Eli Lilly Q4 2025 Earnings Call Transcript

Eli Lilly and Company (NYSE:LLY) reported fourth-quarter financial results on Wednesday. The transcript from the company’s earnings call has been provided below.

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Operator

Thanks for holding. We appreciate your time and patience. Please stay on the line and we’ll be back in just a moment. Thank you for waiting. Your patience is appreciated. Please hold the line and we’ll be right back with you. Right back with you. Thank you for holding. We look forward to talking with you soon. Please hold the line and we’ll be right back with you. Ladies and gentlemen, thank you for standing by and welcome to the Lilly Q3 2025 earnings conference call. At this time, all participants are on listen only mode. Later we will be conducting a question and answer session and instructions will be given at that time. Should you request assistance during the call, please press star then zero and an operator will assist you offline. I would now like to turn the conference over to your host, Mike Safar, Senior Vice President of Investor Relations. Please go ahead.

Mike Safar (Senior Vice President of Investor Relations)

Good morning. Thank you for joining us for Eli Lilly and Company’s Q3 2025 earnings call. I’m Mike Safar, Senior Vice President of Investor Relations. Joining me on today’s call are Dave Ricks, Lilly’s chair and CEO Lucas Lilly, Chief Financial Officer Dr. Dan Skovronsky, Chief Scientific Officer and President of Lilly Immunology Anne White, President of Lilly Neuroscience Ilya Yuffa, President of Lilly USA and Global Customer Capabilities Jake Van Narden, President of Lilly Oncology, Patrick Johnson, President of Lilly International and Ken Cacciatore, President of Lilly Cardiometabolic Health. We’re also joined by Mark Heman, Susan Hedgeland and Wes Tall of the Investor Relations team. During this call, we anticipate making projections and forward looking statements based on our current expectations. Our actual results could differ materially due to several factors including those listed on slide 4. Additional information concerning factors that could cause actual results to differ materially is contained in our latest Form 10K and subsequent filings with the SEC. The information we provide about our products and pipeline is for the benefit of the investment community. It is not intended to be promotional and is not sufficient for prescribing decisions. As we transition to our prepared remarks, please note that our commentary will focus on non GAAP financial measures. Now I’ll turn the call over to Dave. Dave, we’ll turn the call over to you. Oh, sorry.

Dave Ricks (Chairman and CEO)

Thanks Mike. Appreciate it. Q3 was another strong quarter for Lilly. We made progress across all our strategic deliverables. We delivered compelling financial results, advanced our pipeline and achieved key milestones to expand our manufacturing footprint. This is all shown on slide 6. In Q3, revenue grew 54% compared to the same period last year. Revenue from key products more than doubled as our medicines continued to increase their global impact. In the US Lilly gained market share in the incretin analogs market for the fifth consecutive quarter. Lilly medicines account for nearly 6 out of 10 prescriptions within this large and growing class. Outside the US Mounjaro performance accelerated driven by robust uptake around the world. As a result of our strong financial performance, we raised our revenue and earnings per share guidance. Lucas will cover this in more detail. Later in the call. Since our last earnings call, we achieved several key milestones including US FDA approval for imlunestrant under the brand name Orserdu for HR positive HER2 negative ESR1 mutated advanced or metastatic breast cancer. The EU approved Donanemab for early symptomatic Alzheimer’s disease. Positive results from a Phase 3 trial of Jaypirca in treatment of Naive Positive overall survival data for Verzenio in high risk early breast cancer. Positive results from the second phase 3 trial of Orforglipron in obesity, enabling NOW global submissions to begin later this year. Positive results from three additional phase 3 trials of Orforglipron in type 2 diabetes, including one trial that demonstrated head to head superiority versus oral semaglutide. We also made good progress executing our manufacturing expansion agenda. We announced plans to build two new US Facilities that will make active pharmaceutical ingredients and the expansion of an existing facility in Puerto Rico. The new facility in Virginia will support our bioconjugate and monoclonal antibody portfolio and the new facility in Texas and the expansion in Puerto Rico will support our small molecule portfolio including Orforglipron. We plan to announce updates on our two remaining new US Manufacturing facilities in the coming months. During the quarter, we distributed $1.3 billion in dividends and executed approximately $700 million in share repurchases. Now I’ll turn the call over to. Lucas to review the Q3 results.

