 00:05:49.410 --> 00:05:51.430 It's been a boon. There's no denying that. 95 00:05:51.449 --> 00:05:54.290 You know, the demand is higher than what we can 96 00:05:54.329 --> 00:05:55.769 deliver to people today. 97 00:05:56.629 --> 00:06:00.300 And that demand for these drugs is reverberating across society. 98 00:06:00.959 --> 00:06:03.199 And I thought, well, I'll stay on this for life 99 00:06:03.339 --> 00:06:07.540 because it's so helpful. And then I realized what it 100 00:06:07.579 --> 00:06:08.480 was going to cost me. 101 00:06:08.660 --> 00:06:10.220 They're just bank breakers. 102 00:06:10.660 --> 00:06:10.920 Okay. 103 00:06:11.529 --> 00:06:14.649 If I can't get the drug, what can I take instead? 104 00:06:15.189 --> 00:06:15.990 What's close? 105 00:06:16.370 --> 00:06:20.350 There are so many people even selling bathtub Ozempic. 106 00:06:20.470 --> 00:06:21.529 There was a lot of excitement. 107 00:06:21.629 --> 00:06:22.850 There was a lot of skepticism. 108 00:06:22.949 --> 00:06:25.230 And I can imagine a future where life expectancies are 109 00:06:25.310 --> 00:06:28.509 actually increasing because of this class of drugs. 110 00:06:30.389 --> 00:06:32.990 Whether you think these drugs are a miracle or you're 111 00:06:33.009 --> 00:06:36.550 skeptical of what they promise, they're changing how we approach 112 00:06:36.769 --> 00:06:39.310 one of the most intractable issues in our society. 113 00:06:40.050 --> 00:06:40.509 Obesity. 114 00:06:41.410 --> 00:06:50.370 And it's just the beginning. From the Journal, this is 115 00:06:50.470 --> 00:06:53.220 Trillion Dollar Shot. I'm Jessica Mendoza. 116 00:06:53.459 --> 00:06:54.420 And I'm Bradley Olson. 117 00:07:01.870 --> 00:07:27.129 This is Episode One, Birth of a Blockbuster. So, why 118 00:07:27.269 --> 00:07:28.529 did you want to lose weight? 119 00:07:37.230 --> 00:07:40.060 I'm trying to be as honest as I can as 120 00:07:41.069 --> 00:07:41.860 I think about it. 121 00:07:41.879 --> 00:07:44.019 It's a hard question. 122 00:07:44.680 --> 00:07:45.350 Yeah. And. 123 00:07:50.490 --> 00:07:56.709 I wanted to look better. I know that some people 124 00:07:56.730 --> 00:07:59.670 will say it was for my kids and it was, 125 00:07:59.689 --> 00:08:05.699 I wish that I had some noble reason. I'm just 126 00:08:05.720 --> 00:08:10.759 being honest. The noble reason is like, I've got kids 127 00:08:10.819 --> 00:08:12.620 and I wanna run with them. And I would think 128 00:08:12.680 --> 00:08:16.029 about that, but I would run with them. And I 129 00:08:16.050 --> 00:08:20.019 would think about other things, but in the end, I 130 00:08:20.060 --> 00:08:26.839 felt like I'm not supposed to be like this. You know, 131 00:08:28.000 --> 00:08:28.750 this isn't me. 132 00:08:30.689 --> 00:08:35.490 Brad's story is familiar to millions of Americans. For decades, 133 00:08:35.830 --> 00:08:39.570 obesity has been on the rise. The CDC says one 134 00:08:39.610 --> 00:08:43.320 in three adults in the U.S. is obese. The condition 135 00:08:43.379 --> 00:08:47.340 is linked to shorter life expectancy, to diabetes, heart disease, 136 00:08:47.659 --> 00:08:51.179 and to some cancers. not to mention larger healthcare bills. 137 00:08:52.139 --> 00:08:55.500 And billions have been poured into addressing the issue. But 138 00:08:55.559 --> 00:08:58.639 nothing's been able to bring the numbers down. What most 139 00:08:58.679 --> 00:09:03.100 doctors recommend, diet and exercise, they don't work long-term for 140 00:09:03.139 --> 00:09:08.360 most people. And short of surgery, the great minds of industry, technology, 141 00:09:08.399 --> 00:09:11.350 and medicine just haven't been able to find an effective 142 00:09:11.379 --> 00:09:14.210 treatment until this new class of drugs. 143 00:09:15.169 --> 00:09:20.629 Every doctor interaction that you have when it's about weight loss, 144 00:09:20.659 --> 00:09:24.220 it's always the doctor's like, I'm telling you things that 145 00:09:24.240 --> 00:09:26.899 you're not going to do. They don't say that, but 146 00:09:26.919 --> 00:09:30.200 it's just the subtext is basically like this conversation of, 147 00:09:30.820 --> 00:09:33.120 I'm telling you things to do, and I don't think 148 00:09:33.139 --> 00:09:35.299 you're going to do them. It was like we were 149 00:09:35.360 --> 00:09:39.139 performing in a play. He

was pretending to be a 150 00:09:39.179 --> 00:09:41.940 doctor that believed he was giving good advice, and I 151 00:09:41.960 --> 00:09:44.720 was pretending to be a patient that was listening and 152 00:09:44.779 --> 00:09:47.340 was really going to make a change. Neither was true. 153 00:09:48.970 --> 00:09:51.980 And the difference with this conversation was like, this is 154 00:09:52.009 --> 00:09:55.840 going to work. Like, there was no doubt about whether 155 00:09:55.860 --> 00:09:57.409 or not it was going to work. And that was 156 00:09:57.470 --> 00:09:58.210 such a difference. 157 00:09:59.870 --> 00:09:59.950 And. 158 00:10:00.460 --> 00:10:03.139 How did it go? Like how quickly did you start 159 00:10:03.159 --> 00:10:05.639 to lose weight and what were your reactions? 160 00:10:07.039 --> 00:10:12.129 I was just shocked. I had heard people talk about 161 00:10:12.750 --> 00:10:16.679 being on the medicine and how it really zapped their cravings. 162 00:10:16.799 --> 00:10:19.350 You know, I had read that. But to experience it 163 00:10:19.659 --> 00:10:21.330 is another thing entirely. 164 00:10:23.169 --> 00:10:25.590 Brad's going to share more of his own story throughout 165 00:10:25.629 --> 00:10:29.009 this series. But first, we want to go back to 166 00:10:29.049 --> 00:10:32.610 where it all started. Ozempic was developed by a Danish 167 00:10:32.649 --> 00:10:37.889 pharmaceutical company called Novo Nordisk. The story starts in the 168 00:10:38.690 --> 00:10:41.490 1990s with a woman named Lara Bjerre Knudsen. 