Q1 2026 Eli Lilly & Co Earnings Call

April 30, 2026

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Operator 3: Ladies and gentlemen, thank you for standing by. Welcome to the Lilly Q1 2026 earnings conference call. At this time, all participants are in a listen-only mode. Later, we will be conducting a question-and-answer session. Instructions will be given at that time. Should you require assistance during the call, please press star then 0. An operator will assist you offline. I would now like to turn the conference over to your host, Mike Czapar, Senior Vice President of Investor Relations. Please go ahead.

Operator: Ladies and gentlemen, thank you for standing by. Welcome to the Lilly Q1 2026 earnings conference call. At this time, all participants are in a listen-only mode. Later, we will be conducting a question-and-answer session. Instructions will be given at that time. Should you require assistance during the call, please press star then 0. An operator will assist you offline. I would now like to turn the conference over to your host, Mike Czapar, Senior Vice President of Investor Relations. Please go ahead.

Speaker #3: welcome to the LILLY Q1 2026 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. require assistance during the call, please press star, then zero, and an operator will assist you offline.

Speaker #3: ahead.

Speaker #4: Good morning. Thank you for joining us for ELI LILLY & Co Q1 2026 earnings call. I'm Mike Czapar, Senior Vice President of Investor Relations.

Mike Czapar: Good morning. Thank you for joining us for Eli Lilly and Company's Q1 2026 earnings call. I'm Mike Czapar, Senior Vice President of Investor Relations. Joining me on today's call are David Ricks, Lilly's Chair and CEO, Lucas Montarce, Chief Financial Officer, Dr. Daniel Skovronsky, Chief Scientific and Product Officer, Adrienne Brown, President of Lilly Immunology, Dr. Carole Ho, President of Lilly Neuroscience, Ilya Yufa, President of Lilly USA and Global Customer Capabilities, Jacob Van Naarden, President of Lilly Oncology, Head of Business Development, Patrik Jonsson, President of Lilly International, and Kenneth Custer, President of Lilly Cardiometabolic Health. We're also joined by the Investor Relations team, Jim Graffey, Susan Hedgedin, Mark Heman, and Wes Hall. During this call, we anticipate making projections and forward-looking statements based on our current expectations. Our actual results could differ materially due to various factors, including those listed on slide 4.

Mike Czapar: Good morning. Thank you for joining us for Eli Lilly and Company's Q1 2026 earnings call. I'm Mike Czapar, Senior Vice President of Investor Relations. Joining me on today's call are Dave Ricks, Lilly's Chair and CEO, Lucas Montarce, Chief Financial Officer, Dr. Daniel Skovronsky, Chief Scientific and Product Officer, Adrienne Brown, President of Lilly Immunology, Dr. Carole Ho, President of Lilly Neuroscience, Ilya Yufa, President of Lilly USA and Global Customer Capabilities, Jacob Van Naarden, President of Lilly Oncology, Head of Business Development, Patrik Jonsson, President of Lilly International, and Kenneth Custer, President of Lilly Cardiometabolic Health. We're also joined by the Investor Relations team, Jim Graffey, Susan Hedgedin, Mark Heman, and Wes Hall. During this call, we anticipate making projections and forward-looking statements based on our current expectations. Our actual results could differ materially due to various factors, including those listed on slide 4.

Speaker #4: Joining me on today's call are Dave Ricks, LILLY's Chair and CEO, Lucas Montarce, Chief Financial Officer, Dr. Dan Skovronsky, Chief Scientific and Product Officer, Adrian Brown, President of LILLY Immunology, Dr. Carol Ho, President of LILLY Neuroscience, Ilya Yufa, President of LILLY USA and Global Customer Capabilities, Jake Van Narden, President of LILLY Oncology.

Speaker #4: Of Business Development, Patrick Johnson, President of LILLY International, and Ken Custer, President of LILLY Cardiometabolic Health. We're also joined by the Investor Relations team, Jim Graffe, Susan Hedgeland, Mark Keeman, and Wes Tall.

Speaker #4: During this call, we anticipate making projections and forward-looking statements based on our current expectations. Our actual results could differ materially due to various factors, including those listed on slide four.

Speaker #4: Additional information concerning factors that could cause actual results to differ materially is contained in our latest Form 10-K and subsequent filings with the SEC.

Mike Czapar: Additional information concerning factors that could cause actual results to differ materially is contained in our latest Form 10-K and subsequent filings with the SEC. The information we provide about our products and pipeline is for the benefit of the investment community, unintended to be promotional or otherwise influencing prescribing decisions. As we transition to our prepared remarks, please note our commentary will focus on non-GAAP financial measures. Now I'll turn the call over to Dave.

Speaker #4: The information we provide about our products and pipeline is for the benefit of the investment community. Intended to be promotional or otherwise influencing prescribing decisions.

Speaker #4: As we transition to our prepared remarks, please note our commentary will focus on non-GAAP financial measures. Now, I'll turn the call over to Dave.

Speaker #5: Thanks, Mike. 2026 is off to a strong start. During the quarter, we delivered robust revenue growth, advanced our pipeline across all four therapeutic areas, announced multiple business development transactions, and invested to drive our future growth.

David Ricks: Thanks, Mike. 2026 is off to a strong start. During the quarter, we delivered robust revenue growth, advanced our pipeline across all 4 therapeutic areas, announced multiple business development transactions, and invested to drive our future growth. Earlier this month, we achieved an important milestone as Orforglipron was approved by the US FDA under the trade name Mounjaro. Mounjaro has been proven highly effective for weight management, offering the benefits of GLP-1 therapy in a pill form and can be taken at any time of day without food or water restrictions. Mounjaro is a new molecule, a new modality for agonizing GLP-1, and it's a new brand. This is the first time a new incretin medicine has been launched with obesity as its indication first. While the Mounjaro launch has just begun, we're encouraged by momentum against our 2026 launch priorities.

Dave Ricks: Thanks, Mike. 2026 is off to a strong start. During the quarter, we delivered robust revenue growth, advanced our pipeline across all 4 therapeutic areas, announced multiple business development transactions, and invested to drive our future growth. Earlier this month, we achieved an important milestone as Orforglipron was approved by the US FDA under the trade name Mounjaro. Mounjaro has been proven highly effective for weight management, offering the benefits of GLP-1 therapy in a pill form and can be taken at any time of day without food or water restrictions. Mounjaro is a new molecule, a new modality for agonizing GLP-1, and it's a new brand. This is the first time a new incretin medicine has been launched with obesity as its indication first. While the Mounjaro launch has just begun, we're encouraged by momentum against our 2026 launch priorities.

Speaker #5: Earlier this month, we achieved an important milestone as our Forgopron was approved by the US FDA under the trade name Condeo. Condeo has been proven highly effective for weight management, offering the benefits of GLP-1 therapy in a pill form, and can be taken at any time of day without food or water restrictions.

Speaker #5: Condeo is a new molecule, a new modality, for agonizing GLP-1, and it's a new brand. This is the first time a new incretin medicine has been launched with obesity, as it's indication first.

Speaker #5: While the Condeo launch has just begun, we're encouraged by momentum against our 2026 launch priorities. These are: broad digital and traditional distribution availability, high levels of awareness with consumers of this new option for weight management, educating a broad group of HCPs, helping them start new patients and get comfortable with the new GLP-1 molecule, and of course, building broad access in commercial, Medicare via the BRIDGE program, and later Medicaid access for patients.

David Ricks: These are broad digital and traditional distribution availability, high levels of awareness with consumers of this new option for weight management, educating a broad group of HCPs, helping them start new patients and get comfortable with a new GLP-1 molecule, and of course, building broad access in commercial, Medicare via the Bridge program, and later Medicaid access for patients. While the US approval is an important first step, there are over 1 billion people around the world with obesity and related conditions that can be helped by taking an incretin like Mounjaro. Recall that a key advantage of Mounjaro is scalability, and that oral GLP-1s for obesity have not yet been introduced outside the US.

Dave Ricks: These are broad digital and traditional distribution availability, high levels of awareness with consumers of this new option for weight management, educating a broad group of HCPs, helping them start new patients and get comfortable with a new GLP-1 molecule, and of course, building broad access in commercial, Medicare via the Bridge program, and later Medicaid access for patients. While the US approval is an important first step, there are over 1 billion people around the world with obesity and related conditions that can be helped by taking an incretin like Mounjaro. Recall that a key advantage of Mounjaro is scalability, and that oral GLP-1s for obesity have not yet been introduced outside the US.

Speaker #5: And while the US approval is an important first step, there are over 1 billion people around the world with obesity and related conditions that could be helped by taking an incretin-like Condeo.

Speaker #5: Recall that a key advantage of Condeo is scalability. And that oral GLP-1s for obesity have not yet been introduced outside the US. Regulatory reviews are ongoing in over 40 countries for obesity and type 2 diabetes.

David Ricks: Regulatory reviews are ongoing in over 40 countries for obesity and type 2 diabetes, and we plan to submit Mounjaro in the US for type 2 diabetes later this quarter. Included in the US type 2 diabetes submission will be the results from the ACHIEVE-4 trial, which we shared a few weeks ago. In the 7th positive phase 3 registration trial, Foundayo showed cardiovascular safety and a lower risk of all-cause death in adults with type 2 diabetes and obesity without increased cardiovascular risk. In addition to the obesity and diabetes programs, we are actively studying Foundayo in 6 phase 3 programs in other diseases, and we will continue to generate new data for this important new medicine in the quarters and years to come.

Dave Ricks: Regulatory reviews are ongoing in over 40 countries for obesity and type 2 diabetes, and we plan to submit Mounjaro in the US for type 2 diabetes later this quarter. Included in the US type 2 diabetes submission will be the results from the ACHIEVE-4 trial, which we shared a few weeks ago. In the 7th positive phase 3 registration trial, Foundayo showed cardiovascular safety and a lower risk of all-cause death in adults with type 2 diabetes and obesity without increased cardiovascular risk. In addition to the obesity and diabetes programs, we are actively studying Foundayo in 6 phase 3 programs in other diseases, and we will continue to generate new data for this important new medicine in the quarters and years to come.

Speaker #5: And we plan to submit Condeo in the US for type 2 diabetes later this quarter. Included in the US type 2 diabetes submission will be the results from the ACHIEVE4 trial, which we shared a few weeks ago.

Speaker #5: In the seventh positive phase three registration trial, Condeo showed cardiovascular safety and a lower risk of all-cause death in adults with type 2 diabetes and obesity, without increased cardiovascular risk.

Speaker #5: In addition to the obesity and diabetes programs, we're actively studying Condeo in six phase three programs in other diseases. And we will continue to generate new data for this important new medicine in quarters in the quarters and years to come.

Speaker #5: On slide five, you will we list the Q1 financial metrics in the highlights of our progress related to the strategic deliverables of LILLY. Revenue grew 50.6% compared to Q1 2025.

David Ricks: On slide 5, we list the Q1 financial metrics and the highlights of our progress related to the strategic deliverables of Lilly. Revenue grew 56% compared to Q1, 2025. Our key products currently defined as Ebglyss, Inluriyo, Jaypirca, Kisunla, Mounjaro, Omvoh, and Zepbound grew by more than $7 billion. Within key products, our immunology, oncology, and neuroscience medicines collectively grew by 160% compared to the same quarter last year as we continue to invest to drive growth across all of our therapeutic areas. In addition to the progress on Foundayo, we achieved several key pipeline milestones since our last earnings call, including positive phase 3 data for Jaypirca in combination with a time-limited regimen in adults with previously treated CLL. Positive phase 3 data for Ebglyss in pediatric atopic dermatitis.

Dave Ricks: On slide 5, we list the Q1 financial metrics and the highlights of our progress related to the strategic deliverables of Lilly. Revenue grew 56% compared to Q1, 2025. Our key products currently defined as Ebglyss, Inluriyo, Jaypirca, Kisunla, Mounjaro, Omvoh, and Zepbound grew by more than $7 billion. Within key products, our immunology, oncology, and neuroscience medicines collectively grew by 160% compared to the same quarter last year as we continue to invest to drive growth across all of our therapeutic areas. In addition to the progress on Foundayo, we achieved several key pipeline milestones since our last earnings call, including positive phase 3 data for Jaypirca in combination with a time-limited regimen in adults with previously treated CLL. Positive phase 3 data for Ebglyss in pediatric atopic dermatitis.

Speaker #5: Our key products currently define as EBGLIS, INLURIO, JPERCA, KISUNLA, MONJARO, OMVAL, and ZEPBOUND grew by more than 7 billion dollars. Within key products, our immunology, oncology, and neuroscience medicines collectively grew by 160% compared to the same quarter last year.

Speaker #5: As we continue to invest to drive growth across all of our therapeutic areas. In addition to the progress on Condeo, we achieved several key pipeline milestones since our last earnings call, including positive phase three data for JPERCA, in combination with a time-limited regimen in adults with previously treated CLL.

Speaker #5: Positive phase three data for EBGLIS in pediatric atopic dermatitis. Positive phase three data for TALTS plus ZEPBOUND in adults with psoriasis and obesity. Positive phase three data for retacritide in adults with type 2 diabetes.

David Ricks: Positive phase 3 data for Taltz plus Zepbound in adults with psoriasis and obesity. Positive phase 3 data for retatrutide in adults with type 2 diabetes, and the initiation of a new phase 3 programs for alorglutide, sofetamab, mepatecan, and Brenipatide. Consistent with our capital allocation strategy to expand investments in business development, we announced agreements to acquire multiple companies with clinical-stage programs. Orna Therapeutics, a company with an in vivo CAR T pipeline to treat autoimmune diseases. Centessa Pharmaceuticals, a company developing a new class of medicines for the treatment of excessive daytime sleepiness and other neurological conditions. Colonia Therapeutics, a company developing an in vivo platform to treat multiple myeloma and other cancers. Ajax Therapeutics, a company developing next-generation JAK inhibitors for people with blood cancers.

Dave Ricks: Positive phase 3 data for Taltz plus Zepbound in adults with psoriasis and obesity. Positive phase 3 data for retatrutide in adults with type 2 diabetes, and the initiation of a new phase 3 programs for alorglutide, sofetamab, mepatecan, and Brenipatide. Consistent with our capital allocation strategy to expand investments in business development, we announced agreements to acquire multiple companies with clinical-stage programs. Orna Therapeutics, a company with an in vivo CAR T pipeline to treat autoimmune diseases. Centessa Pharmaceuticals, a company developing a new class of medicines for the treatment of excessive daytime sleepiness and other neurological conditions. Colonia Therapeutics, a company developing an in vivo platform to treat multiple myeloma and other cancers. Ajax Therapeutics, a company developing next-generation JAK inhibitors for people with blood cancers.

Speaker #5: And the initiation of a new phase three program for Alorilintide, Sofedabart mipetican, and Brinapitide. Consistent with our capital allocation strategy to expand investments in business development, we announced agreements to acquire multiple companies with clinical stage programs.

Speaker #5: Orna Therapeutics, a company with an in vivo CAR-T pipeline to treat autoimmune diseases. Synthesa Pharmaceuticals, a company developing a new class of medicines for the treatment of excessive daytime sleepiness, and other neurologic conditions.

Speaker #5: Colonial Therapeutics, a company developing an in vivo platform to treat multiple myeloma and other cancers, and Ajax Therapeutics, a company developing next-generation JAK inhibitors for people with blood cancers.

Speaker #5: We expect to remain active in business development to complement our internal portfolio. Well-maintaining the discipline to create shareholder value. We also distributed 1.5 billion dollars in dividends in the first quarter and executed 2.4 billion dollars in share repurchases.

David Ricks: We expect to remain active in business development to complement our internal portfolio while maintaining the discipline to create shareholder value. We also distributed $1.5 billion in dividends in Q1 and executed $2.4 billion in share repurchases. Two important updates occurred this quarter to expand access to obesity medications. First, we launched Lilly Employer Connect. This is a platform introduced as a new way for employers to offer obesity management medicines to their employees. While it's still very early for this innovative model, we're encouraged by the level of employer interest. Second, CMS announced the extension of the Medicare GLP-1 Bridge program, which provides access to obesity medicines to people with Medicare. The program will begin no later than 1 July 2026 and run through December 2027.

Dave Ricks: We expect to remain active in business development to complement our internal portfolio while maintaining the discipline to create shareholder value. We also distributed $1.5 billion in dividends in Q1 and executed $2.4 billion in share repurchases. Two important updates occurred this quarter to expand access to obesity medications. First, we launched Lilly Employer Connect. This is a platform introduced as a new way for employers to offer obesity management medicines to their employees. While it's still very early for this innovative model, we're encouraged by the level of employer interest. Second, CMS announced the extension of the Medicare GLP-1 Bridge program, which provides access to obesity medicines to people with Medicare. The program will begin no later than 1 July 2026 and run through December 2027.