Lucas Lilly

Thanks, Dave. As shown on Slide 7, Q3 was another strong quarter of financial performance. Revenue grew 54% compared to Q3 2024 driven by our key products. Gross margin as a percentage of revenue was 83.6% in Q3, an increase of 1.4 percentage points versus the same quarter last year. This improvement was driven by favorable product mix partially offset by lower realized prices. Research and development expenses increased 27% driven by continued investments in our portfolio. We have initiated 16 new Phase 3 programs since the start of 2024 and continue to advance our pipeline. Marketing, selling and Administrative expenses increased 31% as we continue to increase investment to support ongoing and future launches across therapeutic areas and geographies, our non GAAP performance margin, which we define as gross margin, less R and D marketing, selling and administrative expenses as a percentage of revenue was 48.3%. Performance margin increased by more than 8 percentage points from Q3 2024 driven by revenue growth. At the bottom line, ear

Lilly RD had another productive quarter. I’ll summarize progress by therapeutic area beginning with cardiometabolic health. Since our last call, we announced results from four additional positive phase 3 trials for orphaglipron. Of note, one of those trials was a TANE 2 in people with both obesity and type 2 diabetes. As a reminder, patients with obesity and type 2 diabetes are less responsive to weight loss on GLP1 monotherapy than those without type 2 diabetes. For example, in the step 2 clinical trial of people with obesity and type 2 diabetes, Semaglutide at 2.4 mg and 1 mg resulted in 10.6% weight loss and 7.6% weight loss, respectively. As shown on slide 13. ATTAIN 2 demonstrated 10.5% weight loss and 7.8% weight loss at the 36 mg and 24 mg doses of orphoglipron, respectively aligned with our goal to deliver efficacy similar to injectable GLP1 monotherapy in an easy to use daily pill. This trial completed the clinical package required to initiate global re

Dave Ricks (Chairman and CEO)

Thanks a lot, Dan. A lot to talk about there in the pipeline. We’re pleased with all the progress in 2025 and we’ve had another quarter of really strong execution both in driving the business results and making investments that will help us discover and develop New Lilly medicines to help more people around the world. Now I’ll turn the call over to Mike, who will moderate our Q and A session. Mike?

Mike Safar (Senior Vice President of Investor Relations)

Yeah, thanks, Dave. We’d like to take questions from as many callers as possible. So consistent with prior quarters, we will respond to one question per caller and end the call promptly by 11. If you have more than one question, you can reenter the queue and we will get to you as time allows. Paul, please, please provide instructions for the Q and A and then we’re ready for the first caller.

Operator

Certainly 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 the start. 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. We also ask that while posing your question, you please pick up your handset if listening on speakerphone to provide optimum sound quality. Please hold while we poll for questions. And the first question today is coming from Terence Flynn from Morgan Stanley. Terrence, your line is live.

Morgan Stanley Analyst

Hi. Thanks so much for taking the question. I really appreciate it and congrats on the quarter. A lot of focus obviously on Orphaglipron and path-to-market. I was surprised that it wasn’t on the first list of the Commissioners’ National Priority Review Voucher program. And so maybe you could just comment on kind of if you guys are seeking that voucher and then if not, why not and then how to think about timelines for launch and some of the puts and takes as we think about maybe consensus expectations for 2026. Thank you.

Dave Ricks (Chairman and CEO)

All right, great. Thanks for the question, Terrence. We’ll go to Dave to talk a bit about Orphaglipron. Yeah, hi. Thanks, Terence, for the call. I think as we’ve said before, we’re interested in getting orphaglipron to as many patients around the world as fast as we can, including those in the US So without commenting on specific vehicles, I think investors can expect us to be pursuing an all of the above strategy to get the medicine out more quickly. Also, I’d point out that if you look at this new voucher program, I think Orforglipron checks at least three or four of the boxes laid out. So we’ll see. It’s obviously a government decision about which pathway they choose and the review time itself. But we’re focused on speed here and we’re ready to launch. So the package will go in in the quarter and we hope to get approval as soon as we can after that. Great. Thank you, Dave. We’re ready for the next question.

Operator

Paul, the next question is coming from Chris Schott from JP Morgan. Chris, your line is live.

