Dave Knapp
Appearances
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Most people in the United States are not paying $1,300 a month for Ozempic. In fact, Wegovy, which is the obesity medicine version of Ozempic, most people that are on this are paying less than $25 a month. 80% of the people who are on this are paying $25 a month. Is that with insurance? Yeah, that's with insurance, right?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So there's been sort of a level of frustration and wanting to know what else is on the horizon, what other things that I may be able to explore to get to treat my metabolic dysfunction. And so really what we do is we effort to share the news about these medications, the trial data that comes out.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
whatever's going on in the news that might be pertinent to somebody whose life is being transformed by what I always call leveling the metabolic playing field. That's really, in essence, what these medications are doing for people who are taking them for type 2 diabetes or obesity, is they're actually just giving people a fighting chance for their biology to come into alignment with
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
In the sense that they can kind of work with the medication and bring themselves into better, more full, complete health for themselves. And one of the things that has been just the evergreen topic within this community is just the accessibility. They're extremely expensive medications to use.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
to get, unless you're diabetic, it's a little bit easier if you're diabetic, but then you have to be diabetic to get it.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, yeah. I mean, and sure, that's the other thing that... that we've learned in the Knapp household is the insurance companies will fight you tooth and nail to not cover anything that is expensive. They're essentially practicing medicine, right? At the bureaucratic level of the insurance companies, they're just saying, yeah, there's something better here.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And so ultimately, yeah, it's very difficult to stay on the medication as well as getting treatment for obesity. Once you're below a certain BMI, unless your doctor is coding everything just so, It's very hard to stay on it because now you're not obese anymore, but you need the medication for maintenance.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Many people who are on these medications for obesity will need some level of treatment because like any chronic disease, typically when you need treatment to get it in remission, you need treatment to keep it there. And that sort of bears out in the clinical trials for these as well.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
That's not to say it's going to be everybody's story, but you're leveling the metabolic playing field with a peptide that is supplanting something that's deficient or deficient in your body. And so once you remove that, you're sort of fighting an uphill battle again. So the issue of accessibility has been this evergreen topic.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
I know that you talk about this within your community, many people relying on the compounded versions. Now, compound versions, I don't know how much you want to get into the weeds on this, but essentially pharmacies have been compounding medicines for hundreds of years. That's what they've done, right? But back in 2013, I believe it was, the government wanted to
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
realizing that we had some really glaring holes in the way that drug companies were sort of outsourcing active pharmaceutical ingredients and the manufacturing of their drugs. There was this gaping hole that left the United States open to drug shortages. And so it's like, what happens if all of a sudden we can't get antibiotics that are largely made primarily made in China or India.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
What happens if we can't get those, right? And so they basically made a big distinction and they said, you know, we're going to have 503A pharmacies that have always been around. They can make a drug that is commercially available, not in shortage, but maybe a patient can't
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
stand or is allergic to a certain preservative or a certain dye, or maybe even the doses that are available commercially don't work for that person. So compound 503A pharmacies always have the ability to make a branded medication in a compound form. when there is a medical need that precipitates that.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
But they also, in the Food, Drug, and Cosmetic Act of 2013, established another code that established 503B pharmacies. And basically this was to address that, you know,
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
What the lawmakers could see happening with the outsourcing of drug manufacturing was if we all of a sudden, let's say there's something that happens on the economic stage of the world and we can't import drugs, we need infrastructure in the United States that can manufacture drugs and make sure people have what they need.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And so in establishing 503B pharmacies, they've established basically a pharmacy that's not like a traditional pharmacy. It's a factory. It is a plant that can mass produce medicines. And unlike 503As that have to hold an individual script for a patient, if a drug goes into an FDA shortage, they can mass produce it.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
and sort of fill in the gaps for where the drug manufacturers can't meet the demand or import enough, et cetera, et cetera. Now, back these medications because of their efficacy, because they are leveling the metabolic playing field, and because the disease of obesity and diabetes are so prevalent in the United States, These went almost immediately into shortage.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
People like me started making content about it. They haven't even really had to advertise these that much. Of course, everybody knows the Ozempic song, so they have been advertised to some extent. But once people really started to realize that these are absolute metabolic game changers, it's like everybody and their sisters on them.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
There's just no way these two drug companies have been able to keep up. So they've been in shortage. The problem with that system is that these are... essentially a handshake agreement between big pharma and the fda that says yes our drug is in shortage or no it's not in shortage and so when october of 2024 hit eli lilly
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
reported to the FDA that Manjaro and Zepbound, which Terzepatide, it's probably the, not probably, it is probably the most powerful anti-obesity medication and type 2 diabetes medication on the market. It's like the next generation of Ozempic. They said... our stuff is commercially available, which set off a chain reaction of stopping the 503 manufacturing.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And there's upwards, I have direct contact with all the people that are kind of at the upper echelons of these industries. The estimated amount of semaglutide compound scripts that were made in 2023 was 80 million. 80 million scripts for compounds of maglutide in 2023.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
