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Chapter 1: What is the expected launch timeline for Eli Lilly's weight loss pill?
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We release our guide for 2026. 25% is the midpoint of the growth that we expect to see in 2026. It's industry-leading growth, and that's a continuation of the momentum that we see as well in 2025. By the way, thinking about the Q4 that we also release the revenue that we deliver in the fourth quarter, we deliver 43% growth. So it's a continuation of that strong momentum getting into 2026.
What is driving that is the similar drivers, the key growth products that we have. Of course, the incretin is getting all the attention, but we have a breadth of a portfolio across all our therapeutic areas that will continue to drive that growth into 2026. Thinking about the drivers that you mentioned, we talk about the incrementing portfolio both in the U.S. and OUS.
You see that the market in the fourth quarter on the anti-obesity space grew 85%, and we actually outpaced that growth in the fourth quarter, and very strong growth as well in type 2 diabetes, 17%. So we continue to drive that growth into 2026. You mentioned as well the introduction of Orfolgripon. Very excited.
We submitted for regulatory approval in the fourth quarter, and we expect to have regulatory action as early as Q2.
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Chapter 2: What growth trends is Eli Lilly experiencing in 2026?
So expect to see as well our oral bill coming into the market, a very exciting opportunity to expand the market. In addition to that, we are expanding through access as well with the agreement that we have signed with the administration in Medicare that we expect not later than July will be
provide access to Medicare patients, more than 40 million patients that could benefit to have access to anti-obesity medications as well. So very exciting time, very exciting opportunity ahead of us.
So, Lucas, there's a lot to dig into there. And you mentioned, of course, the breadth of your portfolio. But investors really, really care about the pill at this moment. So I have to ask a little bit more about that. You mentioned that potential 2Q launch. Is there a possibility that this outlook that you gave this morning gets upgraded as we start to see some of the uptake there?
Yeah, it's early days at this time. We just put the guide out there. We have a very thorough process and we feel good about the guide that we have in place for 2026. It's still very compelling, by the way. 25%, there is no single pharma company growing at this pace.
Chapter 3: How is Eli Lilly expanding access to anti-obesity medications?
So we feel a bit about good. We can see throughout the year if we see that continue to trend in the positive direction. But at this time, given all the variables that we have, we feel good about the guide that we have in place.
And so let's talk about the timeline a little bit more here. You and I spoke a few weeks ago at the JP Morgan Healthcare Conference. You said that you're on track for that second quarter approval. You reiterated that timeline today, of course, pending FDA approval. Let's talk a little bit about the FDA. There's been some challenges there. There's been some turnover.
Do you see that potentially impacting the timeline at all?
At this time, we are engaging with the FDA, and we feel good about the progress. And so the time that I covered in JP Morgan that you alluded is still consistent with our expectation that we expect to see regulatory action as early as Q2.
All right. Well, we're almost in the second quarter, so we'll keep looking for updates there. I want to talk about pricing as well, because you take a look at this headline. You see global pricing declines in the low to mid teens. This caught my eye because, of course, Novo Nordisk came out with that early release yesterday.
And then they said on their earnings call this morning that they're facing unprecedented pricing pressure this year. So talk us through that, what that means for Eli Lilly and how you plan to make that up.
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Chapter 4: What challenges does Eli Lilly face with FDA approval?
Yeah, well, actually the guide, 25%, is encompassing as well the price step up or step down that we have in 2026. So that's included in our guide for 2026 already. When you think about the valuables, they are all actually out there. We talk about the agreement with the administration. Those prices are public.
We talk about direct to patient that we adjust the price by $50 across all our presentations. That's actually already implemented in the marketplace as of last December. And then we have the Medicare access that, again, we have a price of $245. That's also public price, public information out there as well. So those variables are out there.
There is no news from my perspective in terms of the pricing dynamics. It's still going to be a price erosion versus last year. That's included in our guide. Very strong volume growth that we expect to see that will more than offset that to get to that 25% that we have in our guide.
Well, the dynamic is really interesting between pricing and volume. Another line in your earnings release that caught my eye was that you take a look at U.S. revenue. It increased 43 percent. That was driven by a 50 percent increase in volume, but it was partially offset by that 7 percent decrease due to those lower realized prices.
So is the hope that, you know, you think about some of the things in the pipeline, the pill being one of them, is the hope that that's going to help expand the market and thus expand volume as you see that price erosion?
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Chapter 5: How is pricing pressure affecting Eli Lilly's market strategy?
Yeah, that's very important. As you mentioned, again, when you think about the volume growth and the volume opportunity, in particular starting with both obesity and type 2 diabetes, we have a large opportunity. Both segments are really large, in particular in anti-bacterial medications. We are talking about more than 100 million patients in the U.S. that we can serve.
And then globally, there is another 900 million patients that we can serve as well. Nowadays, we are serving... low single digits. So the penetration is low. So there is a big opportunity to continue to drive that growth. The fourth quarter, I mentioned that the market in the U.S. grew 85%. So there is a very big runway to continue to drive growth into the future.
That's reflected on our volume growth expectation for 2026.
And you touched on this a little bit, Lucas, but I do want to talk a little bit more about MFN pricing there. What impact would you expect that to have on your weight loss sales this year?
So the impact is included in that guide that I talk about, again, the low to mid-teens in price erosion. That's reflected in that price guide that we have for the year. And the prices, as I mentioned, are public. They're $2.45 for the government segment, and the public prices that we have indirect to patients, including the adjustment that we did for $50.
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Chapter 6: What impact does Medicare access have on Eli Lilly's business?
All these public prices, we have been very disciplined on our pricing strategy. You can look at the results quarter on quarter that we maintain that discipline throughout 2025. And my commitment is to maintain that price discipline getting into 2026 as well.
All right, fair enough. And I should bring up Medicare access as well, because expanding Medicare access, that is certainly top of mind for investors. And I'd love to hear from your perspective, how do you see that wider access impacting the market? And again, when it comes to the pill, would you expect that to be available to Medicare patients at launch?
That's a great point. Of course, again, not only Tercepetide, again, Cepbound, but also Orfoglipron will be available in the Medicare segment once that access is provided. So both molecules will have access to Medicare patients and the patients will pay, actually $50 will be the copay that the patients will be paying for both medicines. So great opportunity to drive access.
I mentioned 40 million patients. As always, penetrations will build over time. So starting off July, hopefully we will see that penetration growing over time. So that will build not only in 2026, but also getting into 2027 as well.
And Lucas, before I let you go, one thing that has changed since you and I spoke a couple weeks ago back in January is that your ZipBound QuickPen, it actually won approval last month. As I understand it, that product is tied to your deal that you have with the Trump administration. So talk us through the rollout here.
Do you plan to make QuickPen available to all patients or would it only be an option for those Medicare patients?
Yeah, it's great news, by the way.
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Chapter 7: How does Eli Lilly plan to address pricing and volume dynamics?
I'm glad that you brought it up, because you asked me about the QuickPen approval. And again, it has been three weeks, and now we have the QuickPen approval, and we are planning to bring it to the market within the next 30 days. So that will bring another option. Of course, again, we are discussing about the channel segments. You mentioned Medicare being one of them.
But also, we will bring it in direct to patients. So that we will have more broad access is another opportunity, another option for patients that will have the opportunity to get to the QuickPen device. By the way, the QuickPen device is one that we have available in many countries globally with great acceptance as well.
All right, Lucas, thank you so much.
Chapter 8: What is the significance of the QuickPen approval for Eli Lilly?
I know it's a busy morning, so really appreciate you taking the time for us.