JPMorgan Analyst

Great. Thanks so much for the question. I just wanted to touch base a bit more on the Mounjaro International ramp. It’s obviously had a pretty impressive step up in sales these past two quarters. Can you just elaborate a little bit. More on how some of these new country launches are trending relative to your expectations, how to think about growth off of this new higher base and is just there any meaningful stocking as we appreciate kind of look at these numbers just a little bit more color on what’s been driving this big step up. Thank you.

Patrick Johnson (President of Lilly International)

Great. Thanks, Chris. Thanks for the question on Lilly International. We’ll go to Patrick for that to talk a bit about Mounjaro uptake new country launches growth. Thank you very much, Chris. I think we are very encouraged by what we’re seeing outside of the US and the business, as we shared earlier, is 75% out of pocket and 25% type 2 diabetes. What we have seen is of course an initial stocking in both markets where we launched and we refer to the big ones being in Q2 in China, Brazil, Mexico and India. Since then we have seen a lift in the performance also in Those markets in Q3 and A continued very strong performance globally. Looking forward, I think the major opportunities is number one in Type two, we have reimbursement currently in aid markets and we’ll continue those efforts across all of US Markets. But that’s going to take some time. And secondly, the big opportunity when it comes to obesity is really about patient activation and we will lean in on all of those efforts also in 2026. When you look at international, it’s important to while it’s one line in the income statement we are referring to more than 55 countries and our different market dynamics, different buying patterns such we have seen over the last several quarters. It’s not going to be a straight line but there are significant opportunities outside of us also moving Forward across type 2 and chronic weight management. Great, thank you Patrick. We’ll go to the next question.

Operator

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

Guggenheim Analyst

Thanks so much for taking the question. So mine is actually on some of the behaviors that we’re seeing in the market around M and A and how the competitors dynamics are playing out and how you, Dave and Dan see the market evolving from here. You’ve commented on Retatrutide, perhaps segmenting the heavier patient population with greater comorbidities. You have orphaglipron potentially targeting a maintenance and lower end portion of the market that’s massively scalable. And you also have Tirzepatide kind of blowing the numbers out and potentially cornering the competitor to some degree in other markets. Just wanted to get a sense of if that behavior would be concerning to you if you don’t really spend much time thinking about it because you’re so focused on your own business or if there are other considerations as you work to further segment the market and take. A deeper leadership position. Thanks so much.

Dan Skovronsky (Chief Scientific Officer)

Thanks for the very long and involved question there, Seamus. I think we’ll go to Dan actually to talk about that. Yeah, sure. Thanks Seamus, for Good question. You know, of course Lilly’s been focused on the obesity opportunity for quite some time. We have a very strong R and D engine behind it. I think when you look at where the science leads us and sort of every kind of reasonable or logical target to pursue, we have robust programs against those targets. And in nearly every case I think we have either a best molecule or first molecule or both actually. So I like our portfolio. Clearly the late stage clinical molecules that the street is paying attention to, we like where they are. But behind it, I can assure you there’s a robust pipeline that we like. No surprise then that every probably just about every other company in this industry looks at that and wants to improve their own position. So that doesn’t surprise us. We watch that and of course pay attention. But we haven’t seen anything that changes our view about the competitiveness of our portfolio or the lead that we have in this space which we intend to maintain through robust investments not just in research and development, but as you’ve seen today in multiple phase three trials and new indications.

Maybe just to add, I Think that’s. Sorry Mike, maybe just to add, I think that’s a great answer. I think for a long time we’ve all been saying we’re focused on every logical target and pursuing the full extent of what these medicines can do for various conditions. I mean today’s call highlights that with some of the new studies Dan highlighted. But it’s also important to note in addition to innovation you need to execute this is a highly scaled business and reaching potentially tens or even hundreds of millions of people. And, and here also I think Lilly’s really done well. It’s a combination of those two things that’s I think built the lead we have and we are very focused on both of them, both the innovation Dan talked about but also executing with manufacturing, build out in market performance, new ways to reach consumers. Of course everybody would like to be in our position but we’re focused on defending it and mostly just executing the play we have. So it’s a good question. We’ll probably see more dynamics and noise from other pharmaceutical manufacturers. That’s normal. What we need to do is run the strategy out that we’ve outlined. Thanks for the question.

