Cardiometabolic medicine is entering an era in which the most effective therapies are also among the least accessible. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), sodium–glucose cotransporter-2 inhibitors (SGLT2i), and the non-steroidal mineralocorticoid receptor antagonist finerenone now sit at the heart of international guidelines for type 2 diabetes, atherosclerotic cardiovascular disease, heart failure, chronic kidney disease, and obesity [1,2]. Yet, for many patients, these drugs remain aspirational rather than attainable.
