These companies use the creative forces of capitalism to solve big problems—and do well by doing good.

Pharmaceutical company Eli Lilly is known for breaking ground in insulin, polio vaccines, penicillin, and antidepressants, most famously developing Prozac. Now, in the age of GLP-1 medications, which have transformed obesity and diabetes treatment, the company has shown it can move fast. Eli Lilly brought tirzepatide (sold as Mounjaro and Zepbound) from clinic to market in six years, compared with the company’s usual 11-year development cycles. An ongoing battle for Lilly, as well as Novo Nordisk, involves fighting copycat versions of its GLP-1 products made by compounders, and forcing them to modify their disputed claims. The FDA has warned patients and health care professionals about the dangers of compounded GLP-1 drugs and unapproved weight-loss medicine.

Change the World

The companies on the Global 500 employ 70.2 million people, and their revenue represents more than one-third of the world’s GDP.

Fortune Global 500

With a combined revenue of $21 trillion and $2.1 trillion in profits, the 2026 Fortune 500 is the definitive list of America's largest companies.

Eli Lilly, the Indiana-based pharma company, is celebrating its 150th anniversary in grand style: Its revenues have tripled since 2018, to $65.2 billion last year. It owes its surge to Mounjaro (for diabetes) and Zepbound (for weight management), which together command about 60% of the manically growing U.S. market for GLP-1 drugs.

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The 300 companies on this year’s list brought in over $12.5 trillion in revenue for the latest 12 months, with the median revenue figure at $24 billion.

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Eli Lilly ranks 69 on this year’s Fortune 100 Best Companies to Work For – Europe list.

Fortune 100 Best Companies To Work For – Europe

The corporations on our annual list of the world's 500 largest companies combined to generate $41.7 trillion in revenue over the past year.

Almost $20 trillion in revenue—and a record-breaking $1.87 trillion in profits. Introducing the 2025 Fortune 500, the definitive list of the biggest companies in America.

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The Future 50

Founded over 145 years ago in Indianapolis, pharmaceutical company Eli Lilly established its first European affiliate in 1934. Lilly has provided more than two million doses of diabetes and cancer medicines to hospitals and patients in Ukraine via humanitarian partners, and its Foundation aims to extend Lilly's reach and impact and support programs that align with its philanthropic priorities. The pharma company's Skills First approach gives individuals without four-year degrees access to job opportunities that may not be available through traditional recruiting practices; apprentices receive a combination of formal training, on-the-job learning and mentoring in a key functional area to equip them for a full-time role.

The corporations on our annual list posted aggregate revenues of $41 trillion for the second year in a row.

Industries included in the sector are insurance and managed care, medical products and facilities, pharmacy services, and pharmaceutical companies.

Fortune Sector Leaders: Health Care

The Fortune 500, in its 70th year in 2024, ranks the biggest U.S. companies by revenue.

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WMA 2024-Eli Lilly

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This year’s Fortune 500 marks the 68th running of the list.

Total revenue for the world’s biggest companies fell 4.8% to $31.7 trillion this year—the first decline in half a decade.

This pharmaceutical giant has produced some of the most game-changing drugs in modern history, including the first commercially available insulin product for diabetics and Prozac, widely used by psychiatrists to treat depression. The company’s sales grew this year thanks in part to its antibody drug bamlanivimab, used for treating COVID-19.

This year’s Fortune 500 marks the 67th running of the list.

This year's Fortune 500 marks the 66th running of the list.

F500-2020-145-Eli-Lilly

The pharmaceutical giant was founded in Indianapolis in 1876. It introduced the world's first commercially available insulin product, Iletin, in 1923 for the treatment of diabetes. It was also the first company to manufacture and globally distribute Jonas Salk's polio vaccine. Today Lilly is known best for clinical depression drugs Prozac (1986) and Cymbalta (2004) and antipsychotic medication Zyprexa (1996), though its biggest revenue drivers are diabetes drugs Trulicity (2014) and Humalog (1996). Still headquartered in Indiana's capital city, the company made its largest acquisition ever in 2019 when it purchased Stamford, Conn.'s Loxo Oncology for $8 billion.

This year's Fortune 500 marks the 65th running of the list.

This year's Fortune 500 marks the 64th running of the list.

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This year's Fortune 500 marks the 63rd running of the list.