Speaker #5: Two important updates occurred this quarter to expand access to obesity medications. First, we launched LILLY Employer Connect, this is a platform introduced as a new way for employers to offer obesity management medicines to their employees.

Speaker #5: While it's still very early for this innovative model, we're encouraged by the level of employer interest. Second, CMS announced the extension of the Medicare GLP-1 BRIDGE program, which provides access to obesity medicines to people with Medicare.

Speaker #5: The program will begin no later than July 1st, 2026. And run through December 2027. This program has the potential to help improve the health of millions of seniors while capping their out-of-pocket costs at $50 per month.

David Ricks: This program has the potential to help improve the health of millions of seniors while capping their out-of-pocket costs at $50 per month. Now I'll turn the call over to Lucas to review our Q1 financial results.

Dave Ricks: This program has the potential to help improve the health of millions of seniors while capping their out-of-pocket costs at $50 per month. Now I'll turn the call over to Lucas to review our Q1 financial results.

Speaker #5: Now I'll turn the call over to Lucas to review our Q1 financial results.

Speaker #4: Thanks, Dave. As shown on slide six, Q1 was another strong quarter of financial performance. Revenue grew 56% compared to Q1 2025, driven by ZEPBUND and MONJARO, and solid momentum across all therapeutic areas and geographies.

Lucas Montarce: Thanks, Dave. As shown on slide 6, Q1 was another strong quarter of financial performance. Revenue grew 56% compared to Q1 2025, driven by Zepbound and Mounjaro and solid momentum across all therapeutic areas and geographies. Gross margin as a percentage of revenue was 82.6% in Q1, a decrease of approximately 1 percentage point versus the same quarter last year. The change was driven primarily by lower list prices. Marketing, selling, and administrative expenses increased 19% as we continue to invest in promotional activities to support ongoing and planned new product launches. R&D expenses increased 28%, driven by continued investments in our pipeline, including 42 active phase 3 programs. Our non-GAAP performance margin was 50%, an increase of approximately 7 percentage points from Q1 2025, driven by revenue growth.

Speaker #4: Gross margin as a percentage of revenue was 82.6% in Q1, a decrease of approximately 1 percentage point versus the same quarter last year. The change was driven primarily by lower prices.

Speaker #4: Marketing, selling, and administrative expenses increased 19%. As we continue to invest in promotional activities to support ongoing and plan new product launches. R&D expenses increased 28%, driven by continued investments in our pipeline, including 42 active phase three programs.

Speaker #4: Our non-GAAP performance margin was 50%, an increase of approximately 7 percentage points from Q1 2025, driven by revenue growth. Non-GAAP earnings per share was $8.55.

Lucas Montarce: Non-GAAP earnings per share was $8.55, including acquired R&D charges of $0.52. This compares to non-GAAP earnings per share of $3.34 in Q1 2025, inclusive of $1.72 of acquired R&D charges. On slide 7, we quantify the effect of price, rate, and volume on revenue growth. US revenue increased 43% in Q1, primarily driven by volume growth from Zepbound and Mounjaro, as well as contributions from our immunology, oncology, and neuroscience portfolio. US price declined by 7%, including the impact of the previously announced direct-to-patient prices for Zepbound. US price was positively impacted by a one-time adjustment to estimates for rebates and discounts, primarily impacting Zepbound and Mounjaro. Excluding this impact, US price will have declined 10%.

Speaker #4: Including acquired IPR&D charges of $52. This compares to non-gap earnings per share of $3.34 in Q1 2025, inclusive of $1.72 of acquired IPR&D charges.

Speaker #4: On slide seven, we quantified the effect of price, rate, and volume on revenue growth. US revenue increased 43% in Q1, primarily driven by volume growth from Zepbound and Mounjaro.

Speaker #4: As well as contributions from our immunology, oncology, and neuroscience portfolio. 7%, including the impact of the previously announced direct-to-patient prices for Zepbound. U.S. price was positively impacted by a one-time adjustment to estimates for rebates and discounts, primarily impacting Zepbound and Mounjaro.

Speaker #4: Excluding this impact, US price would have declined 10%. Europe revenue grew 37% in constant currency, driven by sustained strong volume growth of MONJARO. In Japan, revenue grew 42% in constant currency, driven by MONJARO for type 2 diabetes.

Lucas Montarce: Europe revenue grew 37% in constant currency, driven by sustained strong volume growth of Mounjaro. In Japan, revenue grew 42% in constant currency, driven by Mounjaro for type 2 diabetes. In China, revenue growth accelerated with the inclusion of Mounjaro on the National Reimbursement Drug List for type 2 diabetes. In rest of the world, revenue more than doubled in constant currency as Mounjaro achieved rapid share gains in Latin America and Asia. On slide 8, we provide an update on the performance of our key products. Within Immunology, we continue to increase our presence in atopic dermatitis with DUPIXENT. US new patient starts increased by 90% compared to Q1 2025. We steadily gain share within the specialty dermatology market. We continue to focus on patient activation and expanding HCP engagement to drive additional gains in share of market.

Speaker #4: In China, revenue growth accelerated with the inclusion of MONJARO on the national reimbursement dry list for type 2 diabetes. And in the rest of the world, revenue more than doubled in constant currency.

Speaker #4: As Mounjaro achieved rapid share gains in Latin America and Asia, on slide eight, we provide an update on the performance of our key products.

Speaker #4: Within immunology, we continue to increase our presence in atopic dermatitis with EPGLIS. US new patient starts increased by 90% compared to Q1 2025. And we steadily gained share within the specialty dermatology market.

Speaker #4: We continue to focus on patient activation and expanded HCP engagement to drive additional gains in share of market. In oncology, JYPERCA posted a strong quarter of growth, gathering additional momentum in the US from the expanded post-BTK indication in CLL.

Lucas Montarce: In oncology, Jaypirca posted a strong quarter of growth, gathering additional momentum in the US from the expanded post-BTK indication in CLL. Worldwide sales grew 79% compared to Q1 2025, and we continue to hear positive feedback from physicians globally. We believe Jaypirca has the potential to be a foundational therapy across multiple settings and regimens within CLL. Although still early, Inluriyo performance in the US was encouraging during its first full quarter launch, achieving over 35% share of oral SERD new patients start in metastatic breast cancer in Q1. For the SERD market growth also increased, largely driven by the launch of Inluriyo. In neuroscience, Kisunla continues to be the US leader in amyloid-targeting therapies. The market continues to steadily increase as diagnostic capabilities for Alzheimer's disease expand. We expect European launches to begin contributing to growth throughout 2026.

Speaker #4: Worldwide sales grew 79% compared to Q1 2025, and we continue to hear positive feedback from physicians globally. We believe JYPERCA has the potential to be a foundational therapy across multiple settings and regimens within CLL.

Speaker #4: Although still early, in LURIO performance in the US was encouraging during its first full quarter launch. Achieving over 35% share of oral CERT new patient starts in metastatic breast cancer in Q1.

Speaker #4: Oral CERT market growth also increased, largely driven by the launch of INLURIO. In neuroscience, GISANLA continues to be the US leader in amyloid targeting therapies.

Speaker #4: The market continues to steadily increase as diagnostic capabilities for Alzheimer's disease expand. We expect European launches to begin contributing to growth throughout 2026. Finally, in cardiometabolic health, MONJARO and ZEPBUND global revenue was $12.8 billion combined, contributing 6.7 billion of growth compared to Q1 2025.

Lucas Montarce: Finally, in cardiometabolic growth, Mounjaro and Zepbound global revenue was $12.8 billion combined, contributing $6.7 billion of growth compared to Q1 2025. As seen on slide 9, the US incretin analog market continued robust growth in Q1. The recent approval of oral GLP-1s expanded the market, enabling more people to benefit from the GLP-1s. Within the US incretin analog obesity market, total prescriptions grew by over 80% in Q1, and Zepbound prescriptions grew at even faster rate. Zepbound performance was driven by continuous strong uptake in self-pay channel, as well as steady growth in the commercial segment. However, the loss of Medicaid access in certain states had a negative impact on Q1 prescription growth in the high single digits.

Speaker #4: As seen on slide nine, the US increase in analog market continued robust growth in Q1. The recent approval of oral GLP-1s expanded the market, enabling more people to benefit from the GLP-1s.

Speaker #4: Within the US increase in analog obesity market, total prescriptions grew by over 80% in Q1. And ZEPBUND prescriptions grew at even faster rate. ZEPBUND performance was driven by continuous strong uptake in self-pay channel as well as steady growth in the commercial segment.

Speaker #4: However, the loss of Medicaid access in certain states had a negative impact on Q1 prescription growth in the high single digits. We recently launched ZEPBUND in the US, in a new quick pen device that includes a full month of supply of medicine in one pen.

Lucas Montarce: We recently launched Zepbound in the US in a new KwikPen device that includes a full month of supply of medicine in 1 pen. Self-pay continues to be an important segment for Zepbound and accounted for approximately 45% of total Zepbound prescriptions in Q1 and 55% of new prescriptions. In the US, type 2 diabetes incretin analog market, total prescriptions grew 11%, and Mounjaro gained another 3 percentage points of market share compared to the end of 2025. Outside the US, Mounjaro continues steady progress within the incretin analog market. Slide 10 shows aggregate trends in the international incretin analog market. The total international market has increased by 77% since the same period last year, as measured by IQVIA gross sales.

Speaker #4: Self-pays continues to be an important segment for ZEPBUND and accounted for approximately 45% of total ZEPBUND prescriptions in Q1 and 55% of new prescriptions.

Speaker #4: In the US, type 2 diabetes increase in analog market, total prescriptions grew 11%. And MONJARO gained another 3 percentage points of market share compared to the end of 2025.

Speaker #4: Outside the US, MONJARO continues a steady progress within the increase in analog market. Slide 10 shows aggregate trends in the international increase in analog market.

Speaker #4: The total international market has increased by 77% since the same period last year, as measured by IQVIA gross sales. In Q4 last year, LILLY became the market leader outside the US.

Lucas Montarce: In Q4 last year, Lilly became the market leader outside the US, and the strong growth of Mounjaro in Brazil, UK, Korea, and China, among others, has resulted in additional share of market gains in Q1 2026. We expect continued strong performance outside the US, with share of market leadership already established, increased patient activations will be key to drive sustainable growth. Lastly, on slide 11 is an update of the Fondeo launch. Early feedback from payers, physicians, and patients is encouraging. Fondeo was broadly available in pharmacies on 9 April and is available on more than 12 major telehealth platforms. Discussions with payers have been productive, commercial access has been confirmed at 2 of the 3 largest US pharmacy benefit managers, effectively mid-May.

Speaker #4: And the strong growth of MONJARO in Brazil, UK, Korea, and China, among others, has resulted in additional share of market gains in Q1 2026.

Speaker #4: We expect continued strong performance outside the US, but with share of market leadership already established, increased patient activations will be key to drive sustainable growth.

Speaker #4: Lastly, on slide 11 is an update of the Fondeo launch. Early feedback from payers, physicians, and patients is encouraging. Fondeo was broadly available in pharmacies on April 9th and is available on more than 12 major telehealth platforms.

Speaker #4: Discussions with payers have been productive, and commercial access has been confirmed at two of the three largest US pharmacy benefit managers, effectively mid-May. In addition, the GLP-1 bridge program will start no later than July 1st.

Lucas Montarce: In addition, the GLP-1 bridge program will start no later than 1 July, which brings new access to anti-obesity medicines for people with insurance through Medicare. While HCP digital awareness campaigns went live shortly after approval, we began in-person promotion to HCPs on 17 April. We expect to drive brand awareness and differentiation through full-scale consumer promotion, including direct-to-consumer TV advertising beginning in Q3. We are focused on commercial execution to drive long-term growth. On slide 12, we provide an update on capital allocation. Moving to slide 13, we share updated expectations for 2026 financial guidance. We have increased the top and the bottom end of the revenue range by $2 billion and now expect full year revenue to be between $82 billion and $85 billion. This reflects a strong underlying performance of Mounjaro and Zepbound in Q1.

Speaker #4: Which brings new access to anti-obesity medicines for people with insurance through Medicare. While HCP digital awareness campaigns went live shortly after approval, we began in-person promotion to HCPs on April 17th.

Speaker #4: We expect to drive brand awareness and differentiation through full-scale consumer promotion including direct-to-consumer TV advertising beginning in Q3. We are focused on commercial execution to drive long-term growth.

Speaker #4: On slide 12, we provide an update on capital allocation. Moving to slide 13, we share updated expectations for 2026 financial guidance. We have increased the top and the bottom end of the revenue range by $2 billion and now expect full-year revenue to be between $82 and $85 billion.

Speaker #4: This reflects a strong underlying performance of MONJARO and ZEPBUND in Q1. The midpoint of the new revenue range represents 28% growth compared to 2025.

Lucas Montarce: The midpoint of the new revenue range represents 28% growth compared to 2025. We still expect price to be a headwind in the low to mid-teens for the full year. We expect our non-GAAP performance margin to be between 47% and 48.5%, driven by higher revenue. Our tax rate remains unchanged, and we now expect non-GAAP earnings per share of $35.50 to $37, an increase of $2 to the top and bottom of the non-GAAP earnings per share. We are pleased with our Q1 results and confident in our ability to deliver another year of industry-leading growth. Now, I will turn the call over to Daniel Skovronsky to highlight our progress on R&D.

Speaker #4: We still expect price to be a headwind in the low-to-mid teens for the full year. We expect our non-gap performance margin to be between 47 and 48.5% driven by higher revenue.

Speaker #4: Our tax rate remains unchanged, and we now expect non-gap earnings per share of $35.50 to $37. An increase of $2 to the top and bottom of the non-gap earnings per share.

Speaker #4: We are pleased with our Q1 results, and confident in our ability to deliver another year of industry-leading growth. Now I will turn in the call over to Dan to highlight our progress on R&D.

Daniel Skovronsky: Thanks, Lucas. Since our last earnings call, we've been busy with portfolio progression and significant business development in each of our major therapeutic areas. I'll share updates by area, beginning with cardiometabolic health. In addition to the US approval of Foundayo for obesity, we also announced positive top-line results from ACHIEVE-4, the seventh and final phase 3 trial in our global registration programs for type 2 diabetes and obesity. This trial evaluated the time to first occurrence of MACE events for Foundayo compared to insulin glargine in adults with type 2 diabetes and obesity or overweight, who are at increased cardiovascular risk. As shown on slide 14, Foundayo met the primary endpoint of non-inferiority with a 16% lower risk of MACE 4 events. Foundayo met the secondary endpoint with a 23% lower risk of MACE 3 events.

Dan Skovronsky: Thanks, Lucas. Since our last earnings call, we've been busy with portfolio progression and significant business development in each of our major therapeutic areas. I'll share updates by area, beginning with cardiometabolic health. In addition to the US approval of Foundayo for obesity, we also announced positive top-line results from ACHIEVE-4, the seventh and final phase 3 trial in our global registration programs for type 2 diabetes and obesity. This trial evaluated the time to first occurrence of MACE events for Foundayo compared to insulin glargine in adults with type 2 diabetes and obesity or overweight, who are at increased cardiovascular risk. As shown on slide 14, Foundayo met the primary endpoint of non-inferiority with a 16% lower risk of MACE 4 events. Foundayo met the secondary endpoint with a 23% lower risk of MACE 3 events.

Speaker #5: Thanks, Lucas. Since our last earnings call, we've been busy with portfolio progression and significant business development in each of our major therapeutic areas. I'll share updates by area, beginning with cardiometabolic health.

Speaker #5: In addition to the US approval of Fondeo for obesity, we also announced positive top-line results from ACHIEVE 4, the seventh and final Phase 3 trial in our global registration programs for type 2 diabetes and obesity.

Speaker #5: This trial evaluated the time to first occurrence of MACE events for Fondeo compared to insulin glargine in adults with type 2 diabetes and obesity or overweight who are at increased cardiovascular risk.

Speaker #5: As shown on slide 14, Fondeo met the primary endpoint of non-inferiority. With a 16% lower risk of MACE 4 events. And Fondeo met the secondary endpoint with a 23% lower risk in MACE 3 events.

