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We're betting a lot on organic R&D build out. We currently have about 4,200 PhD scientists at Lilly. By the way, it's about the same as MIT and Harvard combined. So the scale of the science enterprise is huge.
And at Lilly, we think about our job a little differently. We want to create a solution to some other problem people have. And we think we're good at that and can uniquely do it. So we should try.
Well, I think we've had this totally asymmetric success. So what do we do with it? I think one version of it is to sort of play out the cash flow game, return to shareholders, and return at some future date, remembering that in pharma, we have no enduring franchise. Everything we make goes to zero because of the patent system. So in 2030-something, Manjaro will go to zero.
We spend 25% of sales on R&D. This year that'll be $14.2 billion. That has to get paid for. And we pay for it through revenue.
We've told the street, expect single-digit deflation in this category over time.
The main goal is to get it reimbursed. Why is it we pay for antihypertensive drugs that the moment you stop taking them, you have the same exact risk as before, but we don't pay for anti-obesity drugs? That makes no sense to me.
We're committed to bringing the pricing down. And I want to come back to the supply situation because that led to some of the compounding, but also affects pricing. You know, we've led in reducing the out-of-pocket costs from, it was originally $1,000. Now it's $499 from us. We'll push that down further with new medicines like orals.
We had to stop the study because they were losing too much weight too quickly. They were basically not eating. So scientists are like, actually, it's good news. We can tune the dose down. We can work with this. And from there, it was kind of just execution. We knew it was going to be huge.
I'd estimate around 20 million take prescription GLP-1s.
$8.1 billion in revenue. Just in a quarter? Growing at 80%, yeah.
actually in Q2, we reported global sales, which surpassed Keytruda to becoming the best-selling drug in the world, actually the best-selling drug in the world of all time in Q2 this year.
We're building the largest API site in the history of the United States in Indiana.
we launched at a 20% discount to Nova's product, even though we have better efficacy data and we've only cut the price since then. And I think, we see a kind of a generational opportunity for the company to both be, have the best product. So efficacy and quality, but also mass production. And that requires a pricing strategy consistent with that.
this medicine could augment 100, 200 adult diseases in a meaningful way.
the pressure is a privilege in a way it means we made something useful enough that a lot of people need it and want it. And now our job is to work with, you know, the healthcare system to sustainably adopt it.
Net pricing, uh, for us, you know, is going to be something like three, $4,000 a year in the steady state per person. But I think we'll create more value than that. We'll save the system more money than that per year per user.
this is a very long investment cycle business. Um, as we talked about earlier, like we launched the first GOP one drug in the world in 2005. And since that time we've been working for, you know, this kind of performance because we took risk against that idea, right. And refined it and worked that problem. And that it, you know, I think that time scale is hard for people to think about, but also, you know, the dollar scale of the R and D this year, we'll spend over $11 billion on R and D, which i
it's called orforglupron. It's a, it's a chemical drug. So here, not an amino acid, but, uh, organic chemistry that mimics, that mimics the activating, uh, part of the peptide. Um, and so it's, uh, it's an oral GLP one, um, in our hands it it's about as good as, as high dose semaglutide. And, um, we're, we're doing phase three right now. Um, so that will start to read out next year. The benefit of this is one it's oral. So it's a little easier to take, you don't have to refrigerate, you don't ha
The, the physiology of GOP one and GIP right now, that's not how it works, right? If, if you don't have them on board, your body res, restores itself to its previous position. We, there is a theory that if you sustain low body weight for long enough, you can kind of reset your thermostat in a way and your body will stop trying to defend what it perceives as a starvation state, which is you, you're not carrying as much weight as you normally would. But, you know, we haven't had these drugs around
We have a, a savings card program that's about $600 per month. And then we also just launched in the lowest two doses, uh, a vial form, which is a little easier for us to make. We can get into the supply issues here, uh, maybe in this discussion too. And that's, um, $399, uh, basically and $550 for those two doses. So almost, you know, 60% off.
back in January, we launched what we call Lilly Direct. So people can go to their doctor or use our telehealth platform. We have a bunch of partners who will see you as a physician and they're obesity specialists, and they'll send the prescription to Lilly and we'll fulfill it directly via mail, DTC. This solves two problems. One is people can go to a place where they're not stigmatized for being overweight and two, they always get it at the same price and it's the lowest price available to them
So right now about 50% of the employer-sponsored insurance plans cover it. ... I think in five years, we'll look back and we'll say that was crazy.
I was actually in a big investor of mine's office a few weeks back, and they said, oh, the last company in here was a reinsurance company, and they're changing their actuarial tables for people who are on these drugs
What we see today with whether it be Lily's products in this category or Novo's is really broad acceptance of by insurance and healthcare practitioners in treating outright diseases like diabetes, type two diabetes. And I think like these cardiovascular conditions we're studying, I think they'll be adopted quickly and reimbursed quickly.
we just read that study out with Manjaro, which showed that three years on our drug, 94% fewer new diagnosis of outright diabetes.
Currently, Lily has 105 studies going with trisepatide in these other diseases. So this is a massive, massive undertaking, you know, a clinical trial like that takes a hundred or $200 million each. So you can do the math. It's a, it's a huge bet that we can convert weight loss into sustained health benefit in chronic disease.
this category of medicine's undefeated. We've never had an unsuccessful study in measuring an outcome in a chronic disease.
next up is there's amylin based drugs. That's another gut hormone, and glucagon, another one. So we, we've got a triple acting and all kinds of different ones coming.
we've combined that in trisepatide
And then interestingly, you've got the mood anxiety pieces here. And there's an interesting study done by Epic, you know, they're the big health record company, which is retrospective and not tightly controlled, but it showed people on GLP one drugs, incretins had remarkably lower rates of new clinical depression diagnoses, which is an interesting thing as well.
there's a Danish company, Novo, who's our competitor in this space.
we had partnered with Genentech to do another first, which is create the first biotechnology product on planet earth, which was human insulin made in a, in a bacterial cell.
we were the first company period.