This year's Fortune 500 marks the 62nd running of the list.

This year's Fortune 500 marks the 61st running of the list. Wal-Mart claims the top spot again. See who made the list.

Wal-Mart stayed on top as its sales crept closer to half-a-trillion dollars. Apple moved into the top five. And UnitedHealth Group continued its steady climb. 

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Change The World

Impact Segment

Eli Lilly is the powerhouse behind today’s blockbuster drugs Mounjaro (tirzepatide), prescribed for weight loss; erectile-dysfunction treatment Cialis (tadalafil); Humalog, a rapid-acting insulin; and diabetes treatment Trulicity. Founded in 1876 by Civil War veteran Eli Lilly, it was the first to mass-produce insulin in the 1920s, one of the first to mass-produce penicillin during World War II, and an early producer of the polio vaccine. The company has also developed several major mental-health drugs, including Prozac (fluoxetine), one of the most widely prescribed selective serotonin reuptake inhibitors in the world. Eli Lilly operates in over 100 countries.

Q2 2026

Q1 2026

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Q3 2025

Q2 2025

Q1 2025

Q4 2024

Eli Lilly (LLY): Company Profile, Stock Price, News, Rankings

legacy

Eli Lilly

eli lilly

Ladies and gentlemen, thank you for standing by and welcome to the Lilly Q1 twenty twenty five Earnings Conference Call. At this time, all participants are in a listen only mode. Later, we will be conducting a question and answer session and instructions will be given at that time. I would now like to turn the conference over to your host, Mike Senior Vice President of Investor Relations. Please go ahead.

Good morning. Thank you for joining us for Eli Lilly and Company's Q1 twenty twenty five earnings call. I'm Mike Spar, Senior Vice President of Investor Relations. Joining me on today's call are Dave Briggs, Lilly's Chair and CEO Lucas Montarce, Chief Financial Officer Doctor. Dan Skoronski, Chief Scientific Officer and President of Lilly Immunology Anne White, President of Lilly Neuroscience Wieh Yufo, President of Lilly International Jake Van Narden, President of Lilly Oncology and Patrick Janssen, President of Cardiometabolic Health in Lilly USA.

We're also joined by Mark Hueman, Wes Tull and Wai Wong of the Investor Relations team. During this conference call, we anticipate making projections and forward looking statements based on our current expectations. Our actual results could differ materially due to several factors, including those listed on Slide four. Additional information concerning factors that could cause actual results to differ materially is contained in our latest Form 10 ks and subsequent filings with the SEC. The information we provide about our products and pipeline is for the benefit of the investment community.

It is not intended to be promotional and is not sufficient for prescribing decisions. As we transition to our prepared remarks, please note that our commentary will focus on our non GAAP financial measures. Now, I'll turn the call over to Dave.

Thank you, Mike. Q1 was another exciting quarter. We increased our revenue, advanced our pipeline, invested to drive future growth, and shared the first phase three clinical data from our oral GLP-one, or Forglopron. Dan will share more details during the R and D update, but we're pleased with the results from the Achieve one trial for Forglopron in patients with type two diabetes. These data met our expectations, and are the first steps to delivering our overall goal for the program, which is to create a medicine that offers injectable GLP-one like efficacy, safety and tolerability, with the convenience of a once daily pill, that can be manufactured at scale to meet global demand.

This scientific breakthrough has the potential to eventually impact hundreds of millions of people around the world with chronic diseases. And we expect phase three data from seven global clinical trials to read out over the next twelve months across type two diabetes and obesity. We also expect potential regulatory submissions for obesity to begin worldwide by the end of twenty twenty five. On slide six, we list Q1 financial metrics, and highlight progress related to our strategic deliverables. Revenue grew 45% compared to Q1 of twenty twenty four.

Our key products, defined as Evglis, Jaypirca, Kisunla, Monjaro, Umvoh, Verzenio, and Zefbound, grew by more than $4,000,000,000 and now account for $7,500,000,000 of revenue for the company. In addition to the aforigapron readout, we achieved several other key pipeline milestones this quarter. They include the approval of J PERCA in The EU for CLL, the approval of Omvoh in The US, EU, and Japan for Crohn's disease, and the initiation of a phase three program for olimarasib in resected adjuvant non small cell lung cancer. We also shared plans to more than double our manufacturing investment in The U. S.