Speaker #5: Additionally, in a pre-planned analysis not controlled for multiplicity, the survival advantage for patients on Fondeo was 57% compared to insulin glargine. These data add a new dimension to Fondeo's well-characterized effects on reducing A1C and weight, as demonstrated in multiple previous Phase 3 trials.

Daniel Skovronsky: Additionally, in a pre-planned analysis not controlled for multiplicity, the survival advantage for patients on Foundayo was 57% compared to insulin glargine. These data add a new dimension to Foundayo's well-characterized effects on reducing A1C and weight, as demonstrated in multiple previous phase 3 trials. Now, with results from ACHIEVE-4, cardiovascular safety and a lower risk of all-cause death are added to the clinical profile. Adverse events were generally consistent with other incretin-based therapies, and no hepatic safety signal was observed in ACHIEVE-4, nor across the 7 positive Foundayo phase 3 registrational trials. ACHIEVE-4 is also the last trial required for the US type 2 diabetes core registration package. We plan to complete the US submission for type 2 diabetes in late Q2 and anticipate regulatory action before the end of this year.

Dan Skovronsky: Additionally, in a pre-planned analysis not controlled for multiplicity, the survival advantage for patients on Foundayo was 57% compared to insulin glargine. These data add a new dimension to Foundayo's well-characterized effects on reducing A1C and weight, as demonstrated in multiple previous phase 3 trials. Now, with results from ACHIEVE-4, cardiovascular safety and a lower risk of all-cause death are added to the clinical profile. Adverse events were generally consistent with other incretin-based therapies, and no hepatic safety signal was observed in ACHIEVE-4, nor across the 7 positive Foundayo phase 3 registrational trials. ACHIEVE-4 is also the last trial required for the US type 2 diabetes core registration package. We plan to complete the US submission for type 2 diabetes in late Q2 and anticipate regulatory action before the end of this year.

Speaker #5: Now, with results from ACHIEVE 4, cardiovascular safety and a lower risk of all-cause death are added to the clinical profile. Adverse events were generally consistent with other increase-in-based therapies.

Speaker #5: And no hepatic safety signal was observed in ACHIEVE 4, nor across the seven positive Fondeo Phase 3 registrational trials. ACHIEVE 4 is also the last trial required for the US type 2 diabetes core registration package.

Speaker #5: We plan to complete the US submission for type 2 diabetes in late Q2. And anticipate regulatory action before the end of this year. Moving to RETA/TRUTIDE, our GIP/GLP-1 and glucagon triple agonist, we announced positive top-line results from TRANSCEND P2D1, the first Phase 3 trial of RETA/TRUTIDE in people with type 2 diabetes.

Daniel Skovronsky: Moving to retatrutide, our GIP, GLP-1, and glucagon triple agonist, we announced positive top-line results from TRANSCEND-T2D1, the first phase 3 trial of retatrutide in people with type 2 diabetes. Given the potential counter-regulatory impacts of glucagon activity on blood sugar control, we were excited to see profound improvements in hemoglobin A1C, as shown on slide 15. Compared to placebo, retatrutide lowered A1C by an average of 1.7 to 2.0 percentage points across doses. Importantly, we saw that participants lost an average of 11.1 to 16.6 kilograms, or 25 to 37 pounds. While cross-trial comparisons have limitations, these data suggest retatrutide can deliver glycemic control in line with the most widely prescribed incretin therapy for type 2 diabetes, tirzepatide, while delivering additional weight loss.

Dan Skovronsky: Moving to retatrutide, our GIP, GLP-1, and glucagon triple agonist, we announced positive top-line results from TRANSCEND-T2D1, the first phase 3 trial of retatrutide in people with type 2 diabetes. Given the potential counter-regulatory impacts of glucagon activity on blood sugar control, we were excited to see profound improvements in hemoglobin A1C, as shown on slide 15. Compared to placebo, retatrutide lowered A1C by an average of 1.7 to 2.0 percentage points across doses. Importantly, we saw that participants lost an average of 11.1 to 16.6 kilograms, or 25 to 37 pounds. While cross-trial comparisons have limitations, these data suggest retatrutide can deliver glycemic control in line with the most widely prescribed incretin therapy for type 2 diabetes, tirzepatide, while delivering additional weight loss.

Speaker #5: Given the potential counter-regulatory impacts of glucagon activity on blood sugar control, we were excited to see profound improvements in hemoglobin A1C. As shown on slide 15.

Speaker #5: Compared to placebo, RETA/TRUTIDE lowered A1C by an average of 1.7 to 2.0 percentage points across doses. Importantly, we saw that participants lost an average of 11.1 to 16.6 kilograms, or 25 to 37 pounds.

Speaker #5: While cross-trial comparisons have limitations, these data suggest RETA/TRUTIDE can deliver glycemic control in line with the most widely prescribed increase-in-therapy for type 2 diabetes, TURZEPATIDE, while delivering additional weight loss.

Speaker #5: This is critically important given the difficulties people living with type 2 diabetes face, when trying to lose weight, and the significant need for better weight loss medications for this population.

Daniel Skovronsky: This is critically important given the difficulties people living with type 2 diabetes face when trying to lose weight and a significant need for better weight loss medications for this population. With these data on hand, we're optimistic that retatrutide can meet this need. Adverse events seen with retatrutide were generally consistent with what have been observed in clinical trials of incretin-based therapies, and discontinuation rates due to adverse events were 5% or less across all arms. We look forward to presenting detailed TRANSCEND-T2D-1 results at the American Diabetes Association Scientific Sessions in June. Together with the positive TRIUMPH-4 results in obesity and knee osteoarthritis, we are beginning to establish a favorable clinical profile for retatrutide, consistent with our goals for this molecule. The next retatrutide trial to read out is TRIUMPH-1, an 80-week study in people with obesity.

Dan Skovronsky: This is critically important given the difficulties people living with type 2 diabetes face when trying to lose weight and a significant need for better weight loss medications for this population. With these data on hand, we're optimistic that retatrutide can meet this need. Adverse events seen with retatrutide were generally consistent with what have been observed in clinical trials of incretin-based therapies, and discontinuation rates due to adverse events were 5% or less across all arms. We look forward to presenting detailed TRANSCEND-T2D-1 results at the American Diabetes Association Scientific Sessions in June. Together with the positive TRIUMPH-4 results in obesity and knee osteoarthritis, we are beginning to establish a favorable clinical profile for retatrutide, consistent with our goals for this molecule. The next retatrutide trial to read out is TRIUMPH-1, an 80-week study in people with obesity.

Speaker #5: With these data in hand, we're optimistic that RETA/TRUTIDE can meet this need. Adverse events seen with RETA/TRUTIDE were generally consistent with what had been observed in clinical trials of incretin-based therapies, and discontinuation rates due to adverse events were 5% or less across all arms.

Speaker #5: We look forward to presenting detailed TRANSCEND T2D1 results at the American Diabetes Association Scientific Sessions in June. Together with the positive TRIUMPH 4 results in obesity, and knee osteoarthritis, we are beginning to establish a favorable clinical profile for RETA/TRUTIDE.

Speaker #5: Consistent with our goals for this molecule. The next RETA/TRUTIDE trial to read out is TRIUMPH 1. An 80-week study in people with obesity. We look forward to sharing top-line results later this quarter.

Daniel Skovronsky: We look forward to sharing top-line results later this quarter. Also in cardiometabolic health, we initiated 3 additional phase 3 programs for eloralintide. In addition to the ongoing phase 3 obesity programs, we initiated phase 3 programs in OA knee pain, obstructive sleep apnea, and as an add-on therapy for obesity. As a selective amylin receptor agonist, or SARA, eloralintide has shown a unique profile in phase 2 trials with GLP-1-like weight loss and improved tolerability. We're eager to explore additional indications for this promising molecule in what we expect to be a very robust phase 3 program across a number of potential indications. We also recently completed our acquisition of Ventix Biosciences, which brings a pipeline of small molecule therapeutics, including NLRP3 inhibitors designed to treat inflammation across a broad range of diseases. Both NLRP3 inhibitors are now shown in the Lilly pipeline.

Dan Skovronsky: We look forward to sharing top-line results later this quarter. Also in cardiometabolic health, we initiated 3 additional phase 3 programs for eloralintide. In addition to the ongoing phase 3 obesity programs, we initiated phase 3 programs in OA knee pain, obstructive sleep apnea, and as an add-on therapy for obesity. As a selective amylin receptor agonist, or SARA, eloralintide has shown a unique profile in phase 2 trials with GLP-1-like weight loss and improved tolerability. We're eager to explore additional indications for this promising molecule in what we expect to be a very robust phase 3 program across a number of potential indications. We also recently completed our acquisition of Ventix Biosciences, which brings a pipeline of small molecule therapeutics, including NLRP3 inhibitors designed to treat inflammation across a broad range of diseases. Both NLRP3 inhibitors are now shown in the Lilly pipeline.

Speaker #5: Also in cardiometabolic health, we initiated three additional Phase 3 programs for Alora LINTIDE. In addition to the ongoing Phase 3 obesity programs, we initiated Phase 3 programs in OA knee pain, obstructive sleep apnea, and as an add-on therapy for obesity.

Speaker #5: As a selective amylane receptor agonist, or SARA, Alora LINTIDE has shown a unique profile in Phase 2 trials. With GLP-1-like weight loss, an improved tolerability.

Speaker #5: We're eager to explore additional indications for this promising molecule in what we expect to be a very robust Phase 3 program across a number of potential indications.

Speaker #5: We also recently completed our acquisition of VENTIX Biosciences, which brings a pipeline of small molecule therapeutics, including NLRP3 inhibitors, designed to treat inflammation across a broad range of diseases.

Speaker #5: Both NLRP3 inhibitors are now shown in the LILI pipeline. We also announced a licensing agreement with CSL for CLAZEKIZIMAB for certain indications, and that molecule will be reflected in our pipeline chart once LILI trials have begun.

Daniel Skovronsky: We also announced a licensing agreement with CSL for clazakizumab for certain indications, and that molecule will be reflected in our pipeline chart once Lilly trials have begun. Moving to immunology, we reported two important datasets for eglifimoz atopic dermatitis. First, in the Add-Long phase 3b open label extension study, Ebglyss delivered durable disease control for up to 4 years with once-monthly maintenance dosing. Nearly all patients achieved meaningful skin improvements. 75% achieved near complete skin clearance, and 80% maintained their results without the need for topical corticosteroids. For people living with chronic relapsing diseases like atopic dermatitis, sustained control delivered with convenience is the ultimate goal. We're pleased that our once every 8 weeks maintenance regimen is currently under FDA review, and we expect regulatory action later this year.

Dan Skovronsky: We also announced a licensing agreement with CSL for clazakizumab for certain indications, and that molecule will be reflected in our pipeline chart once Lilly trials have begun. Moving to immunology, we reported two important datasets for eglifimoz atopic dermatitis. First, in the Add-Long phase 3b open label extension study, Ebglyss delivered durable disease control for up to 4 years with once-monthly maintenance dosing. Nearly all patients achieved meaningful skin improvements. 75% achieved near complete skin clearance, and 80% maintained their results without the need for topical corticosteroids. For people living with chronic relapsing diseases like atopic dermatitis, sustained control delivered with convenience is the ultimate goal. We're pleased that our once every 8 weeks maintenance regimen is currently under FDA review, and we expect regulatory action later this year.

Speaker #5: Moving to immunology, we reported two important data sets for EBGLIS in atopic dermatitis. First, in the ADLONG Phase 3b open-label extension study, EBGLIS delivered durable disease control for up to four years with once-monthly maintenance dosing.

Speaker #5: Nearly all patients achieved meaningful skin improvements, 75% achieved near complete skin clearance, and 80% maintained their results without the need for topical supportive steroids.

Speaker #5: For people living with chronic relapsing diseases like atopic dermatitis, sustained control delivered with convenience is the ultimate goal. We're pleased that our once-every-eight-weeks maintenance regimen is currently under FDA review, and we expect regulatory action later this year.

Speaker #5: If approved, less frequent dosing may be a more convenient option to improve the patient experience and further differentiate EBGLIS from competitors. The second readout was the Phase 3 Adorable Slime trial.

Daniel Skovronsky: If approved, less frequent dosing may be a more convenient option to improve the patient experience and further differentiate Ebglyss from competitors. The second readout was the Phase 3 ADorable-1 trial. Ebglyss delivered positive outcomes for children as young as 6 months old with moderate to severe atopic dermatitis. As shown on slide 16, 63% of children treated with Ebglyss achieved significant skin improvement as measured by EASI 75. In addition, 44% achieved clear or almost clear skin as measured by IGA 01 score. This makes Ebglyss the first and only selective IL-13 inhibitor with positive Phase 3 data in this age group, where there are fewer approved medicines than in adolescents and adults. We plan to submit these data to regulators later this year for potential label expansion.

Dan Skovronsky: If approved, less frequent dosing may be a more convenient option to improve the patient experience and further differentiate Ebglyss from competitors. The second readout was the Phase 3 ADorable-1 trial. Ebglyss delivered positive outcomes for children as young as 6 months old with moderate to severe atopic dermatitis. As shown on slide 16, 63% of children treated with Ebglyss achieved significant skin improvement as measured by EASI 75. In addition, 44% achieved clear or almost clear skin as measured by IGA 01 score. This makes Ebglyss the first and only selective IL-13 inhibitor with positive Phase 3 data in this age group, where there are fewer approved medicines than in adolescents and adults. We plan to submit these data to regulators later this year for potential label expansion.

Speaker #5: EBGLIS delivered positive outcomes for children as young as six months old with moderate to severe atopic dermatitis. As shown on slide 16, 63% of children treated with EBGLIS achieved significant skin improvement as measured by easy 75.

Speaker #5: In addition, 44% achieved clear or almost clear skin as measured by IGA-01 score. This makes EBGLIS the first and only selective IL-13 inhibitor with positive Phase 3 data in this age group, where there are fewer approved medicines than in adolescents and adults.

Speaker #5: We plan to submit these data to regulators later this year for potential label expansion. Also in immunology, we reported positive top-line results from TOGETHER PSO, a Phase 3B study of exekizumab plus TURZEPATIDE in adults with psoriasis and obesity.

Daniel Skovronsky: In immunology, we reported positive top-line results from TOGETHER-PsO, a phase 3b study of ixekizumab plus tirzepatide in adults with psoriasis and obesity. In TOGETHER-PsO, 27% of participants on tirzepatide plus ixekizumab achieved the co-primary endpoint of total skin clearance and 10% or more weight loss, compared to less than 6% of patients on ixekizumab alone. These results are the second successful trial highlighting the benefits of treating psoriatic disease and obesity with concomitant ixekizumab and tirzepatide therapy. This result provides further evidence that incretins may have a broader role in treating immunological diseases. We have additional ongoing phase 3b combination trials in immunology studying mirikizumab plus tirzepatide in Crohn's disease and ulcerative colitis. We continue to assess other immunology settings where incretins may provide additional benefits. We announced business development in immunology with our agreement to acquire Orna Therapeutics.

Dan Skovronsky: In immunology, we reported positive top-line results from TOGETHER-PsO, a phase 3b study of ixekizumab plus tirzepatide in adults with psoriasis and obesity. In TOGETHER-PsO, 27% of participants on tirzepatide plus ixekizumab achieved the co-primary endpoint of total skin clearance and 10% or more weight loss, compared to less than 6% of patients on ixekizumab alone. These results are the second successful trial highlighting the benefits of treating psoriatic disease and obesity with concomitant ixekizumab and tirzepatide therapy. This result provides further evidence that incretins may have a broader role in treating immunological diseases. We have additional ongoing phase 3b combination trials in immunology studying mirikizumab plus tirzepatide in Crohn's disease and ulcerative colitis. We continue to assess other immunology settings where incretins may provide additional benefits. We announced business development in immunology with our agreement to acquire Orna Therapeutics.

Speaker #5: In TOGETHER PSO, 27% of participants on TURZEPATIDE plus exekizumab achieved the coprimary endpoint of total skin clearance, and 10% or more weight loss. Compared to less than 6% of patients on exekizumab alone.

Speaker #5: These results are the second successful trial highlighting the benefits of treating psoriatic disease and obesity. With concomitant exekizumab and TURZEPATIDE therapy. This result provides further evidence that incretins may have a broader role in treating immunological diseases.

Speaker #5: We have additional ongoing Phase 3B combination trials in immunology studying mirakizumab plus TURZEPATIDE in Crohn's disease and ulcerative colitis. We continue to assess other immunology settings where incretins may provide additional benefits.