In one year. Now, that's not 80 million people. That's 80 million scripts. So divide that by 12. And then you sort of get how many, you know, prescriptions per year per people. But the other thing is... Terzepatide at that time is estimated to have been at about 30 million scripts. That's 2023. 2024, those numbers had to have jumped by conservatively 30%, probably more.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, right.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Right. So conservatively in 2023, the estimate is that there were almost 30 million people on compounded triseptide. And so you can obviously see an increase happening in 2024 when this really blew up. I'm sure you had something to do with that as well as many creators. And the interesting thing is I come from the TikTok world, right? And in the TikTok world,
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
There are creators that are pushing compounded versions of medications that are making $20,000 a month pushing this stuff. What? It's huge. How?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, it's huge money.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, it's crazy. So I would also just throw in me either. I am an advisor for a company called Rho, which is a telehealth company that just simply wants somebody who represents the community to help them know what tools to develop and how to speak to the community, etc., But I haven't either because it all seems like a very legal gray area.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
But essentially, it's these telehealth companies have shared affiliate codes and they go on live and they share about the medication, what it's done for them. And if you want to do this for yourself, you can use my code. Use code Dave10, whatever it may be.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And then ultimately, TikTok has such a far reach that people are getting people to sign up in the hundreds every month, receiving large kickbacks.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah. It's so, it's definitely a wild little sidebar rabbit hole to go down, but it, it all has, you know, at the end of the day, what it's done is it is ex, exponentially increased accessibility to these treatments, again, at an affordable rate, at an accessible rate, because these copies of the branded versions have been allowed to proliferate because the drugs are in shortage.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
But now that the drug companies, these pharmaceutical companies, have sort of had enough of their intellectual property being sort of usurped by this new sort of sector of the economy that has arisen, right? No drug has ever been compounded and mass produced the way that GLP-1s have. There's definitely pushback from Big Pharma.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
In that pushback, Lilly removed their medication from the shortage list, which set off a legal battle between the Outsourcing Facilities Association, basically a trade organization that represents 503Bs, these big outsourcing factories that have been able to mass produce these during the shortage.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And they basically argued in court, what's going on to end the shortage in the data that is being shared is nothing more than what Lilly wanted to present to the courts and, or excuse me, the FDA and the FDA has just gone along with it. Meanwhile, we have an estimated, you know, between the 80 million and 30 million, 110 million prescriptions per year. You divide that by 12. I don't know.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
You get somewhere in the ballpark of what a hundred thousand people, um, or sorry, a million people, uh, on these probably more people, uh, And so it's very interesting to see this sort of unfold shortly after Terzapatide was removed from the shortage list. You saw Novo Nordisk follow suit, remove theirs. Interesting timing, right?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And these are also two companies that have been sort of embroiled in lawsuits over price fixing over insulin. And so you kind of look at the template there and it's very interesting to see how this is all unfolding because you definitely have sectors, I'm not saying this is my point of view, but you definitely have people out there saying this is the insulin fix 2.0 being done for GLP-1.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Now, in fairness to both Lilly and Novo, They have both gobbled up about every ounce of manufacturing capacity that is to be gobbled up to increase production of the branded supply. Eli Lilly just announced a $27 billion investment in infrastructure in the United States to continue to increase their manufacturing capacity.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And one of the things that I think is really amazing that Lilly has done in all this is is they've repatriated the active pharmaceutical ingredient to the United States. So actually the active ingredient in Manjaro will be made in Lebanon, Indiana. And so I think there are some positives to this.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
You've also seen because of this sort of market that has popped up, and I don't even know how to, let's call it big pharma, little pharma, right? This little pharma sort of, market that has popped up in 503Bs is it put pressure on Eli Lilly and Novo Nordisk to reduce the cost of the prescription. So you always hear like, how many times have you heard this?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Well, we pay in America five times what they pay in Australia or the United Kingdom for these medications. That all has to do with the list price. Most people in the United States are not paying $1,300 a month for Ozempic. In fact, Wegovy, which is the obesity medicine version of Ozempic, most people that are on this are paying less than $25 a month.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
80% of the people who are on this are paying $25 a month. Is that with insurance? That's, yeah, that's with insurance, right? So you have the list price at $1,300, but most people in the United States are paying 80% or paying $25 or less. Now, why is that?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
We had the CEO of Novo Nordisk testifying on Capitol Hill that PBMs, which are the pharmacy benefit managers, they're the ones for your audience that are the ones that gatekeep what drugs you can have on your insurance plan. And they basically do this the way that Walmart sells a toaster, right? So Walmart wants to sell a toaster.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
They bring in five toaster manufacturers and they say, who can give us a $5 toaster? Because we're going to sell it for 15. And the one guy goes, well, it cost me eight to make it. And so that person's option is either outsource his manufacturing to a foreign country where they pay slave labor wages, or they don't have a lot of choices.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So whoever can bring them that $5 toaster gets added to the Walmart shelves, right? Same with the insurance formulary and the PBMs. The PBMs go, you want your anti-obesity medication on our formulary? Well, here's what you're going to pay us to have it there in the form of rebates.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And so the testifying on Capitol Hill that the HELP committee ran, this is chaired by Senator Bernie Sanders, but it's a bipartisan committee in the Senate. And they brought up the CEO of Novo Nordisk. And, you know, you got Bernie up there. He's like, why does it cost Americans five times what it costs Australians? And so you get these great sound bites.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And he basically said the PBMs are taking 70 cents on every dollar of every drug that we sell in the United States. 70 cents.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
They got to go.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, it's wild. And, you know, not to get too far in the weeds, but essentially what happened during the, we talked a little bit at the beginning about the Affordable Care Act. The Affordable Care Act had some noble things it was pursuing, but like all noble things, like big money is always going to find a way around it, right?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So, but what the Affordable Care Act did to insurance companies is that you can't be more than 15% profitable. That was their way of sort of controlling this out of control, rising cost of insurance premiums in this country. They said, you can't be more than 15% profitable.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