169 00:10:41.980 --> 00:10:44.779 I did a lot of work in the laboratory. I 170 00:10:44.820 --> 00:10:46.570 was the lab rat. 171 00:10:48.629 --> 00:10:51.950 Lada was a young scientist at Novo Nordisk. When she 172 00:10:51.990 --> 00:10:54.669 was just starting her career, she was focused on what 173 00:10:54.769 --> 00:10:58.129 most scientists at Novo were there to do, develop drugs 174 00:10:58.220 --> 00:10:59.340 for treating diabetes. 175 00:11:00.039 --> 00:11:03.100 I always wanted to work for this company. 176 00:11:03.240 --> 00:11:08.059 And I was very set on wanting to make product-related research. 177 00:11:08.159 --> 00:11:10.950 I never wanted to be an academic researcher. 178 00:11:11.990 --> 00:11:15.070 I just knew that I wanted to make products that 179 00:11:15.129 --> 00:11:16.929 could somehow be useful. 180 00:11:17.009 --> 00:11:17.870 For human beings. 181 00:11:18.669 --> 00:11:20.950 And Lara had a bit of a reputation. 182 00:11:20.970 --> 00:11:24.389 I won't say that I have a temper. Maybe some 183 00:11:24.429 --> 00:11:27.549 people would say that about me. But I'm very dedicated 184 00:11:28.070 --> 00:11:29.049 and energy. 185 00:11:29.090 --> 00:11:33.929 I had ideas. I wasn't really shy and I did 186 00:11:34.490 --> 00:11:35.789 not give up too easily. 187 00:11:38.309 --> 00:11:40.179 And so what was it that you were working on? 188 00:11:41.049 --> 00:11:43.519 We had all kinds of ideas, you know. At that 189 00:11:43.580 --> 00:11:48.059 point in time in pharma for diabetes, there was a 190 00:11:48.139 --> 00:11:52.600 big desire to do something new, you know. And then 191 00:11:52.659 --> 00:11:56.690 GLP-1 was just one of those ideas that were around 192 00:11:56.750 --> 00:11:58.090 in the community. 193 00:11:57.570 --> 00:11:58.190 At that time. 194 00:12:00.850 --> 00:12:06.169 GLP-1. It stands for glucagon-like peptide. It's a gut hormone, 195 00:12:06.669 --> 00:12:08.539 and it's the basis for this new class of drugs. 196 00:12:09.639 --> 00:12:11.970 When Lada started working on it, there was research that 197 00:12:12.019 --> 00:12:16.169 showed that the GLP-1 hormone lowered blood sugar levels, which 198 00:12:16.210 --> 00:12:19.529 is important for treating diabetes. But no one had figured 199 00:12:19.590 --> 00:12:22.470 out how to make GLP-1 work as an effective treatment. 200 00:12:23.149 --> 00:12:25.029 It didn't hold up in the human body for long. 201 00:12:25.490 --> 00:12:26.990 It was gone in two minutes. 202 00:12:27.809 --> 00:12:31.250 That was really the problem to be solved was to 203 00:12:31.330 --> 00:12:33.210 make GLP-1 long-acting. 204 00:12:33.990 --> 00:12:36.850 So when you say gone in two minutes or making 205 00:12:36.889 --> 00:12:39.480 it long-acting... Does that mean it like breaks down in 206 00:12:39.500 --> 00:12:41.279 the body as soon as it like appears? 207 00:12:41.960 --> 00:12:45.360 Yeah, there are several ways that things can disappear from 208 00:12:45.399 --> 00:12:49.240 the body, right? One is that metabolic enzymes can degrade it, 209 00:12:49.799 --> 00:12:54.509 but then also things can be taken out via the kidneys. 210 00:12:55.549 --> 00:12:57.850 Lotto worked with a team to try to solve this puzzle, 211 00:12:58.429 --> 00:13:00.850 to try to get this powerful hormone to stay in 212 00:13:00.870 --> 00:13:04.250 the body long enough to work. But then she went 213 00:13:04.309 --> 00:13:07.970 on maternity leave. And when she came back in 1994, 214 00:13:07.970 --> 00:13:09.809 Novo had gone through some restructuring. 215 00:13:10.610 --> 00:13:12.490 Most of the people I'd worked with, they were gone. 216 00:13:13.009 --> 00:13:16.549 So I was kind of like the only one that 217 00:13:16.990 --> 00:13:20.610 knew anything about those projects. And the new leadership said 218 00:13:20.629 --> 00:13:23.470 to me, you know, you are the one that kind 219 00:13:23.529 --> 00:13:26.549 of knows this biology, so you figure out what we 220 00:13:26.580 --> 00:13:26.909 should do. 221 00:13:27.980 --> 00:13:29.600 What did you do? Did you freak out? 222 00:13:30.539 --> 00:13:34.129 Not so that anyone could see it, right? But it 223 00:13:34.750 --> 00:13:36.950 was a little bit of a lonely time, right? Because 224 00:13:36.970 --> 00:13:40.409 the people that I considered my closest work friends, they 225 00:13:40.450 --> 00:13:43.149 were gone, right? So

I still had a group of 226 00:13:43.250 --> 00:13:46.750 laboratory technicians that were working with me and doing cool 227 00:13:46.789 --> 00:13:49.769 things in a lab. But this thing about figuring out 228 00:13:49.850 --> 00:13:53.220 how to lead the project, which idea to focus on, 229 00:13:53.669 --> 00:13:57.940 I was completely alone with that. So I was basically 230 00:13:57.980 --> 00:14:01.590 sitting in my in my office for a couple of months, 231 00:14:01.710 --> 00:14:03.210 kind of staring at the walls. 232 00:14:06.669 --> 00:14:10.230 Lada was now leading the GLP-1 team. But they weren't 233 00:14:10.269 --> 00:14:14.169 making much headway towards a functional drug. And leaders at 234 00:14:14.250 --> 00:14:17.929 Novo started to get antsy. Leaders like this guy. 235 00:14:18.450 --> 00:14:21.850 Yeah, my name is Lars-Oribian Sorensen. I used to be 236 00:14:21.929 --> 00:14:23.850 the CEO of Novo Nordisk. 237 00:14:25.450 --> 00:14:29.919 GLP-1 research was not the company's priorities. So Lars was like, 238 00:14:30.379 --> 00:14:32.259 why were they even messing around with this hormone? 239 00:14:33.340 --> 00:14:35.740 Well, I have to admit at the time, I thought 240 00:14:35.759 --> 00:14:40.639 it was a strange idea. We were primarily selling insulin. 241 00:14:40.750 --> 00:14:40.919 Right. 