Eli Lilly at Goldman Sachs Conference: Navigating Policy and Growth

On Tuesday, 10 June 2025, Eli Lilly (NYSE:LLY) presented at the Goldman Sachs 46th Annual Global Healthcare Conference, addressing both opportunities and challenges in the pharmaceutical sector. The company discussed policy uncertainties, international market strategies, and its financial outlook, while emphasizing its commitment to reducing patient costs and expanding its market presence.

Key Takeaways

• Eli Lilly is focusing on reducing patient out-of-pocket costs and enhancing direct-to-consumer experiences.
• The company is experiencing strong growth in the GLP-1 class with Zepbound and Mounjaro.
• Financially, Eli Lilly expects mid- to high single-digit price erosion but maintains strong revenue guidance.
• The company is expanding its international presence, particularly in China, India, and Mexico.
• Ongoing clinical trials and business development activities align with strategic growth areas.

Financial Results

Eli Lilly reported a disciplined approach to pricing, with expectations of mid- to high single-digit price erosion across its portfolio. The company highlighted a significant 11 percentage point expansion in its operating margin in Q1 compared to the previous year, alongside a gross margin progressing to 82%-83%.

• Revenue guidance remains strong, driven by Zepbound and Mounjaro uptake.
• The company successfully maintains pricing separation between Medicare and commercial channels.
• Eli Lilly has regained market leadership in the GLP-1 class in Q1.

Operational Updates

Eli Lilly is advancing its market access and international presence:

• Opt-in access is increasing, with new constructs from payers potentially expanding employer access.
• International launches in China, India, and Mexico are progressing well, with Mounjaro now present in about 40 countries.
• Lilly Direct’s expansion includes incretins and direct shipment of Zepbound vials, along with telehealth services.

Future Outlook

Looking ahead, Eli Lilly is preparing for several critical data readouts and strategic initiatives:

• Clinical trial results for orforglipron and the SURPASS CVOT trial are anticipated in Q3.
• The company aims to secure a CV benefit label claim for tirzepatide.
• Ongoing development in Alzheimer’s treatment and preclinical studies like TB3 are underway.

Q&A Highlights

During the Q&A session, Eli Lilly addressed several key topics:

• The impact of the MFN executive order remains uncertain from a pricing perspective.
• Payer dynamics are consistent, with contracting cycles concluding in the summer.
• Telehealth services are helping to manage compounding issues for key medications.

For more detailed insights, please refer to the full transcript below.

Full transcript - Goldman Sachs 46th Annual Global Healthcare Conference:

Unidentified speaker, Conference Host: All right. Great. We’re just about at time, so we can get started here. Welcome to good day two of our health care conference. The weather is still holding up.

Thank God for that. Very pleased to kick off our morning session this morning with Eli Lilly. We have Lucas Montard, CFO and Mike Zappa, Senior Vice President, Investor Relations. Thank you, Lucas and Mike, for being with us. Happy to be here.

Thank you. Great. So I guess to kick off, Lucas, and we were talking a little bit about this at breakfast. We feel compelled just given the external environment, just to start with a big picture question, for all of our companies. And that’s all of these policy related uncertainties that are bearing down on the pharmaceutical sector.

It’s now about thirty days post the MFN executive So what can you tell us about how conversations with the administration have been going? What’s the status? And does it feel like there’s going to be resolution anytime soon?

Lucas Montard, CFO, Eli Lilly: Yes. No surprise. It’s always the question that I’m getting in each one of the conferences. Unfortunately, there is not much details at this time. Going back to your question about the conversations, the conversations are positive in general.

Again, they’re very receptive and hearing our thoughts on what we are focusing that is basically how we reduce patient out of pocket in The U. S. And we’ve had good examples of that similar to what we did, for example, with insulins a few years back that we reduced the price of the product to a cap to $35 So that’s one of the things that we share with the administration. The other one is they are very interested on direct to consumer. Again, it’s part of the executive order, so we shared the experiences that we had with Lidi Direct.

As you know, we implemented this type of approach that we go direct to the patients a few years ago, very successfully now with zip bound. So those are kind of the things that we’ve been sharing with the administration. Going back to your last question about anything imminent, we don’t know at this time. It’s hard to make any assumption about when, but they haven’t shared with us any details at this time of how are they thinking about this and even the scope associated with that as well.