Operator

Great, thank you Dave. Thank you, Dan. Paul, ready for the next question? The next question will be from James Chin from Deutsche Bank. James, your line is live.

Deutsche Bank Analyst

Morning. Thank you for the question. I got one for David. David, you previously mentioned narrowing the gap between list and net pricing. Cigna recently announced drug rebates would be. Replaced with GPO fees. And it sounds like it’s going to. Lead to greater discounts as well as. More employer opt ins. So does that suggest greater GTN pressure. Than what normally have with rebates? Does this make clinical profiles more relevant. To form like positioning or access? What kind of changes should we expect?

Dave Ricks (Chairman and CEO)

Great, thanks James. We’ll go to Dave to talk about some of the recent announcements from PBMs on business model. Yeah, I think you’re talking about the Cigna move and there’s also, I’d also point out increasing share in large employer market from kind of non traditional PBMs I guess we call them. I applaud this. I think it’s a good move for innovators, it’s a good move for patients. It’S a good move for payers, for. The commercial payers and probably smart of Cigna to make this first move to recoup market share, gain market share. I think that everyone wants more transparency. And lower out of pocket for patients. And this kind of model will produce both of those. And what we want is to make the basis of competition 1 of clinical differentiation that doctors and patients both appreciate in a way non transparent rebates and other behind the scenes activities that determine which medicine a patient gets is not in our interest. So as an innovator, probably the leading spender on innovation in the sector coming up, we’re for this. I think David and his team at Cigna did a good thing here and we hope others follow and the market in the US can rapidly transition to such a system. I don’t think that per se that reads through to some pricing effect. What I hope is that more valuable medicines will have that value recognized in pricing and less valuable medicines will have a harder time competing now because you can’t just rebate away some number and find formulary position ahead of a better medicine. So, so we’re for this and again it’s a good move. Hats off to David Cordani and the. Team and hopefully others rapidly follow.

Operator

Great, thanks Dave. Next question please. Paul, the next question will be from Jeff Meacham from Citi. Jeff, your line is live.

Citi Analyst

Morning guys. Thanks so much for the question. Just had another one on Orforglipron. When you guys think about commercial strategy. Would you characterize it as more concept consumer centric through Lilly Direct or should we think about it as a more typical pharma launch with PBM and payer negotiations being really critical on day one. And I guess the puts and takes.

Ilya Yuffa

Of both of those. Thank you. Okay, great. Thanks for the question, Jeff. Orthoglyphrom is kind of a US bent, so we’ll go to Ilya to talk about some of the ORFO launch thinking. Sure Jeff, thanks for the question. Obviously we’re excited about the profile of or for Glipron and how to commercialize it in the US and outside the US as well. Obviously we think about this similarly to how we’ve viewed Zepbound where we need to drive great commercial and overall access for patients for accessibility. But we also recognize that there’s significant demand in the consumer segment related to finding ways to get outside some of the frictions in the healthcare system. And so we see both looking at broad coverage as well as looking at expanding how we do our direct to consumer platform and ensuring that every patient has the ability to access medicines across the portfolio.

Operator

Great, thanks Celia. Next question please.

TD Cowen Analyst

Paul, the next question will be from Steve Scala from TD Count. Steve, your line is live. Oh, thank you so much. I know it’s Lilly’s policy not to comment on interims, but it’s also a bit unusual for Lilly to speak about them in some detail. And Lilly has spoken in some detail about the Trailblazer ALS3 interim on both the Q1 25 and Q4 24 calls and likely other forms as well. So with that said, has the trailblazer Alice 3 interim already been taken? The initiation of return NATUG in the same setting would not seem the best sign for donanemab in Alzheimer’s prevention. Thank you. Great.