242 00:14:41.779 --> 00:14:46.950 And competition in the area of insulins were quite fierce. 243 00:14:47.669 --> 00:14:52.269 This GLP-1 compound was very, very short-lived. 244 00:14:52.610 --> 00:14:52.830 Right. 245 00:14:52.950 --> 00:14:55.970 And really, it was difficult to create a drug out 246 00:14:56.009 --> 00:14:59.320 of it. Quite frankly, I was worried that we were 247 00:14:59.549 --> 00:15:03.379 spreading our resources too thinly. We were a small company, 248 00:15:03.419 --> 00:15:06.059 so I knew everybody. And they would come into my 249 00:15:06.179 --> 00:15:09.320 office and, you know, ask for more resources. 250 00:15:10.899 --> 00:15:13.090 I asked Lars if Lotta was one of those people. 251 00:15:13.879 --> 00:15:17.529 Oh, yeah, all the time. I could not meet Lotta 252 00:15:17.570 --> 00:15:22.889 without her really getting on my case to prioritize her 253 00:15:22.950 --> 00:15:27.980 projects better. Lotte Knudsen is a person that's very, very 254 00:15:28.299 --> 00:15:29.379 difficult to say no to. 255 00:15:33.259 --> 00:15:36.799 Even with Lotte pushing the project, Lars considered canning the 256 00:15:36.840 --> 00:15:37.279 whole thing. 257 00:15:37.299 --> 00:15:40.360 I do recall that we did give him 12 months 258 00:15:40.419 --> 00:15:41.980 to say, you've got to come up with something which 259 00:15:42.039 --> 00:15:47.220 is more convincing. And my recollection is it was extraordinarily 260 00:15:47.259 --> 00:15:50.730 slow developing at the time. And I'm sure a lot 261 00:15:50.750 --> 00:15:52.870 of people will say this is because we had no resources. 262 00:15:53.669 --> 00:15:57.629 But anyway, because of their stubbornness and their skills and 263 00:15:57.669 --> 00:16:03.759 their professionalism, they eventually were able to create a molecule 264 00:16:03.799 --> 00:16:07.039 that was protracted so it became a real drug that 265 00:16:07.059 --> 00:16:09.879 we could start to make clinical trials on. 266 00:16:10.879 --> 00:16:14.419 Lada and her team had met the deadline. By then, 267 00:16:14.440 --> 00:16:18.659 it was 1997. All told, it had taken about four 268 00:16:18.759 --> 00:16:21.340 years for them to create a compound that mimicked the 269 00:16:21.379 --> 00:16:25.090 effects of GLP-1, and didn't immediately break down in the body. 270 00:16:26.029 --> 00:16:29.509 They called this compound liraglutide, and it stayed in the 271 00:16:29.549 --> 00:16:33.169 body for 24 hours. Think of it as a precursor 272 00:16:33.250 --> 00:16:38.639 to Ozempic. Same scientific idea, just not as powerful. The 273 00:16:38.679 --> 00:16:42.899 next step was to test liraglutide on patients. But inside 274 00:16:42.940 --> 00:16:46.620 Novo Nordisk, Lada's team still had to fight for limited resources, 275 00:16:47.320 --> 00:16:49.580 and that problem felt to Lada's boss. 276 00:16:50.240 --> 00:16:52.970 As a very young lad, I had Big hair, big 277 00:16:52.990 --> 00:16:57.620 curly hair, lots of hair, not anymore. And so I 278 00:16:57.629 --> 00:16:59.820 look like a typical young, nerdy scientist. 279 00:17:00.620 --> 00:17:04.380 That's Mads Krogsgaard-Thomsen, a former senior vice president at the 280 00:17:04.420 --> 00:17:07.539 company and a big champion of Lottas. And he wasn't 281 00:17:07.579 --> 00:17:09.920 afraid to get creative to keep her project going. 282 00:17:10.819 --> 00:17:13.279 Well, the first stumbling block was that we were a 283 00:17:13.279 --> 00:17:16.660 little bit behind in production capacity for insulin. So we 284 00:17:16.740 --> 00:17:21.309 literally had no utilization of any production facility in the company. 285 00:17:21.799 --> 00:17:24.390 So I had to give the team money to go 286 00:17:24.430 --> 00:17:27.849 to Belgium to ask another pharmaceutical company to produce. 287 00:17:27.569 --> 00:17:27.930 It for us. 288 00:17:28.470 --> 00:17:30.829 And so you had to do it basically off campus 289 00:17:31.509 --> 00:17:32.470 to get this stuff done? 290 00:17:32.809 --> 00:17:34.130 In a competing company already. 291 00:17:34.170 --> 00:17:35.089 In a competing company. 292 00:17:35.130 --> 00:17:35.730 Another company. 293 00:17:37.890 --> 00:17:41.490 Eventually, they did get enough medicine for human trials. But 294 00:17:41.539 --> 00:17:44.220 at first, it produced a really nasty side effect. 295 00:17:45.769 --> 00:17:47.430 The people in the phase one trial, they vomited. 296 00:17:47.710 --> 00:17:47.970 Wow. 297 00:17:48.279 --> 00:17:49.579 So they literally felt sick. 298 00:17:50.240 --> 00:17:52.759 And this, of course, didn't convince management that this was 299

00:17:52.799 --> 00:17:53.980 very exciting at all. 300 00:17:54.440 --> 00:17:54.660 Right. 301 00:17:54.680 --> 00:17:56.480 They were like, I don't know what you guys are 302 00:17:56.500 --> 00:17:59.079 doing over there, but it doesn't seem to be working. No. 303 00:17:59.519 --> 00:18:02.869 So there was actually a feeling of, OK, is this 304 00:18:02.960 --> 00:18:05.950 the end stage for this GLP-1 project? 305 00:18:07.329 --> 00:18:09.890 And then there was a concern about cancer. 306 00:18:10.529 --> 00:18:13.829 We saw tumors in rats and mice up here in 307 00:18:13.849 --> 00:18:18.269 the thyroid gland. And suddenly these tumors seem to be 308 00:18:18.369 --> 00:18:22.369 happening dose-dependently over time in rodents. Luckily, we didn't see 309 00:18:22.410 --> 00:18:25.019 them in rabbits. We didn't see them in dogs. We 310 00:18:25.059 --> 00:18:28.599 didn't see them in monkeys. But the regulators, FDA and 311 00:18:28.640 --> 00:18:31.920 so on, were not happy with seeing tumors in two species. 312 00:18:35.400 --> 00:18:39.009 The team did more testing. And ultimately, they concluded that 313 00:18:39.049 --> 00:18:42.190 the tumors they saw in rodents were not relevant in humans. 