Unidentified speaker, Conference Host: Okay. And I guess in a recent press conference, the administration talked about that they would support pharma in negotiating prices with Europe. Have those discussions with Europe been happening? And what have your interactions been on that front?

Lucas Montard, CFO, Eli Lilly: What we have seen so far is and I think it’s public information. You’ve seen that as part of the trade agreement with The U. K, they have included high level language associated with improving the health care system in The UK, including the pharmaceuticals as well, but nothing in detail. That’s starting point. We are not aware of any engagement on this regard with the rest of the European countries at this time.

As I mentioned, coming from all The U. S. Markets as well and having experience in Europe, this will require regulatory changes. So it’s not up to the pharma companies to set up the price. There is a system in place that you go through based on the value proposition that you bring to the product, and it’s usually compared versus the standard of care in each one of the market.

And based on that, it set up the price either at a premium or at parity to the standard of care. So if we want to change that, that will require regulatory changes. So not much that we are familiar with or aware at this time coming from the conversations with the administration. What we discussed so far has been more focused on

Unidentified speaker, Conference Host: The U. S. Side. Okay. Got it.

So maybe we can just shift the lens a little bit more towards Lilly specific questions. Just sticking with the pricing theme, obviously, it’s very much top of mind for the GLP-one class broadly on a number of different fronts. There’s obviously the MFN related concerns that have been brewing. And then there’s, of course, potential PBM related dynamics that could potentially affect pricing, too. So I guess starting with MFN and the Trump drug pricing policy agenda, how do you see that affecting the pricing dynamic in this market at all?

And how could it really play into potential pricing and really launch strategies? You’ve got offaglipperon potentially launching at some point this year. That’s going to be a global next year, that’s going to be a global product out of the gates. And it’s been framed by Dave as a sort of a GLP one for the masses. Yes.

Lucas Montard, CFO, Eli Lilly: Well, on MFN, it’s pretty much similar to what I shared before. It’s hard to speculate at this time implications from the pricing perspective. Thinking about new launches, you mentioned orforglipron to use that one as an example, our pricing strategy remains pretty much consistent even with MFN on how we think about pricing the products, which is based on the value proposition. It’s early days, so nothing that I’m planning to share today about, again, defining the price for ofroglipron. But that’s how we think about for all our portfolio, and ofroglipron will not be anything different from that perspective.

You mentioned payer dynamics. You all have seen the announcement from CVS a month or two ago. Also the other payers have confirmed open access for both basically ingredients on the obesity space. That has been our strategy. We remain disciplined on our pricing strategy as well.

So we are pleased again with those payers that provided open access. In the case of CVS, we see those payer dynamics happening all the time. That has been factoring our guide and our projections for the full year. And from the pricing point of view, we talk about, again, that our portfolio, our expectation was mid- to high single digit price erosion. Our view has not changed to that.

That’s a portfolio view. But of course, again, increasing is a big portion of our portfolio.

Unidentified speaker, Conference Host: And I guess as you on the payer dynamic front, as you think about the current contracting cycle, are you seeing anything that would potentially suggest greater price erosion than the high single digits or mid to high single digits that you’ve laid out in your guidance?

Lucas Montard, CFO, Eli Lilly: No. I think it’s very consistent. And when does that contracting cycle end? Contracting cycle is usually for the next year. It’s during the summertime.

Unidentified speaker, Conference Host: Okay. And Lucas, just you’ve talked a little bit about sort of limited spillover into the commercial channel from to the extent you do see pricing pressure on government channels. This market, however, is behaving a little bit differently than any other market we’ve seen in terms of the

Lucas Montard, CFO, Eli Lilly: So just given the consumer element, so what gives you confidence that those traditional barriers won’t start to cave? Yes. And I’ve been open about it, thinking about, in particular, the classes that we have been in the market for quite some time, including incretins in type two diabetes that we have been able to maintain that separation on pricing between, for example, Medicare and commercial and we have been successful to do so over time, very different payers, different of course patient populations as well. So we have been very successful to maintain that separation.

We don’t think about this one anything different in obesity. I will add that in the case of obesity we have also the out of pocket business as well that is growing very nicely and that’s repricing, right? Again, we set up the price ourselves and it’s completely separate from the negotiations with the payers as well. So we feel good about that separation even from the obesity space as well. Okay.