Speaker #5: We also announced business development in immunology with our agreement to acquire Orna Therapeutics. Orna's in vivo CAR-T pipeline includes potential best-in-class programs to reset the immune system and address B-cell-driven autoimmune diseases.

Daniel Skovronsky: Orna Therapeutics' in vivo CAR T pipeline includes potential best-in-class programs to reset the immune system and address B-cell-driven autoimmune diseases. We look forward to exploring the full potential of Orna Therapeutics' platform together with the Orna team. Turning to oncology, we announced positive top-line results from a phase 3 pirtobrutinib trial, BRUIN CLL-322. This ambitious study evaluated pirtobrutinib in addition to a fixed-duration regimen of venetoclax and rituximab in patients with previously treated CLL or SLL. Pirtobrutinib significantly extended progression-free survival compared to the fixed-duration regimen and was the first medicine to utilize and outperform a venetoclax-containing control arm in a phase 3 trial in the history of CLL drug development. As shown on slide 17, pirtobrutinib has now been successful in 4 phase 3 studies in CLL, each with compelling efficacy and profitability.

Dan Skovronsky: Orna Therapeutics' in vivo CAR T pipeline includes potential best-in-class programs to reset the immune system and address B-cell-driven autoimmune diseases. We look forward to exploring the full potential of Orna Therapeutics' platform together with the Orna team. Turning to oncology, we announced positive top-line results from a phase 3 pirtobrutinib trial, BRUIN CLL-322. This ambitious study evaluated pirtobrutinib in addition to a fixed-duration regimen of venetoclax and rituximab in patients with previously treated CLL or SLL. Pirtobrutinib significantly extended progression-free survival compared to the fixed-duration regimen and was the first medicine to utilize and outperform a venetoclax-containing control arm in a phase 3 trial in the history of CLL drug development. As shown on slide 17, pirtobrutinib has now been successful in 4 phase 3 studies in CLL, each with compelling efficacy and profitability.

Speaker #5: We look forward to exploring the full potential of Orna's platform together with the Orna team. Turning to oncology, we announced positive top-line results from a Phase 3 erthrobrutinib trial, Bruin CLL322.

Speaker #5: This ambitious study evaluated perturbrutinib in addition to a fixed-duration regimen of venetoclax and rituximab in patients with previously treated CLL or SLL. Perturbrutinib significantly extended progression-free survival compared to the fixed-duration regimen, and was the first medicine to utilize and outperform a venetoclax-controlled containing control arm in a Phase 3.

Speaker #5: In the history of CLL drug development. As shown on slide 17, perturbrutinib has now been successful in four Phase 3 studies in CLL, each with compelling efficacy and possibility.

Speaker #5: Perturbrutinib has been studied across early and later line settings of CLL, demonstrated efficacy as a monotherapy and in combination, and shown efficacy head-to-head against chemoimmunotherapy, a covalent BTK inhibitor, and now a venetoclax-based regimen.

Daniel Skovronsky: Pirtobrutinib has been studied across early and later line settings of CLL, demonstrated efficacy as a monotherapy and in combination, and has shown efficacy head-to-head against chemoimmunotherapy, a covalent BTK inhibitor, and now a venetoclax-based regimen. The breadth of evidence suggests pirtobrutinib has potential to become a foundational therapy in CLL. Data from BRUIN CLL-313 and BRUIN CLL-314 are currently under review by regulators for potential label expansion into the first-line setting, and we plan to submit the results of BRUIN CLL-322 to regulators later this year. Building on the breakthrough therapy designation received in January for platinum-resistant ovarian cancer, we initiated second phase 3 trials of sofetabart mipitecan, our folate receptor alpha antibody-drug conjugate for platinum-sensitive ovarian cancer. We also announced the acquisition of Colonia Therapeutics.

Dan Skovronsky: Pirtobrutinib has been studied across early and later line settings of CLL, demonstrated efficacy as a monotherapy and in combination, and has shown efficacy head-to-head against chemoimmunotherapy, a covalent BTK inhibitor, and now a venetoclax-based regimen. The breadth of evidence suggests pirtobrutinib has potential to become a foundational therapy in CLL. Data from BRUIN CLL-313 and BRUIN CLL-314 are currently under review by regulators for potential label expansion into the first-line setting, and we plan to submit the results of BRUIN CLL-322 to regulators later this year. Building on the breakthrough therapy designation received in January for platinum-resistant ovarian cancer, we initiated second phase 3 trials of sofetabart mipitecan, our folate receptor alpha antibody-drug conjugate for platinum-sensitive ovarian cancer. We also announced the acquisition of Colonia Therapeutics.

Speaker #5: The breadth of evidence suggests perturbrutinib has potential to become a foundational therapy in CLL. Data from BRUIN CLL-313 and BRUIN CLL-314 are currently under review by regulators for potential label expansion into the first-line setting.

Speaker #5: And we plan to submit the results of Bruin CLL322 to regulators later this year. Building on the breakthrough therapy designation received in January for platinum-resistant ovarian cancer, we initiated a second Phase 3 trial of sofitabart/mifeticab, our folate receptor alpha antibody-drug conjugate, in platinum-sensitive ovarian cancer.

Speaker #5: We also announced the acquisition of Colonia Therapeutics, Colonia's lentiviral in vivo CAR-T platform, has shown very promising early clinical results in people with multiple myeloma.

Daniel Skovronsky: Colonia's lentiviral in vivo CAR-T platform has shown very promising early clinical results in people with multiple myeloma, and we look forward to rapidly advancing the lead program with the Colonia team, as well as building future medicines using this technology platform. Earlier this week, we announced the acquisition of Ajax Therapeutics, the lead program, the phase I JAK2 inhibitor for myelofibrosis and polycythemia vera, builds on Lilly's established capabilities in blood cancer. Moving on to neuroscience, we initiated a phase 3 program for praneptide, our GIP GLP-1 dual agonist in major depressive disorder. This trial will assess if praneptide can delay time to relapse, a significant unmet need in psychiatry, where rates remain high despite available treatments.

Dan Skovronsky: Colonia's lentiviral in vivo CAR-T platform has shown very promising early clinical results in people with multiple myeloma, and we look forward to rapidly advancing the lead program with the Colonia team, as well as building future medicines using this technology platform. Earlier this week, we announced the acquisition of Ajax Therapeutics, the lead program, the phase I JAK2 inhibitor for myelofibrosis and polycythemia vera, builds on Lilly's established capabilities in blood cancer. Moving on to neuroscience, we initiated a phase 3 program for praneptide, our GIP GLP-1 dual agonist in major depressive disorder. This trial will assess if praneptide can delay time to relapse, a significant unmet need in psychiatry, where rates remain high despite available treatments.

Speaker #5: And we look forward to rapidly advancing the LEAD program with this Colonia team. As well as building future medicines using this technology platform. Earlier this week, we announced the acquisition of Ajax Therapeutics, the LEAD program, the Phase 1 JAK2 inhibitor for myelofibrosis and polycythemia vera, built on Lilly's established capabilities in blood cancer.

Speaker #5: Moving on to neuroscience, we initiated a Phase 3 program for brinepatide, our GIBGLIT-1 dual agonist, in major depressive disorder. This trial will assess if brinepatide can delay time to relapse, with significant unmet need in psychiatry where rates remain high despite available treatments.

Speaker #5: We've also begun Phase 2 trials of brinepatide in opioid use disorder and schizophrenia. And initiated Phase 2 trials for two pain assets: anav 1.8 inhibitor and an AT2 receptor antagonist.

Daniel Skovronsky: We've also begun phase 2 trials of praneptide in opioid use disorder and schizophrenia, and initiated phase 2 trials for 2 pain assets, a Nav1.8 inhibitor and an AT2 receptor antagonist. Lastly, we announced an agreement to acquire Centessa Pharmaceuticals, which will expand our neuroscience portfolio and capabilities into treating sleep disorders. Centessa, a leader in orexin science, is advancing a pipeline of orexin receptor 2 agonists that target the neurobiological system governing the sleep-wake cycle. The lead candidate, clamenorexin, has demonstrated a potential best-in-class profile.

Dan Skovronsky: We've also begun phase 2 trials of praneptide in opioid use disorder and schizophrenia, and initiated phase 2 trials for 2 pain assets, a Nav1.8 inhibitor and an AT2 receptor antagonist. Lastly, we announced an agreement to acquire Centessa Pharmaceuticals, which will expand our neuroscience portfolio and capabilities into treating sleep disorders. Centessa, a leader in orexin science, is advancing a pipeline of orexin receptor 2 agonists that target the neurobiological system governing the sleep-wake cycle. The lead candidate, clamenorexin, has demonstrated a potential best-in-class profile.

Speaker #5: Lastly, we announced an agreement to acquire sintessa pharmaceuticals. Which will expand our neuroscience portfolio and capabilities into treating sleep disorders. Sintessa, a leader in a REX in science, is advancing a pipeline of a REX in receptor 2 agonists.

Speaker #5: The target that neurobiological systems governing the sleep-wake cycle. The lead candidate from AREXTIN has demonstrated a potential best-in-class profile. We look forward to welcoming the Sintessa team to Lilly later this year and continuing the development of these important molecules.

Daniel Skovronsky: We look forward to welcoming the Centessa team to Lilly later this year and continuing the development of these important molecules. Slide 18 shows pipeline movements since our last earnings call, and slide 19 shows the full list of key events expected in 2026. I'll now turn the call back to David for closing.

Dan Skovronsky: We look forward to welcoming the Centessa team to Lilly later this year and continuing the development of these important molecules. Slide 18 shows pipeline movements since our last earnings call, and slide 19 shows the full list of key events expected in 2026. I'll now turn the call back to David for closing.

Speaker #5: Slide 18 shows pipeline movements since our last earnings call, and slide 19 shows the full list of key events expected in 2026. I’ll now turn the call back to Dave for closing.

Speaker #2: Thanks, Dan. We're pleased with the progress to start this year. We executed well, both in driving business results and bringing new medicines to patients.

David Ricks: Thanks, Dan. We're pleased with the progress to start this year. We executed well both in driving business results and bringing new medicines to patients. We posted another quarter of impressive revenue and earnings growth. Shared top-line results from 5 positive phase 3 trials, announced 4 acquisitions, initiated 6 new phase 3 programs, and launched an important new Lilly medicine. Productive quarter, yet a lot more to come in 2026. Let me turn the call over now to Mike for the Q&A session.

Dave Ricks: Thanks, Dan. We're pleased with the progress to start this year. We executed well both in driving business results and bringing new medicines to patients. We posted another quarter of impressive revenue and earnings growth. Shared top-line results from 5 positive phase 3 trials, announced 4 acquisitions, initiated 6 new phase 3 programs, and launched an important new Lilly medicine. Productive quarter, yet a lot more to come in 2026. Let me turn the call over now to Mike for the Q&A session.

Speaker #2: We posted another quarter of impressive revenue and earnings growth. We shared top-line results from five positive Phase 3 trials, announced four acquisitions, initiated six new Phase 3 programs, and launched an important new Lilly medicine.

Speaker #2: Productive quarter and yet a lot more to come in 2026. Let me turn the call over now to Mike for the Q&A session.

Mike Czapar: Great. Thank you, David Ricks. We'd like to take as many questions as possible, so consistent with prior quarters, please limit yourself to a single 1-part question. Paul, please provide the instructions for how to join the queue, and then we're ready for the first caller.

Speaker #3: Great. Thank you, Dave. We'd like to take as many questions as possible. So consistent with prior quarters, please limit yourself to a single one-part question.

Speaker #3: Paul? Please provide the instructions for how to join the queue, and then we're ready for the first caller.

Speaker #4: Thank you. At this time, we will be conducting a question-and-answer session. If you have any questions, please press star 1 on your phone at this time.

Operator 3: Thank you. At this time, we will be conducting a question-and-answer session. The first question today is coming from Geoff Meacham from Citi. Geoff, your line is live.

Operator: Thank you. At this time, we will be conducting a question-and-answer session. The first question today is coming from Geoff Meacham from Citi. Geoff, your line is live.

Speaker #4: Again, we ask that participants limit themselves to one question on today's call. If you do have a follow-up question, please rejoin the queue by pressing star 1 at any time.

Speaker #4: We also ask that while posing your question, you please pick up your handset if listening on speakerphone to provide optimum sound quality. And please hold while we pull for questions.

Speaker #4: And the first question today is coming from Jeff Meacham from City. Jeff, your line is live.

Geoff Meacham: Great. Hey, guys. Congrats on the quarter. Thanks for the question. Maybe this one is for Dave. You know, investors seem to be acutely focused on pricing in incretins with not a lot of emphasis on volume. I know you don't want to get too specific, but can you talk about, you know, at a high level, the margins under a wide range of price scenarios for Lilly? How do you see the investments you've already made in, say, manufacturing, and how does that add to the dynamic and what that means in terms of the competitive moat? Thanks.

Speaker #5: Great. Hey guys, congrats on the quarter. Thanks for the question. Maybe this one is for Dave. Investors seem to be acutely focused on pricing in incretins, with not a lot of emphasis on volume.

Speaker #5: I know you don't want to get too specific, but can you talk about, at a high level, the margins under a wide range of price scenarios for Lilly?

Speaker #5: How do you see the investments you've already made in, say, manufacturing, and how does that add to the dynamic and what that means in terms of the competitive moat?

Speaker #5: Thanks.

Speaker #3: Great. Thanks, Jeff. Dave, do you want to take a deep minute to talk about pricing in incretins?

Mike Czapar: Great. Thanks, Geoff. Dave, do you want to maybe just talk about pricing in incretins?

David Ricks: Sure. Thanks for the question, Geoff. Maybe a couple things to point out now that we're 5 or 6 quarters deep into this sort of post-shortage world, and we can really pursue expansion on volume in an aggressive way. I think you can see something just a little different about the obesity and weight loss category from what we think about in other pharmaceuticals, where, you know, the barrier, I mean, is typically more informational, not price sensitivity. Here, clearly, because the out-of-pocket nature, 75% of ex-US, you know, business for Mounjaro is out-of-pocket, US is a meaningful portion, as well, that we see, you know, quite expansionary volume, perhaps non-linear, to price reductions. Of course, there's a floor on that, and we have sensitivity on our cost structures, et cetera.

Speaker #2: Sure. Thanks for the question, Jeff. Maybe a couple of things to point out now that we're five or six quarters deep into this sort of post-shortage world.

Dave Ricks: Sure. Thanks for the question, Geoff. Maybe a couple things to point out now that we're 5 or 6 quarters deep into this sort of post-shortage world, and we can really pursue expansion on volume in an aggressive way. I think you can see something just a little different about the obesity and weight loss category from what we think about in other pharmaceuticals, where, you know, the barrier, I mean, is typically more informational, not price sensitivity. Here, clearly, because the out-of-pocket nature, 75% of ex-US, you know, business for Mounjaro is out-of-pocket, US is a meaningful portion, as well, that we see, you know, quite expansionary volume, perhaps non-linear, to price reductions. Of course, there's a floor on that, and we have sensitivity on our cost structures, et cetera.

Speaker #2: And we can really pursue expansion on volume in an aggressive way. I think you can see something that's a little different about the obesity and weight loss category from what we think about in other pharmaceuticals.

Speaker #2: Where the barrier. Is typically more informational, not price sensitivity. But here, clearly, because of the out-of-pocket nature, 75% of XUS business for Mounjaro is out-of-pocket.

Speaker #2: US is a meaningful portion as well. That we see quite expansionary volume perhaps non-linear to price reductions. Of course, there's a floor on that.

Speaker #2: And we have sensitivity on our cost structures, etc. But pretty much every time we reduce pricing, we see a pretty large expansion. You also see built into this, the primary pricing affecting Q1 are actually negotiated outcomes with governments.

David Ricks: Pretty much every time we reduce pricing, we see a pretty large expansion. We also see built into this, the primary pricing effect in Q1 are actually negotiated outcomes with governments. Both the MFN package we negotiated with the Trump administration, your cut out-of-pocket costs. You see strong growth, like Lilly's vials really had a quite a strong quarter in Q1, with at slightly lower prices. In China, we negotiated for diabetes access at a meaningful price reduction, but you can see the volume far outstripping the price concession. Kind of a different dynamic, and I think if investors can think about this category perhaps unlike other pharmaceutical categories in the past.