314 00:18:43.049 --> 00:18:45.950 But it would take years before the FDA was satisfied 315 00:18:46.309 --> 00:18:50.009 that Novo's liraglutide was safe for people. And Novo Nordisk 316 00:18:50.130 --> 00:18:53.119 still advises against taking GLP-1 drugs if you have a 317 00:18:53.160 --> 00:18:59.920 history of thyroid cancer. So the FDA approved liraglutide in 2010. 318 00:18:59.920 --> 00:19:02.140 Do you remember the moment you heard about it? 319 00:19:02.920 --> 00:19:05.549 My wife and kids had gone to bed. And then 320 00:19:05.609 --> 00:19:09.450 I actually, I get a phone call at like 11.30 321 00:19:09.450 --> 00:19:14.339 in the evening. Mads, we've got it. We've got an approval. And, 322 00:19:14.359 --> 00:19:18.220 you know, you just shout out loud. I just got 323 00:19:18.259 --> 00:19:21.039 extremely excited, so much that my family woke up and 324 00:19:21.079 --> 00:19:22.640 was really annoyed with me. 325 00:19:22.660 --> 00:19:25.839 They're like, why are you so excited? It's the middle 326 00:19:25.859 --> 00:19:26.160 of the night. 327 00:19:26.200 --> 00:19:26.589 Yeah, yeah. 328 00:19:26.609 --> 00:19:30.950 I had to apologize. So I took a good McGowan whiskey, 329 00:19:31.349 --> 00:19:33.289 took a good shot of that and celebrated over the 330 00:19:33.329 --> 00:19:34.690 phone with the colleagues. 331 00:19:36.529 --> 00:19:39.970 Yes, I was in my bed, but the minute I 332 00:19:40.069 --> 00:19:44.019 saw the number on my phone, I knew we got this. 333 00:19:44.839 --> 00:19:47.549 I felt a great sense of accomplishment. 334 00:19:48.009 --> 00:19:49.630 It was more than 10 years. 335 00:19:50.119 --> 00:19:53.380 In the making, and if we hadn't gotten that U.S. approval, 336 00:19:53.819 --> 00:19:57.339 maybe it

would have been just not going anywhere. That 337 00:19:57.380 --> 00:20:01.089 would have been a great shame for the people who 338 00:20:01.109 --> 00:20:02.509 need this kind of medicine. 339 00:20:04.150 --> 00:20:08.119 Liraglutide went on sale under the brand name Victoza. It 340 00:20:08.150 --> 00:20:10.799 was approved to treat type 2 diabetes, and it was 341 00:20:10.819 --> 00:20:15.119 a modest success. More importantly, though, it was a proof 342 00:20:15.140 --> 00:20:19.579 of concept. Lotta's GLP-1 research had led to an effective drug. 343 00:20:20.539 --> 00:20:24.170 And the next drug, a new invention building off liraglutide, 344 00:20:24.690 --> 00:20:31.250 was already in the pipeline. It would be a blockbuster. 345 00:20:32.170 --> 00:20:34.589 One that would turn Novo Nordisk into a company that 346 00:20:34.630 --> 00:20:38.390 was known for more than diabetes. Because here's the thing. 347 00:20:39.170 --> 00:20:42.170 Since almost the beginning of Lotta's research, she knew that 348 00:20:42.250 --> 00:20:48.690 GLP-1 had another effect. Weight loss. Did that surprise you 349 00:20:49.210 --> 00:20:52.210 that it was weight loss really that made these drugs 350 00:20:52.289 --> 00:20:55.190 kind of soar to the top and make it kind 351 00:20:55.230 --> 00:20:57.009 of a household name at this point? 352 00:20:57.769 --> 00:21:00.109 Yes and no, because I remember I've heard it for 353 00:21:00.170 --> 00:21:04.049 such a long time. Ever since back to the early 2000s, 354 00:21:04.109 --> 00:21:06.910 when I was first lucky enough to be able to 355 00:21:07.009 --> 00:21:10.569 actually hear from some patients, they had tears in their eyes. 356 00:21:10.789 --> 00:21:13.069 And they said, you know, I've been hungry for 20 years. 357 00:21:13.650 --> 00:21:15.289 Now I can manage to have. 358 00:21:15.170 --> 00:21:15.789 A normal life. 359 00:21:18.269 --> 00:21:21.819 So how did a diabetes drug turn into a weight 360 00:21:21.859 --> 00:21:24.440 loss phenomenon? That's after the break. 361 00:21:31.079 --> 00:21:33.980 It's been a busy week, right? Sounds like it's time 362 00:21:34.019 --> 00:21:38.740 for that takeaway. Deliveroo's on it. Whether it's extra saucy 363 00:21:38.819 --> 00:21:43.019 wings from Nando's, a tasty taco bowl from Sprout & Co, 364 00:21:43.500 --> 00:21:47.539 or maybe even some California birria from Boojum. We'll deliver 365 00:21:47.660 --> 00:21:52.700 in as little as 25 minutes. Order now. You've earned it. Deliveroo. 366 00:21:53.259 --> 00:21:57.759 That finish line Friday feeling just got even better. Geographical restrictions, 367 00:21:57.799 --> 00:22:00.059 teas and season fees apply. Delivery times vary. See app 368 00:22:00.079 --> 00:22:00.779 or web for info. 369 00:22:01.529 --> 00:22:04.049 Hey, it's Wendy from Science Versus, and I want to 370 00:22:04.089 --> 00:22:07.420 tell you about a podcast that I love, Science Friday. 371 00:22:07.599 --> 00:22:10.140 They cover all

sorts of amazing things in the weird 372 00:22:10.180 --> 00:22:14.200 and wonderful world of science, from how concussions affect our 373 00:22:14.269 --> 00:22:17.329 brain to the inner secrets of a snake with a 374 00:22:17.430 --> 00:22:19.950 spider on its tale. It's a lot of news that 375 00:22:20.009 --> 00:22:22.450 you can use and some that you can't, but you're 376 00:22:22.470 --> 00:22:25.490 going to love anyway. It's hosted by Ira Flato and 377 00:22:25.670 --> 00:22:28.779 Flora Lichtman, who is an old friend of the show 378 00:22:28.920 --> 00:22:31.680 and loves a pun as much as we do. Science 379 00:22:31.740 --> 00:22:34.900 Friday is on every day, wherever you get your podcasts. 380 00:22:45.900 --> 00:22:48.759 Welcome to what we call the factory of the future. 381 00:22:48.359 --> 00:22:49.460 Within Novo Nordisk. 382 00:22:50.109 --> 00:22:53.750 At the drug company Novo Nordisk, they're very serious about 383 00:22:53.829 --> 00:22:55.289 how you wear your socks. 