You either have to put that money back in to expanding access or improving efficiencies within your business, but you can't be more than 15% profitable. So what did they do? Well, they decided we're just going to go buy the pharmacy benefit managers and we're going to change that game. And that's where we're going to make back the difference. And so, yeah.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So you have the list price at $1,300, but most people in the United States are paying, 80% are paying $25 or less.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So, so what you've seen Eli Lilly and Novo do in response to this secondary market that has popped up to ultimately has it, has it increased accessibility because there's shortages? Absolutely. It has fulfilled its, its dutiful responsibility as designed within the code of the U S law. But what it's also done is it's,
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
added a level of competition that usually doesn't exist for drugs that are under a patent. And because it did this, it forced Eli Lilly and Novo Nordisk to look at this a different way. So what they decided to do is they decided to say, we're going to cut out the PBMs altogether, which is actually a very bold move for pharmaceutical companies to make because
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Pharmaceutical companies have always seen PBMs as their customers, right? We sell to the PBMs. The PBMs then put it on the formularies and doctors prescribe it based upon what's on the formula. How many times have you gone to the doctor, people who are watching, and the doctor says to you, let's see, you have this. So here's the four or five antibiotics I could prescribe.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And this is the one your insurance company likes. They like it because they get kickbacks, right? They decided to just go around them all together. And so now Eli Lilly and Novo Nordisk both have direct to patient programs that offer a cash pay price that just cuts insurance out of the whole deal.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And they charge 400 and basically it's a little bit more convoluted than this, but for all intents and purposes, it's $499 a month for all the doses of Wegovy. And up to the 10 milligram of Zepbound, which is the weight loss version of this one, $499 a month, right? For the single dose vial versions.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
they've done this because they're able to then forget about what the PBMs have to get paid in this, and they just offer it at a direct cash pay price for $4.99. Still a lot higher.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Correct. In a sense, yes. That's novel, too.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
It is. There is a little bit of a middleman... in that they have partnered with telehealth companies to If you don't just go to Eli Lilly, you've got to go to... Well, I guess now it's a little bit different. You can go to anybody and they can prescribe these vials.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And yes, it comes directly from essentially the manufacturer by way of some... Like Amazon Pharmacy, I think, is offering the Lilly vials now. So there is a distribution element to it, kind of. But yeah, by and large, yeah, it's a novel approach by Big Pharma to go direct to patients. And actually just this week, there was a letter sent from some senators.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
I think it was a bipartisan letter sent to some of the telehealth companies that Lilly Direct and Novocare, that's these two direct-to-consumer programs, and basically gone to their telehealth partners and said, we think there might be a conflict of interest that you're pushing people to your drug. We want to look closer at this. But yes, it did create a novel sort of approach.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Now, the sad part about it To me, I mean, I think it's great competition, great cheaper drugs for people, great, especially because people on Medicare are just screwed out of this stuff. Medicare is illegal for obesity medication to be covered under Medicare. Now they're getting some secondary...
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
sort of comorbidities that have been approved for cardiovascular disease, heart disease with preserved ejection fraction, sleep apnea, some of these backdoor indications to get you on if you're on Medicare. But by and large, it's illegal for Medicare to cover anti-obesity medicine because going back to the obesity medicines of old, what were they? They were amphetamines, basically.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
The last thing they wanted to do was give a 75, 80-year-old person an amphetamine. So it's a bit of an archaic law that there are some things trying to correct. The Biden administration moved at the end of their administration to sort of add it, and hopefully the Trump administration picks that up. But There are some positive things.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
I think the sad part is the PBMs have been squeezing out our local pharmacies for the last 20 years, roughly 17 years. They've been squeezing them out by way of not reimbursing them the appropriate rate. So for example, if you're going to fill your Manjaro at a local pharmacy, chances are they're losing $25 to $50 every time they fill that script.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Right. And not not to even make mention of the fact that so a pharmacy, a local pharmacy, a mom and pop corner shop. Who is serving their community in some cases have been serving the community for 75 years longer. they have to cut these deals with the PBMs because typically you go to any town in the USA, there's one large employer.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
They're going to carry United Healthcare or Blue Cross, Blue Shield, Humana, whatever it may be. you have to take that PBM's insurance in order to be in business. But what they do in these, it's so evil what they do to these pharmacies, is what they do is, one of the things that most people don't know is that if you go to the pharmacy for, let's say, a generic medication,
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
they're going to default by contractually, they're contractually defaulted to run it through your insurance. And sometimes you're going to pay more with your insurance than you would to just pay the cash pay price. So one little word to the wise is always ask your pharmacy, what's my cash pay price versus running it through insurance? Because you might be like, well, I trust my pharmacy.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Why don't they just tell me it's cheaper? Because they're contractually obligated not to tell you that.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, it's legalized corruption.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
I think if you just go to Google and just hit on the pen, you're going to find it or onthepen.com, you should find it. But man on the Manjaro was my handle. That's sort of, it was a play of man on the moon and my handle in most places is man on the Manjaro.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, yeah. There's a lot to unpack here. When the OFA originally brought this case... The OFA, which again is a trade organization that represents these big manufacturers of compound drugs that are produced in times of shortage, they are located in Fort Worth, Texas. In Fort Worth District Court, there is a judge. His name is Judge Mark Pittman. And Judge Pittman has been an absolute...
