I'm Becky Quick of CNBC and your host of The Forum. I'll be guiding you through exclusive conversations among some of the world's global leaders—conversations previously held behind club doors, but today we invite you in. The Economic Club of New York serves as the premier forum for nonpartisan discussion dedicated to connecting the world's brightest minds with preeminent public and private sector leaders. A nonprofit 501(c)(3), the club is a 115-year-old platform for the conversations that help shape the future of our world. The Economic Club of New York: brightest minds, critical conversations, catalyst for innovation.
Just thinking about when you took the reins as CEO in 2017. Now, not everyone looks at the charts as much as I do, and I'm sure you never spent a moment looking at the share price, but the fact that it has tenfold under your leadership, and of late it has been just an extraordinary time for us all to be discussing, and attention completely ripped whether it's AI on one side, but ultimately suddenly we're talking about GLP-1s or GIPs—and none of us quite know what it stands for, but what we do know is it seems to be a cure for not only just obesity, but they're having profound effects on heart, on liver, on all parts of ultimately the way in which we can be driving our health. And I just want to understand, with Mounjaro, with Zepbound, how much do you feel that the oxygen is being sucked out of the room of just all this obsession with this new breakthrough that you have been helping drive?
It's difficult to go to cocktail parties these days without getting one sip in and a question about weight-loss drugs, GLP-1—what is GLP-1? People say it without knowing it, as you said, GIP and so forth. And what an honor that is to have such an interesting invention that can augment so many people's lives. So, we've been working in this space for a very long time, that's probably not well recognized. We licensed our first GLP-1, we partnered it with a company called Amylin in 2003. We launched the drug in 2005. It was a twice-a-day injection, and it wasn't very good, but it was the first GLP-1 drug. So I like to talk about this as sort of a 20-year overnight success.
Most of the appreciation of that has come in the last 18 months, but kind of what we do well, and I think an underappreciated part of our industry, is the time and energy it takes to create so-called breakthroughs. In some ways, the industry showed a lot of prowess during COVID, and we're very proud of that, but viral pathogens are really easy to conquer. Human disease that's more metabolic, or cancer which is innate, or immunity are much harder. And that sort of taught everyone that if we just put enough money and attention on something, we could fix it in a year, right? But that's not how most diseases work, and not how obesity works.
Through the years, we iterated and we found new things, mostly that what was a drug designed for blood sugar control, that if we could give it at higher doses, you saw pretty profound weight changes. And then our scientists in the early part of the 2010s noticed that if we put two of these so-called incretin family proteins—so as you're eating your salad, your stomach is sending proteins to the other parts of your body to say, "I'm being fed right now." One of those is GLP-1, which really affects glucose signaling. Another is GIP, which affects fat metabolism, right? And by putting them together in a mouse in 2010, we demonstrated that you would lose even more weight, and it tolerized as well some of the nausea that people experience with GLP-1 alone. So we went about designing that into a drug, which we did in 2014.
In 2016, I remember a phone call I got from our current chief scientific officer—he was in a different role at the time—saying, "You have to see this data. We tried this medicine in like a dozen people in Singapore who were otherwise healthy, most of which had to drop out of the study because they lost so much weight they needed to eat." So at that moment, I was like, okay, now we go as hard as we can.
And when you're trying to go as hard as you can, ultimately there is a sheer force of demand and limitations of supply. What does that look like right now? Because this is able to be consumed, to be used, almost worldwide, but actually only a few markets you can actually get into at the moment.
Yeah, we've really only launched in three markets right now in a full form. We're working on expanding supply. In 2022, when we launched Mounjaro in the US, between Lilly and Novo combined, we probably made enough of this class of medicines for about 12 million people on the planet—just 12. And two weeks ago, the WHO said there's a billion people with obesity, so we're a little short of the goal. We set about building new facilities. Novo has as well—they're buying companies, and we're partnering with other companies to expand.
The interesting thing is these are proteins, so they're a very specific kind of medicine that's complicated. And then we put it in an injectable system which has to be—we can't assure that it's pure at the end of the process, we have to make sure the whole process is. So it's ultra-cleanroom conditions, basically, to make it, and then we put it in a little injection device. That kind of system, probably in the whole world, 80% of the capacity is already controlled by Lilly and Novo. So there are not built sites to go buy or rent to make more; we have to make them ourselves.
So we're doing that. We currently have six manufacturing facilities under production or being stood up. We had 14 before, so that's like a 50% increase. We'll probably have a few more by the end of the year announced. I mean, we're going as hard as we can, but capital is not the constraint; time is the constraint. Those buildings take three or four years from announcement to come online. So right now in the US, there's frustration because there are shortages of these, but we haven't even introduced them in most of Europe or the world. So more to do.
One project we're working on could change that, which is an oral solid. So it's not a protein, it's chemistry, and it's not in that injectable device which is so difficult to make; it's a pressed tablet. A lot of the world is awash in those capacities, and so should the drug be successful, I think we'll be able to tap into quite a bit more supply, which will be good for the US, but even better for places like Brazil, or Mexico, or China, where actually most obese people on the planet live and where the biggest health difference could be made.
But ultimately, how are you seeing the limitations, the constraints to the way in which healthcare is served in the US, and indeed better or worse in other geographies that you're currently in, helping or hindering you getting it into the hands of the right people?
I think it's no different than any other condition where we see those health inequities in the US are built into the system. It's not about the medicine; it's more how the system works. This is the best healthcare system in the world; it can also be one of the worst at the same time. Our system is complicated, it's diffuse, and it's expensive. So people who have trouble accessing healthcare have trouble accessing these obesity medications. The federal government themselves have said that we're not reimbursing these in Medicare. So for seniors, that makes terrible sense, because the one part of the system that has at least a notion of sort of some functional dynamics that—we can spend a lot of time on healthcare if you like—is the federal government, because they provide, they have the opportunity to provide preventative care and they are the payer of last resort anyway.
So they have the most to gain by preventing disease. There was a moment of insight where they finally agreed in the Part D program that seniors use to pay for all vaccines with no out-of-pocket. It took COVID to get them to do that, but that's what they do now. That'll be a really wise investment for our country, for our taxpayers, and certainly for the health of seniors. In a lot of ways, obesity is kind of a parallel thing. The top three spenders for Medicare, which are heart disease, diabetes, and cancer, all are augmented by obesity, yet the federal government doesn't pay for obesity drugs for seniors.
Now, private companies do. Currently about half of covered lives in America, in the commercial markets, have access to these medications with various constraints and steps and so forth. Some companies require three months of diet and exercise; some require you to stay on them longer so you get the full benefit. That seems rational. But half don't. And as you might guess, those that do, it's like about the wage scale. So we have a lot of banks in the room, bankers—I'm sure probably the banks pay for these drugs because we're well compensated in banking, but does Walmart pay? No. Do automakers? No. So I think that's an obvious inequity, right? It's not unique, and that's true across all of commercial insurance, Medicaid even worse.
I can imagine in this election cycle that we're basically already in, drug prices are going to come up, come up. And it feels as though everyone turns to you and says, "Well, what are you doing about it?" Ultimately, can you educate us a little bit about how this needs to go hand in glove with the federal government, how much realistically you can do your side, and how much we can see done from the other side to ensure that the right people are able to access at the right price?
