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Case Conclusion Initial combination therapy with metformin, paired with a DPP-4 inhibitor or an SGLT2 inhibitor (or a combination of a DPP-4 inhibitor and an SGLT2 inhibitor in patients with a contraindication or intolerance to metformin [81] in accordance with the current AACE algorithm), would be reasonable treatment options for this young patient who does not have overt CVD, but who does have related risk factors including hypertension, elevated HbA1c levels, and excess body weight

doi: 10.3390/ijms24010042, 115

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But this massive price drop introduces a brutal mathematical paradox that every sophisticated investor must ask: How can pharmaceutical companies sustain their margins when their flagship product loses 70% of its retail value