Eli Lilly CEO: Our pill supply can 'reach the planet'

So we're announcing the approval of Foundo, which is the trade name for what used to be known as orforglipron. This is our once-daily oral pill that's a GLP-1 agonist. You don't have to worry about food effects when you take it, and it does what a GLP-1 agonist does. It helps you lose weight, and later we'll get an indication for diabetes and potentially other things as well that are under review. It's a simple new option, and of course, the price points are a bit lower. We have a lot of manufacturing capacity, so we don't have to worry about shortage or anything like that. We'll be taking this around the world. The US is just the first of potentially 40 approvals in the next year or so. This is really a way we can affect human health at a planet level, because obesity isn't just a US problem, it's a global problem.

It's a big moment. I think, you know, we've obviously been working in this category of medicines for a while. We launched the first GLP-1 medication 20 years ago and have been improving on it ever since. Here is an option that's not more effective—that's been more the pathway us and our competitor have been working on—but it's more accessible. It's easier to fit into your daily routine. We have great data on maintenance. A lot of people reach their goals on injectable and then want to go to something less invasive than injecting themselves once a week. Some people don't mind that, but some people do. So, here's an oral option. Or some people have been held back by that barrier and now they can access an oral option. Or maybe some people couldn't afford it or didn't have insurance coverage. We hope to expand insurance coverage, and of course, it will be more affordable even for those paying out of pocket. Later this year, the government will expand insurance coverage, including Foundo, to all seniors. So, that's a big step up. I think this year will be a story not just of better efficacy in this category, but here now with Foundo, more accessibility, easier to access, easier to take.

Yeah. So, this will be available as low as $149 a month for the entry dose. We announced that back in November. The exact same thing we said then is what we'll do now. The highest dose is a little over $300. There are six different dosage forms, so depending on what you need to reach your health goals, there will be different price points. Those are the out-of-pocket prices. Now, many Americans do have insurance coverage. As I said, seniors will have insurance coverage starting in the summertime. For most Americans with commercial coverage, we have a coupon you can apply to that, so it'll be no more than $25 a month with insurance. And then for the seniors in Part D, it'll be $50. So those are pretty affordable price points. I think particularly for seniors, Angelica, who are on fixed incomes, the out-of-pocket pricing has—I get more responses from them that that's out of reach. So, I think the senior program that the Trump administration is implementing is pretty important, not just to help people control their weight, but actually to affect the health status of our seniors. I'm excited to have that happen. Foundo will probably be a key tool because it so easily fits into your daily routine. We all know our parents who have a pill box Monday, Tuesday, Wednesday, and the other medications they take, and Foundo will just go right in that. It'll be simple to integrate in their life and help them lose weight and control their chronic disease. So, yeah, a lot of accessibility benefits happening this year.

I think it might be, but remember we have like six different dose levels. I think they have four, so there are some differences there. Most people on GLP-1 agonist—Foundo, I would expect this to be true, and it's certainly true for semaglutide, both oral and injectable—don't get to the top dose. Many people find these medicines to be effective at the moderate doses. The entry dose is really a titration step, that's the 0.8 milligrams, but people on a 5.5 dose or even a little higher had a lot of success in our clinical trials. I think what we see consumers doing is not seeking the maximum weight loss as fast as possible, but seeking slow and steady progress, and those are more affordable price points. I think again, the oral convenience here will really help people do that quite simply as they go about their day.

Yeah, there's two distinct benefits of this being a small molecule. Organic chemistry makes this medicine. It's a much smaller molecule than a protein or peptide, which is how the other GLP-1s work, including the oral form of semaglutide. What that does is it allows for scalability, and that will allow us to launch this globally on the first instance. So today you can get the oral semaglutide in the US, but you really can't get it elsewhere at the highest dose. This will be marketed around the world as soon as we have regulatory approvals. We essentially have as much scale as we need to supply the world with an oral GLP-1 inhibitor. The other benefit is like other medicines we're used to taking, whether it be a statin or a blood pressure medication or a diabetes medication, we just sort of take the pill in the morning and we don't have to think about other things. It doesn't have food effects. It can be just part of your regular routine. You can actually take it any time of day. If you take your medicines at night, that's okay, too. I think for people living their daily lives with polypharmacy, which is a reality for many Americans with chronic disease, this will fit in perfectly to that. And it's just simple. I think we find consumers really like that when we test that idea and in our clinical trials.