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
I mean, I think he's just been great with some of his rulings against the FDA and Big Pharma. One in particular was just in December, over early December, over the COVID vaccine from Pfizer. And the FDA had kind of had this sort of handshake with Pfizer that they wouldn't release documents pertaining to adverse effects of the vaccine for like 40 years or something like that.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
It was longer than that. 40 or 70 or something. Yeah, it was like 75 years. It was crazy. Yeah, it was ridiculous. Ridiculous, right? And so he comes in and he goes, no, you're going to start releasing 50,000 pages a month immediately.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, yeah. So he's a hero. Yeah, so there really couldn't have been a better venue or a better judge like on the surface. I don't... pretend to know like all the judges and all that. I don't any judges before I got into this stuff. But when I saw that, I was like, this is our guy, right? And the need, right?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And so if anybody was going to sort of see that there is like something inherently wrong with the fact that there's no transparency in this process, that the FDA is just relying on reported numbers from Eli Lilly, that there's got to be some kind of conflict in there, right?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Like even if everything's on the up and up, let's say there's still something wrong with that process where that's the only information that gets you know, sort of taken into consideration by the FDA to determine that the drug's commercially available.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So the trisepatide lawsuit has not evolved the way that I maybe thought it would based upon the judge, but we actually had a correspondent sit in on the one physical hearing that took place and he kind of gave me a call afterwards, gave me the rundown. He goes, this judge is extremely annoyed by the fact that this, that this, is even in his courtroom.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
He knows that whatever the outcome, it's going to an appeals court, and he just doesn't think it belongs in this venue. Well, that didn't play well for compound terzepatide. It didn't bode well for the case for people who were relying on that mass-produced peptide. And it's sort of played out that way.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
He denied the preliminary injunction last week, which essentially would have protected compounders until this trial was resolved. He denied that. And then he actually went one step further and moved for a summary judgment, which essentially means both sides are going to get a couple weeks to respond back and forth to his decision. declaration of a summary judgment and then he's just going to rule.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
There won't even be a trial, witnesses, whatever. He just wants it out of his court. As luck would have it, he's the one who drew the subsequent lawsuit that was filed by the OFA against the FDA in the semaglutide shortage. So he's overseeing that case as well. It was a little interesting at first. Novo tried to interject
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
uh they're local they have to have local representation and they're a danish company so they hired a guy outside of the jurisdiction and so they he kind of slapped him down initially but novo was eventually able to join that lawsuit just like lily joined the terzapatide lawsuit to defend the fda's decision and so it's the ofa versus the fda and lily and the ofa versus the fda and novo
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And so, you know, it's just it's not going to bode well. Both both of the mass produced compound versions will be going away. This will they filed the OFA filed an appeal in the Fifth Circuit, but that will take a long time to resolve and resolve. It's unclear whether the Fifth Circuit will do anything to sort of stay enforcement.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So my prediction of what's going to happen is you're going to see the mass compounding go away of both terzepatine and semaglutide. Everybody's going to move back to these 503As, which from my perspective is just, there's a spectrum here, right? There's a spectrum of non-branded medications. The...
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
big pharmaceutical companies would want you to believe that all non-branded are created equal they're just not right so 503 b's are subject to the current goods and manufacturing process long way of saying they have fda oversight when you move to 503 a's and that's kind of what we explained earlier where you take the active ingredient and then you you do it in a dose that isn't available commercially or you add b12 because somebody has
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
fatigue or whatever it may be. Niacinamide is another one that gets added a lot. So basically, there's something that's not commercially available because there's a medical need precipitating it. I think, A, they're sort of operating outside of the spirit of why 503As exist, right? Because all of a sudden, they're going to move
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
millions of people who are on normal dosages, just exact copies of the branded medication to these custom formulations, prescribers are going to run into problems with the FDA, I believe.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
I think both will be on the receiving end of something. I think prescribers, potentially, I think the industry is preparing itself for the FDA
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
to come and and sort of stick their nose into the way these are being prescribed but we definitely know that both novo and lily are putting out cease and desist letters to compound pharmacies to providers to telehealth companies everybody's getting them and so once this march 19th is the cutoff that's just coming right around the corner um march 19th hits
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
That has to end, and then you'll see massive movement legally from Lilly. Novo Nordisk is like a month behind, and so semaglutide will be about a month behind that. All the telehealths are saying we're moving to custom formulations. It remains to be seen how they will respond in the face of legal threats and the legions of...