Ann White

Well, thanks Steve, and thanks for the question on Alzheimer’s. We’ll go to Ann to talk about some of our clinical trials and early Alzheimer’s. Great. Well, thanks for the question. Yes, I think we’re all looking forward to these results. As you know, we tend not to comment on interims. As we’ve shared previously, we have completed enrollment in Trailblazer 3. So now it just continues to be a matter of reaching a sufficient number of events. And this is an event based trial in ClinicalTrials.gov we list a date, excuse me, of 2027, though it could be earlier than that. We are pleased though, and this is what I think we comment on to see momentum and awareness. And I think that was really evidenced by the enthusiastic enrollment in our remternetug preclinical study as well. And as Dan mentioned, what we have the opportunity there is to innovate with the Sub Q dosing formulation as well as a monthly dosing in a again in a fixed duration dosing paradigm. So we continue to innovate in Alzheimer’s space and you’ll see us continue to commit to that even as we build on the foundation of a very strong There’s a couple things that we’re doing right now to make sure that we’re ready for this readout. I will mention in preclinical because it does require a few fundamental shifts. It requires awareness and education on the importance of treating in that earlier stage of disease and the need to be proactive really around brain health. And very importantly, it requires a simple and accessible blood test to make the diagnosis in the preclinical space, which is also referred to stage one and two. So there’s quite a bit to do. So you’ll hear us continue to talk about the readiness work that we need to do to get ready for this readout, but more to come in the future.

Operator

Great. Thank you, Ann. Next question please. Paul, the next question will be from Mohit Mansal from Wells Fargo. Mohit, your line is live.

Wells Fargo Analyst

Great. Thank you very much for taking my question and congrats on all the progress. I would Love to understand or think through your thoughts around EVO trial and GLP-1s and GIPs in general for Alzheimer’s disease. How do you think about this space evolving and could Brineptine, the new GLP. GIP. Be a drug for Alzheimer’s given that this has neural properties?

Dave Ricks

Thank you. Great. Thanks, Mohit for the question about as well as just brinepatide. So we’ll go to Dan to take both of those.

Dan Skovronsky

Yeah, thanks, Mohita. Obviously we follow this space closely. I think we are leaders in Alzheimer’s disease and also leaders in incretin therapy. You correctly point out that Brunepatide has got some of the attributes that make us excited about it for use for CNS indications that could be inclusive of Alzheimer’s disease. Although we haven’t laid out any plans there yet, we’re sort of on the verge of seeing, I believe evoke data that’ll be very informative. I think given our strength in our portfolio, almost regardless of that outcome, we have opportunities to build there and create something that could potentially be more meaningful for patients. So we’ll wait, we’ll see that at the end and then you can expect us to talk in more detail about our next steps.

Operator

Thanks, Dan. Next question please. Paul, the next question will be from Courtney Breen from Alliance Bernstein. Courtney, your line is live.

Alliance Bernstein Analyst

Hi guys. Thank you so much for taking the question today. I wanted to loop back to author Victoza which I know had to focus on. You seem to be preparing for a very large scale launch and by our calculations, on the basis of some of the comments we’ve made, we could have enough doses to support at least 5 million patients for a full year based on the inventory already built. And I think Dave, you’ve mentioned kind of this could be the GLP one for all. Can you help us understand kind of the potential for expansion to the market with Orforglipron and should we expect to see a slowdown in get down new stocks during the initial period of of that goal further?

Yeah, Courtney, it was a little hard. To hear, but I think some of the questions was about thinking about how to expand the market for Orforglipron. Different indications, different opportunities. So we’ll go to Ken to talk a bit about some of our ambitions for Orphaglipron.

Ken Cacciatore

Sure, Courtney, thanks for the question. Now with six phase three studies in hand, I think we really understand the profile of this emerging medicine. It continues to recapitulate the efficacy and safety safety of injectable GLP1s. In fact, Anne recapped some of that during the early part of the call, recapping the attaining two data, which seemed very consistent with step two as well as the achieve three data showing superiority versus oral semaglutide. So we think this is a great profile. You’re getting glucose benefits, weight benefits, improvements in blood pressure, lipids, inflammatory markers, all that in a simple once daily pill with no restrictions on food and water. And of course which we can manufacture and distribute at scale. So we tend to think at a different magnitude about the opportunity here than historically what we’ve done with Incretens. You know, in the United states there’s probably 8 or 8.5 million people on incretins out of maybe 170 million who might benefit. And globally that’s a much bigger number, probably measured in the high hundreds of millions or even billions. So this is now, I think the generational opportunity to figure out how to get an Incretin to a much larger group of people. We can do that through the simplicity of the profile, which is also easier to manufacture and distribute. So really our plan will be about accomplishing that at international level, getting it out there as quickly as possible. Of course we’re also developing Ortho Glibron in a lot of other settings beyond obesity and diabetes. Dan, recap some of those new Nihlecs that we’ve announced. And of course just to recap as well, we see an opportunity not just as a starter Incretin here with Orcalipron, but also something that could potentially even use for patients to continue the success they’ve had with a drug like Wegovy or Zepbound. We’re assessing that now in the attain maintain study and look forward to sharing those data later this year.