In total, we've announced over $50,000,000,000 of new U. S. Manufacturing investments since 2020, including our most recent announcement to build four new facilities, of which three will be API, or active pharmaceutical ingredient facilities. Lastly, we distributed $1,300,000,000 in dividends in the first quarter, and executed a $1,200,000,000 share repurchase. We realize there's a lot of investor focus right now on tariffs and trade, so I'll make a few comments that reflect our current views on these complex and quite dynamic matters.

We support the U. S. Government's goals to increase domestic investment. However, we don't believe tariffs are the right mechanism. Enhanced tax incentives and or the extension of the Tax Cut and Job Act are better tools to achieve their goals.

The announcement the announced tariffs currently in effect do not materially change Lilly's twenty twenty five financial outlook. However, the expansion of tariffs in other geographies, or increases in retaliatory tariffs would have a negative effect on Lilly and for our industry. As a company, Lilly has a large US manufacturing footprint, with 10 active projects ongoing to build and expand new sites. Upon completion of our manufacturing agenda, we will be able to supply medicines for The US market entirely from US facilities, as well as increase the volume of medicines we export. We will continue to execute our U.

S. Manufacturing agenda, however, we urge the administration to negotiate deals with key trading partners as soon as possible, to level the playing field for American exporters like Lilly, and remove harmful tariffs and non tariff market access barriers in the developed economies. Now I'll turn the call over to Lucas to review our Q1 financial results.

Thanks, Dave. As shown on Slide seven, Q1 was another strong quarter of financial performance with revenue growing 45 compared to Q1 twenty twenty four, driven by our key products. Gross margin as a percentage of revenue was 83.5% in Q1, an increase of one percentage points versus the same quarter last year. Gross margin was positively impacted by improved production costs and favorable product mix, which were partially offset by lower realized prices. Marketing, selling and administrative expenses increased 26% as we invested in promotional activities to support new launches across our therapeutic areas.

R and D expenses increased 8%, driven by higher development expenses for late stage assets and additional investments in early stage research. In Q1, we recognized acquired IP R and D charges of $1,570,000,000 primarily related to the previously announced acquisition of Scorpion Therapeutics PI3K alpha inhibitor program. In total, IPR and D charges negatively impacted earnings per share by $1.72 Our non GAAP performance margin, which we define as gross margin less R and D, marketing, selling and administrative expenses as a percentage of revenue, was 42.6%, an increase of over 11 percentage points from Q1 twenty twenty four. Our Q1 effective tax rate was 20.2%. The Q1 tax rate was negatively impacted by the previously described non deductible acquired IPR and D charges.

At the bottom line, we delivered earnings per share of $3.34 in Q1, inclusive of the negative impact of 1.72 from acquired IPR and D charges. This compares to earnings per share of $2.58 in Q1 twenty twenty four, inclusive of $0.10 of acquired IPR and D charges. On Slide eight, we quantify the effect of price, rate and volume on revenue growth. U. S.

Revenue increased 49% in Q1, driven by strong volume growth of our key products, including SEPAN and MONCHARO, partially offset by a 7% decline in price. Moving to Europe, revenue increased 71% in constant currency. Q1 twenty twenty five was positively impacted by a one time benefit of $370,000,000 related to further restructuring our alliance with Boehringer Ingelheim. Excluding this benefit, constant currency revenue grew 46%, driven primarily by Moncharo, partially offset by a 7% decline in price. Japan revenue grew 15% in constant currency with volume growing 16% driven by Mounjaro and Jardiance.

Moving to China, Q1 revenue increased 21% in constant currency. Volume growth was primarily driven by Mounjaro. As a reminder, we recently initiated a limited Mounjaro launch in China with expectation to gradually increase commercial launch in the second half of twenty twenty five as supply becomes available. Revenue in the rest of the world increased 17% in constant currency, primarily driven by volume growth from Monjaro and to a lesser extent Verzenio. Slide nine provides an update on the performance of our key products.

Beginning with immunology, we have seen encouraging U. S. Uptake of at least in atopic dermatitis. New patient starts are increasing and we are making good progress securing access and reimbursement. Atlas is currently covered by two of the largest pharmacy benefit managers and we expect further access improvement later this year.