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
It would be apropos. Yeah, except mine's in a plastic bottle.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
you know, attorneys and lawyers that will be dispatched to basically squash anything that is not the branded version, not to mention the FDA. What remains to be seen too is like how much, what's the appetite of this administration moving to enforce anything against these compounders that we don't know, but we do know that, you know,
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Trump has about 27 billion reasons why from Eli Lilly this past week as to why they would go ahead and try to help enforce non-legal, at least in their version, at least from their position, non-legal prescribing of compounds.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yep, right. So I used to work at Olive Garden. That's sort of my history is I was a restaurant manager for literally from the time I was like 15 years old to the time that I was 25. eight years old, I managed restaurants.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
We know, we know that his best buddy, Elon is, he's openly said that he's taking this epic. And I believe in Jaro even now. And, and, you know, I mean, they're, And from the perspective of this, if you just go and buy the numbers, a good percentage of people within his cabinet have probably been on a GLP-1 also. So I don't think that the benefit of these drugs has escaped them at all.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
It'll just be interesting to see what the appetite for the FDA to actually enforce this stuff is.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah. Yeah, I talked a little bit how there's a spectrum, right? So 503Bs have the The 503B pharmacies have the CGMP that is overseen by the FDA. The 503As don't. So 503A pharmacies are overseen by their state pharmacy boards.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So when you start, for anyone who's switching to a 503A, a custom formulation or a custom dose in the interim, I would really strongly encourage you to know what pharmacy it's coming from. and then do some research on the state pharmacy boards and make sure that they're a pharmacy in good standing. Because again, there are different checks and balances for 503Bs that don't exist for 503A.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And then way over here, you have the research grade peptides that are available in the far reaches of the internet without a doctor's prescription that are labeled not for human consumption. So there's a spectrum of safety checks and balances that are built into the non-branded versions. And so when you're talking about that spectrum, they're just simply not all created equal.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So the ironic thing about this is the crusade that Lilly and Novo have against compounded versions, their actions are actually leading people to progressively less potentially safe options.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And one of my guilty pleasures when I worked at Olive Garden was, you know, there's a lot of guilty pleasures working at Olive Garden, but they had glass bottles of San Pellegrino and glass bottles of Aquapana. You know, that is such good spring water. And man, I probably drank my salary in fancy water. Pellegrino.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, the established 503Bs, I believe it was 2013, 2011 or 2013.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, and there's definitely nothing wrong with 503A. It's just that there's not uniformity in the way that they're governed. And so one state to another state has different rules. And the other thing that I would add too is, You should have a great level of confidence from your provider.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
If your provider is writing this script, it really is incumbent upon your provider to do the legwork in determining, am I sourcing this from an appropriate place? There was a story back in the last few months when this first came off, Shortage to Repetite, in October.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Many telehealths, a lot of the littler fly-by-night telehealth companies that are out there started offering, you could fill six months, nine months, 12 months of compounded medication in one fell swoop. And I was like, when that happened, I was like, slow down, everybody. Like, slow down. We're not sure. Like these don't have the same exact preservatives as the branded medications do.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
You're sitting with a year's worth of medicine in your refrigerator. You better make sure that your refrigerator is holding a steady temperature. That's a lot of medicine to sit on when you're putting it in your body.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And one of the interesting things that happened was there was a couple of them that started offering this right away from some fly-by-night compound pharmacy in Florida that ended up not having a sterile compound license. And they were getting... getting their peptides in from unnamed sources and then sending them out to people and they didn't even hold the proper license to do it.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And so I think more than anything, it's important to have a great relationship with your provider. If your provider understands this, if your provider has done the legwork, then you should have full faith and confidence in what they prescribe to you.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
But when we go from 503Bs that are governed and regulated by the CGMP, which means that all the API has to be sourced from FDA approved sources, et cetera, et cetera, you're just moving to something that's state governed. And so you just want to be familiar with what sort of regulations go on in the state that your medicine is coming from.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And then just familiarize yourself with what that pharmacy's history has been because everybody's getting into this game. Yeah. That's the Wild West. Even some people that don't belong in it. So that would just be my only word of caution.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
But it's funny because a lot of my journey to obesity, I think can be, obviously there's the genetic components. We have lots of stories about, or not stories, but we have lots of clinical trial data that bears out the fact that obesity is, there's a genetic component. There's a very genetic component to living with obesity. And then once you sort of get to the point where you have
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
I think a lot of us were bullish on Dr. Marty Macari, who has been nominated to head up the FDA. I think he's already gone through some of the back and forth on Capitol Hill even. He was the chief medical officer of Sesame Health, which is a huge prescriber of compounded GLP-1 medications. And so I think a lot of us were bullish on that. But, you know, TBD, right?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
They need to be able to arbitrate the cost and bring the cost of these medications down when they're purchasing them in bulk through Medicare or Medicaid. I think the other thing to kind of jump back on Well, first of all, the Medicare thing, you think about this, like they find the money for absolutely everything else.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
When we talk about bankrupting anything, it's like pretty crazy to think what our government spends money on. And then when it comes to something like this that could literally change the course of the history of the United States by writing this broken metabolic ship that we've created, it's just so short-sighted. But the other thing that I think that we see- So short-sighted. Yeah.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
