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I would guess they are purchasing a Chinese made chemical and throwing it in a bottle

Among other things, there can be no guarantee that planned or ongoing studies will be completed as planned, that future study results will be consistent with the results to date, that Zepbound will receive additional regulatory approvals, or that Zepbound will be commercially successful or that we will meet anticipated timelines for its commercialization

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It targets three hormone receptors: GLP-1, GIP, and glucagon