As of May 1, Atlas will be reimbursed on plans that account for sixty percent of people who are commercially insured. For Ombo, we have received approval of Crohn's disease across the globe as a second indication. Commercial activities is going to drive new patient starts in this larger patient population. Moving to oncology, JYPRICA was recently approved in Europe for relapsed or refractory CLL in patients who previously treated with a BTK inhibitor. We anticipate launches beginning in Q2.

We also expect readouts from additional global Phase three trials later this year, which we believe will be important to evaluate JYPRICA in earlier settings of CLL, including a head to head comparison with ibrutinib. Verzenio global sales grew 10% in Q1, as Verzenio continues to be the standard of care in high risk early breast cancer. As expected, we have seen some impact from competition in early breast cancer. However, Verzenio share of market in high risk early breast cancer is stable and total prescription to continue to grow. U.

S. Prescription grew by 7% in Q1, partially offset by the wholesaler inventory destocking in the quarter. International volumes for Fresenio grew 30% in Q1. Within neuroscience, GESUNLA is now approved in 12 countries. We have seen a steady increase in the use of blood based biomarkers.

The conversion rates from diagnosis to treatment and the number of new patients starting treatment in both The U. S. And Japan. While it is encouraging to see progress, we do still expect that it will take some time to build this market. We expect U.

S. Regulatory action for the modified dosing regimen for KISONLA in the next few months. Finally, moving to cardiometabolic health, both Mounjaro and Zepbound posted a strong revenue growth. MONJARO sales were $3,800,000,000 more than double the same quarter last year. In The U.

S, MONJARO exited Q1 as the market leader in new prescription within diabetes incretin Anadol. Outside The U. S, Moncharo has launched in over 40 countries and Q1 was another quarter of steady sequential growth. We recently launched in India and Mexico and plan to continue with additional countries throughout 2025. Our focus internationally is on seeking reimbursement for type two diabetes and developing the ecosystem to treat obesity as a chronic disease.

Performance was also robust as sales increased by $1,800,000,000 to $2,300,000,000 in the quarter. SEPAN is The U. S. Branded anti obesity market leader in both total prescription and new prescription, reaching sixty percent and seventy four percent respectively at the end of Q1. We also launched higher dose Zeppelin vials adding two additional doses for patients to access Zeppelin through the self pay channel.

The update of Zeppelin vials has been strong and vials accounted for approximately 10% of total prescription and 25% of new prescriptions in Q1. On Slide 10 is an update on trends in The U. S. Incretin Analog market, which includes incretin prescriptions in both type two diabetes and obesity. Q1 was another quarter of steady market growth as total prescriptions grew by 46% compared to Q1 twenty twenty four.

Lilly performance was strong as a four week rolling average share of market increased by five percentage points compared to Q4 twenty twenty four and by 10 percentage points compared to the same quarter last year. On Slide 11, we provide an update on capital allocation. Moving to slide 12 is our updated 2025 financial guidance. Our performance in Q1 was strong and we are encouraged by the underlying trends we saw across our portfolio of medicines. As a result, we are reaffirming our revenue and performance margin guidance.

Our non GAAP earnings per share guidance is unchanged, except for Q1 charges related to acquired IPR and D. As Dave mentioned, the situation regarding tail rates and tariffs remains dynamic. We continue to monitor the external environment however, we estimate that the announced tariff currently in effect will have a limited impact financially, which we have absorbed within our 2025 guide. Now I will turn the call over to Dan to highlight our progress on R and D.

Thanks, Lucas. I'll start with key data from our recently completed orforglipron Phase III trial and provide some context on our development plans and timelines for this important molecule. I've previously said that our hypothesis was that orforglipron could deliver efficacy, safety, and tolerability similar to the best seen for available GLP-one monotherapy injectables. I believe the results from Achieve one trial support that hypothesis. Let me start with efficacy.

Beginning on slide 13, you can see the reduction of 1.3% to 1.6 for hemoglobin A1c. Given the relatively low baseline of eight point zero in this forty week monotherapy study, patients on the two highest doses ended the study with a mean A1C of about 6.5%, similar to the lowest levels achieved in trials of other monotherapy GLP-one agonists. In fact, with orforglipron, more than sixty five percent of patients achieved an A1c less than or equal to six point five percent, which is below the American Diabetes Association's defined threshold for diabetes. In a key secondary endpoint, orforglipron also helped people with diabetes lose approximately sixteen pounds, or 7.9% of their body weight at the highest dose. These data are in line with weight loss demonstrated with existing injectable GLP-1s in patients with diabetes, especially when considering the baseline weight and other demographic factors in this trial.