The other thing that I think we see in the Maha movement where they have it wrong is that just like everything politically, we've been given this false dichotomy. It's like we have to remove, we have to switch oils to, you know, beef tallow and we have to get the dyes out of the Froot Loops and like all good endeavors, like let's clean up the toxic environment, food environment.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
But what do we do for people who are already sick? That's the part of the conversation that seems to get, well, what are we just going to tell them to eat less and move more? That's been a real winning strategy for the last 40 years.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
a lot of excess adiposity, as you talk about often, it is very hard to pull somebody back from that. And so the years that I spent in the restaurant industry and the years I spent sort of on this roller coaster of dieting was a huge contributing factor to my overweight condition and to ultimately developing type 2 diabetes.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
If we can just embrace a little bit of the science that we know about broken metabolism, hormonal dysregulation, then maybe we can embrace getting sick people the treatment that they deserve. And then at the same time, like we can walk and chew gum at the same time, right? clean up the food environment, and we can address people that are getting sick.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And oh yeah, by the way, if you want to bring down the cost of GLP-1s, why don't we let 503Bs continue to compound this and actually look at the fact that Novo Nordisk and Eli Lilly will never be able to meet
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
the demand of 100 million people in the United States alone that are living with the disease of obesity, not to mention type 2 diabetes, if we're just honest about their capacity to meet that problem, then 503B should be able to let the 503Bs cook. That's what I keep saying. That's why we created them. We created them to fill a shortage.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Now, if they just took a deeper look at this issue and made sure that this was happening on the up and up, I think we may have a different outcome.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
It's not just physical. It creates nice little soundbite clips. But one of the things, and I realize we've gone a little long here, but if I may... One of the things that I started sort of shifting towards in 2025 for On The Pens, I said, you know, I kind of gave the history of how we started and sort of what we've become. But we've gotten a lot of media attention over the last year and a half.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
I mean, we were in a Fortune magazine article right next to Eli Lilly in a big expose about them. We've been featured in Bloomberg and Fortune magazine. I'm heading out to do a health.com piece in New York City this weekend. We've had a lot of opportunities that I just never would have imagined were going to come my way.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And I was like, we're not going to go into 2025 just awestruck with the opportunity we have. We're going to be ready to actually advocate for some things. And one of the things that I've been advocating for with the change of this administration is why are we not taking obesity as serious, every bit as serious as we took the coronavirus?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
because this is an epidemic that is that has national security implications it has economic implications it has health implications it has societal implications we need to advocate for this administration and the next administration whoever it may be to take obesity serious and so that's why one of the things i've been advocating for is like this
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
not that Operation Warp Speed was some great template, but in the sense that it was an all of government approach to figuring out how to navigate a problem. We need an all of government approach to figuring out how we're going to eradicate the disease of obesity. And that comes from everything from figuring out how to get the cost of these medications down
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So back in, let's say, about 2011, which I was probably about 25, 26 years old at the time, it was time to get out of the restaurant world. It was like 90 hours a week. It was horrible sleep schedules. I mean, just, you know, you'd be there at 5 o'clock in the morning some days, some nights you'd be there until 1 or 2 a.m., And I wanted to start a family with my wife.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
figuring out how to get shots in the bodies of every single metabolically ill person who could benefit from them and really starting to correct this course. And you touched on one of the things, why isn't there some sort of subsidization of, of, uh, health and fitness programs. Why aren't we forming the SNAP system?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Why aren't we protecting compound pharmacies to do what we set out for them to do? Why aren't we implementing bulk buying programs under Medicare and Medicaid to get the cost of these down? Why aren't we just rethinking this system as a whole? And instead, like you said, we're focusing on fricking Froot Loops, like who even eats Froot Loops anymore?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, so I wrote a book, it's called Decoding GLP-1. It's a guide for friends and family of people using anti-obesity medications, specifically GLP-1. One of the big things that really became apparent right away to me once I started building community was that there were so many people on these medications that because of the stigma around obesity and the shame and the guilt and everything,
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
that people are led to believe about themselves, even though people with obesity, I would argue most of my community are people who have more gumption, more stick-to-itiveness, more drive, because they have to do something. We've been working against our biology, so we have to fight, and we're fighting like a losing battle all the time.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So we're fighting against something that we know is probably not even going to work out in our favor, but we fight and we fight and we fight, even though we don't see the external rewards. Um, Yeah, I wrote this for those people to empower them to have conversations with those people in their life who they love and felt like they couldn't have these conversations with.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And then boom, all of a sudden, about two months into this, I had a lot of velocity behind the book, all organic. There's no publisher. I wrote it. I released it. I released it to my community for that purpose. They were eagerly anticipating it. So it did well. We were right next to Dr. Jason Fung and the Diabetes Code.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Funny, the whole reason I got into restaurants is I was going to go into marketing and I was dating my wife at the time who has rheumatoid arthritis. And accessibility is a huge issue with the Knapp family because the one thing her parents said to me when I asked if I could marry her is they said, well, there can never be a gap. in her health insurance or she loses access to her medicine.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, they just wiped it out one day and told me it was... I can't even remember at this point. It was wild. It was like, your book violates our community terms. Meanwhile, there are like 100 different GLP-1 books out there, many of them towing the line on what should be acceptable and not, but mine was singled out. Thankfully, our community...
