Drug Development Failure: how GLP-1 development was abandoned in 1990
Pharmaceutical history may have looked very different if Pfizer hadn’t abandoned early development of GLP‑1 drugs for diabetes and obesity in 1990, a move later contrasted with Novo Nordisk’s decades-long persistence that led to Ozempic- and Wegovy-like therapies. Commenters explore how misjudging patient acceptance of injections, market size, and regulatory risk can kill promising treatments, and link these choices to today’s high obesity rates and potentially avoidable COVID deaths. They also debate the ethics and economics of modern obesity drugs: patent-driven pricing around $1,000/month in the U.S., the temporary role of compounding pharmacies, and whether the FDA’s conservative stance on approvals saves more lives than it costs.
GLP-1 History, Missed Opportunity, and Hindsight Bias
- Pfizer/MetaBio abandoned GLP-1 in 1990 despite efficacy and patents; Novo Nordisk restarted work shortly after and eventually created blockbuster drugs.
- Commenters debate whether this was an obvious mistake vs a reasonable decision given then‑limited obesity prevalence, long timelines, and competing pipelines.
- Several note “resulting”/hindsight bias: pharma has many parallel bets (e.g., obesity drugs, Alzheimer’s pathways, CETP inhibitors) and most fail despite smart, persistent teams.
- Another angle: MetaBio’s startup structure was flawed (wholly owned from day 1, founders not fully committed), which left them powerless when the parent shifted priorities.
Injections, Patient Acceptance, and Delivery Tech
- Disagreement over how much injection aversion mattered in 1990: some recall large syringes and clinic visits; others point out disposable syringes and short needles existed and subcutaneous injections are manageable.
- Needle phobia and pain sensitivity are described as real barriers for some patients, influencing route-of-administration decisions.
Obesity, Diet, and Corporate vs Personal Responsibility
- US obesity rose from ~17% (1990) to ~40% today; some estimate many deaths could have been avoided had GLP-1 therapy been available earlier.
- Debate over primary drivers:
- One side stresses cheap sugar/HFCS, 1970s farm policy, and “low‑fat, high‑sugar” reformulations.
- Others cite data showing sugar intake has fallen since 2000 while obesity still rose, arguing hyper‑palatable foods (fat + sodium/sugar) and processed food engineering are bigger culprits.
- Some emphasize parental/individual responsibility; others stress corporate manipulation and structural food environment.
Pricing, Patents, and Compounded Semaglutide
- Strong criticism of US pricing (~$1k/month list, with limited insurance coverage for weight loss vs diabetes indications).
- Compounded semaglutide is much cheaper while the drug is on the FDA shortage list; commenters explain that status temporarily permits compounding without licenses, but this will end.
- Some compounders reportedly crush oral Rybelsus tablets as API; others worry about opaque sourcing and “shady” operators.
- International price gaps (e.g., UK much cheaper) are noted, often blamed on US policy and lobbying.
Regulation, FDA Conservatism, and Access to Risky Drugs
- Tension between protecting patients from harmful drugs vs the “hidden graveyard” of people who die because beneficial drugs are delayed or never developed.
- Proposals: multi‑tier approval (experimental classes, noncommercial/terminal‑only), “accredited ingestor” status, or easier use of drugs approved in other rich countries.
- Counterarguments stress fraud risk, desperation of terminal patients, manufacturing limits, and that even early‑stage drugs often fail on safety/efficacy.
- Historical examples (e.g., thalidomide abroad vs delayed beta‑blocker approval in the US) are used on both sides to argue the FDA is too lax or too strict.