384 00:22:56.390 --> 00:22:58.450 When you put your socks on, it would be something 385 00:22:58.470 --> 00:22:58.849 like this. 386 00:22:59.769 --> 00:23:00.490 You put them on. 387 00:23:02.190 --> 00:23:06.119 Novo Nordisk is based near Copenhagen, Denmark. The factory there 388 00:23:06.200 --> 00:23:07.359 is a hive of activity. 389 00:23:07.380 --> 00:23:10.980 All right, just keep an eye out. 390 00:23:11.019 --> 00:23:12.599 Now we're in the area with a little bit more 391 00:23:12.660 --> 00:23:13.519 robot traffic. 392 00:23:14.200 --> 00:23:17.200 On an assembly line, a machine places vials of clear 393 00:23:17.259 --> 00:23:20.880 liquid into blue syringes. You can see the pens clattering out. 394 00:23:25.240 --> 00:23:26.920 What's on the line there? 395 00:23:26.940 --> 00:23:27.569 Uh, semaglutide. 396 00:23:30.769 --> 00:23:31.529 Semaglutide. 397 00:23:31.990 --> 00:23:32.210 Or. 398 00:23:32.529 --> 00:23:33.369 Semaglutide. 399 00:23:33.470 --> 00:23:34.170 Semaglutide. 400 00:23:34.289 --> 00:23:34.970 Semaglutide. 401 00:23:34.990 --> 00:23:36.769 Semaglutide. Semaglutide. 402 00:23:36.789 --> 00:23:36.849 Or. 403 00:23:37.549 --> 00:23:38.990 We've been saying semaglutide. 404 00:23:39.049 --> 00:23:39.569 Is that right? 405 00:23:39.750 --> 00:23:40.819 That is so correct. 406 00:23:40.890 --> 00:23:41.769 Okay, because we. 407 00:23:41.670 --> 00:23:45.880 Hear like semaglutide or... So that's incorrect. It is. 408 00:23:46.119 --> 00:23:46.980 It's semaglutide. 409 00:23:47.079 --> 00:23:52.720 For the record. Thank you. However you say it, semaglutide 410 00:23:52.900 --> 00:23:59.460 is Novo's successor to liraglutide. It came with some side effects. Nausea, vomiting, 411 00:23:59.819 --> 00:24:04.990 gastrointestinal issues. But semaglutide is a more effective GLP-1 compound. 412 00:24:05.609 --> 00:24:07.190 And you only need to take it once a week 413 00:24:07.630 --> 00:24:11.170 instead of once a day. It's also the key ingredient

414 00:24:11.309 --> 00:24:19.150 in Ozempic. In 2017, the FDA approved Ozempic specifically to 415 00:24:19.210 --> 00:24:23.559 treat type 2 diabetes. That year, Novo Nordisk geared up 416 00:24:23.599 --> 00:24:29.759 for a big U.S. campaign. Did people inside Novo realize 417 00:24:29.799 --> 00:24:33.099 they had a hit or a blockbuster in Ozempic around 418 00:24:33.119 --> 00:24:33.880 the time of the launch? 419 00:24:34.539 --> 00:24:39.619 So there was a lot of excitement and preparation. We 420 00:24:39.640 --> 00:24:42.000 thought this could be one of the most important products 421 00:24:42.400 --> 00:24:44.500 that the company had brought to market to date. 422 00:24:45.339 --> 00:24:47.829 That's Dave Moore. He was in charge of sales and 423 00:24:47.869 --> 00:24:51.970 marketing when Ozempic launched in the U.S. in 2018. With 424 00:24:51.990 --> 00:24:54.910 a possible hit on their hands, Dave says the company 425 00:24:54.930 --> 00:24:57.690 started to get the word out. They promoted the drug's 426 00:24:57.730 --> 00:25:00.920 ability to lower blood sugar levels to specialists and doctors. 427 00:25:01.660 --> 00:25:04.000 And they spent a lot of money on branding and marketing. 428 00:25:05.000 --> 00:25:08.119 But you probably know that already because of this catchy tune. 429 00:25:11.500 --> 00:25:14.319 People with type 2 diabetes are excited about the potential 430 00:25:14.339 --> 00:25:15.799 of once-weekly Ozempic. 431 00:25:15.960 --> 00:25:17.359 Who came up with the idea for the jingle? 432 00:25:18.059 --> 00:25:22.119 We test these, and there was a really strong recall, 433 00:25:22.440 --> 00:25:24.720 which is important in any of these campaigns. 434 00:25:25.599 --> 00:25:27.119 Did you like the song? Did it resonate with you? 435 00:25:27.759 --> 00:25:29.869 I did know the song, and I can actually tell 436 00:25:29.880 --> 00:25:31.970 you the first time I heard it, and I'll date myself, 437 00:25:32.029 --> 00:25:34.990 but I was roller-skating. back when I was in school 438 00:25:35.009 --> 00:25:38.829 in 75. And, you know, it was a hit, right? 439 00:25:40.210 --> 00:25:41.170 I don't know if you'll hear this. 440 00:25:42.339 --> 00:25:51.400 Oh, oh, oh, it's magic, you know. Never believe it's 441 00:25:51.460 --> 00:25:52.579 not so. 442 00:25:55.220 --> 00:25:55.680 There you go. 443 00:25:56.039 --> 00:25:57.519 That's incredible. 444 00:25:58.940 --> 00:26:04.069 My name's David Payton. I'm the singer-songwriter with the band pilot, 445 00:26:04.509 --> 00:26:09.970 and I wrote the song Magic, being used by Ozempic extensively. 446 00:26:11.009 --> 00:26:14.900 David Payton wrote Magic 50 years ago. He didn't think 447 00:26:14.920 --> 00:26:16.720 too much of the fact that it was recently picked 448 00:26:16.799 --> 00:26:19.259 up for a drug ad, not even when he saw 449 00:26:19.299 --> 00:26:23.490 the company Novo Nordisk on his royalty statement. David figured 450 00:26:23.789 --> 00:26:25.529

Magic had been used many times before. 451 00:26:26.470 --> 00:26:30.109 When it first came out in 74, Coca-Cola got in 452 00:26:30.150 --> 00:26:33.490 touch with me and they, yeah, it's been used extensively 453 00:26:33.630 --> 00:26:37.990 for a long time. And even Selena Gomez, you might know, 454 00:26:38.049 --> 00:26:41.450 she had a pretty big hit with it in the 455 00:26:41.490 --> 00:26:47.019 States around about 2009 or thereabouts. I've heard lots of 456 00:26:47.099 --> 00:26:51.180 hip hop versions, which are very strange because, you know, 457 00:26:51.200 --> 00:26:53.500 there's a lot of rapping going on and then the 458 00:26:53.539 --> 00:26:57.990 chorus is used. Flo Rida did a version of Magic. 459 00:26:58.799 --> 00:27:02.880 But something about this version seemed to land differently. About 460 00:27:02.920 --> 00:27:05.500 a year after Ozempic hit the market, David was at 461 00:27:05.539 --> 00:27:07.950 home in Scotland when he got a call from a friend. 