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
But yeah, thankfully, we got it back. But yeah, I mean, for the last three or four months, every video I put out on TikTok goes into this holding pattern before it's even posted, like reviewing my content. And it's like, who's reviewing it? And for what? I talk about the news. 99% of the videos that I put out, I'm just talking about what we talked about here today.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Here's the news, the OFA suing the FDA. This is what the judge said today. Or a clinical trial just dropped and this is the top line data that we got. Or there's a new drug in development and this is what it's called and this is who's making it. That's literally what I do. I'm not out there saying controversial things. I'm just simply reporting the news.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Now, I've given a little bit more of my opinion today on this podcast, but I've given way more opinion today than I usually do on my podcast. So, yeah, I do believe that there is a narrative out there and that if you step outside of that, you don't even like you said, you don't even know sometimes who that enemy is, what they're doing, but you definitely feel it. And it's it's hard to.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
It's hard sometimes to stick to it when you've sort of given your life's work. And, you know, it's not just me who has given up things. It's my family. It's time away from them. I'm a sick kid out here. You know, like we are sacrificing, our families are sacrificing so that we can give people information that's going to help them live better lives. And we believe in the mission.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So when it's tamped down by the powers that be, it can be a very frustrating place to be.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Nobody knows that better than you.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
He's got a ways to go on this topic for sure.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
I wish he would give out. He needs to tune out the Jillian Michaels and the Cali means of the world and actually embrace some people who've lived with this disease. I'm so sick of hearing from people who have never lived with obesity that the same old, uh, mantra of eat less and move more is the solution to this. If it were the solution, we wouldn't be in this position.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And I know that because I live with it. And I know that I've lost probably over 500 pounds in my lifetime. But the problem is my biology is working against me. And the second that I'm not living in a constant state of complete denial of entire food groups or entire
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And at the time, this was a foreign world to me. As I said, the biologic she's on that keeps her arthritis at bay is $4,000 a month without insurance. And if there's ever any gap, she doesn't get that medication covered again. So this is all pre-Affordable Care Act when they could sort of drop you from coverage if there was any sort of gap. And so I was like, man, I really want to marry this girl.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Life is devoted to being in a gym, which as a father of four and two jobs and everything, the only way for me to move the needle is to live in a way that is completely unsustainable for me. And I think if people actually understood that and lived in the shoes of somebody that has lived with severe metabolic illness, they would start to understand why that old mantra is so...
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
ineffective and we need we need sick people need treatment and that's exactly what these peptides are doing and they're only getting better right and as they get better and better like more and more people will find hope and treatment and healing but we have to have people at the upper echelons of the government that actually understand that and embrace it instead of listening to these people who have
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
you know, maybe larger platforms, but have no effing clue what it's like to live with a metabolic disease.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Such a positive way. One of the interesting things that I always tell people, I eat keto for the most part because I want to keep my blood sugars down. I feel terrible. If I'm eating carbohydrates as a diabetic, I'm feeling terrible. But some of us just need more to move that needle on a weight loss scale.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
spectrum this is a thing that measures your your ketones through your breath and i just wanted to to kind of throw this in there for the that person who's like well they just need to do this because eventually i get just comments like if he would just eat this way or that way like this is measuring my ketones haven't eaten for a few hours yeah better score than i get
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
I have no idea what it'll be, but my point is I'm doing the things I'm supposed to be doing. There's metabolic things that are not going well in my body that are keeping me from getting to where somebody who would eat the way that I do would potentially lose weight or maintain their weight or whatever. It's just not as cut and dry as people want to make it for sure.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So I better either go back to school or I better... you know, figure out a way to get good health insurance. So I went to my manager at Olive Garden. I said, hey, I'm going to go back to school. And he goes, well, do you ever think about becoming a manager at Olive Garden? And I was like, no, no, I haven't. And he's like, well, here's the deal. Here's what we pay for.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, so first of all, I appreciate the opportunity to be here on your platform and share. Thank you so much for having me. If people want to find the news, if GLP-1 news like these lawsuits on compounds or whatever new is coming down the pike with anti-obesity medication, onthepen.com is a great rallying point. From there, you can find me on literally all the socials.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
I'm at man on the manjarro, but if you just do a Google search for On The Pen, you'll see my little logo, this little guy. Man on the Moon Jar was a play of Man on the Moon. So if you see that anywhere, that's probably me or it's an imposter and they'll have at least some of my account content on their imposter account. But yeah, at Man on the Moon Jar pretty much everywhere.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
TikTok and YouTube are home base for me.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Yeah, I don't think so. I think we covered so much here. There's much, much more to be said. We have our own podcast called On the Pin, the weekly dose that you can listen to if you want the weekly tidbits of news that come out. And we do a show that you were actually just on a Thursday night live show that gets uploaded to the podcast too. We cover everything there.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
You know, at the time, it was like a $60,000 a year salary. So for somebody who was like 20 years old at the time, And then he's like, full benefits, 401k. I was like, wait, what about that full benefits? Is that health insurance too? He's like, yeah. And so I literally was like, I'll do it. And within a couple of weeks, asked her parents to marry her.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
I think for anyone, my heart... specifically goes out to people who use these medications that feel like they can't share that uh experience with their loved ones that's really you know where my heart is that's why i wrote the book decoding glp-1 it's very i've made it very inexpensive by design because i want people to be able to get it and if
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