Dave Ricks: Pretty much every time we reduce pricing, we see a pretty large expansion. We also see built into this, the primary pricing effect in Q1 are actually negotiated outcomes with governments. Both the MFN package we negotiated with the Trump administration, your cut out-of-pocket costs. You see strong growth, like Lilly's vials really had a quite a strong quarter in Q1, with at slightly lower prices. In China, we negotiated for diabetes access at a meaningful price reduction, but you can see the volume far outstripping the price concession. Kind of a different dynamic, and I think if investors can think about this category perhaps unlike other pharmaceutical categories in the past.

Speaker #2: Both the MFN package we negotiated with the Trump administration cut out-of-pocket costs. You see strong growth, like Lilly's up on vials, really had quite a strong quarter in Q1 with a slightly lower prices.

Speaker #2: And then in China, we negotiated for diabetes access at a meaningful price reduction, but you can see the volume far outstripping the price concession.

Speaker #2: So kind of a different dynamic. And I think if investors can think about this category, perhaps unlike other pharmaceutical categories in the past, in terms of margin sensitivity, it remains true that for this category, for us at least, the unit economics are really driven by fixed costs that are either sunk in the past or unmovable depending on the volume.

David Ricks: You know, in terms of margin sensitivity, it remains true that, you know, for this category, for us at least, the unit economics are really driven by fixed costs that are either sunk in the past or unmovable, depending on the volume in the present. As a result, you know, both covering the amortized R&D costs as well as CapEx is a concern from an accounting perspective. At the margin, we do have latitude. You know, that said, we want to invest in future medicines, and I think that's probably the biggest, as we've said before, as we think about long-term operating margin for the company, you know, the X factor.

Dave Ricks: You know, in terms of margin sensitivity, it remains true that, you know, for this category, for us at least, the unit economics are really driven by fixed costs that are either sunk in the past or unmovable, depending on the volume in the present. As a result, you know, both covering the amortized R&D costs as well as CapEx is a concern from an accounting perspective. At the margin, we do have latitude. You know, that said, we want to invest in future medicines, and I think that's probably the biggest, as we've said before, as we think about long-term operating margin for the company, you know, the X factor.

Speaker #2: In the present, and as a result, both covering the amortized R&D costs as well as capex is a concern from an accounting perspective. But at the margin, we do have latitude that said, we want to invest in future medicines.

Speaker #2: And I think that's probably the biggest, as we've said before, as we think about long-term operating margin for the company. The X factor, if we have good projects, we won't hesitate to invest in them, whether it be existing medicines.

David Ricks: If we have good projects, we won't hesitate to invest in them, whether they be existing medicines. I think you see kind of a record load of phase III Nylex at Lilly right now, or for new medicines. We've got a very full phase II and phase I pipeline that we are deploying capital against. We've got a lot of latitude here, Geoff. I think this market works a little differently, and we're all sort of just getting used to that. I think good news, good news for Lilly and our incumbent position.

Dave Ricks: If we have good projects, we won't hesitate to invest in them, whether they be existing medicines. I think you see kind of a record load of phase III Nylex at Lilly right now, or for new medicines. We've got a very full phase II and phase I pipeline that we are deploying capital against. We've got a lot of latitude here, Geoff. I think this market works a little differently, and we're all sort of just getting used to that. I think good news, good news for Lilly and our incumbent position.

Speaker #2: I think you see kind of a record load of Phase 3 Nilex at Lilly right now. Or for new medicines. And we've got a very full Phase 2 and Phase 1 pipeline that we are deploying capital against.

Speaker #2: So we've got a lot of latitude here, Jeff. And I think this market works a little differently. And we're all sort of just getting used to that.

Speaker #2: But I think good news for Lilly and our incumbent position.

Mike Czapar: Great. Thank you, Dave. Paul, next question, please.

Speaker #3: Great. Thank you, Dave. Paul, next question, please.

Operator 3: The next question will be from Chris Schott from J.P. Morgan. Chris, your line is live.

Operator: The next question will be from Chris Schott from J.P. Morgan. Chris, your line is live.

Speaker #4: question will be from Chris Schott from JPMorgan. Chris, your line is live.

Chris Schott: Great. Thanks so much for the question, and congrats on the progress. I just wanted to dig a little bit more into international Mounjaro. Can you just share some of the learnings from, I think it's been a much better expected launch than we all had anticipated here as we think about the ramp going forward and longer term opportunity. Maybe as part of that, can you just, you know, should we expect any impact to the ramp from the entry of generic semaglutide in select markets, or is this at such an early stage of penetration where that's less relevant? Thanks so much.

Speaker #6: Great. Thanks so much for the question and congrats on the progress. I just wanted to dig a little bit more into international Mounjaro and can you just share some of the learnings from, I think it's been a much better expected launch than we all had anticipated here as we think about the ramp going forward and longer-term opportunity?

Speaker #6: And maybe as part of that, can you just should we expect any impact to the ramp from the entry of generic Sema in select markets?

Speaker #6: Or is this such an early stage of penetration where that's less relevant? Thanks so much.

Speaker #3: Great. Thanks, Chris, for the question about international Mounjaro and the potential impact of generic Sema. We'll go to Patrick.

Mike Czapar: Great. Thanks, Chris. For the question about international Mounjaro and the potential impact of generic Semo, we'll go to Patrik.

Speaker #7: Thank you very much, Chris. When we look at the first quarter, it's truly a strong growth of all our prioritized products across international. But of course, particularly Mounjaro.

David Ricks: Thank you very much, Chris. You know, when we look at Q1, it's truly a strong growth of all our prioritized products across international, but of course, particularly Mounjaro.

Patrik Jonsson: Thank you very much, Chris. You know, when we look at Q1, it's truly a strong growth of all our prioritized products across international, but of course, particularly Mounjaro.

Speaker #7: And now we have the fully launched in more than 55 countries. And we have seen a very strong speed of uptake. And also a rapid market share gain.

Patrik Jonsson: Now we have fully launched in more than 55 countries, and we have seen a very strong speed of uptake and also a rapid market share gain. Also in the H2 2025, referring to Brazil and Korea, where we currently have an estimated market share of 60%. Of course, also the China type 2 NRDL reimbursement. When we look at the generics, we only have a few weeks of data from India, but it seems like it's really stimulating the growth in the overall obesity market, and that includes our product. The Mounjaro has actually been holding market share quite nicely. When we look at the Mounjaro prescriptions, they are about 10% higher in recent weeks compared to the period prior to generics entered.

Speaker #7: Also in the market, we launched the second half of 2025, referring to Brazil and Korea, where we currently have an estimated market share of 60%.

Speaker #7: And of course, also the China Type 2 NRDL reimbursement. When we look at the generics, we only have a few weeks of data from India.

Speaker #7: But it seems like it's really stimulating the growth in the overall obesity market. And that includes our product and the Mounjaro has actually been holding market share quite nicely.

Speaker #7: When we look at the Mounjaro prescriptions, they are about 10% higher in recent weeks compared to the period prior to generic-centered. So I think it just underscores that dual agonists trumps single agonists.

Patrik Jonsson: I think it just underscores that dual agonist trumps single agonist. Moving forward, I think we should expect a very strong continued year-on-year growth and some sequential growth. We saw in the slide earlier that we have a market share above 53% all US, and that's an average. In many international markets, we have a market share along the lines of what we see in the US with Zepbound. When you get to that level of share, incremental share gain is getting harder. Of course, we will focus our efforts on patient activation, driving increased penetration in the chronic weight manage market and market growth.

Speaker #7: Moving forward, I think we should expect the very strong continued year-on-year growth. And some sequential growth. We saw in the slide earlier that we have a market share of above 53% OUS.

Speaker #7: And that's an average. And in many international markets, we have a market share along the lines of what we see in the US. We've set bound.

Speaker #7: And when you get to that level of share, incremental share gain is getting harder. And of course, we will focus our efforts on patient activation, driving increased penetration in the chronic weight management market and market growth.

Patrik Jonsson: Also secondly, what we have seen during H2 of the year has been some seasonality, mainly driven by the holiday season in Europe, where patients tend to take a holiday, drug holiday break or actually delay their initiation of the new therapy start. Overall, strong growth across regions. Seems like generic semaglutide is stimulating market growth and we continue to do well. We expect a continued strong year-on-year growth, sequential growth driven by patient activation.

Speaker #7: And also secondly, what we have seen during the second half of the year has been some seasonality mainly driven by the holiday season in Europe, where patients tend to take holiday drug holiday break or actually delay their initiation of the new therapy start.

Speaker #7: But overall, strong growth across regions seems like generic semaglutide is stimulating market growth. And we continue to do well. We expect continued strong year-on-year growth, and sequential growth driven by patient activation.

Mike Czapar: Great. Thank you, Patrik. Next caller please, Paul.

Speaker #3: Great. Thank you, Patrick. Next caller, please, Paul.

Speaker #4: The next question will be from Seamus Fernandez from Guggenheim. Seamus, your line is live.

Operator 3: The next question will be from Seamus Fernandez from Guggenheim. Seamus, your line is live.

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

Speaker #6: Oh, great. Thanks for the question. So really, we just wanted to get a better understanding of how the market, as you see it, is starting to segment and could segment going forward.

Seamus Fernandez: Great. Thanks for the question. Really we just wanted to get a better understanding of how the market as you see it, is starting to segment and could segment going forward. More, you know, as you look forward to the potential introduction of retatrutide, amidst the Soundio launch, as well as then the follow-on to that being the eloralintide. Where do you see the market really opening up with each of these potential assets reaching forward? Thanks so much.

Seamus Fernandez (Guggenhei: Great. Thanks for the question. Really we just wanted to get a better understanding of how the market as you see it, is starting to segment and could segment going forward. More, you know, as you look forward to the potential introduction of retatrutide, amidst the Soundio launch, as well as then the follow-on to that being the eloralintide. Where do you see the market really opening up with each of these potential assets reaching forward? Thanks so much.

Speaker #6: More as you look forward to the potential introduction of Retacutide, amidst the thumb dial launch, as well as then the follow-on to that being the LR Allen punch, where do you see the market really opening up with each of these potential assets reaching forward?

Speaker #6: Thanks so much.

Speaker #3: Great. Thanks, Seamus. For that question, we'll go to Ken to talk a bit about the broadly portfolio and how we see the market segmenting.

Mike Czapar: Great. Thanks, Seamus. For that question, we'll go to Kenneth Custer to talk a bit about the broader Lilly portfolio and how we see the market segmenting.

Speaker #5: Yeah, sure. Thanks for the question, Seamus. I think it's reasonable to expect in this large and growing market an opportunity in obesity that with the number of patients around the world living with overweight or obesity, numbering perhaps in the billions, that many of them are going to want different types of medicines that are tailored to their individual needs and preferences.

Kenneth Custer: Yeah, sure. Thanks for the question, Seamus. I think it's reasonable to expect in this large and growing market and opportunity in obesity that with, you know, the number of patients around the world living with overweight or obesity numbering perhaps in the billions, that many of them are gonna want different types of medicines that are tailored to their individual needs and preferences. We're in early innings in that regard. We're now sort of bringing the third segment, I guess, in. We've had GLP-1 single agonists and then dual agonists and now oral medicines. We see many other sort of plausible opportunities to tailor medicines to different groups.

Ken Custer: Yeah, sure. Thanks for the question, Seamus. I think it's reasonable to expect in this large and growing market and opportunity in obesity that with, you know, the number of patients around the world living with overweight or obesity numbering perhaps in the billions, that many of them are gonna want different types of medicines that are tailored to their individual needs and preferences. We're in early innings in that regard. We're now sort of bringing the third segment, I guess, in. We've had GLP-1 single agonists and then dual agonists and now oral medicines. We see many other sort of plausible opportunities to tailor medicines to different groups.

Speaker #5: We're in early innings in that regard. We're now sort of bringing the third segment, I guess, in. We've had GLP-1 single agonists and then dual agonists.

Speaker #5: And now oral medicines. But we see many other sort of plausible opportunities to tailor medicines to different groups. As you noted, Retacutide is one of those ideas which very obviously could play to individuals who are seeking greater weight loss.

Kenneth Custer: As you noted, retatrutide is one of those ideas, which very obviously could play to individuals who are seeking greater weight loss, although I will say we see opportunities for retatrutide elsewhere and across the spectrum of obesity. Eloralintide, we can position that a few ways based on the phase 2 data that we've seen. The first of which is that this could be a great medicine for patients seeking a non GLP-1-based mechanism, perhaps due to tolerability they've experienced or tolerability that they're fearful of. It may also be a good drug that could be added on top of existing incretin therapies to provide incremental weight lowering. There's many other ideas out there Lilly's investing in. That includes medicines that could be dosed even less frequently, perhaps those that dial in addition.

Ken Custer: As you noted, retatrutide is one of those ideas, which very obviously could play to individuals who are seeking greater weight loss, although I will say we see opportunities for retatrutide elsewhere and across the spectrum of obesity. Eloralintide, we can position that a few ways based on the phase 2 data that we've seen. The first of which is that this could be a great medicine for patients seeking a non GLP-1-based mechanism, perhaps due to tolerability they've experienced or tolerability that they're fearful of. It may also be a good drug that could be added on top of existing incretin therapies to provide incremental weight lowering. There's many other ideas out there Lilly's investing in. That includes medicines that could be dosed even less frequently, perhaps those that dial in addition.

Speaker #5: Although I will say we see opportunities for Retacutide elsewhere and across the spectrum of obesity. Alorilintide we can position that a few ways based on the Phase 2 data that we've seen.

Speaker #5: The first of which is that this could be a great medicine for patients seeking a non-GLP-1-based mechanism, perhaps due to tolerability they've experienced or tolerability that they're fearful of.

Speaker #5: It may also be a good drug that could be added on top of existing Incretin therapies to provide incremental weight lowering. But there's many other ideas out there.

Speaker #5: Lilly's investing in. That includes medicines that could be dosed even less frequently. Perhaps those that dial in additional metabolic benefits. And maybe some that are sort of ultra-long-acting using genetic medicine approaches.

Kenneth Custer: Excuse me, additional metabolic benefits, and maybe some that are sort of ultra long-acting using genetic medicine approaches. We see all of these as compelling ideas, and we also feel we're in a leading position in most, if not all, of those spaces. You know, in terms of how the market will ultimately shake out in terms of percentage of use across those different ideas, it's hard to prognosticate that. Many of these ideas are tied to common manufacturing platforms, and we're making the investments to support any of them, should they prove to be really the most favorable option for managing weight and obesity.

Ken Custer: Excuse me, additional metabolic benefits, and maybe some that are sort of ultra long-acting using genetic medicine approaches. We see all of these as compelling ideas, and we also feel we're in a leading position in most, if not all, of those spaces. You know, in terms of how the market will ultimately shake out in terms of percentage of use across those different ideas, it's hard to prognosticate that. Many of these ideas are tied to common manufacturing platforms, and we're making the investments to support any of them, should they prove to be really the most favorable option for managing weight and obesity.

Speaker #5: We see all of these as compelling ideas, and we also feel we're in a leading position in most, if not all, of those spaces.

Speaker #5: In terms of how the market will ultimately shake out in terms of percentage of use across those different ideas, it's hard to prognosticate that.

Speaker #5: But many of these ideas are tied to common manufacturing platforms. And we're making the investments to support any of them, should they prove to be really the most favorable option for managing the overweight and obesity.

Speaker #3: Great. Thank you, Ken. We'll go to the next question, please, Paul.

Mike Czapar: Great. Thank you, Ken. We'll go to the next question, please, Paul.

Speaker #4: The next question will be from Alex Hammond from Wolf Research. Alex, your line is live.

Operator 3: The next question will be from Alexandria Hammond from Wolfe Research. Alex, your line is live.

Operator: The next question will be from Alexandria Hammond from Wolfe Research. Alex, your line is live.

Speaker #8: Good morning, guys. Thanks for taking the question. On Medicare Access, can you walk us through your strategy to activate these patients? And when do you kind of see this playing out in terms of either maybe a 4Q dynamic or more of a 2027 as these patients pull through?

Alexandria Hammond: Good morning, guys. Thanks for taking the question. On Medicare access, can you walk us through your strategy to activate these patients? When do you kinda see this playing out in terms of either maybe a Q4 dynamic or more of a 2027 as these patients pull through? I guess as well, with the attractive price point, how do you think about persistence in this population?

Alex Hammond: Good morning, guys. Thanks for taking the question. On Medicare access, can you walk us through your strategy to activate these patients? When do you kinda see this playing out in terms of either maybe a Q4 dynamic or more of a 2027 as these patients pull through? I guess as well, with the attractive price point, how do you think about persistence in this population?

Speaker #8: And I guess as well with the attractive price point, how do you think about persistence in this population?

