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They already have the most competitive pricing out there

Mounjaro (tirzepatide for T2DM) and Zepbound (tirzepatide for obesity) from Eli Lilly are growing at the fastest CAGR, driven by the dual GLP-1/GIP receptor agonist mechanism that has consistently demonstrated superior weight loss outcomes versus semaglutide in head-to-head clinical comparisons

Its more common outside the UK and I'd not really come across it in the UK - and it tends to be more common in countries where B12 for medical purposes is over the counter rather than prescription only - I know this happens in France, Russia and Egypt

Is the environment (or their kit) organized and clean