If for some reason, even the $10 cost is a barrier for people, I don't want it to be. If this can be helpful for you to pass it on to a loved one who's, you know, just think of that aunt or, you know, grandma in your life who's like, you're not on one of those shots. Are you going to get thyroid cancer? This book is for them. It's very digestible.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And I just, I hope that people will check it out because I think it has the power to really transform those relationships. And I, once again, thank you for the opportunity to be here.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Awesome. Awesome. Thank you so much again. I appreciate it.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And then that set off the first eight years of our marriage. I worked in restaurants. and just bat this obesity snowball, this down 25 pounds, up 35 pounds, down 25 pounds, up 35 pounds. The fettuccine Alfredo probably wasn't a helpful contributing factor to that either. But I wanted to get off this roller coaster. My father had done video production in the community that we live in for 25 years.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And I stopped into his office one day on the way into an Olive Garden shift. And I was like, dad, you got to help me get out of this. I've got the chops to do marketing. I'm passionate about it. What's out there? So I sort of repeat this stopping into his office for a period of a couple of weeks. And he popped in one day. He's like, finally, I got something for you.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
It got me out of the restaurant industry. And I was about six months into that job where I was like, I want to just go talk to my dad today. I just felt this nudge. I was pumping gas. I can still remember it clear as day. I was pumping gas. It's like, why do I feel like I need to go see my dad?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So I went to see my dad and we have this big, long two hour discussion about everything from politics to the state of our family, to the fact that I really wanted to do marketing. And so he, he sort of says, Hey, I'll teach you what I'm doing from a video production side. You just have to sit with me a couple hours a week. And I was like, all right, let's do it. I got to get back to work.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And so I'm walking out, I'm sliding his slider door shut, and he goes, don't forget this conversation, boy. And that's kind of how my dad was. I was like, all right, all right, we'll see you later. To make a very long story short, those would be the last words my dad ever spoke to me. Died of a massive heart attack a few days later. He was 54 years old.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
It was obviously sudden and painful and traumatic and all of the things. But the last conversation that I had with him was rattling around in my brain for about six months. And ultimately, it led me to start a small marketing company. And that's sort of how I got into marketing. Now, it got me out of this restaurant cycle, but it didn't get me out of this obesity cycle.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Just every year, down 25, up 35, down 25, up 35, until finally, it was the year of COVID. It was 2021. And I had COVID a couple of times, a couple of positive tests from 2020 to 2021. I went into the doctor because I felt like I had long COVID. And I was just like, I'm tired every day. All I want to do is sleep. I don't know what's wrong with me. And he goes, oh, your A1C is a 7.9.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
You're diabetic. I was like, what? It was like literally that was my response. I never had fasting glucose that showed that I was on the track to diabetes. So I felt like I was just punched in the gut. I knew that I was overweight. I knew that I had a family history, but I never had numbers that would indicate like, hey, you're on the fast track to type 2 diabetes.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
So it was like this sudden thing. And this is coming off COVID, right? And so I'm full of all sorts of skepticism towards medicine and the medical community. And I think that probably mirrors a lot of people's story. And he goes, what do you want to do, Dave? And I said, well, I've yo-yoed on keto for like 20 years. And that was the diet that I'd always lose 25, gain 35.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
He's like, well, that's the only way you can stay off medicine. I said, well, if it means staying off medicine, I'll do it. So I'd bear down, white knuckle, did keto for a full year. And I mean, I was under 20 grams of carbohydrates every day. I was lifting weights. I was doing everything humanly possible. With keto, I was able to get my A1C down from a 7.9 to a 5.3, non-diabetic, right?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Really great. But my weight went from 319 to 312. I lost seven pounds. And granted, you know, some of it was probably some body composition change. I was lifting weights, but not what you would expect to see with somebody with that much weight to lose. So super frustrated, right? And just beyond frustrated.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And the interesting thing at that time to me was that even though my A1C was under control with the diet, my insulin levels were still off the charts 12 months after being extremely strict on keto. Now I had never really like gone off the rails eating. Like I'm not a donut eater. I'm not a, I'm definitely guilty of drinking diet soda, but I'm not a, a sugary beverage drinker.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
Just like not your typical who you would expect a 300-pound 37-year-old to eat, right? ate lower in carbs anyway. I was aware that those probably weren't going to be handled by my body in the best way. So we're a year into the diabetes diagnosis and he goes, you know what? I don't know.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
You're one of several people on this program out of a thousand people that have gone through this program that just haven't responded from a weight loss perspective. And I was kind of like, I could have told you that when we started. But He goes, you're probably a candidate for bariatric surgery. And I'm going, I'm 37 years old. I don't want to have my anatomy rearranged.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
That's where my mental state was at the time. I'm not knocking anybody who makes that decision for themselves. In fact, I'm still considering it at 39 years old, that that actually might be the best course for me. I don't know. but still sort of wrestling with it is my point. But I didn't have coverage for it. So he goes, there's this new class of medications, right?
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
They're actually mimicking what happens when people have bariatric surgery. We found that there are a bunch of hormonal changes that happen like on the operating table. Once we make these changes, there's a hormonal regulation that starts to happen almost immediately. And they're starting to mimic that with this class of medications called GLP-1s. And so he goes, I'm going to put you on Manjaro.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
It's expensive, but you're diabetic, so you should be able to get it covered. So I went home, again, still super skeptical of medicine in general coming off of all the shenanigans that we saw around that time. And... I'm like, I'm not going to just put this into my body. I'm going to learn everything there is to learn about this. And so I went to YouTube.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
And what I found from YouTube was a bunch of stories. Like, hey, I lost 100 pounds in six months on Ozempic. Yada, yada. And there's 100 stories out there. But I didn't find anybody talking about what they were, what they did, how they worked, what the study showed. And I thought...
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
You know, I'm going to go find this information, but I'm going to share it because somebody else is going to come behind me and they deserve to be able to find this information. And so that's sort of where On The Pen was born is just this desire to empower people with information. Right. And so essentially.
The Dr. Tyna Show
The Fight for Affordable GLP1s & the Truth About Big Pharma | Dave Knapp
this sort of has evolved as, as I've been a slower responder, I've seen many people in our community. We have probably 110,000 people between we're split, spread out across the platforms, right? TikTok, YouTube, Twitter, email, Facebook, everything. Um, but I've heard such dramatic stories about, uh, just massive transformations in, in weight loss, et cetera. It's just not been my story. Um, and,