Unidentified speaker, Conference Host: Maybe we can then pivot to the demand side. When you look at script data, weekly patient starts for Zepbound have shown a very strong upward inflection. What can you tell us in terms of just framing demand dynamics at a high level, including any color on share capture from the compounding pharmacies? And then how are you thinking about the impact from the CVS formulary decision, which kicks in, in a couple of weeks?

Lucas Montard, CFO, Eli Lilly: Yes. Maybe stepping back, very pleased again with the progression of the class in terms of the market growth and penetration that we have seen. On top of that, you see again that after restarting basically our commercial efforts in Q4, we regain market leadership in the class in the first quarter of the year. So very pleased to see that. And that’s all very much in line to what I shared about the expectation for this year.

So very much consistent towards our guide and our expectations. In terms of the continuation of the class growth, we continue to actively pursue that. Again, on commercially, you see the DTC campaign out there, you see as well all the efforts that we do commercially. We continue to make progress on the access side as well. You see the opt in moving from high 40s to high 50s.

And there are new construct that some of the payers are announcing, including Cigna very recently, that could potentially open it up more opt in access for some employers that have not opt in so far. So we continue to see great progress of the class and penetration. Don’t expect to see any inflection point from my perspective. Going back to your question about component, it’s hard to see what is the size of the compounding business. We have been open about this.

And though we have been successfully legally on all the court rulings that we have seen so far, we don’t expect to see kind of a major inflection to happen all of a sudden. As you know, compounders are have shifted now to personalization, basically combining, again, incretins with other molecules or other vitamins and we are taking action legally as well, but it takes time for the FDA to enforce the removal of those compounders. So we are not assuming a major to take place anytime soon. But we are very pleased with the projections and the growth that we have seen. Another data point I think is worth to share at this time, you’ve seen that we announced several agreements with compounders or telehealth services that were compounding product as well, including Roe that we signed last December.

And how we construct our agreements is that we are enforcing in those agreements that as long as the product is out of the shortage list, that those telco services are not compounding either trisepatide or semaglutide, right? So it’s also another way to move those out and move into the original brands. So that’s just to give you a little bit more color on that. Maybe the last dynamic in terms of, again, modeling for the rest of the year, how the crops will continue to progress, it’s worth to know that there is seasonality. And we’ve seen that in the last year in type two diabetes, we’ve seen it for many years.

So there is more growth acceleration in the part of the year, start to slow down in the part of the year, continue to grow but not at the same pace. That’s what we have modeled as well for our projections for the part of this year. And then maybe just going back to the CVS formulary impact, any I can comment on that. Thank you for reminding me about that. So in the case of CVS, I’ve been open to sure that, again, roughly the template formulary that it has been moving to one of one is roughly 200,000 TRX.

What we have assumed on that is again to be that is going to be starting on July 1. But as you can imagine, with all the moves that happen with payers, it takes time to implement. Also there is a medical exception process that patients can go through and get that exception in place. So don’t expect that will be all of a sudden 100% of those TRx moving into the competition brand, but it will take time to see that happening. That’s kind of what we are modeling our projections as well.

Unidentified speaker, Conference Host: Okay. Let’s shift to the international launches.

Lucas Montard, CFO, Eli Lilly: Happy to talk about international.

Unidentified speaker, Conference Host: Maybe, Lukas, just remind us, high level, what does your guidance assume in terms of international uptick over the course of the year? And then maybe just give us some color on how these international launches are progressing. I mean, I read somewhere last week that the Mounjaro in India is just flying off the shelves. And so maybe just kind of give us some high level framing around that.

Lucas Montard, CFO, Eli Lilly: Yes. Happy to talk about international business. The launch sequence is progressing within the plans that we put in place. We showed in Q1 that now Stepan, well, Mounjaro, because we have only one brand in our U. S, is present in about 40 countries.

If you go back maybe to Q3 last year, we were talking about a dozen countries. So quite a lot of ramp up of countries that we launched both in Q4 and the first quarter of this year and very in line with our expectations. We talked about some of the large countries that we launched as well and we were openly talking about China, India and Mexico. So large patient populations, high unmet need that we just recently launched into those markets. So and then the progression of it’s early days, but we see very nice uptake similar to what we’ve seen in The U.