Dave Ricks

Great, thank you Ken Paul, we’re ready for the next question please.

Operator

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

Goldman Sachs Analyst

Great, thanks for taking the question and. Congrats on all the ongoing progress. Just sticking with Opagliperon maybe given the. Importance just high level question on pricing. And volume dynamics ahead of the launch. So the cash-pay channel is where you’re continuing to see the most rapid growth in the obesity market. Zeppelin vials are now almost 40% of new scripts and related on ex US price elasticity. You saw a shift in volumes in the UK when Mounjaro prices increased. So I guess what are the learnings. From this for the offer glip around ramp next year as it relates to the elasticity of demand across different prices. And I guess my question is specifically related to how you’re thinking about US versus OUS volume unlocks for orthoglybaron as it launches in a world of potential MFN equilibrium prices. Thank you.

Dave Ricks

Okay, thanks Assad. I think we’ll maybe we’ll start with Ilya to discuss some of the US dynamics and then maybe Patrick, if you want to make a couple brief comments about some of the OUS learnings from the UK as well.

Ilya Yuffa

Yeah, thank you for the question. Obviously we have experienced significant growth overall in the total market, so we’ve seen even sequential growth in the covered. Overall the sequential growth is 15% but we’re seeing significant more volume go through a direct to consumer platform with Lilly Direct, which says a lot about one what consumers and patients as well as providers see as the benefit of zepbound in particular and also the ability to remove some of the friction and the ability to have accessibility to medicine. And so we see this channel as a significant channel now and into the future and then as part of that, obviously having more offerings, whether you include being able to pick up your zepbound vial at a local Walmart which we announced yesterday, or expanding the offering on having another treatment like orphaglipon, that’s an important element for us to expand the ability for patients to get treated. That is the main goal that we have is to improve overall health outcomes and we have multiple medicines and different platforms to achieve that.

Dave Ricks (Chairman and CEO)

Patrick, maybe just a few additions from an OUS perspective.

Patrick Johnson (President of Lilly International)

I think first and foremost in the UK, with the race in price that was effective September 1st, I think we learned pretty much what we expected to learn. What we did was just to take the UK price at the level of rated to the level of a European price. And even if there were regulations in the uk, we actually saw export of medicines out of UK to other markets. So that has probably stopped with the intervention we did put in place. Secondly, we’re also learning something about consumer pricing elasticity. So that exists. But most importantly I think of Oglipron will meet a slightly different need of a marketplace. We know that obesity is a heterogeneous disease and for people with a BMI below 35 and that might not need the weight loss of tir Zepatide. We believe there is a significant opportunity o US and also driven by the other features that Ken referred to earlier, the opportunity to scale here and to reach other patient populations and with no need of refrigeration, et cetera. So we see those as being very complementary in the OUS business setting as well. Thank you both Next question please, Paul.

Operator

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

Bank of America Analyst

Thank you. I have a question on GLP1 pricing. So with Novo’s SEMA we get IRA. Negotiated price within the next month. My sense from talking to some industry folks is that that negotiated price may be more favorable than the investment community is expecting, meaning less degradation to the current net price. And that of course would be good for everyone in the space. What is Lilly picking up on this and whatever that level of discount ends up being, Would you agree that it quite likely has a direct impact on pricing of Lilly’s own products in 2027? Or do you think Emma’s negotiated price. Just won’t translate across?

Dave Ricks (Chairman and CEO)

Okay, thanks for the question, Tim. We’ll go to Ilya to talk a bit about some of the broad thinking about SEMA IRA negotiation technology. Were not part of the discussion.

Ilya Yuffa

Sure. Thanks Tim for the question. Obviously we don’t know the price being negotiated. At the same time there are several things that are important to note. One, that it only applies to SEMA in part d beginning in 2027. Overall, if you take a look at our volumes, Medicare Part D is a small proportion of our overall volume. Obviously it’s predominantly in type 2 diabetes since there’s lack of coverage in obesity. Probably the most important element to include here is that Tirzepatide has demonstrated superior efficacy versus SEMA and head to head trials which is a strong foundation for any value based discussions that we have with payers. Not only in our data but you see that as well in provider preference as well as patient preference that you see in the market.

