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In addition, astrocytes, which normally support neurons, become dysfunctional through a process called astrogliosis, which worsens glutamate imbalance and reduces neuronal support (Taylor et al., 2016), and genetic mutationssuch as SOD1 (causing harmful protein accumulation), FUS (interfering with RNA handling), and TBK1 or OPTN (which impair the cell's waste disposal system known as autophagy

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The GLP-1 market illustrates a specific dynamic: when two large manufacturers with comparable product efficacy compete for formulary position, the rebate competition between them drives gross-to-net discounts to levels that compress both manufacturers net revenue while primarily benefiting the PBMs plan sponsor clients