Given that the study was only forty weeks in duration, participants had not yet reached a weight plateau at the conclusion of this study. This result is encouraging as we look ahead to our first phase three readout in people with obesity that we expect in Q3. Most importantly, we were pleased to see the safety profile of orforglipron in this trial. The most common adverse events were gastrointestinal, which is consistent with the GLP-one class. We did not see any hepatic safety issues in ACHieve one.

As you can see on slide 14, discontinuations due to adverse events were low, with only four percent to eight percent of patients discontinuing orfagliptron due to adverse events. The slow and stepwise dose escalation we utilized in phase three, combined with the relatively long, about twenty four hour half life of this molecule, resulted in a tolerability profile that matched our expectations and was consistent with weekly injectable GLP-1s. The Achieve one full results will be presented at the ADA's eighty fifth scientific sessions and will be published in a peer reviewed journal. This was the first of several Phase III trials that we'll read out for orforglipron. On slide 15, you can see how Achieve one fits into the broader orforglipron development program.

Over the next twelve months, we expect to get results from four additional diabetes trials, where we're studying orforglipron compared to insulin and head to head versus other oral diabetes medicines. We also expect to get results in our two obesity phase three trials, one trial in people with obesity without diabetes, and a second trial in people with obesity and diabetes. Assuming success in these Phase III programs, we plan to submit orforglipron for obesity in Q4 later this year, followed by type II diabetes in the first half of twenty twenty six. We also have an ongoing Phase maintenance setting, a phase three trial in obstructive sleep apnea in obesity. And we will initiate a phase three trial in hypertension later this quarter.

We look forward to seeing more data from this robust clinical development program as we continue to find the impact orforglipron can have for patients. Moving on to other R and D updates since our last call. On the regulatory front, following discussions with the FDA, we've withdrawn our application for the heart failure with preserved ejection fraction indication for tirzepatide. We believe the positive phase three data from the SUMMIT trial do support an indication. However, FDA indicated an additional confirmatory clinical trial is required.

Regulatory reviews are ongoing in other countries. Continuing with updates in cardiometabolic health, we're sharing today plans to initiate a new phase three trial studying our triple agonist, retreutide, in patients with obesity and chronic low back pain. We're also announcing today next steps for our oral once daily program targeting lipoprotein A, movalaplin. In Phase II data we presented last year, movalaplin lowered lipoprotein A levels by up to 85% at the highest tested dose. Based on these data, we plan to initiate a Phase III program later year in atherosclerotic cardiovascular disease, and we're excited about the potential to bring what could be the first ever oral small molecule approach for lowering lipoprotein A to patients.

Moving to oncology. We've now started a new phase three program with olimarasib in KRAS G12C mutant resected adjuvant lung cancer. This is the third potential indication that we're simultaneously pursuing for olimarasib. Across our therapeutic areas, we made good progress in our early phase portfolio, and we advanced five new medicines into phase I clinical trials, as shown on slide 16. I'll now turn the call back to Dave for closing remarks.

Thanks, Dan. We know uncertainties exist right now in trade tax and international relations. While Lilly is actively engaged in shaping the external environment, we're mostly focused on executing our winning strategy, discovering, developing, and making new medicines that can help people live healthier lives. We made good progress this quarter, and we are well positioned to deliver strong and sustained growth going forward. Now I'll turn the call over to Mike to moderate our Q and A session.

Thanks, Dave. We'd like to take questions from as many callers as possible. Consistent with prior quarters, we will respond to one question per caller, and we'll end the call promptly at 11AM. Paul, please provide the instructions for the Q and A session, and then we're ready for the first caller.

Certainly. At this time, we will be conducting a question and answer session. You. And the first question today is coming from Asad Haider from Goldman Sachs. Asad, your line is live.

Thanks. Thanks for taking the question. Dave, just in light of the CVS formulary announcement this morning, favoring Wegovy over Zepbound, there are clearly some investor concerns about the PBM dynamic in obesity, given what we've seen in other big health care markets in the past, where PBMs pit two companies against each other. So two part question. Number one, what is your expectation on market share dynamics in the next weeks and months from the CVS formulary loss?