S, which has seen a couple of quarters in most of these markets becoming market leader. So and then the market, which is more important in these markets given the low penetration of the class is to expand the market. So and we continue to see very nice, again, uptake on how much the class is growing, but it’s early days at this time. Maybe the last data point you mentioned about this article about India. When you go and look at the details, that was the month of the product into the market and comparing versus the month, and we launched in the middle of the month.

So that comparison month to month, I don’t think that is a good proxy to use. But we are pleased with the launch uptake as well that we’ve

Unidentified speaker, Conference Host: seen in India. And I guess just going back to the pricing question on the international side, you have oral generics hitting several international markets, I believe starting next year or the year after that. So how do you see that impacting the pricing strategy for the tirzepatide complex globally overall?

Lucas Montard, CFO, Eli Lilly: Yes. Maybe one thing that is worth to note as well on the international markets because I focus my comments more on the obesity space. The other part going to your question about SEMA, we are also going through the process of getting reimbursement in type two diabetes as well. That takes time in all the markets to get that reimbursement. Usually the countries takes six months and it goes all the way to two years.

So we are going through the process of getting reimbursement for Mounjaro in type two diabetes. We are in Germany, Japan, U. K, Italy and The Netherlands. Those are usually the ones to go. We feel good about the launch sequence on those markets as well.

And price concessions in part of the all U. S. Markets when you go through their investment is very natural, and that has been factoring our assumptions. Like with all the generics, again, takes place as well in part of our assumptions when we think about the modeling on our projections OUS. Given the differentiation on the value proposition, we feel strongly about what we are bringing to the market and our ability to separate from the generics as well.

And then the channels, in particular, in many markets or U. S. As well, how the generics are being managed versus the originals is different, right? So for example, in China, you go through, for example, all the originals go through a national reimbursement process called NRDL. The generics go through a tender process called BBP, right?

So those are very different channels and they manage different pricing separate and apart from each other. So we feel good about our ability to continue to separate and maximize the opportunity for the originals as well O U. S.

Unidentified speaker, Conference Host: So I guess just hearing you speak, Lukas, just in terms of what you’re observing across the infotainment market right now, is it fair to say it’s generally consistent with your expectations when you set revenue guidance this year?

Lucas Montard, CFO, Eli Lilly: It is very consistent with our expectations. We put the bar high, as always, and you see that playing out in the results that we are seeing after starting commercialization back in fourth quarter. We feel very good about the uptake that we’ve seen for both Mounjaro and Step Bound and also the class penetration that we are seeing nowadays. So very much consistent with our guide. Take a pause there for any questions from the audience before moving on.

Unidentified speaker, Conference Host: Okay. Let’s maybe talk about BD, So just maybe starting with this Gamerus deal you did last week. Tell us a little bit about this drug delivery technology and just the strategy here in the context of your views on how market dynamics are unfolding in terms of optimal dosing schedules. Do you want

Lucas Montard, CFO, Eli Lilly: to comment on this one? Sure.

Mike Zappa, Senior Vice President, Investor Relations, Eli Lilly: I can speak to the specific transaction, and you can talk a bit more about broader BD. So we’ve got a large number of investments across different targets pursuing cardiometabolic health. And some of those are looking at, like I said, novel targets. Some of them are looking at less frequent dosing. And so this transaction adds the potential to move some of our medicines to potentially monthly dosing, which is part of the cover every square on the obesity development landscape strategy that we’ve got in place.

And so a nice addition. And as we think about less frequent dosing, it may have a little more applicability in a maintenance setting because as you’re starting up on a medicine, having the ability to intervene if there is something that you want to modify, it may be more beneficial to have a weekly dose. But a nice sort of a small transaction to help round out the early phase portfolio. And I guess,

Unidentified speaker, Conference Host: is this strategy of tuck ins you did another deal recently with SiteOne to expand your pain portfolio. Are these the types of deals that we should continue to expect? I mean you’re generating just a tremendous amount of cash. Is there any appetite at all to go larger?

Lucas Montard, CFO, Eli Lilly: Yes. So again, both you mentioned SiteOne. We did Scorpion as well in the first quarter in oncology, very nice asset, PI3K alpha inhibitor. Those are very much within our strategy, right, that we see that we can add value, we bring them early on, we put on our R and D engine and accelerate their development as well. So it’s our strategy and very much within our core therapeutic areas.

