Guide//5 min
Heat, saunas and hot tubs
Heat lowers blood pressure and removes fluid from a body that is already short of both. Nothing about it is dangerous in isolation, which is precisely why people underestimate the stack.
The Business
Supply & Shortages
Who can actually get a pen this month, and why that keeps changing.
9 pieces
Guide//5 min
Travelling with your GLP-1 pen
The pens are more robust than people fear and less robust than a hot car boot. Most travel problems come down to three numbers and one decision about which bag it goes in.
News//4 min
The federal GLP-1 pricing deal
A negotiated price, a direct-purchase channel and a Medicare pilot. It is the largest change to GLP-1 access in America since the drugs arrived — and the fine print decides whether any of it reaches you.
News//3 min
The compounding question, after the shortages
Compounded semaglutide filled a real gap during a genuine shortage. The regulatory basis for that gap has narrowed — and the market has not gone anywhere. Here is how to reason about it.
News//4 min
Buying direct: the new cash prices
Both makers now sell straight to patients, below list, outside the insurance machinery. For the uninsured it is the biggest practical change in years — and it quietly reprices the entire gray market.
Deep Dive//5 min
The oral GLP-1 is coming
An effective GLP-1 in tablet form is not mainly a convenience story. It is a manufacturing story — and manufacturing is what has rationed these drugs since the day they arrived.
News//3 min
Generic semaglutide, elsewhere
Patent expiry in several countries has produced generic semaglutide at a fraction of the American price. The US patent runs years longer, which is already driving people toward routes that carry real risk.
Deep Dive//5 min
Medicare and the obesity drug exclusion
A single clause written in 2003, before anyone had a weight-loss drug worth arguing about, now shapes the entire American market. It is the most expensive sentence in obesity medicine.
Guide//5 min
Judging a compounded source
There is a real difference between a licensed 503A pharmacy with a prescriber behind it and a website selling vials labelled 'not for human consumption'. Most people cannot tell them apart, and the marketing is designed that way.
Also in The Business
On The Jab
The
GLP‑1
Handbook
Dr. Nick Robertson
MD
The book · 14 chapters
The GLP-1 Handbook
Everything I tell my own patients before their first injection. 214 pages of what actually matters in the first year — dosing, side effects, food, muscle, cost, and the part nobody prepares you for: maintenance.
$4Less than your morning coffee.
Priced at four dollars because it should be affordable to everyone taking these drugs — not because it's worth four dollars. No upsell, no course, no supplement line.