Mike Czapar: Okay. Thanks, Alex. For the question about Medicare access and sort of staging over time, we'll go to Ilya.

Speaker #3: Okay. Thanks, Alex, for the question about Medicare Access and sort of staging over time. We'll go to Ilya.

Speaker #9: Yeah, great. Thank you for the question. Obviously, we're excited about having Part D access starting to activate for obesity medicines starting in July. And the way that we think about it, there are millions of Part D beneficiaries that are eligible.

Ilya Yufa: Yeah, great. Thank you for the question. Obviously, we're excited about having Part D access starting to activate for obesity medicines starting in July. In the way that we think about it, there are millions of Part D beneficiaries that are obese or overweight people. The path to that with having a long trajectory with a big bridge program of not only starting in July all through 2027 is an important aspect. Obviously, that'll take time to build. We need to have the education across physician base, pharmacies, as well as consumer base understand the full path of different medicines that we have and that are available for treating obesity. That'll be a gradual path in 2026 as it starts, and then continued growth in 2027.

Speaker #9: And so the path to that with having a long trajectory with a good program of not only starting in July. All through 2027 is an important aspect.

Speaker #9: Obviously, that'll take time to build. We need to have the education across physician-based, pharmacies, as well as consumer-based to understand the full path of different medicines that we have and what are available for treating obesity.

Speaker #9: And so that'll be a gradual path in 2026 as it starts. And then continued growth in 2027. And obviously, the $50 a month copay is an important element of affordability for seniors.

Ilya Yufa: Obviously, the $50 a month copay is an important element of affordability for seniors. We've already seen for Zepbound as well as Mounjaro that they've had great persistency overall relative to other chronic conditions, and we continue to see that. Obviously, the $50 copay and affordability will only just add to that in addition to all of the health benefits and experiences that people will have over time. We're excited about expanding access very soon.

Speaker #9: We've already seen for Zepbound as well as Mounjaro that they've had great persistency overall relative to other chronic conditions. And we continue to see that.

Speaker #9: Obviously, the $50 copay and affordability will only just add to that in addition to all of the health benefits and experiences that people will have over time.

Speaker #9: So we're excited about expanding access very soon.

Mike Czapar: Great. Thank you, Ilya. Next question please, Paul.

Speaker #3: Great. Thank you, Ilya. Next question, please, Paul.

Speaker #4: The next question. The question will be from Evan Segerman from BMO Capital. Evan, your line is live.

Operator 3: The next question will be from Evan Seigerman from BMO Capital. Evan, your line is live.

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

Speaker #10: Hi, guys. Thank you so much for taking my question. Bigger picture, strategically, as you think about the next levers of growth for the business, what do you need to see from either the INI, neuroscience, or oncology franchises to kind of match the scale of the obesity metabolic businesses or particular assets?

Evan Seigerman: Hi, guys. Thank you so much for taking my question. Bigger picture, strategically, you know, as you think about the next, you know, levers of growth of the business, what do you need to see from either the I&I, neuroscience, or oncology franchises to kind of match the scale of the obesity metabolic businesses or particular assets? Is it, you know, BD or something else? Thank you.

Speaker #10: Is it BD or something else? Thank you.

Speaker #3: Great. Thanks, Evan. We'll go to Dan to talk about some of the important programs that he's focused on to drive growth in the future.

Mike Czapar: Great. Thanks, Evan. We'll go to Dan to talk about some of the important programs that he's focused on to drive growth in the future.

Speaker #11: Yeah, thanks, Evan, for that question. And it's an important one to us. For starters, you're asking about scale. But I'd point out, in growth rate, that those businesses are growing extremely fast—even without the obesity and metabolic business, Lilly would be the fastest, or certainly one of the fastest-growing pharmaceutical companies in the industry.

Daniel Skovronsky: Thanks, Evan, for that question. It's an important one to us. To start, you're asking about scale. I point out in growth rate, those businesses are growing extremely fast. Even without the obesity and metabolic business, Lilly would be the fastest or certainly one of the fastest-growing pharmaceutical companies in the industry. We're proud of what we're doing in those three areas. I think each of them has very significant unmet medical needs that we can scale into as our medicines are successful. We like what we got. We like the direction we're going. Of course, in each of those areas, we also see opportunities to get a lot bigger. We've highlighted some of the themes already in those areas.

Dan Skovronsky: Thanks, Evan, for that question. It's an important one to us. To start, you're asking about scale. I point out in growth rate, those businesses are growing extremely fast. Even without the obesity and metabolic business, Lilly would be the fastest or certainly one of the fastest-growing pharmaceutical companies in the industry. We're proud of what we're doing in those three areas. I think each of them has very significant unmet medical needs that we can scale into as our medicines are successful. We like what we got. We like the direction we're going. Of course, in each of those areas, we also see opportunities to get a lot bigger. We've highlighted some of the themes already in those areas.

Speaker #11: So we're proud of what we're doing in those three areas. And I think each of them has very significant unmet medical needs, that we can scale into as our medicines are successful.

Speaker #11: So we like what we got. We like the direction we're going. Of course, in each of those areas, we also see opportunities to get a lot bigger.

Speaker #11: And we've highlighted some of the themes already in those areas. You'll also see us address some of that through business development. So for example, the Synthesa acquisition allows us to play in a new area here in sleep-wake medicines.

Daniel Skovronsky: You'll also see us address some of that through business development. For example, the Centessa acquisition allows us to play in a new area here in sleep-wake medicines. The Orna acquisition allows us to play in new areas of immune reset, for example.

Dan Skovronsky: You'll also see us address some of that through business development. For example, the Centessa acquisition allows us to play in a new area here in sleep-wake medicines. The Orna acquisition allows us to play in new areas of immune reset, for example.

Speaker #11: The Warna acquisition allows us to play in new areas of immune reset, for example.

Mike Czapar: Great. Thanks, Dan. Next question please, Paul.

Speaker #3: Great. Thanks, Dan. Next question, please, Paul.

Speaker #4: The next question will be from Asad Haider from Goldman Sachs. Asad, your line is live.

Operator 3: The next question will be from Asad Haider from Goldman Sachs. Asad, your line is live.

Operator: The next question will be from Asad Haider from Goldman Sachs. Asad, your line is live.

Speaker #12: Great, thanks for the quote of getting the question, and congrats on the continued strong execution. Maybe just going back to Fundayo, appreciate all the color on early launch dynamics, which is sort of playing out along the lines of your messaging that the initial launch trajectory is going to live below that of oral Wegovy.

Asad Haider: Great. Thanks for taking the question and congrats on the continued strong execution. Maybe just going back to Foundayo, appreciate all the color on early launch dynamics, which is sort of playing out along the lines of your messaging that the initial launch trajectory is gonna live below that of oral Wegovy, but then there's gonna be an acceleration as we move into H2. Just now with a few weeks of launch under your belt, I think you said 15,000 patients have started taking the drug already, what's your level of confidence on that launch curve framing in the context of the early experience?

Speaker #12: But then there's going to be an acceleration as we move into the back half of the year. So just now with a few weeks of launch under your belt, I think you said at 15,000 patients have started taking the drug already.

Speaker #12: What's your level of confidence on that launch curve framing in the context of the early experience? And then, related to the guidance range, are you able to provide any high-level commentary on what type of contribution was factored in for Fundayo, recognizing that you said the revised range reflects mainly the strong underlying performance of Mounjaro and Zepbound?

Asad Haider: Related on the guidance range, are you able to provide any high-level commentary on what type of contribution was factored in for Foundayo, recognizing that you said that the revised range reflects mainly the strong underlying performance of Mounjaro and Zepbound? Thank you.

Speaker #12: Thank you.

Mike Czapar: Great. Great. Great. Thanks for the question, Asad. Ilya, do you wanna talk about some of the early launch metrics that you're tracking and the feedback you're hearing, and then maybe just a short comment from Lukas about the guide?

Speaker #3: Great. Great. Great. Thanks for the question, Asad. Ilya, do you want to talk about some of the early launch metrics that you're tracking and the feedback you're hearing?

Speaker #3: And then maybe just a short guide.

Speaker #12: Sure. Well, first, it is early days, but we're pretty pleased with the trajectory and encouraging first start to launch. Obviously, we just started active Salesforce promotion just over a week ago.

Ilya Yufa: Sure. Well, first it is early days. We're pretty pleased with the trajectory and encouraging first start to launch. Obviously, we just started active salesforce promotion just over a week ago, having broad availability in the supply channel just two weeks ago. Really, we're encouraged by the initial leading indicators. The way that we think about it, there are probably three key factors and catalysts of growth. Those three are, one, growing the familiarity among healthcare providers on the clinical profile of Foundayo, building out the access, and growing the awareness of Foundayo with consumers. We're making progress on all three fronts. On HCPs, if you take out the early indicators, we now have over 8,000 prescribers of Foundayo, a third of which who have not previously written an oral GLP-1.

Speaker #12: Having broad availability in the supply channel just two weeks ago. Really, we're encouraged by the initial leading indicators. And the way that we think about it, there are probably three key factors and catalysts of growth.

Speaker #12: And those three are: one, growing the familiarity among healthcare providers on the clinical profile Fundayo, building out the access, and growing the awareness of Fundayo with consumers.

Speaker #12: And we're making progress on all three fronts. And so on HTPs, if you think about the early indicators, we now have over 8,000 prescribers of Fundayo, a third of which who have not previously written an oral GLP-1.

Speaker #12: And so this is expansive. And the current sentiment so far, what we're hearing is really positive on the overall efficacy and kind of the no-hassle factor on a daily oral GLP-1.

Ilya Yufa: This is expansive, and the current sentiment so far, what we're hearing is really positive on the overall efficacy and kind of the no hassle factor on a daily oral GLP-1. That's an important aspect. We'll continue on the execution related to HCPs around sampling, continued promotion throughout salesforce, as well as educational seminars, and we're fully in the field with our promotional efforts with HCPs. Good progress there. On access, we've confirmed commercial access at 2 of the large PBMs as by middle of May, so just in a couple of weeks. You know, to the earlier question on Medicare access will start at the beginning of July. Those are continued catalysts of growth upcoming in the next couple of months.

Speaker #12: And so that's an important aspect. We'll continue on the execution related to HTPs around sampling, continued promotion through our Salesforce, as well as educational seminars and we're fully in the field with our promotional efforts with HTPs.

Speaker #12: So good progress there. On access, we've confirmed commercial access at two of large PBMs by middle of May, so just in a couple of weeks.

Speaker #12: And to the earlier question on Medicare, Medicare access will start at the beginning of July. And so those are continued catalysts of growth upcoming in the next couple of months.

Speaker #12: And so we see that as an important unlock and expansion as well. And then on the third piece on consumer front, we now have just over 20,000 patients treated to date.

Ilya Yufa: We see that as an important unlock and expansion as well. On the third piece, on consumer front, we now have just over 20,000 patients treated to date. One important element there is that 80% of those Foundayo prescriptions are new to class. This is expansive in bringing new people into being treated for overweight or obesity. We've done a number of aspects already around the direct to consumer on digital, on social media and others, but obviously we will continue those efforts on a full-scale direct to consumer and TV launch in Q3. Important there is just to ensure that prescribers have familiarity around the profile of Foundayo before we do that. Bottom line, I think we're pleased with the progress.

Speaker #12: And one important element there is that 80% of those Fundayo prescriptions are new to class. So this is expansive in bringing new people into being treated for overweight or obesity.

Speaker #12: We've done a number of aspects already around the direct-to-consumer on digital on social media, and others. But obviously, we will continue those efforts on a full-scale direct-to-consumer and TV launch in Q3.

Speaker #12: Important there is just to ensure that prescribers have familiarity around the profile of Fundayo before we do that. So bottom line, I think we're pleased with the progress.

Speaker #12: Early indicators are positive and moving in the right direction. And the trajectory will build over time. This is a new brand, new medicine that we're bringing into the market.

Ilya Yufa: Early indicators are positive and moving in the right direction, and the trajectory will build over time. This is a new brand, new medicine that we're bringing to the market. We're pleased and ready to go.

Speaker #12: So we're pleased and ready to go.

Speaker #3: Maybe on the second part, going to the guidance, Asad, just to highlight a couple of things. Of course, again, the increase on our guide is driven by the strength of the entire portfolio that we mentioned during the call, starting, of course, with the increasing portfolio, both in the US and OUS.

Lucas Montarce: Maybe on the second part, going to the guidance, just to highlight a couple of things. Of course, again, the increase on our guide is driven by the strength of the entire portfolio that we mentioned during the call, starting of course, with the incretin portfolio, both in the US and our US. In terms of Foundayo per se, you've heard already from Ilya about how we continue to see progress and very encouraging feedback that we hear from payers, physicians and patients as well. We set up the plan at the beginning of the year, and it's very early days. We have 3 weeks of data at this time, so it's tracking to our expectations, and we will continue to see how this progress over the year.

Speaker #3: In terms of Fundayo per se, you've heard already from Ilya about how we continue to see progress, and very encouraging feedback that we hear from payers, physicians, and patients as well.

Speaker #3: We set up the plan at the beginning of the year. And it's very early days. We have three weeks of data at this time.

Speaker #3: So it's tracking to our expectations. And we will continue to see how this progress over the year. But we feel very confident on the trajectory that we've seen so far.

Lucas Montarce: We feel very confident on the trajectory that we've seen so far.

Speaker #12: Great. Thanks, Lucas. Paul, next caller, please.

Mike Czapar: Great. Thanks, Lucas. Paul, next caller, please.

Speaker #4: The next question will be from James Shen from Deutsche Bank. James, your line is live.

Operator 3: The next question will be from James Shin from Deutsche Bank. James, your line is live.

Operator: The next question will be from James Shin from Deutsche Bank. James, your line is live.

Speaker #13: Hey, good morning, guys. Thank you for the question. This one's for Dave. With bridge extending into 2027, Dave, what's next for balance? Is Lilly working with stakeholders on revisions to secure longer-term Medicare access?

James Shin: Hey, good morning, guys. Thank you for the question. This one's for Dave. With Bridge extending into 2027, Dave, what's next for Balance? Is Lilly working with stakeholders on revisions to secure longer term Medicare access? Thank you.

Speaker #13: Thank you.

Speaker #3: Thanks, James. Dave, do you want to share a few comments about the bridge balance dynamics?

Mike Czapar: Thanks, James. David, do you wanna share a few comments about the Bridge/Balance dynamics?

Speaker #12: Sure. Yeah. Look, when we signed the agreement with the administration, we all knew Bridge was going to be put in place because it was a mid-year launch.

David Ricks: Sure, yeah. look, when we signed the agreement with the administration, we all knew Bridge was gonna be put in place 'cause it was a mid-year launch. we had understood at the time that there was a commitment to 2027, if, as a contingency, the Part D plans did not choose to opt in at a certain rate. Of course, we now know they didn't, and maybe that's not so surprising. you know, they operate on their margins. There's been other, disturbances and market events in the Part D program, for instance, the IRA products, et cetera, that have changed their economics. unfortunately, I guess not being a part of those discussions, but they couldn't cross with the major players for calendar 2027. the government's doing what they said, and they're extending Bridge.

Dave Ricks: Sure, yeah. look, when we signed the agreement with the administration, we all knew Bridge was gonna be put in place 'cause it was a mid-year launch. we had understood at the time that there was a commitment to 2027, if, as a contingency, the Part D plans did not choose to opt in at a certain rate. Of course, we now know they didn't, and maybe that's not so surprising. you know, they operate on their margins. There's been other, disturbances and market events in the Part D program, for instance, the IRA products, et cetera, that have changed their economics. unfortunately, I guess not being a part of those discussions, but they couldn't cross with the major players for calendar 2027. the government's doing what they said, and they're extending Bridge.

Speaker #12: And we had understood at the time that there was a commitment to 27 if, as a contingency, the Part D plans did not choose to opt in at a certain rate.

Speaker #12: Of course, we now know they didn't. And maybe that's not so surprising—they operate on margins. There's been other disturbances and market events in the Part D program.

Speaker #12: For instance, the iPay products, etc., that have changed their economics. And unfortunately, I guess, not being a part of those discussions, but they couldn't cross with the major players for calendar 27.

Speaker #12: So the government's doing what they said. And they're extending bridge. I think for manufacturers, there's some puts and takes in that. But the fact that they'll be accessed to the consumers at $50 a month, I think, is a very compelling proposition, as Ilya highlighted before.