Thinking about large deals, we look at all the options always, but it’s hard to see how we can add value. When you look at the business cases, usually on many of the large deals, are bringing revenue, products in the market. Given the growth trajectory that we are experiencing nowadays, most of those are actually dilutive to our growth. So it’s hard to make that work as well. And then the value, of course, as well, when you look at it, is not actually adding value for the organization.

So we feel strongly about the strategy that we have in place to bring early phase, and we will remain disciplined on that. But it doesn’t mean that we are not looking at everything.

Unidentified speaker, Conference Host: Any there’s been a lot of excitement certainly in the oncology world about these PD L1 VEGF bispecifics. Any updated thoughts on your level of interest in potentially participating in that opportunity? Well, Mike

Lucas Montard, CFO, Eli Lilly: was the CFO in oncology, so he can comment more on the oncology assets as well.

Mike Zappa, Senior Vice President, Investor Relations, Eli Lilly: No. I mean it’s certainly closely, but we look broadly across all different targets, and we’ve been pretty active in oncology over the last couple of years, whether that’s, like Lucas mentioned, the Scorpion transaction, or we added a radioligand therapy platform. We added some antibody drug conjugates throughout the course of the last twelve to eighteen months, and those are all progressing quite nicely. So expect us to continue to be active and assessing the landscape.

Unidentified speaker, Conference Host: Let’s maybe talk about the cost base and just, I guess, just in the context of on the tariff front, I guess you’ve made some significant R and D and CapEx investments. And just high level, just do these influence spend in other areas or require any rethinking of the expense? Any updated thoughts on margins broadly?

Lucas Montard, CFO, Eli Lilly: Yes. That’s a good question. And we’ve seen other companies announcing restructuring and making adjustment on their cost basis. We feel strongly on the position that we are nowadays. Again, when you think about the last two, three years, the company has been basically growing at a fast pace, just last year, almost five, six times the average of the growth of the industry, right?

So and we are bringing new products to the market. So we are investing to fully maximize the launches and continue to advance our pipeline across the board. It doesn’t mean that we are not doing that with discipline and continue to expand the margins. Just looking at the first quarter of the year comparing versus the last the same quarter last year, we expanded 11 percentage points on our op margin, so significant expansion that we continue to see. But we are investing to maximize the opportunity.

Are we being disciplined? Yes. Just to give you a few examples in SG and A, all the investment that you’re seeing and the growth, I think, in the mid-20s in investment in SG and A growth versus the same quarter last year is mainly on variable. The fixed cost, what we call, again, commercial footprint and so on, we leverage the platform that we have globally to drive basically the launches globally as well. So we are not adding more sales force.

Very pleased as well on the progress on the gross margin because also the new sites are more efficient and we’re running the lines at full speed as well. So you see progress as well, gross margin getting into the 82%, 83%. So very nice progress. If you compare with any other peers, we are very competitive both in SG and A and R and D and gross margin. R and D, we are intentional, right?

We are more on the high end, but it’s also part of our BD strategy that we bring assets early on and that brings also the burning in the cost in the R and D as well because we put all of those assets in our R and D engine. But it has played out really well. And how we look at the productivity from R and D, Dave alluded to this many times, and I’ve been part of this journey as well, is thinking about future value of the pipeline comparing to the investment that we are doing, we are well above of all the industry peers even without the incretins as well. And then thinking about the speed of bringing molecules to the market that we are doing that at really super fast pace comparing with the average of the industry as well. That’s how we measure the productivity of our R and D engine.

Unidentified speaker, Conference Host: Okay. I will move away from the Encritment portfolio and get to the non Encritment portfolio,

Mike Zappa, Senior Vice President, Investor Relations, Eli Lilly: I promise. But I just want to

Unidentified speaker, Conference Host: touch really quickly on some of the key upcoming events that are top of mind for investors. Mike, maybe ADA is coming up. You guys are hosting something next Sunday night. Maybe talk to us about what Lilly is presenting, what we should be expecting.

Mike Zappa, Senior Vice President, Investor Relations, Eli Lilly: Sure. So three ADA sponsor sponsor symposia for Lilly at ADA upcoming. is the ACHieve one or for GLP-one Phase III trial, so the Phase III trial that we top lined recently. We put a lot of data in that press release, efficacy, safety, tolerability. So shouldn’t expect any major surprises from the presentation, but it’s an important milestone for an important program for us at Lilly to have the full detailed data disclosed.

