Docs Who Lift finally got a big pharma exec on the show. Dr. Ken Custer is President of Lilly's Cardiometabolic Health, and he came straight from the EASD conference in Milan with fresh data on what's coming after tirzepatide.
If you've been waiting on retatrutide, this is the episode. Spencer and Karl get Custer to walk through the new phase 3 results and the tirzepatide plus eluralintide combination, including why stacking these mechanisms seems to deliver more than drug developers usually get. You'll hear how amylin works on a completely different set of brain pathways than GLP-1, why Lilly walked away from one version of the drug in favor of another, and what the early tolerability data looks like. That last part matters if you're one of the people who couldn't handle a GLP-1, or you've been too nervous to try one.
The conversation then opens up to the questions patients actually ask. What's next if you hit a wall on tirzepatide and still have weight to lose. Whether these medications will ever be approved for people who aren't sick yet, just heading that direction. And why it's getting harder to run trials at all when everyone can tell whether they're on the real drug.
The back half goes behind the curtain. Custer is honest about how often drug development fails, what these trials cost, and what it was like to be in the room the day Lilly chose tirzepatide, a molecule he's now spent 12 years on. He takes on the pricing question directly, explains where coverage is headed, and makes his case for why access is still the biggest problem.
It ends where you'd want it to. The gray market, what regulation actually gets you, and how to think about doctors who work with pharma versus the people calling them shills while selling supplements with zero data behind them.
Nobody got paid for this one.
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