CONFIDENTIAL | March 21, 2026

Normalized Rate Analysis

Substance signals normalized against verbatim adoption ramp | MPC Signal Detection Project
March 2026 estimation: The dataset covers March 1-5 only (5 of 31 days). Where March appears in charts and tables, values are estimated by multiplying partial data by 31/5 (6.2x) and marked with a dagger (†). Normalized rates use the same factor for both numerator and denominator, so the rate itself is based on actual data, not the estimate.

Verbatim Adoption Ramp

Gray bars = all closed cases (~200k/month, flat). Purple area = verbatim-containing cases (the searchable pool). Only verbatim records are searchable. The purple area is the denominator.

Verbatim Completion Rate

Percentage of all closed cases with a verbatim field. Each step is a poison center coming online. 6.7% to 90.0% in 16 months.

What Survives Normalization

Retatrutide

Real surge
Raw: 21.6x | Normalized: 11.5x
0.23 to 4.01 per 10k verbatims

7-OH

Real surge
Raw: 36.8x | Normalized: 7.5x
0.92 to 7.84 per 10k verbatims

Medetomidine

Stable endemic
Raw: 5.9x | Normalized: 1.8x
Fluctuates 0.3 to 1.1 per 10k

Cagrilintide

Stable, low volume
32 total cases, 7 misspellings found
Flat ~0.1 to 0.3 per 10k verbatims

Melanotan II

Possible late uptick
Feb 2026 spike (0.60/10k), small n

Tesofensine / SLU-PP-332

Too sparse
5 and 1 cases. Methodological value only.

Retatrutide: Raw vs Normalized

Bars = raw monthly cases (left axis). Line = rate per 10,000 verbatim records (right axis). If the line rises, the signal is real.

7-OH: Raw vs Normalized

Early months had high per-verbatim rates when few centers reported. From mid-2025 onward (adoption >50%), the upward trend is reliable.

Medetomidine: Raw vs Normalized

Normalized rate (line) is essentially flat. Raw bar growth is mostly adoption artifact.

Cagrilintide: Raw vs Normalized

32 total cases (including CagriSema combo product). Has its own product code (8618310). Coded under GLP-1 Agonists and Hypoglycemics: Other or Unknown. 7 misspellings found: cagliniide, cagrilinitide, cagrillintide, cargenlintide, cargrilintide, cagrisema, CagriSema.

Complete Monthly Data

Denominators from Dan's file 10 (ALL Calls) and file 11 (Verbatim Only), all GCs nationally. Substance counts from 71-GC dataset. March 2026† estimated from 5 days of data (x6.2). Rates use actual partial-month data (same 5/5 ratio in numerator and denominator).

Month All Cases Verb Cases Verb % Retat /10kV 7-OH /10kV Medet /10kV Cagri /10kV Melan /10kV

Methodology

Denominator: Total verbatim-containing closed cases per month across all GCs nationally, from "Case Log Counts Verbatim ONLY (11).xlsx" (1,913,218 total). This is the searchable pool: a substance can only be detected in a record that has a verbatim field.

Numerators: Substance-specific case counts from the 71-GC verbatim dataset (210,786 rows). Matched by regex on Verbatim and Product Code fields.

Rate: (substance cases / verbatim cases in month) x 10,000

March 2026 estimation: Dataset contains Mar 1-5 (5 days). Full-month estimates use factor of 31/5 = 6.2. Normalized rates are unaffected because both numerator and denominator cover the same 5 days.

Caveat: Numerator comes from 71 GCs; denominator covers all GCs. Absolute rates are conservative (denominator is broader). Trend direction is unaffected.

Cagrilintide Details

32 cases found across two product codes: Cagrilintide (8618310, 25 cases) and Semaglutide and Cagrilintide combo (8618352, 7 cases). Coded under two GCs: Hypoglycemics: Other or Unknown (0233000) and GLP-1 Agonists (0310100). 7 unique misspellings detected. 7 Moderate outcomes, 3 Minor, no deaths or Major effects. One case (Aug 2025) combined cagrilintide with retatrutide. Normalized rate is flat at ~0.1-0.3 per 10k verbatims, consistent with a low-volume approved pharmaceutical generating steady adverse event reports.