David Ricks: I think for manufacturers there's some puts and takes in that. The fact that there'll be access to the consumers at $50 a month, I think is a very compelling proposition, as Ilya Yufa highlighted before, will drive great persistency. In an 18-month window, I think we will start to see population-level health improvements if these are used at scale. That will set up the 2028 discussion. I would expect the government to lean hard into getting Part D plan participation in 2028 and normalizing obesity care as a standard preventative treatment and something that should be used to treat comorbidities of obesity within the senior population. We may have the evidence to support that as we exit 2027. It may need a little more time, but I think they're gonna push to help make that happen.

Dave Ricks: I think for manufacturers there's some puts and takes in that. The fact that there'll be access to the consumers at $50 a month, I think is a very compelling proposition, as Ilya Yufa highlighted before, will drive great persistency. In an 18-month window, I think we will start to see population-level health improvements if these are used at scale. That will set up the 2028 discussion. I would expect the government to lean hard into getting Part D plan participation in 2028 and normalizing obesity care as a standard preventative treatment and something that should be used to treat comorbidities of obesity within the senior population. We may have the evidence to support that as we exit 2027. It may need a little more time, but I think they're gonna push to help make that happen.

Speaker #12: We'll drive great persistency. And in an 18-month window, I think we will start to see population-level health improvements if these are used at scale.

Speaker #12: That will then set up the '28 discussion. I would expect the government to lean hard into getting Part D plan participation in '28, and normalizing obesity care as a standard preventative treatment, and something that should be used to treat comorbidities of obesity within the senior population.

Speaker #12: We may have the evidence to support that as we exit 27. It may need a little more time, but I think they're going to push to help make that happen.

Speaker #12: And I think that normalization is overdue in the commercial market. So it'll be a good leading indicator for us across the US business. We'll continue to work with the government closely through that period.

David Ricks: I think that's, that normalization is overdue in the commercial market, so it'll be a good leading indicator for us across the US business. We'll continue to work with the government closely through that period and of course, try to work with them to activate patients and make sure they can find success on our medicines. Stay tuned. Probably more news as we exit 2026 on the actual 2028 plans.

Dave Ricks: I think that's, that normalization is overdue in the commercial market, so it'll be a good leading indicator for us across the US business. We'll continue to work with the government closely through that period and of course, try to work with them to activate patients and make sure they can find success on our medicines. Stay tuned. Probably more news as we exit 2026 on the actual 2028 plans.

Speaker #12: And of course, try to work with them to activate patients and make sure they can find success on our medicines. So stay tuned. Probably more news as we exit 26 on the actual 28 plans.

Mike Czapar: Great. Thank you, Dave. Next question please, Paul.

Speaker #3: Great. Thank you, Dave. Next question, please, Paul.

Speaker #4: The next question is coming from Mohit Pansal from Wells Fargo. Mohit, your line is live.

Operator 3: The next question is coming from Mohit Bansal from Wells Fargo. Mohit, your line is live.

Operator: The next question is coming from Mohit Bansal from Wells Fargo. Mohit, your line is live.

Speaker #3: Great. Thank you very much for taking my question, and congrats on the progress. I just want to touch upon the Employer Connect program that you are embarking upon.

Mohit Bansal: Great. Thank you very much for taking my question and congrats on the progress. I just want to touch upon the Employer Connect program that you are embarking upon. It seems like the insurance, or commercial insurance has been relatively stable-ish year over year. This seems to be the way to grow it. Employers are worried about, you know, their cost long term and everything. Would love to understand what are the steps to convince employers to buy in into the Employer Connect program and the mechanics of it. Thank you.

Speaker #3: So, it seems like the insurance, or commercial insurance, has been relatively stable-ish year over year. So, this seems to be the way to grow it.

Speaker #3: And employers are worried about their costs long-term and everything. So we'd love to understand what are the steps to convince employers to buy in into the employer connect program and the mechanics of it.

Speaker #3: Thank you.

Speaker #12: Thanks, Mohit. Ilya, do you want to make a few comments about employer connect and the progress and focus?

Mike Czapar: Thanks, Mohit. Ilya, do you wanna make a few comments about Employer Connect and the progress and focus?

Speaker #2: Sure. Thanks, Mohit. Yeah, listen, as you mentioned, the overall commercial access has been pretty steady around 50%. And one of the key aspects that we're excited about is having an employer connect platform where we work with a number of third parties to actually go out and talk to different employers about the value of covering obesity care, but there are several.

Ilya Yufa: Sure. Thanks, Mohit. As you mentioned, the overall commercial access has been pretty steady around 50%. One of the key aspects that we are excited about is having a Employer Connect platform where we work with a number of third parties to actually go out and talk to different employers about the value of covering obesity care. There are several things that are a little bit different with our Employer Connect program. One is a transparent price that is known to all of the employers and providing the flexibility and design around the employer/employee contribution towards obesity coverage. We do think that this is a positive element to increase the number of employers to opting in. Obviously, the selling cycle and the timeline for making decisions for 2026 has already passed.

Speaker #2: That are a little bit different with our employer connect program. One is a transparent price that is known to all of the employers. And providing the flexibility and design around the employee-employee contribution towards obesity coverage.

Speaker #2: And so we do think that this is a positive element to increase the number of employers opting in. Obviously, the selling cycle and the timeline for making decisions for '26 has already passed.

Speaker #2: So, while we are currently having positive conversations and positive feedback from employers around this new platform, that will most likely have a gradual impact in the back half of '26.

Ilya Yufa: While we are currently having positive conversations and positive feedback from employers around this new platform, that will most likely have a gradual impact in the back half of 2026 and most likely incremental opt-ins for 2027. As part of that, obviously, there's gonna be more data on real-world evidence and also components of where employers do cover, what are the benefits to their employees overall, both in their health and productivity over time. As that data comes out, that will only reinforce the positive decision to provide coverage for obesity care.

Speaker #2: And most likely, incremental opt-ins for '27. And then, as part of that, obviously there's going to be more data on real-world evidence. And also, components of where employers do cover—what are the benefits to their employees overall, both in their health and productivity over time.

Speaker #2: And as that data comes out, that will only reinforce the positive decision to provide coverage for obesity care.

Speaker #3: Great. Thank you. Next question, please, Paul.

Mike Czapar: Great. Thank you. Next question, please, Paul.

Speaker #4: The next question will be from Terrence Flynn from Morgan Stanley. Terrence, your line is live.

Operator 3: The next question will be from Terence Flynn from Morgan Stanley. Terence, your line is live.

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

Speaker #13: Great. Congrats on all the progress. Had a question broadly. You talked to the portfolio that you're going to be you currently have, but you're also rolling out across the Incretin area.

Terence Flynn: Great. Congrats on all the progress. Had a question broadly. You talked to the portfolio that you currently have, but you're also rolling out across the incretin area. As you think about the evolution, I guess, of the DTC channel, what are some of the things you're considering to kind of leverage Lilly's scale in that channel? Then also anything that you think will help there from a commercial side in terms of driving additional coverage, in terms of having scale across the portfolio. Thank you.

Speaker #13: And the DTC channel, what are some of the things you're considering to kind of leverage Lilly's scale in that channel? And then also, anything that you think will help there from a commercial side in terms of driving additional coverage in terms of having scale across the portfolio?

Speaker #13: Thank you.

Speaker #3: Thanks for the question, Terrence. We'll go to Dave to talk a bit about the portfolio strategy and leveraging DTC.

Mike Czapar: Thanks for the question, Terence. We'll go to David to talk a bit about the portfolio strategy and leveraging DTC.

Speaker #14: Sure. And Ilya and Patrick can jump in here. I think you're pointing out something story here for our growth, which is consumers wanting to take charge of their own health and activate the digital platforms to control weight and obesity.

David Ricks: Sure. Ilya and Patrik can jump in here. I think you're pointing out something that has evolved and been developing part of the story here for our growth, which is, you know, consumers wanting to take charge of their own health and activate the digital platforms to control weight and obesity. I think this is here to stay, and it's a big part of our business now and probably something we need to continue to invest in. We're doing just that, so you should expect continuous improvement in that experience for consumers in the US and then expansion nationally with the current offerings. I would also say, you know, this notion as we move into other kinds of medicines that could be more preventative, could be quite a useful platform to reach more people.

Dave Ricks: Sure. Ilya and Patrik can jump in here. I think you're pointing out something that has evolved and been developing part of the story here for our growth, which is, you know, consumers wanting to take charge of their own health and activate the digital platforms to control weight and obesity. I think this is here to stay, and it's a big part of our business now and probably something we need to continue to invest in. We're doing just that, so you should expect continuous improvement in that experience for consumers in the US and then expansion nationally with the current offerings. I would also say, you know, this notion as we move into other kinds of medicines that could be more preventative, could be quite a useful platform to reach more people.

Speaker #14: I think this is here to stay. And it's a big part of our business now and probably something we need to continue to invest in.

Speaker #14: We're doing just that. So you should expect continuous improvement. And that experience for consumers in the US. And then expansion nationally. With the current offerings, I would also say this notion, as we move into other kinds of medicines that could be more preventative, could be quite a useful platform to reach more people.

Speaker #14: We all know that the financing of the current healthcare system is a struggle everywhere. And with all the noise around PAs and other barriers to care people need, people want to take it in their own hands.

David Ricks: We all know that the financing of the current healthcare system is a struggle everywhere, and with, you know, all the noise around PAs and other barriers to care people need, people wanna take it in their own hands. I think, of course, we need to do that within the confines of the regulations and law, but there's a lot of room for improvement for consumers, and it's a great outlet potentially for us. Let me ask Ilya or Patrik to add to that if they have anything to add on LillyDirect and our offerings.

Dave Ricks: We all know that the financing of the current healthcare system is a struggle everywhere, and with, you know, all the noise around PAs and other barriers to care people need, people wanna take it in their own hands. I think, of course, we need to do that within the confines of the regulations and law, but there's a lot of room for improvement for consumers, and it's a great outlet potentially for us. Let me ask Ilya or Patrik to add to that if they have anything to add on LillyDirect and our offerings.

Speaker #14: And I think, of course, we need to do that within the confines of the regulations and law. But there's a lot of room for improvement for consumers.

Speaker #14: And it's a great outlet potentially for us. So let me ask Ilya or Patrick to add to that if they have anything to add.

Speaker #14: On Lilly Direct and our offerings.

Speaker #2: Yeah, sure. Just maybe a few key components of what we've seen on Lilly Direct. Even with Zepbound, you've seen that currently, around 55% of new patient starts are coming through self-pay, most of which is coming through Lilly Direct or telehealth players, which is a component of reducing some of the frictions in place.

Ilya Yufa: Yeah, sure. Just maybe a few key components of what we've seen on Lilly Direct. Even with Zepbound, you've seen that currently around 55% of new patient starts are coming through self-pay for, most of which is coming through Lilly Direct or telehealth players, which is a component of reducing some of the frictions in place. Even early in our launch at Foundayo, with limited promotion, we're seeing that that reduced friction level and understanding direct to the consumer is an important lever. About 45% of our volume for Foundayo early on is coming through Lilly Direct. We continue to look at ways to improve on the experience for both providers and for consumers in the way they get their health and enter their journey for disease.

Speaker #2: And even early in our launch, at Fondeo, with limited promotion, we're seeing that that reduced friction level and understanding direct to the consumer is an important lever.

Speaker #2: About 45% of our volume for Fondeo early on is coming through Lilly Direct. And so, we continue to look at ways to improve on the experience for both providers and for consumers in the way they get their disease, and obviously, it plays a significant role for obesity currently.

Ilya Yufa: Obviously, it plays a significant role for obesity currently.

Speaker #3: Thank you.

Speaker #13: Yeah. Similarly, outside of the US, I thought earlier to us being at a very high market share and most of the markets already and patient activation is going to drive the most of the coming growth.

David Ricks: Great.

Dave Ricks: Great.

Patrik Jonsson: Yeah. Similarly, outside of US, I referred earlier to us being at a very high market share in most of the markets already, patient activation is going to drive the most of the coming growth. We have seen that the markets are responding to patient activation efforts, although it's a slower ramp. That's going to be key, taking into account the low penetration of incretin outside of the US.

Speaker #13: And we have seen that the markets are responding to patient activation efforts, although it's a slower ramp. But that's going to be key, taking into account the low penetration of incretin outside of the US.

Speaker #3: Thank you. Let's move to the next question, please.

Mike Czapar: Thank you. Let's move to the next question, please.

Speaker #4: The next question will be from Umar Rifat from Evercore. Umar, your line is live.

Operator 3: The next question will be from Umair Rafat from Evercore. Umair, your line is live.

Operator: The next question will be from Umair Rafat from Evercore. Umair, your line is live.

Speaker #15: Hi guys. Thanks for taking my question. I thought I'd spend a quick second on Zepbound's commercial dynamics in the US. And really, what I'm trying to understand is, for example, in Q1, 7 million TRx and $4.1 billion sales for Zepbound in the US, meaning it's about $580 per prescription.

Umair Rafat: Hi, guys. Thanks for taking my question. I thought I'll spend a quick second on Zepbound's commercial dynamics in US. Really what I'm trying to understand is, for example, Q1, 7 million TRx and $4.1 billion sales for Zepbound in US, meaning it's about $580 per prescription. Even if you adjust for the one-timer adjustments, it's still about $550 per Rx. Whereas we understand the cash pay prices to be about $450 or so, I mean, net prices too. I guess what explains that delta? Or maybe IMS is just not capturing some of your online channels. Thank you.

Umer Raffat: Hi, guys. Thanks for taking my question. I thought I'll spend a quick second on Zepbound's commercial dynamics in US. Really what I'm trying to understand is, for example, Q1, 7 million TRx and $4.1 billion sales for Zepbound in US, meaning it's about $580 per prescription. Even if you adjust for the one-timer adjustments, it's still about $550 per Rx. Whereas we understand the cash pay prices to be about $450 or so, I mean, net prices too. I guess what explains that delta? Or maybe IMS is just not capturing some of your online channels. Thank you.

Speaker #15: And even if you adjust for some of the one-timer adjustments, it's still about 550 dollars per RX. Whereas we understand the cash payer prices to be about 450 or so.

Speaker #15: Net prices too. I guess what explains that delta? Or maybe IMS is just not capturing some of your online channels. Thank you.

Speaker #3: Great, thanks, Umar. We'll go to Lucas to talk a bit about pricing dynamics in the U.S.

Mike Czapar: Great. Thanks, Umair. Well, Luke gets to talk a bit about pricing dynamics in the US.

Speaker #16: Yeah. Umar, thank you for your question. And quick math that your math is pretty spot on, by the way. So just to highlight, yes, an even normalizing by this period adjustments.

Lucas Montarce: Umair, thank you for your question and quick math. Your math is pretty spot on, by the way. Just to highlight, yes, and even normalizing by these peer period adjustments. First of all, again, going back to the initial question on pricing. If you carve out what we agreed on MFN side as well back in November and then the NRDL access, prices has been relatively stable quarter-on-quarter. I think it's going back to what we discussed last time about maintaining that price discipline. We continue to see that happening while we continue to grow significantly on the volume side as well. And yes, again, going back to your analysis on the pricing, yes, you have the LillyDirect prices that, as you know, we have adjusted down starting in December.

Speaker #16: First of all, again, going back to the initial question on pricing, if you carve out what we agreed on MFN side, as well back in then the NRDL access, prices have been relatively stable quarter on quarter.

Speaker #16: I think it's going back to what we discussed last time about maintaining that price discipline. We continue to see that happening while we continue to grow significantly on the volume side as analysis on the pricing, yes, you have the Lilly Direct prices that, as you know, we have adjusted down starting in December.

Lucas Montarce: Those prices have been very stable on that front as well. The rest, basically by difference, you get into the commercial business, mainly that that's the different portion that it gets to that net 550 that you highlighted.

Speaker #16: And those prices have been very stable on that front as well. And then the rest, basically by difference, you get into the commercial business, mainly that that's the different portion that it gets to that net 550 that you highlighted.

Speaker #3: Maybe just one add. I think that isn't widely appreciated is that there is a reasonable amount of medical exception and OSA usage that moves across channels at close to an undiscounted price.

David Ricks: Maybe I just wanna add, I think that isn't widely appreciated, there is a reasonable amount of medical exception and OSA usage that moves across channels at close to an undiscounted price. I think that's probably the piece of your math, Umair, that you might wanna take a look at.

Dave Ricks: Maybe I just wanna add, I think that isn't widely appreciated, there is a reasonable amount of medical exception and OSA usage that moves across channels at close to an undiscounted price. I think that's probably the piece of your math, Umair, that you might wanna take a look at.