Dave Ricks (Chairman and CEO)

Great. And then David, do you want to add a couple comments? I think he covered it well. Maybe just one thing because we’ve been talking about Orforgipron and its upcoming launch. We think about single acting GLP1s as one category and double and triple acting as others. And probably both weight loss and clinical value will be quite different between these medicines. And of course we’re paying close attention to the SEMA price but as Ilya said, it’s a part D only channel. So let’s let it all play out. I think we’re in a good position because we have so many options.

Operator

Great, thank you both.

Operator

Next call or Paul, the next question will be from Alex Hammond from Wolf Research. Alex, your line is live.

Wolf Research Analyst

Thanks for taking the question. Can you walk us through the important of the upcoming attain maintain trial to orphagliparon’s commercial opportunity and is there an outcome that might meaningfully change your view on how quickly Orphaglipron’s launch may scale.

Dave Ricks (Chairman and CEO)

Great. Thanks Alex. For the question on Attain Maintain, we’ll go to Ken.

Ken Cacciatore

Sure. Thanks for the question Alex. On Attain Maintain, this is a really first of its kind study and we’re looking forward to these data later this year. We took advantage of the opportunity to re randomize patients from for their Surmount 5 study who were maximally tolerated on either semaglutide or tirzepatide. We randomized them to Orphaglipron or placebo and we’re going to measure the percentage of the weight that they lost over the course of 72 weeks that they keep off while taking Orthoglipron. Of course this is a first of its kind study. We don’t know exactly what the results will be, but we’re hopeful that orfaglipron will provide a simple once daily oral option that lets patients keep the majority of their weight off. And so we think this is really an opportunity to expand the market even further for Orthogopron. Of course we have very bullish expectations for it as a first line starter ink return. But also this is an opportunity to continue to grow that I don’t think as we think about over government, we don’t think about sort of cannibalization in that way. This is an opportunity to grow the market at a very different rate and we think the data from Attain Maintain could be really just an exciting boost and allow us to have some meta points information to disseminate to physicians about how they can help patients switch from drugs like Wegovy and Zepbound. But of course we also know that all weight management drugs are of course indicated for maintenance. So these are just data to help HCPs and patients guide between these medicines.

Operator

Excellent. Thanks Ken. Next question please.

The next question will be from Ume Rafat from Evercore Umay Alaina’s live

Evercore Analyst

Morning guys. I just wanted to touch up on Glip pricing and on the one hand there’s a lot of commentary on some of the expectations you’ve laid out on orphoglipron pricing frameworks, if you could expand on that. But also on the other hand there’s. A lot of actions and changes at your main competitor over the last few. Months and I almost wonder do you. Think they will stay a mature player from a pricing front or would that no longer be a base case for us? Thank you.

Paul

Great.

Lucas Lilly

Thanks Umar for the question on GLP1 pricing. Maybe we’ll hear from Lucas, to weigh in on those dynamics. Yeah, thank you for the question, Umar. Maybe just thinking about the pricing dynamics, when you actually unpack our Q3 performance, you see that actually our pricing continued to perform as what we expected. Right. So I think it’s a good data point after the CVS move that we didn’t see again, a significant price erosion, but actually was very much in line to what we said early in the year for the full year as well. So maybe just a good data point that you can take from that perspective and thinking more broadly about the competition in the marketplace. Again, we always pay close attention on the competition in the marketplace, but also how we differentiate both commercially but also on the label of the product. And Ilya Dan, Ken mentioned about the differentiation and you see that in the marketplace, though, if you take for example, a good proxy that for me is really direct. We have been priced over the last maybe six months already at that starting point at 349, going to 499 and maintain that price and you see the penetration and the competition is placed at the same level as well. So we don’t see materially changing the dynamics that we see from that perspective and as we continue to penetrate the market and mobilize patients to seek more treatment.

Paul

Great. Thanks, Lucas. Next question please.

Operator

Paul, the next question will be from Akash Tiwari from Jefferies. Akash, your line is live.