462 00:27:08.589 --> 00:27:11.690 And he phoned me up really excited and said, David, 463 00:27:12.099 --> 00:27:15.660 do you realize your song is on television here in 464 00:27:15.700 --> 00:27:18.359 the States? And I said, it must be every 20 465 00:27:18.359 --> 00:27:22.099 minutes I'm hearing your song. And I said to him, well, 466 00:27:22.160 --> 00:27:24.680 I knew it was being used, but I didn't realize 467 00:27:25.200 --> 00:27:28.089 it was that much coverage that was going on in 468 00:27:28.130 --> 00:27:28.650 the States. 469 00:27:29.809 --> 00:27:35.029 Ozempic was really starting to pick up steam. Except the 470 00:27:35.049 --> 00:27:39.170 hype wasn't because it was a drug for diabetes. People 471 00:27:39.210 --> 00:27:42.779 were talking about it for weight loss. It's known as 472 00:27:42.859 --> 00:27:47.279 Hollywood's worst kept secret as celebrities dropped noticeable amounts of 473 00:27:47.380 --> 00:27:48.220 weight quickly. 474 00:27:48.720 --> 00:27:52.619 I mean, I cannot scroll through my social media without 475 00:27:52.799 --> 00:27:56.319 someone mentioning the Ozempic diet. 476 00:27:56.599 --> 00:27:58.900 By the way, you've been working on your body and 477 00:27:58.940 --> 00:27:59.460 on your health. 478 00:27:59.619 --> 00:28:00.960 No, that's Ozempic. 479 00:28:01.559 --> 00:28:05.380 The topic Ozempic has over 300 million views. 480 00:28:05.619 --> 00:28:07.700 When I look around this room, I can't help but wonder, 481 00:28:08.440 --> 00:28:09.660 is Ozempic right for me? 482 00:28:14.690 --> 00:28:18.960 Now, companies can't promote their medicines for off-label use. But 483 00:28:19.000 --> 00:28:22.980 it's not unusual or necessarily unethical for doctors to prescribe 484 00:28:23.019 --> 00:28:27.339 a drug for something it isn't FDA approved for. I 485 00:28:27.420 --> 00:28:29.839 asked Dave Moore about all this. He's the guy who 486 00:28:29.859 --> 00:28:34.380 led the launch of Ozempic in the U.S. As you know,

today, 487 00:28:34.400 --> 00:28:38.579 a lot of people don't necessarily associate Ozempic with diabetes. 488 00:28:38.940 --> 00:28:43.049 They associate it with obesity treatment and weight loss. How 489 00:28:43.069 --> 00:28:45.849 did that happen? And when did people at Novo start 490 00:28:45.910 --> 00:28:49.869 realizing that it was being prescribed off-label for weight loss? 491 00:28:51.069 --> 00:28:54.250 Yeah, I'm glad you asked that question. I'll start with 492 00:28:54.390 --> 00:28:58.730 the first part. It's really important, and I'd love to 493 00:28:58.769 --> 00:29:03.299 stress to your listeners that Ozempic is for type 2 diabetes. 494 00:29:04.039 --> 00:29:04.309 And I. 495 00:29:05.990 --> 00:29:10.220 Would ask everyone to really think about the uses of 496 00:29:10.279 --> 00:29:14.799 these medicines based on what they're intended for. The second 497 00:29:14.819 --> 00:29:19.440 part to your question, we knew that there was a 498 00:29:19.769 --> 00:29:24.490 need for new medicine for people living with obesity. And 499 00:29:24.509 --> 00:29:31.329 we were studying higher doses of semaglutide for chronic weight management. 500 00:29:31.829 --> 00:29:37.230 And that was in clinical trials while Ozempic, of course, 501 00:29:37.410 --> 00:29:39.950 was being launched into the market as a type 2 diagnosis. 502 00:29:40.490 --> 00:29:41.130 Medication. 503 00:29:41.450 --> 00:29:45.140 I totally understand what you're saying. However, it did happen 504 00:29:45.200 --> 00:29:48.740 that doctors prescribed Ozempic off-label. I mean, they were making 505 00:29:48.779 --> 00:29:51.779 jokes about it at the Oscars. Like, what do you 506 00:29:51.859 --> 00:29:52.240 do in a. 507 00:30:00.359 --> 00:30:04.539 Play our role and do our part to ensure that 508 00:30:04.900 --> 00:30:10.460 we try to correct, you know, anytime that happens. We, 509 00:30:10.500 --> 00:30:17.450 of course, you know, are not denying that those things happen, right? 510 00:30:17.789 --> 00:30:24.009 We're not being shy. You know, we see the media. 511 00:30:25.089 --> 00:30:29.210 And ultimately, clinicians make the choice, right? 512 00:30:29.390 --> 00:30:29.549 Right. 513 00:30:29.900 --> 00:30:34.680 And our position is firm and clear. We don't want 514 00:30:34.779 --> 00:30:38.019 Ozempic used off-label, and we only want it to be 515 00:30:38.119 --> 00:30:39.480 used as it's intended. 516 00:30:41.319 --> 00:30:44.869 As Dave mentioned, Novo was doing research into their GLP-1 517 00:30:44.890 --> 00:30:48.009 drugs and weight loss. But for a long time, it 518 00:30:48.109 --> 00:30:52.750 wasn't the priority. Diabetes was. Because drugs to treat obesity 519 00:30:52.869 --> 00:30:57.190 look like a risky proposition. Here's Lars Rabian Sorensen, the 520 00:30:57.210 --> 00:30:58.230 former Novo CEO. 521 00:30:59.039 --> 00:31:02.680 I was not against that. I actually thought it was 522 00:31:02.720 --> 00:31:07.680 a good idea. However, I