And then second, can you talk to your strategy on how you're going be navigating an environment where we could see PBMs continue to try and restrict formulary access between Zepbound and Begovy? Thank you.

Yeah, thanks for the question. You know, we're not surprised that this kind of thing was announced. If we, you know, look at what's happening in the market, we're pretty deep into a replacement cycle, particularly on obesity, and tirzepatide, as we've highlighted on this call, is gaining a lot of market share, basically most of the growth in the categories happening with our medicine. Of course, you know, the private pay market is an important segment. We'd like to grow that segment, and we'd like to grow choice and access in that So we're not interested at all in one of one deals of reducing access and choice for doctors and patients.

We want to expand it. So this type of thing isn't too interesting to us, but it's understandable that it can happen and obviously in this one case did. Our focus is on making better medicines and more accessible medicines. Orforgoprion is a topic today, excited by the possibility of an oral that could be more widely distributed around the world and here in The US with GLP-one, injectable GLP-one like profile, like Dan highlighted. And of course on driving more advanced therapies as well, a combination or triple acting agents like ritagutide.

So that's our focus. It doesn't surprise me that this happened and we'll work through it, recognizing in this case as well, you know, we're talking about the templated lives at CVS and probably opt in rates for employers in the templated part of their book are pretty low compared to the national average, just to maybe inform your analysis. And we'll work through it. Our job will be to continue to drive share and preference for our brand. I think the team's done a great job of that year to date, and we'll continue to focus on that while we wait for the or for launch and Reddit data later this year.

Thanks Dave, thanks Assad. Next question please.

The next question will be from Geoff Meacham from Citibank. Geoff, your line is live.

Morning guys, thanks for the question. For Dan or for Dave, when you look at the positioning of Orfagliptron, is the ultimate goal to have meaningfully more indications enters appetite, just given the oral convenience. I think when you look beyond just weight loss would seem that broader cardio investment makes sense, but maybe also perhaps combos and INI or autoimmune and or even neuropsych. Thank you.

Great. Thanks, Jeff. We'll go to Dan talk about the orphan development strategy.

Yeah, thanks, Jeff. And I think you're correctly pointing out that oral medicine like orfagliptron could be acceptable for use in a number of broad indications, particularly primary care type indications. That's guided our thinking on indications that we're pursuing. I think coming out of this readout, we have even more confidence in this molecule and we'll aggressively pursue whatever directions we think work. Combinations surely are on the table where that makes sense for patients, particularly in disease areas where there could be synergy with other mechanisms.

Probably there are a number of good ideas in immunology and neuroscience, as you point out. Also just a reminder, Jeff, it's not our only oral incretin. We have another molecule behind that, and we're continuing to innovate with even multifunctional orals. So I'm pretty excited about what's yet to come here. And surely we start with type two diabetes and obesity, but more to come.

The next question is coming from Chris Schott from JPMorgan. Chris, your line is live.

Great. Thanks so much. Just another orfagliptron data. Just post the data we've seen here, can you just elaborate a bit more on the role you see orfagliptron playing in the core obesity and diabetes market relative to injectables? And maybe as part of that, any thoughts on what type of share you would envision orals taking in the market over time?

Great. Thanks, Chris. We'll go to Patrick to talk about the role of oral in the broader Engerton market.

Thanks a lot, Chris. I think there are significant opportunities here for foglepron. Just looking at the type two market today, we know that approximately fifty percent of patients have a preference for an oral, giving everything as equal on the efficacy and the safety side. And similarly on the obesity side, we know that we have approximately twenty five percent of the patients in The US suffering from needle fear. So I think that position us very nicely to be a first line incretin for both type two and chronic weight management.

The other benefits as well, I think with an oral here, we can scale and reach patients that is more or less impossible with only injectables. So I think it provides a huge global opportunity for us with ofoglepron and also from a manufacturing side, probably a significant benefit as well. So overall, I think tremendous opportunities here with both for open type two and obesity in The U. S. And other markets

have launched, but also to scale globally to an extent we can't do with injectables.

Maybe two quick adds there, segments that we're thinking about actively. One, of course, we're doing the maintain studies which switch people from injectable to oral to maintain weight loss. That's a big unmet need in the market. People like the idea of stepping down and using less medicine. They're trying things on their own now and will have science based solution using oral, which we think will be an attractive choice.

