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10.1038/s41586-021-04369-3 Nature 138 YangP.PavlovicD.WaldvogelH.DragunowM.SynekB.TurnerC.et al (2015)

Conaghan PG

Small-batch production, amino-acid sequencing verification, third-party purity testing

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Chronic, untreated metabolic acidosis may increase the risk for nephrolithiasis or nephrocalcinosis and may also result in osteomalacia (referred to as rickets in pediatric patients) and/or osteoporosis with an increased risk for fractures

One reason is to try to improve patient outcomes, but another is that medicines lose their patents, and companies cannot make as much money