was a little bit cautious 523 00:31:07.859 --> 00:31:15.410 about expressing this publicly because at the time, almost all 524 00:31:15.470 --> 00:31:21.670 without exception, weight-lowering drugs have failed, some even so badly 525 00:31:21.750 --> 00:31:27.079 that companies were sued. So I knew that If we 526 00:31:27.130 --> 00:31:32.259 started talking too much about the obesity effect of GLP-1, 527 00:31:32.299 --> 00:31:36.779 we might taint a very good diabetes drug. 528 00:31:37.559 --> 00:31:40.210 There was a quote that's been circulating the internet a 529 00:31:40.230 --> 00:31:43.269 little bit that is attributed to you from 2005, where 530 00:31:43.309 --> 00:31:47.210 you say that obesity is primarily a social and cultural problem. 531 00:31:47.789 --> 00:31:50.450 It should be solved by means of a radical restructuring 532 00:31:50.470 --> 00:31:53.660 of society. There's no business for Novo Nordisk in that area. 533 00:31:54.099 --> 00:31:55.000 Do you remember saying that? 534 00:31:55.930 --> 00:31:59.009 I remember that, and I believed it at the time. 535 00:31:59.349 --> 00:31:59.609 Yeah. 536 00:32:00.109 --> 00:32:03.710 I was not aware at that time of the great 537 00:32:03.809 --> 00:32:10.039 difficulty number of people with severe overweight. I have absolutely 538 00:32:10.099 --> 00:32:11.380 no doubt that I said this. 539 00:32:12.259 --> 00:32:17.460 What ultimately changed your mind about developing GLP-1s for obesity treatment? 540 00:32:18.200 --> 00:32:20.519 First of all, you get in contact with these individuals 541 00:32:20.579 --> 00:32:23.980 that are struggling with this for their entire life. That 542 00:32:24.019 --> 00:32:28.230 has an enormous impact. impact on you as an individual, 543 00:32:29.049 --> 00:32:33.049 then there's also a commercial motive in this. This is 544 00:32:33.109 --> 00:32:38.759 a huge potential commercial market for the company. So it 545 00:32:38.779 --> 00:32:46.519 was composite of patient consideration, but also pursuing a commercial 546 00:32:47.220 --> 00:32:48.400 opportunity for the company. 547 00:32:49.539 --> 00:32:53.460 So Novo Nordisk released Wigovi in 2021, a higher dose 548 00:32:53.480 --> 00:32:58.539 of semaglutide approved specifically for weight loss. In one major trial, 549 00:32:58.980 --> 00:33:02.069 patients lost an average of about 15% of their body 550 00:33:02.109 --> 00:33:08.130 weight in just over a year. And it wasn't just Novo. 551 00:33:08.869 --> 00:33:12.750 Another pharmaceutical giant, Eli Lilly, had also been working on 552 00:33:12.809 --> 00:33:15.869 GLP-1s for years. And in 2022, they were hot on 553 00:33:15.890 --> 00:33:23.640 Novo's heels. Eli Lilly answered Novosemaglutide with her own compound, Terzepatide. 554 00:33:25.420 --> 00:33:30.500 Terzepatide mimics two gut hormones, GLP-1 and another one called GIP. 555 00:33:31.269 --> 00:33:35.650 That made Terzepatide even more effective. In the spring of 2022, 556 00:33:35.650

--> 00:33:40.369 Eli Lilly released Manjaro, which was approved for type 2 diabetes. 557 00:33:40.910 --> 00:33:44.150 I started taking Manjaro, and I've lost 65 pounds. 558 00:33:46.299 --> 00:33:50.099 Last year, they came out with Zepbound for weight loss. Zepbound, 559 00:33:50.279 --> 00:33:51.359 made by Eli Lilly. 560 00:33:51.799 --> 00:33:54.900 Potentially more effective for losing weight than any other drug 561 00:33:54.960 --> 00:33:55.509 on the market. 562 00:33:57.849 --> 00:34:01.630 And GLP-1 medications also got a huge endorsement from one 563 00:34:01.650 --> 00:34:03.630 of the most trusted voices in America. 564 00:34:03.930 --> 00:34:08.159 For 25 years, making fun of my weight was national sport. 565 00:34:09.539 --> 00:34:12.199 In my lifetime, I never dreamed that we would be 566 00:34:12.260 --> 00:34:16.480 talking about medicines that are providing hope for people like 567 00:34:16.599 --> 00:34:20.989 me who have struggled for years with being overweight or 568 00:34:21.030 --> 00:34:21.699 with obesity. 569 00:34:25.110 --> 00:34:29.309 Suddenly, Novo Nordisk and Eli Lilly were leading a booming market. 570 00:34:30.230 --> 00:34:33.389 Novo is now the most valuable company in Europe. It's 571 00:34:33.429 --> 00:34:35.369 locked in a race with Lilly to become the first 572 00:34:35.550 --> 00:34:40.000 trillion-dollar pharmaceutical company by market cap. And demand for these 573 00:34:40.039 --> 00:34:43.530 drugs has gotten so high that Novo and Lilly cannot 574 00:34:43.590 --> 00:34:47.409 keep up. The FDA put semaglutide on an official shortage 575 00:34:47.449 --> 00:34:53.510 list in 2022. Terzepatide followed just months later. Here's Novo's 576 00:34:53.570 --> 00:34:56.559 Mads Thomsen again. Did you ever dream that it could 577 00:34:56.579 --> 00:34:58.820 be this big, ultimately? 578 00:34:59.900 --> 00:35:02.119 My dream, but that was just a dream, was that 579 00:35:02.199 --> 00:35:04.059 one day it could be the number one drug class 580 00:35:04.239 --> 00:35:07.480 in the world. And right now, this year, the latest 581 00:35:07.519 --> 00:35:10.059 forecast is that the GLP-1 class is actually going to 582 00:35:10.099 --> 00:35:13.239 be the number one drug class in the world. But 583 00:35:13.340 --> 00:35:16.719 it's gone surprisingly fast to the extent that neither we 584 00:35:17.159 --> 00:35:20.449 nor our peers at Eli Lilly can deliver enough products 585 00:35:20.590 --> 00:35:21.969 to satisfy the market. 586 00:35:21.989 --> 00:35:27.750 Thank you for calling Walgreens Pharmacy. 587 00:35:27.769 --> 00:35:28.329 I can help you. 588 00:35:28.349 --> 00:35:29.190 Where are you from? 589 00:35:29.210 --> 00:35:29.659 I can help you. 590 00:35:29.710 --> 00:35:30.530 I'm trying to go to pharmacy. 591 00:35:30.550 --> 00:35:31.179 I can help you. 592 00:35:31.760 --> 00:35:37.110 Pharmacists can't stock the stuff fast enough. My colleague, Brad Olson, 593 00:35:37.510 --> 00:35:39.110 you heard from him at the start of the episode. 594 00:35:39.789 --> 00:35:41.869 He and I called a bunch of pharmacies all over 595 00:35:41.889 --> 00:35:42.369 the country. 596 00:35:42.389 --> 00:35:46.179 I'm just calling to see if you have any GLP-1 597 00:35:46.440 --> 00:35:49.039 drugs in stock, like Ozempic or Mount Jaro. 598 00:35:50.300 --> 00:35:50.960 No, we don't. 599 00:35:51.199 --> 00:35:52.679 No, unfortunately, we do not. 600 00:35:52.760 --> 00:35:54.780 We haven't gotten it in the past few months. 601 00:35:54.880 --> 00:35:56.199 No, it's not available. 602 00:35:56.219 --> 00:35:58.239 I think next month it's going to be available. 