That data's not in hand yet, we need to wait for that to prove that out. But, you know, I think that that's an interesting segment that will probably grow quite large over time, Chris. The other one is reaching segments of the population that maybe have comorbid risk, maybe not comorbid disease, have overweight but not obesity, and don't need dramatic weight loss, but sustained lower body weight is an important factor in their long term health. We'll look at studies there, I think the prior question was alluding to that, in terms of indications that might be suitable for that space. So we have big ambitions here, and of course need to see the full data package come in on obesity, but a pretty exciting opportunity.

Great. Thanks, Patrick. Thanks, Dave. We're ready for the next question, please.

The next question will be from Terence Flynn from Morgan Stanley. Terence, your line is live.

Great. Thanks for taking the question. Two part on orfagliptron as well. I know you're obviously not going to comment directly on pricing at this point, but maybe just conceptually, if you're delivering the same profile as an injectable medicine, why would you decide to price lower, I guess, given you price to value? And then as you think about having a portfolio of weight loss medications potentially in 2026, does that give you additional leverage with some of these PBM discussions?

Okay. Going on the risk curve again, Terrence, with the two part question, but go to Patrick to weigh in the thoughts on the ORFO pricing and then the portfolio implications as well.

Well, thanks a lot, Terence. I think in terms of pricing, we normally don't comment on that until the time of launch, But I think truly having a portfolio in this space and as Dave shared earlier on oral that you actually could approach patients with a BMI above twenty seven lower BMIs, ghepsepathy probably will play as foundation for treatment of chronic weight management for quite some time to come and potentially a triple agonist where you could target people with a BMI above thirty five. So I think that gives us a position of strength in this marketplace.

Maybe just one like policy related add, like how do we think about pricing forward, especially in a category like this? The past was really about very high list prices and relatively deep discounts to leverage PBM access. And we've been very vocal about trying to move away from that past, basically to have a more transparent, closer pricing between list and net, maybe important to say that based on this morning's news as well. So we priced that bound at a discount to the competitor, some meaningful discount on list price with the idea of trying to squeeze those two numbers together. We'd like to continue that progress so that patients and payers have a more similar basis for cost sharing and net cost.

I think that's a better way forward. So just as Patrick and the team work on pricing strategies, etcetera, know that in the background we're trying to push these two numbers together over time, reduce gross to net spreads, have less rebate flow into the channel and more transparent overall pricing.

Great, thank you Dave, thank you Patrick. Next question please.

The next question will be from Mohit Bansal from Wells Fargo. Mohit, line is live.

Great, thank you very much for taking my question.

think going back to the CVS announcement this morning, there are two ways to look at it. I mean, one could be, which, you know, obviously the stop reaction is like that. It seems like, I mean, a Z bound versus the Gobi kind of price war, or the other way could be, I mean, looking at CVS comments, it seems like a lot of our employers did not opt in and CVS is finding a way to actually provide affordable access to this medicine. How do you view this development? And in longer term, think, is it better versus GLP-1s you see, or is it a GLP-1s versus the access situation you see this is going to evolve over a couple of years?

Thanks for the question, Mohit. I think, Dave, do you want to elaborate on some of the earlier comments about the CVS, Yeah,

actually, mean, think those are good questions to ask Novo and CVS, really. Just pointing out that the book of business we're talking about is smaller employers who tended to let, you know, take the templated formulary, the opt in rates already are low. So it is possible that depending on what net price that CVS is going offer this client, so you get more opt in. I think that's a net good thing overall, because what we see despite the press is when employers opt in, tend to not opt out. Employees like to be on these medicines and there's a big study yesterday you may have seen from Aon, which looked at real world data, which is very compelling.

Within two years there's ROI, a 40% reduction in MACE events in the real world, etcetera. So that could be good as you're saying. On the other hand, I guess we're focused on innovation and differentiation. We see kind of a mega category here that will have many different choices and solutions. And it seems like the wrong idea to reduce choice.

Maybe there's patients who are taking Zepbound in one of these formularies and as of July 1 they won't have that choice, I think they'll be quite upset about that. And we'll see how the market reacts and how much share it gets moved ultimately, but as I said, our preference is to expand access, not reduce it.

