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The honest version of the economic argument is: we have an evidence gap because the incentives are broken

Azova, S., & Wolfsdorf, J

[1] [4] Important safety warnings include: Risk of pancreatitis seek urgent medical attention for severe, persistent abdominal pain (possibly radiating to the back) with or without vomiting Gallbladder disease including gallstones Diabetic retinopathy complications caution in patients with pre-existing retinopathy, especially if also using insulin Risk of dehydration from gastrointestinal side effects, which may affect kidney function There is no official link between Rybelsus and increased urination as a direct adverse effect