603 00:35:58.420 --> 00:36:01.309 Literally, like, every injection right now is so hard to get. 604 00:36:01.590 --> 00:36:02.730 We're out of stock on it. 605 00:36:03.030 --> 00:36:03.519 On all of it? 606 00:36:04.400 --> 00:36:04.880 Yeah. 607 00:36:09.130 --> 00:36:13.369 Today, there's no doubt Americans want these drugs. But almost 608 00:36:13.510 --> 00:36:16.670 everyone we spoke to for the series, from patients to 609 00:36:16.710 --> 00:36:21.480 doctors to lawmakers, pointed to the same big issue. Price. 610 00:36:22.519 --> 00:36:25.800 These drugs are very expensive, about $ 1, 000 a month out 611 00:36:25.820 --> 00:36:29.199 of pocket in the U.S. Insurance often won't cover them 612 00:36:29.219 --> 00:36:32.079 for weight loss. And it's recommended that the medicine be 613 00:36:32.099 --> 00:36:35.489 taken for life. Or else studies show people gain the 614 00:36:35.510 --> 00:36:40.489 weight back. My colleague Brad also ran into the affordability issue. 615 00:36:41.630 --> 00:36:45.050 And so you did stop taking Manjaro after about five months. 616 00:36:45.840 --> 00:36:46.090 Why? 617 00:36:46.110 --> 00:36:51.340 I would say it's mainly cost. I just can't afford, 618 00:36:51.360 --> 00:36:55.500 you know, that expense over the course of my lifetime 619 00:36:55.699 --> 00:37:01.110 out of pocket. And So for me, starting without insurance 620 00:37:01.190 --> 00:37:03.050 is sort of like a choice where you know in 621 00:37:03.090 --> 00:37:05.130 the end that the jig is up, like you're not 622 00:37:05.150 --> 00:37:07.010 going to be able to keep taking it. 623 00:37:08.150 --> 00:37:11.750 So how long after your last dose before you started 624 00:37:11.769 --> 00:37:13.190 to feel the cravings come back? 625 00:37:14.110 --> 00:37:15.210 It was probably three weeks. 626 00:37:16.090 --> 00:37:16.389 Okay. 627 00:37:16.769 --> 00:37:19.670 It became hard because it became like you're kind of 628 00:37:19.789 --> 00:37:23.860 without a net. You know, in the circus, you're on 629 00:37:23.900 --> 00:37:27.460 the tightrope and there's no net under you, you know. 630 00:37:28.059 --> 00:37:30.699 And the medicine was like having the net. You're like, oh, 631 00:37:30.739 --> 00:37:35.320 I can fall off this tightrope, no big deal. That's 632 00:37:35.340 --> 00:37:35.980

what it feels like. 633 00:37:36.139 --> 00:37:36.360 Yeah. 634 00:37:37.679 --> 00:37:41.250 Brad decided to go without a net. But as we 635 00:37:41.289 --> 00:37:44.130 reported the series, he and I talked to people who 636 00:37:44.190 --> 00:37:46.349 weren't so willing to give up a drug that they 637 00:37:46.389 --> 00:37:49.409 felt changed their lives, even if it was more than 638 00:37:49.429 --> 00:37:50.110 they could afford. 639 00:37:50.610 --> 00:37:53.829 Okay, if I can't get the drug, what can I 640 00:37:53.869 --> 00:37:54.590 take instead? 641 00:37:55.130 --> 00:37:59.780 What's close? And so... they resorted to riskier measures. 642 00:38:00.380 --> 00:38:03.579 What I received in the mail was a tiny vial 643 00:38:03.639 --> 00:38:05.179 filled with white powder. 644 00:38:05.719 --> 00:38:05.980 Okay. 645 00:38:06.000 --> 00:38:09.099 Which could, honest to God, be anything, because, like, who knows? 646 00:38:10.579 --> 00:38:24.550 That's next time on Trillion Dollar Shot. Trillion Dollar Shot 647 00:38:24.619 --> 00:38:26.980 is part of The Journal. which is a co-production of 648 00:38:27.039 --> 00:38:30.579 Spotify and The Wall Street Journal. This episode was hosted 649 00:38:30.619 --> 00:38:34.909 by me, Jessica Mendoza, with Bradley Olson. It was produced 650 00:38:34.969 --> 00:38:38.690 by Matt Kwong, with help from Jivika Verma. Additional production 651 00:38:38.769 --> 00:38:43.250 from Adrienne Murray-Nielsen. This series is edited by Catherine Brewer. 652 00:38:43.610 --> 00:38:48.579 Fact-checking by Sophie Hurwitz. Series art by Pete Ryan. Sound 653 00:38:48.599 --> 00:38:51.500 design and mixing by Peter Leonard. Music in this episode 654 00:38:51.539 --> 00:38:55.409 by Peter Leonard and Bobby Lord. Our theme music is 655 00:38:55.449 --> 00:38:58.610 by So Wiley. Remix for the series by Peter Leonard. 656 00:39:01.630 --> 00:39:06.829 Special thanks to Maria Byrne, Stephanie Ilgenfritz, Kate Leinbaugh, Peter Loftus, 657 00:39:07.210 --> 00:39:11.969 Sarah O'Brien, Enrique Perez de la Rosa, Sarah Platt, Suna Rasmussen, 658 00:39:12.309 --> 00:39:18.010 Jonathan Sanders, Nathan Singapak, Leying Tang, Rolf Winkler, Liz Esley-White, 659 00:39:18.329 --> 00:39:24.219 and Tatiana Zamise. Thanks for listening. Episode 2 drops next Sunday, 660 00:39:24.539 --> 00:39:32.940 May 19th. Hey, Wendy here again. 661 00:39:32.960 --> 00:39:36.239 So that was episode one of Trillion Dollar Shot from 662 00:39:36.280 --> 00:39:38.639 The Journal. You can listen to the series by finding 663 00:39:38.679 --> 00:39:41.940 The Journal wherever you get podcasts. We'll be back in 664 00:39:41.980 --> 00:39:45.260 your ears with an episode of Science Versus in just 665 00:39:45.300 --> 00:39:47.920 a couple of days. And we are diving into the 666 00:39:47.980 --> 00:39:52.050 science of protein. How much do you really need to 667 00:39:52.449 --> 00:39:57.050 get jacked or to, you know, just be healthy? It's 668 00:39:57.090 --> 00:39:59.630 a really, really fun episode. I can't wait to share 669 00:39:59.650 --> 00:40:02.400 it with you. I'm Wendy Zuckerman. Back to you in 670 00:40:02.420 --> 00:40:04.010 a couple of days. Order now. 671 00:40:11.090 --> 00:40:35.119 You've earned it. Deliveroo. That finish line Friday feeling just 672 00:40:35.199 --> 00:40:38.730 got even better. Geographical restrictions, teas and season fees apply. 673 00:40:38.769 --> 00:40:40.809 Delivery times vary. See app or web for info.