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If drug levels are not measured, how does the article say efficacy gets confirmed

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Based on the typical UK regulatory pathway, the most realistic timeline is: Late 2026 / early 2027: Eli Lilly expected to submit regulatory filings to the FDA and MHRA following completion of the remaining TRIUMPH Phase 3 readouts Late 2027 to mid-2028: Possible MHRA marketing authorisation, allowing private UK prescribing 2028 to 2029 onwards: Possible NHS availability following a NICE technology appraisal and NHS commissioning decisions Timelines may differ across the four UK nations, as Scotland, Wales, and Northern Ireland assess medicines separately through the Scottish Medicines Consortium (SMC), All Wales Medicines Strategy Group (AWMSG), and the Department of Health Northern Ireland respectively