Speaker #3: So, I think that's probably the piece of your math, Umar, that you might want to take a look at.

Mike Czapar: Great. Good. Thanks, Dave. Next question, please. We'll try to get through a couple more if we can.

Speaker #2: Good add. Thanks, Dave. Next question, please. We'll try to get through a couple more if we can.

Speaker #4: The next question will be from Courtney Breen from Bernstein. Courtney, your line is live.

Operator 3: The next question will be from Courtney Breen from Bernstein. Courtney, your line is live.

Operator: The next question will be from Courtney Breen from Bernstein. Courtney, your line is live.

Speaker #17: Hi, guys. Thanks so much for taking the question today. I know there's been a huge amount of focus on kind of the first few weeks of Fondeo.

Courtney Breen: Hi, guys. Thanks so much for taking the question today. I know there's been a huge amount of focus on kind of the first few weeks of Foundayo, and specifically kind of the launch strategy and activation of the different channels. Perhaps, Ken, it would be helpful if you could talk through how does this compare to kind of a traditional primary care launch? What things are you accelerating? What things are you holding back and for what reasons, particularly in the context of the fact that you've got extreme amounts of inventory pre-prepared for the launch of this product?

Speaker #17: And specifically, kind of the launch strategy and activation of the different channels. Perhaps can it be helpful if you could talk through how does this compare to kind of a traditional primary care launch?

Speaker #17: What things are you accelerating? What things are you holding back? And for what reasons? Particularly in the context of the fact that you've got extreme amounts of inventory pre-prepared for the launch of this product.

Speaker #3: Okay. Thanks, Courtney. Ilya, do you want to make a few more comments about the Fondeo launch, vis-à-vis primary care?

David Ricks: Okay. thanks, Courtney. Ilya, do you wanna make a few more comments about the Foundayo launch vis-à-vis primary care?

Dave Ricks: Okay. thanks, Courtney. Ilya, do you wanna make a few more comments about the Foundayo launch vis-à-vis primary care?

Speaker #16: Sure. Yeah, maybe just probably the three elements I discussed earlier are probably the same for all of our primary care launches. Where you need to grow the prescriber base and understanding of the profile of the medicine and that's what we're doing here with Fondeo.

Ilya Yufa: Sure. Probably the three elements I discussed earlier are probably the same for all of our primary care launches, where you need to grow the prescriber base and understanding of the profile of the medicine, and that's what we're doing here with Foundayo. Building out access and, quite frankly, this is actually gaining access very early in launch, both on the commercial side, having two of the three being activated in the next couple of weeks and getting Part D, which usually lags in July, is a faster ramp on access, and so we're excited about that aspect. The piece that is probably on the primary care side an important element that many have noted is around DTC.

Speaker #16: Building out access and, quite frankly, this is actually getting access very early in launch. Both on the commercial side—having two of the three being activated in the next couple of weeks—and getting Part D, which usually lags.

Speaker #16: In July, is a faster ramp on access. And so we're excited about that aspect. The piece that is probably on the primary care side an important element that many have noted is around DTC and we activated from day one in the first week a number of both digital social media and out-of-home advertising on the brand itself.

Ilya Yufa: We activated from day one in the first week, a number of both digital, social media, and out-of-home advertising on the brand itself. It does take time to build out consumer understanding and awareness of the brand. The current sentiment, if you follow the total number of impressions and what consumers are saying about the profile of Foundayo, is resonating, so both in the efficacy as well as the overall profile on not having food or water restrictions. That element is positive. Obviously, having full DTC launch, we're still activating that probably earlier than normal because there is familiarity around a GLP-1. We do wanna take a moment and be disciplined in the approach of making sure that physicians actually understand what Foundayo is before activating fully.

Speaker #16: But it does take time to build out consumer understanding and awareness of the brand. The current sentiment, if you follow the total number of impressions and what consumers are saying about the profile Fondeo, is resonating.

Speaker #16: So both in the efficacy, as well as the overall profile on not having food or water restrictions. And so that element is positive. Now, obviously, having full DTC launch—we're still activating that, probably earlier than normal because there is familiarity around the GLP-1.

Speaker #16: But we do want to take a moment and be disciplined in the approach of making sure that physicians actually understand what Fondeo is before activating fully.

Speaker #16: But overall, this is following an accelerated path in primary care. And if I compare we've had the opportunity to launch many brands within primary care with Trulicity, with Mounjaro, Zepbound, Jardiance, all of which have gone towards leadership in those categories in a competitive space.

Ilya Yufa: Overall, this is following an accelerated path in primary care. If I compare, we've had the opportunity to launch many brands within primary care with Trulicity, with Mounjaro, Zepbound, Jardiance, all of which have gone towards leadership in those categories in a competitive space. We feel pretty good about all of the actions we're taking, the three key factors, and the pace at which we are activating all three components.

Speaker #16: So we feel pretty good about all of the actions we're taking, the three key factors. And the pace at which we are activating all three components.

Speaker #3: Maybe just to reiterate one thing, which we said earlier, but just so it's not lost. The three major products that are used in obesity in the United States are all line extensions.

David Ricks: Just to reiterate one thing, which we said earlier, but just so it's not lost, is the three major products that are used in obesity in the United States are all line extensions. The molecule was on the market before, and in some cases, the brand name was used before. Consumer awareness, which is the brand name, and the molecule itself, which is the physician part, we're starting from a much lower baseline. We've got to build that, but we're hugely confident we'll be able to build it. We've launched many primary care drugs that are new successfully. The final thing I'll say is related to your inventory. I mean, that really speaks to the international rollouts.

Dave Ricks: Just to reiterate one thing, which we said earlier, but just so it's not lost, is the three major products that are used in obesity in the United States are all line extensions. The molecule was on the market before, and in some cases, the brand name was used before. Consumer awareness, which is the brand name, and the molecule itself, which is the physician part, we're starting from a much lower baseline. We've got to build that, but we're hugely confident we'll be able to build it. We've launched many primary care drugs that are new successfully. The final thing I'll say is related to your inventory. I mean, that really speaks to the international rollouts.

Speaker #3: So the molecule was on the market before. And in some cases, the brand name was used before. So consumer awareness, which is the brand name, and the molecule itself, which is the physician part, we're starting from a much lower baseline.

Speaker #3: We've got to build that. But we're hugely confident we'll be able to build it. We've launched many, many primary care drugs that are new, successfully.

Speaker #3: And then the final thing I'll say is the related to your inventory. I mean, that really speaks to the international rollouts. That's why we keep mentioning there's 40 different countries under review.

David Ricks: That's why we keep mentioning there's 40 different countries under review, and we expect that to happen also in one of the most accelerated cadences, perhaps in the history of the industry. Expect launches as we exit this year into next year in quite scaled markets. We know from what we're seeing on this call with Mounjaro and international, there's a huge opportunity for Foundayo around the world.

Dave Ricks: That's why we keep mentioning there's 40 different countries under review, and we expect that to happen also in one of the most accelerated cadences, perhaps in the history of the industry. Expect launches as we exit this year into next year in quite scaled markets. We know from what we're seeing on this call with Mounjaro and international, there's a huge opportunity for Foundayo around the world.

Speaker #3: And we expect that to happen also in one of the most accelerated cadences perhaps in the history of the industry. So expect launches as we exit this year into next year in quite scaled markets.

Speaker #3: And we know from what we're seeing on this call with Mounjaro and International, there's a huge opportunity for Fondeo around the world.

Speaker #2: Great. Thanks, David. One last quick question, and then we'll go to the close.

Mike Czapar: Great. Thanks, Dave. We'll do one last quick question. Then we'll go to the close.

Speaker #4: Final question today will be from Dave Reisinger from Lyrinc. Dave, your line is live.

Operator 3: Final question today will be from David Risinger from Leerink. David, your line is live.

Operator: Final question today will be from David Risinger from Leerink. David, your line is live.

Speaker #3: Can you hear me there?

David Risinger: Can you hear me there?

David Risinger: Yes. Sorry. Can you hear me okay now?

Speaker #18: Yes, thanks. Yeah, sorry. Can you hear me okay now?

David Risinger: Yes. Sorry. Can you hear me okay now?

Speaker #2: Yes.

David Ricks: Yes.

Dave Ricks: Yes.

Speaker #18: Sorry about that. Thanks for taking the question. So Dave, I was hoping that you could just frame your vision for employer coverage in the United States.

David Risinger: Sorry about that. Thanks for taking the question. Dave, I was hoping that you could just frame your vision for employer coverage in the United States. In the U.S. pharmaceutical business, employer coverage is most important for drugs, particularly drugs that treat various medical conditions beyond cosmetic. I understand that you have the employer direct initiative, but I'm just trying to get my head around what you think will happen with regular employer insurance coverage in coming years, versus coverage that will involve greater cost-sharing by participants that engage with LillyDirect for consumers to pay more out of pocket than they are paying today under regular employer coverage. Thanks very much.

Speaker #18: So in the US pharmaceutical business, employer coverage is most important for drugs. Particularly drugs that treat various medical conditions beyond cosmetic. And so I understand that you have the employer direct initiative but I'm just trying to get my head around what you think will happen with regular employer insurance coverage in coming years.

Speaker #18: Versus coverage that will involve greater cost sharing by participants that engage with Lilly Direct, for consumers to pay more out of pocket than they are paying today under regular employer coverage.

Speaker #18: Thanks very much. Okay. Thanks, Dave, for the question. Obviously, an important factor in we do think just as policy matter that obesity and overweight medications should be broadly this journey is actually the July 1 Medicare.

David Ricks: Thanks, David, for the question. Obviously, an important factor, and we do think just as a policy matter, that obesity and overweight medications should be broadly covered. I think a big step in this journey is actually the July 1 Medicare. There's often spillover benefits into commercial from there, and I think setting a standard that people in America should expect if they've paid into their insurance program or their employer has, that it will cover their health needs. That said, I think the likely path from here to, you know, what I think will ultimately begin to look like other chronic medication markets like diabetes and hypertension, I think we'll get there with this category. It won't be a straight line. It won't be a straight line. It won't be kind of everything we want on day 1. Why?

Dave Ricks: Thanks, David, for the question. Obviously, an important factor, and we do think just as a policy matter, that obesity and overweight medications should be broadly covered. I think a big step in this journey is actually the July 1 Medicare. There's often spillover benefits into commercial from there, and I think setting a standard that people in America should expect if they've paid into their insurance program or their employer has, that it will cover their health needs. That said, I think the likely path from here to, you know, what I think will ultimately begin to look like other chronic medication markets like diabetes and hypertension, I think we'll get there with this category. It won't be a straight line. It won't be a straight line. It won't be kind of everything we want on day 1. Why?

Speaker #18: There's often spillover benefits into commercial from there. And I think setting a standard that people in America should expect if they've paid into their insurance program or their employer has that it will cover their health needs.

Speaker #18: That said, I think the likely path from here to what I think will ultimately begin to look like other chronic medication markets like diabetes and hypertension I think we will get there with this category.

Speaker #18: But it won't be a straight line. It won't be a straight line. It won't be kind of everything we want on day one. Why?

Speaker #18: Because the economics you're mentioning it's a very broad disease. 70% of adults have overweight or obesity. And are potential candidates for these medications. And it's the last thing in.

David Ricks: Because the economics you're mentioning, it's a very broad disease. 70% of adults have overweight or obesity and are potential candidates for these medications, it's the last thing in. We know that, despite the fact that it could be one of the most valuable healthcare interventions available, it's the last one we see, so it's easier to say no to. You know, we do see progress there. The, as Lilly said, Lilly Employer Connect is all about creating new options to get to yes with employers, alternate pathways. We'll continue to publish data, as I'm sure, Novo Nordisk will, that demonstrate that pretty much all of these drugs in this category have had a profound effects and are probably cost-effective at their current prices. Of course, prices have been trending down. We'll continue to make progress.

Dave Ricks: Because the economics you're mentioning, it's a very broad disease. 70% of adults have overweight or obesity and are potential candidates for these medications, it's the last thing in. We know that, despite the fact that it could be one of the most valuable healthcare interventions available, it's the last one we see, so it's easier to say no to. You know, we do see progress there. The, as Lilly said, Lilly Employer Connect is all about creating new options to get to yes with employers, alternate pathways. We'll continue to publish data, as I'm sure, Novo Nordisk will, that demonstrate that pretty much all of these drugs in this category have had a profound effects and are probably cost-effective at their current prices. Of course, prices have been trending down. We'll continue to make progress.

Speaker #18: And we know that despite the fact that it could be one of the most valuable healthcare interventions available it's the last one we see.

Speaker #18: So it's easier to say no to. But we do see progress there. As Lilly said, employer direct is all about creating new options to get to yes with employers.

Speaker #18: Alternate pathways. We'll continue to publish data as I'm sure Novo Nordisk will that demonstrate that pretty much all of these drugs in this category have had a profound effect and are probably cost-effective at their current prices.

Speaker #18: And of course, prices have been trending down. So we'll continue to make progress. I should also say we have a number of new indications coming.

David Ricks: I should also say we have a number of new indications coming in per Umair's question earlier. That actually is a pretty good unlock for us when we get indirectly indicated populations with acute comorbid disease. All those things will pull together, and in some future year, we'll look back and say, you know, we got there. It's gonna be, you know, more incremental progress quarter on quarter, and we'll keep updating the street with what to expect as we issue our guidance. Thanks a lot.

Dave Ricks: I should also say we have a number of new indications coming in per Umair's question earlier. That actually is a pretty good unlock for us when we get indirectly indicated populations with acute comorbid disease. All those things will pull together, and in some future year, we'll look back and say, you know, we got there. It's gonna be, you know, more incremental progress quarter on quarter, and we'll keep updating the street with what to expect as we issue our guidance. Thanks a lot.

Speaker #18: And per Umer's question earlier, that actually is a pretty good unlock for us when we get in directly indicated populations with acute comorbid disease.

Speaker #18: So all those things will pull together and in some future year, we'll look back and say we got there. But it's going to be more incremental progress quarter on quarter.

Speaker #18: And we'll keep updating the street with what to expect as we issue our guidance. Thanks a lot.

Speaker #2: Great. Dave, do you want to do comments to the close?

Mike Czapar: Dave, do you want to, do you comments to close?

Speaker #18: I will. So again, appreciate everyone dialing in today on our call. And your interest in Eli Lilly & Company. We hope you'll join us later this year where we're announcing a Lilly investment community update day.

David Ricks: I will. Again, appreciate everyone dialing in today on our call and your interest in Eli Lilly and Company. We hope you'll join us later this year. We're announcing a Lilly Investment Community Update Day. This will be on Monday, 7 December, and details on location and exact timing are to follow. Please follow up with the IR team if you have any questions that we didn't address today, and hope you have a great day. Thanks.

Dave Ricks: I will. Again, appreciate everyone dialing in today on our call and your interest in Eli Lilly and Company. We hope you'll join us later this year. We're announcing a Lilly Investment Community Update Day. This will be on Monday, 7 December, and details on location and exact timing are to follow. Please follow up with the IR team if you have any questions that we didn't address today, and hope you have a great day. Thanks.

Speaker #18: This will be on Monday, December 7th. And details on location and exact timing are to follow. Please follow up with the IR team. If you have any questions, that we didn't address today and hope you have a great day.

Speaker #18: Thanks.

Speaker #4: Thank you. And ladies and gentlemen, this does conclude our conference for today. This conference will be made available for replay beginning at 1:00 PM today, running through June 4th at midnight.

Operator 3: Thank you. Ladies and gentlemen, this does conclude our conference for today. This conference will be made available for replay beginning at 1:00 PM today, running through 4 June at midnight. You may access the replay system at any time by dialing 800-332-6854 and entering the access code 662964. International dialers can call 973-528-0005. Again, those numbers are 800-332-6854 and 973-528-0005 with the access code 662964. Thank you for your participation. You may now disconnect your lines.

Operator: Thank you. Ladies and gentlemen, this does conclude our conference for today. This conference will be made available for replay beginning at 1:00 PM today, running through 4 June at midnight. You may access the replay system at any time by dialing 800-332-6854 and entering the access code 662964. International dialers can call 973-528-0005. Again, those numbers are 800-332-6854 and 973-528-0005 with the access code 662964. Thank you for your participation. You may now disconnect your lines.

Speaker #4: You may access the replay system at any time by dialing 800-332-6854 and entering the access code 662964. International dialers can call 973-528-0005. Again, those numbers are 800-332-6854 and 973-528-0005 with the access code 662964.

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