Its oral bioavailability is achieved by incorporating the absorption enhancer SNAC (Sodium N-[8-(2-hydroxybenzoyl)amino]caprylate), which works through two mechanisms: (1) temporarily raising the local pH in the stomach to reduce pepsin-induced degradation of the peptide drug, and (2) forming hydrophobic ion pairs (HIP) with the peptide drug, improving its membrane permeability
10.1620/tjem.242.129 252 XieB.ZhouH.ZhangR.SongM.YuL.WangL.et al
A few commenters encouraged CMS to increase the weight of the Safety of Care domain within the existing methodology (for example, from 22 percent to 30 percent) while reducing the weight of other domains proportionally, allowing safety to have a greater influence on the Overall Hospital Quality Star Rating without introducing categorical penalties
Compare that to direct hormone replacement, which tops off levels from the outside and can sometimes suppress the glands own output over time
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