The would be some Phase III updates, detailed data readout for our weekly basal insulin. And then the symposia is the what we consider really the initial proof of concept data set for Bimagromab. It’s a combination with semaglutide. It’s an IV administered formulation. So peek to what that looks like.

The key data sets we’re looking towards are actually the combinations with tirzepatide, which we’ll read out in the future. We also do have a Phase I presentation for our selective amylin agent, oloralintide. There’ll be a small section there as well. And we plan to do highlights across the whole portfolio on Sunday night with an investor event. So a quick plug for that as well.

And then SURPASS CVOT, that’s a trial that seems to be getting a little

Unidentified speaker, Conference Host: bit more mindshare. Guess the primary completion date is June 2025 for clinicaltrials.gov. So any update on timing there? And I think higher level, while that trial is powered to achieve superiority versus Trulicity, you frame non at the baseline. But why would that not create payer access coverage risk for the tirzepatide complex if it only achieves non inferiority?

Mike Zappa, Senior Vice President, Investor Relations, Eli Lilly: Sure. So timing, on track for Q3. So look for that data to come in the kind of months to come. In terms of the study, look, we set it up against a strong agent that has a CV benefit, so it’s a head to head versus Trulicity. Non inferiority for us is the path that we set as our base case.

The goal is just to get an updated to get a labeled claim, an indication for a CV benefit added to tirzepatide. Non inferiority gets that. And Trulicity is a really good agent that has strong data from the REWIND study in both primary and secondary prevention. In terms of how we think about it, look, right now, tirzepatide has really broad payer access in Mounjaro. It’s 90% plus.

You’ve got really strong usage in the diabetes setting. It’s a market leader by new prescriptions. And that’s without any CV data in the label. So when you then add in what we hope will be a non inferior study that adds CV indication, that can be nothing but positive data for both the payer and the prescriber discussion. Now taking a step back, that being said, as we look at when you’ve seen these data sets added to existing agents, when Trulicity got its rewind in the label, when some of the competitive data sets have been added to other labels, we don’t really see a meaningful change in prescription habits.

And so our expectation would be non inferiority or superiority. We don’t see that as a major prescriptions. So I know an important event that people are tracking is approximate, but it’s something that we’re looking forward to having the data readout, and we’ll be continuing from there. Helpful. Thank you for that.

Unidentified speaker, Conference Host: And then just last on opagliflozin, just any updated thoughts on ATTAIN-one framing that’s also coming up? And I think you’ve previously referenced SUMMOUNT5, which was the GLP-one injectable monotherapy trial that showed about 13.7% weight loss.

Lucas Montard, CFO, Eli Lilly: Yes. Go ahead, Lucas. Yes. We have you mentioned ATTAIN one, but we have pretty much every single quarter data readouts of ofroglopron coming, right? ATTAIN one gets a lot of attention.

That is the obesity study. We have ATTAIN two that is for obesity and patients with type two diabetes. And then we have several studies on type two diabetes as well that will read out in Q3 and Q4. I think it’s a CHIP2, a CHIP3, and a CHIP5 as well that will read out in the part of this year. So quite a lot of momentum on data readouts that will happen with orforglipron.

Going back to ATIN-one that is getting all the attention, yes, we’re referencing SIRMAN-five that is our study that we compared to sepetide with injectable semaglutide and again our expectations that we have been highlighting as well both in type two diabetes and obesity to be similar to injectable SEMA, right? And we have been successful on that in the type two diabetes. We feel good about again what is coming now and attained, though we don’t have visibility at this time. But we referenced that data point that it was in the double digit range. It was 13% that we’ve seen on SEMA in terms of weight reduction.

I think when you think about this type of asset that you bring on a small molecule, the differentiation on this one will be less about, again, how much weight loss. I think there is, again, a large patient population. If you want higher weight loss getting into that more high teens or into the twenty percent, you have tirzepatide. The benefit of this drug is to have an option that is a small molecule oral daily and that’s the differentiation that it has no restriction on intake as well. So that’s the differentiation.

And there is a large patient population that requires this level of weight reduction. So we see a large opportunity both in The U. S. And also OUS as well. Okay.

Well, we’ve got about five minutes for

Unidentified speaker, Conference Host: the non inscrutable So let’s try and we’ll do a bit of a rapid fire here. So I guess starting with neurology, there’s a lot of interest, particularly as Trailblazer comes into focus. And just maybe just, I guess, frame Lilly’s approach high level. And then just maybe double click on where we are with the Kesinla launch. What are the key readouts to watch?