Jefferies Analyst

Hey, thanks so much. So at the all in Summit, Dave, you noted if ORPA was priced at $100 a month, there’d be no incentive for new medicines in that category to kind of create the next big thing. A few weeks later in Chicago, you mentioned how Lilly’s already made billions of doses for ORFO and it could have an impact on human health at a global level. Can Lilly achieve both goals of kind of preserving continuous innovation in obesity and having Orpho be a drug for hundreds of millions of patients with the parity pricing model between the US and rest of the world. Thanks so much. All right, thanks, Akash. We’ll go to Dave to address those two comments.

Dave Ricks (Chairman and CEO)

Yeah, thanks. And thanks for tuning in to all my podcasts and public events. So, I mean, yes, our strategy is to bridge both. We think, as you’re pointing out, that flatter pricing between the US and other developed countries is important, but there’s like three ways that this works. And I think one important thing here that just to point out on all these pricing questions that is different in this glp. One category is the consumer self pay channel. We haven’t really seen that scale in other categories and it certainly is a channel here partly because of under insurance but partly because the benefits of these medicines manifest so consistently. There really aren’t that many non responders at all and produce a very desirable short term effect in addition to insurance enhancing long term health benefits. It really is a unique situation. So we have seen price elasticity as was mentioned and that it’s on the one hand in our interest to offer consumers a compelling price where they can afford to self pay. It’s also in our interest to continue to build out indications for chronic disease as Ken and Dan were outlining earlier. And we are committed to doing both having a, a strong consumer offering but also proving the health benefit. And that should not compete for consumer dollars but for health care dollars, either government or from private payers. So it’s a both. And, and I do think these can bridge because we have so much evidence coming of long term benefit we should compete with other classes of medicines and chronic diseases or even create whole new classes. And at the same time we’ll probably continue to see consumer self pay demand whether it be for prevention or there are other needs. So I think it’s entirely possible to do both. And I think Ken mentioned earlier some of the numbers. We are literally just scratching the surface of global treatment here and there really is a tremendous opportunity to reach tens or even hundreds of millions or more people in the coming years. And that’s our goal.

Operator
The next question is coming from Evan Segerman from BMO Capital Markets. Evan, your line is live.

BMO Capital Markets Analyst

Hi guys. Thank you so much for taking my question. Dan, you recently commented that you were. Super excited about your pre symptomatic Alzheimer’s program. Appreciate that you don’t want to comment on an interim look, but you spanned. On what drives this view and how. It has changed since the initiation of the program.

David Ricks
Okay, great. A double back on the presymptomatics of Alzheimer’s. So we’ll go to Anne to talk. A bit about that. Yeah, well, thanks. Sorry Ann, you take it. Apologies. No, no, please Dan, you go ahead.

Dan Skovronsky
Okay, thanks. Evan. I apologize. I didn’t say super excited on this call. I’m still super excited about the Alzheimer’s opportunity here to treat in the preclinical space. The reasons for my excitement go back to the data that we saw actually in Trailblazer 1 and Trailblazer 2. In both of those trials where we were treating symptomatic patients, we saw the largest treatment effect on patients who were the earliest in their disease course. Whether you measured early in disease course by symptoms or pathology, et cetera, that’s where the drug had the biggest effect. And in fact we looked at prevention of progression as an outcome in that trial and in those patients we had really profound results. I actually expect the same in Trailblazer 3 as well as Trailrunner 3, which is the trial with remternatug. So I remain extremely excited. No change here at all to my level of enthusiasm or confidence in success.

Mike Safar (Senior Vice President of Investor Relations)

Great. Thanks. With that, we’ll close the Q and A. And Dan, go to Dave to you for a couple of closing remarks.

Dave Ricks

Hey, thanks Mike, and thanks to everyone who called in today and for the excellent questions from the Sell side community. We appreciate everyone’s participation here and as always, follow up with our excellent IR team if you have questions that didn’t get answered today and have a great. Rest of your day. Take care.

Operator

Thank you. And ladies and gentlemen, this does conclude our conference for today. This conference will be made available for replay beginning at 1pm today, running through December 4th at midnight. You may access the replay system at any time by dialing 800-332-6854 and entering the access code 797-327. International dialers can call 973-528-0005. Again, those numbers are 800-332-6854 and 973-528-0005 with the access code 797327. Thank you for your participation. You may now disconnect your

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