Next question will be from Alex Hammond from Wolfe. Alex, your line is live.

Thanks for taking the question. Just one quick one on TRAILblazer ALLS-three. So, during the 4Q call, Dan mentioned that the team is closely watching the preclinical trial, and the study will read out when the target number of progression events were accrued. Can you update us as to where we are from that event's point of view and remind us of what a successful trial looks like? Thank you.

Great. Thanks, Alex. We'll go to Anne for the welcome question on the Alzheimer's portfolio.

Yes. Thanks so much for the question on Alzheimer's. And as we mentioned in the past, we have completed enrollment in the TB3 study, and as you said, it's an event based study, so the timeline for the readout is driven by this. And although our clinicaltrials.gov lists the date in 2027, we believe it could be earlier than that, so we're looking forward to that. Now, these are patients who have elevated levels of amyloid but no detectable symptoms, and our goal is to significantly reduce the risk that people ever experience the symptoms of Alzheimer's disease.

So that's the goal of the study. The actual endpoint is time to event of clinical progression, and we measure that by the CDR global score. So really preventing people from moving to the symptomatic stage, which is the stage at which the greatest impact is happening. So what we saw on TB2 obviously got us very excited about the potential outcome here with the fact that patients earliest in disease and early symptomatic did so well and had such a significant slowing of progression, sixty percent. So we'll look forward to sharing more as the events occur, and again, we'll share more timing when we have those events reached.

Great. Thanks, Anne. Next question, please.

The next question will be from Seamus Fernandez from Guggenheim. Seamus, your line is live.

Thanks for the question. So I'll go with another non obesity question. How is Evolus tracking against your ambition of it being a best in class launch? Is your vision for peak sales in line with consensus sales of $2,000,000,000 or do you see an opportunity materially higher than that? And if not, is the barrier related to Sanofi's claimed rebate wall or something else like the breadth of the label or perceived efficacy differentiation?

Great. Thanks Seamus. We'll go to Dan to talk about the Evolus launch dynamics and some goals for the brand.

Yeah, thanks Seamus. We certainly do have high aspirations for Eglis. It's a great medicine. We saw amazing data in our clinical trials. I think this prepared us well to take on the market leader in atopic derm, which is a large and growing market.

And in the early months of launch, we've seen good uptake, as you can see reflected in the numbers. And I think probably most telling is what we're seeing and hearing from physicians. Initially, I think in any launch, people try it in their most severe patients, people who might have failed other therapies. And when they see good responses there, they move it into the first line setting. That's exactly the motion we're seeing from physicians.

They're happy with the results they're getting, and they're using it more and more. A lot of work to do, and you point out the heavy competitive dynamics, but I like the asset I have. In terms of the rebates and coverage, I think as Lucas said, we're seeing a growing coverage here in The United States. And I think we'll overcome any issues there without trouble. So we look forward to broad access and continued accelerating uptake.

Great, thank you, Dan. Next caller, please.

The next question will be from Tim Anderson from Bank of America. Tim, your line is live.

Thank you. A question on kind of going back to formulary positioning in obesity. So I know you don't want to play the one of one formulary game, but it's still something that might occur anyway because Novo's losing share to you, and price is really the only lever they can pull at the moment. And some payers will look at one of one as a way to manage spend. I know that some states have already taken that approach.

Now we're seeing CVS do it. So really the question is, I guess, of covered lives today, what percent of payers already are having this one of one approach? And just, again, your view for how this is going to evolve going forward, whether you like it or not. Thank you.

Thanks, Tim. For the next question on CVS, we'll go to Patrick.

Yeah, thanks very much, Tim. You know, one on one is quite rare in the marketplace today when it comes to obesity. And as Dave said earlier, we deal with contract negotiations all the time and we're not entirely surprised with the announcement this morning, taking into account Setbounds strong performance. For us, we will just continue to execute as strongly as we can and I think we have a tremendous momentum in the marketplace with a net switch that is quite significant to Setbounds in the marketplace. We will continue those efforts across the PBMs, Medicaid and North America and of course our self pay effort with VIALS as well.

Thank you, Patrick. Next question please.

The next question will be from Evan Seigerman from BMO Capital Markets. Evan, your line is live.

Eli Lilly (LLY) Q1 2025 Earnings Call Transcript

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