Timing? Just how are things going on that side?

Lucas Montard, CFO, Eli Lilly: Yes. And I can share even a little bit of my own experience. I’ve been on the field visiting both diagnostic centers and also Kesandra prescribers. And again, modest initial uptake that we’ve seen but very much in line with our expectations. We share very openly that it will require quite some time to develop the ecosystem from detection, diagnosis to actually treatment taking place.

But we are pleased with the uptake that we are seeing. Forty percent of new prescriptions are going to Kesanla knowing that we launched behind Lekambi as well and it’s growing that. So very initial positive uptake and feedback from physicians that we are seeing. Nowadays, Kesanla is available in all infusion centers, broadly covered as well in The U. S.

So it’s off to a good start, but it will take time to continue to develop the ecosystem. The other, again, data readout that it gets a lot of attention is TB3 that is in preclinical for Alzheimer. That study will is fully enrolled and is completing by the second half of twenty twenty seven. But it’s an event driven study, so it could readout sooner than by the end of twenty twenty seven. Why is that also important, that study?

When you think about preclinical population, you are thinking about patients that have the pathology of amyloid already, but they have no symptoms or cognitive decline. And it’s a larger patient population as well. And also the benefit is the study is designed to be actually diagnosed with a blood biomarker, right, that is more convenient and more broadly used as well. So that could unlock or maybe remove one of the barriers that we see nowadays that is the diagnosis diagnostics, sorry. So that could unlock a significant opportunity as well.

So more to come. As I said, again, we are developing the ecosystem. Initial projections are very much in line with our expectations.

Unidentified speaker, Conference Host: And then maybe shifting to immunology. Epclis had some very encouraging U. S. Uptake in atopic derm. New patient starts are increasing.

Seems like you made pretty good progress on access and reimbursement. So maybe just any updated framing on that?

Lucas Montard, CFO, Eli Lilly: Yes. Happy to share. And as a reference, we launched Epilys in September. We started commercialization in October. Hopefully, you are seeing some of the commercialization efforts we have our DTC campaign out there on linear TV as well since Q1.

So early days, but very positive feedback. And in particular, in terms of the access, we already secured all major PBMs for the part of this year. So broad access similar to the competitor in the marketplace. So it’s off to a great start and we see this adding more optionality for physicians on how they think about their treatment as well. So very promising future ahead for Replies.

And then maybe just in the minute that’s left, can we just talk about the Milli Direct sort of Yeah.

Unidentified speaker, Conference Host: Like what’s the strategy here at a high level? I mean, initially, it seemed like it was I mean, it seems like you’re expanding it now into other areas. Like where are you how are you thinking about this strategically Is there an effort here to maybe think about potentially at some point moving out from the eliminating the middleman and going forward? Yes.

Lucas Montard, CFO, Eli Lilly: So just as a reference, Libidirect is a digital online pharmacy that we put in place two years ago, almost three years ago. It started with insulins and the migraine portfolio and Emgality. We added, again, last year our in creatines as well more on the obesity space. So we have Z band vials out of pocket as well that we ship directly to the patients. We talked already about the Z band vial progression that is, again getting a lot of momentum.

And we continue to improve the customer experience of this Lilly Direct solution and direct to the patients. We also offer again telehealth services or in person services. Those are all independent, but they are offered over there. And on those services, we also added Alzheimer as well, very recently that it was announced as being an infused product. Of course, we don’t ship the product, but again, we offer, again, the services of telehealth as well and helping to also unlock one of the restrictions that we are seeing that is the referral from GPs into neurologists that is taking so long as well.

So this could also unlock some opportunities in the future. So very pleased with the progress that we are seeing. It’s still early days on Libidirect. And then thinking about, again, step bound, we always talk about this as a I call it as a hedge as we continue to grow access, right? Again, while access continue to ramp up, expect again that will have an impact as well into Lilly Direct in my eyes because you think about patients that now can get access or the product basically fully covered or partially covered, they will always go for that access option versus the out of pocket option.

So think about that as a kind of a bridge solution until we continue to ramp up access. Okay. All right.

Unidentified speaker, Conference Host: Well, we are just about out of time. Thank you, Lucas. Thank you, Mike.

Lucas Montard, CFO, Eli Lilly: We appreciate it.

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