Yeah, I think there's like three big expansion opportunities here. One is reaching the ex-US markets, and you may know just last year we really just started launching tirzepatide or Mounjaro, Zepbound in most of these places, off to a great start as we reported in our Q4 results. But we know that still there's many markets that are underserved because of a combination of the price point and the supply. Those things interact because if you can't supply a market, you're not going to lower the price. Here we can reach more people with a single-acting GLP-1 inhibitor. It's not as good as tirzepatide, and we don't expect it to be in terms of maximizing weight loss, but it is better in terms of simplicity. It's a simple oral pill and you take it in your daily routine. We can reach the planet. The second use case is there are people who have reported, and we see in the real world, maybe with the competitor launch even, who've been on the sidelines that for them GLP-1 medicines weren't for them because they were injectable, and that wasn't necessarily needle phobia per se, but just it felt like an escalation in their health treatments and they haven't jumped into the market. I think we're impressed with the start Novo had, and we expect the oral segment to be pretty big in the United States. In Europe and Japan, where the injectables have been available for a while, as sort of a new segment, we don't see a lot of cannibalization. Angelica, when we look at Novo data, about eight out of 10 people trying that have never tried a GLP-1 inhibitor, so that's people coming off the sidelines, and I think that's a very important use case. We'll expand reach here. And then I think the other big use case is maintenance. We'll probably get to that later. But Lilly demonstrated some excellent data last year that after reaching health goals with injectables, patients could safely and easily transition to Foundo and maintain their health status. That's a big question mark that's been in the media—you've covered this—of discontinuation rates, but also, do I have to take an injectable for my life? And here an answer appears, which is no, you could switch to Foundo and maintain most or all your success on an oral therapy. So that's a big use case as well. All three of those will add up to what we think will be a pretty successful launch. And as I said, we've got supply to meet the need of all those.

Yeah, a bit higher actually. And it's important to frame this because if we think about most chronic meds, that number they're giving is about the same as we see with medicines like insulin or metformin in diabetes or beta blockers in hypertension. Discontinuation is a reality of chronic disease. It's not a good thing. We should try to work those numbers up. Persistence is a problem because if you don't take the medications, you don't get the benefit. We see with Zepbound and Mounjaro higher rates than that. We haven't published those yet, so I won't give the numbers out, but if you normalize for the supply shortage problems that occurred in 2024, and if you look at only people who are insured with a good co-pay, the persistence rates are pretty strong for us. And we would expect a similar thing for Foundo, or maybe a little better, because I think the simplicity of a once-daily oral pill—you don't have to think about food effects or other things, you just take it in your normal routine with the other chronic meds you take—I think will be conducive to good persistence in this category. And persistence means better long-term health outcomes. So that's great for the health system. It's great for the individuals taking it.

Well, I think we originally thought that would be a bigger barrier. And let's be honest, I think we're all surprised by the success outside of diabetes of our medicines and our competitors. I mean, that's why we had supply shortages. Those products are difficult to make at scale. They are injectable, so it's not really a regular thing that Americans have experienced before. But maybe what we've learned is that weight management is a very concerning condition for consumers, that people want to control their weight. They know it's good for their health. They know it prevents chronic disease, and they've tried a lot of other things. In our data, the average patient who takes Zepbound today in the US has a BMI of about 37. So, they are obese and overweight. They've tried almost 30 different interventions as adults—diets or intensive regimens—that they've sought to control their weight, and here now with Zepbound they can do it for the first time. They're willing to inject themselves once a week, but what we're learning, I think, with the oral introduction from the competitors, people may prefer an oral. So two things can be true: that people would be willing to inject themselves to have success in losing weight for the first time in their life, and they might prefer an oral. So, you know, we're offering both. They're both from Lilly, Foundo and Zepbound, and people will now have more choice after today's approval.