Eli Lilly's Q3 2025: Contradictions Emerge on Orforglipron Pricing, Weight Maintenance, and CVS Formulary Impact

Date of Call: October 30, 2025

Financials Results

• Revenue: Revenue grew 54% versus Q3 2024; key products accounted for $12.0B of revenue in the quarter
• EPS: $7.02 per diluted share, compared to $1.18 in Q3 2024; includes $0.71 of acquired IPR&D charges (prior year included $3.08)
• Gross Margin: 83.6% of revenue, up 1.4 percentage points versus Q3 2024

Guidance:

• Full-year 2025 revenue expected to be $63.0B to $63.5B (midpoint increased by >$2B).
• Non-GAAP performance margin expected to be 45% to 46% of revenue.
• Non-GAAP EPS expected to be $23.00 to $23.70 for full-year 2025.
• Orforglipron global regulatory submissions beginning imminently; U.S. launch for obesity anticipated in 2026.

Business Commentary:

• Revenue and Financial Performance:
• Eli Lilly reported revenue growth of 54% for Q3 2025 compared to the same period last year, with revenue reaching $23.7 billion.

• This increase was driven by strong performance from key products, particularly Mounjaro, and favorable product mix, offset by lower realized prices.

• Product and Pipeline Developments:

• Key products such as Mounjaro and Jaypirca contributed significantly to revenue growth, with Mounjaro sales nearly doubling year-on-year.

• This growth was supported by several key milestones, including FDA approvals and positive Phase III trial results for various products.

• Market Expansion and International Performance:

• International revenue showed strong growth, with Mounjaro performance accelerating globally, particularly in countries like China, Brazil, and India.

• The international expansion was driven by robust uptake of Mounjaro and strategic launches in key markets, with over 75% of international revenue coming from out-of-pocket payments.

• Investment in R&D and Manufacturing:

• Eli Lilly initiated 16 new Phase III programs in 2024, demonstrating a significant commitment to R&D.
• The company is expanding its manufacturing footprint, including plans for new U.S. facilities to support its bioconjugate and small molecule portfolios.

Sentiment Analysis:

Overall Tone: Positive

• Management called Q3 "another strong quarter," reported revenue up 54% YOY, raised full-year revenue and EPS guidance, and highlighted multiple late-stage positive readouts and manufacturing expansions—all indicating upbeat execution and outlook.

Q&A:

• Question from Terence Flynn (Morgan Stanley): Are you seeking the National Priority Review Voucher for orforglipron and what are the timeline expectations for launch?
  Response: Company pursuing all available pathways to accelerate review; regulatory submission will be filed this quarter and they aim to launch in the U.S. as soon as approval permits.

• Question from Christopher Schott (JPMorgan): How are recent international Mounjaro launches performing versus expectations and is there meaningful stocking?
  Response: Strong uptake internationally with initial stocking observed; continued robust performance driven largely by out-of-pocket obesity demand and growing type 2 diabetes reimbursement efforts in selected markets.

• Question from Seamus Fernandez (Guggenheim): How do you view competitive/industry M&A and segmentation dynamics in obesity therapies?
  Response: Lilly believes its portfolio is competitive and differentiated across targets and remains confident in its R&D and execution; competitive activity doesn't alter their view of their lead.

• Question from James Shin (Deutsche Bank): Does the Cigna move away from rebates to GPO fees increase go-to-market pressure and change how clinical profiles affect access?
  Response: Company supports greater transparency; expects competition to shift toward clinical differentiation and value rather than opaque rebate economics.

• Question from Geoffrey Meacham (Citigroup): Will orforglipron be commercialized consumer‑centric via LillyDirect or through traditional PBM/payer negotiations?
  Response: Hybrid approach: pursue broad payer coverage and PBM negotiations while also leveraging direct‑to‑consumer channels (LillyDirect) to reduce access frictions.

• Question from Steve Scala (TD Cowen): Has the TRAILBLAZER‑ALZ 3 interim already occurred and does remternetug initiation affect donanemab prospects?
  Response: Enrollment for TRAILBLAZER‑3 is complete; they will not comment on interims and are focused on event accrual timing while continuing parallel development of remternetug.

• Question from Mohit Bansal (Wells Fargo): Could GLP/GIP agents like brenipatide have a role in Alzheimer's?
  Response: Brenipatide has CNS‑relevant attributes and is being explored in neuroscience, but Lilly will await upcoming evoke data before defining specific Alzheimer's plans.

• Question from Courtney Breen (Sanford Bernstein): Given potential inventory to support millions of patients, how should we think about orforglipron's market expansion and impact on new starts?
  Response: Orforglipron is positioned to scale broadly as a once‑daily oral GLP‑1‑type option complementing injectables; ATTAIN‑MAINTAIN will inform switching/maintenance strategies but the company expects market expansion rather than simple cannibalization.

• Question from Asad Haider (Goldman Sachs): What are the pricing/elasticity learnings for orforglipron from U.S. cash‑pay trends and U.K. price moves?
  Response: Direct‑to‑consumer demand is significant in the U.S.; international elasticity exists but orforglipron meets different needs (oral, no refrigeration) and is expected to be complementary across markets.

• Question from Timothy Anderson (BofA Securities): Will Novo's negotiated semaglutide Part D price materially affect Lilly pricing in 2027?
  Response: Semaglutide Part D negotiation applies only to Part D in 2027 (a small portion of Lilly volumes); Lilly highlights tirzepatide's superior efficacy as a basis for differentiated, value‑based discussions.

• Question from Alexandria Hammond (Wolfe Research): How critical is ATTAIN‑MAINTAIN to orforglipron's commercial opportunity and could outcomes change launch scale?
  Response: ATTAIN‑MAINTAIN is a novel, informative study on maintenance after injectables and could boost market expansion and physician guidance, but is viewed as additive to an already large commercial opportunity.

• Question from Umer Raffat (Evercore): Are GLP pricing dynamics and competitor actions changing the base case for pricing maturity?
  Response: Q3 pricing trends aligned with expectations and Lilly has maintained LillyDirect pricing; company emphasizes product and commercial differentiation rather than expecting abrupt pricing regime change.

• Question from Akash Tewari (Jefferies): Can Lilly both enable global scale for orforglipron (lower parity pricing) and preserve innovation incentives?
  Response: Yes — company intends to balance accessible consumer pricing and global scale with continued investment in R&D and evidence generation to preserve innovation.

• Question from Evan Seigerman (BMO): Why is management 'super excited' about presymptomatic Alzheimer's programs and has that view changed?
  Response: Based on TRAILBLAZER‑1/2 data showing largest effects in earliest disease, management remains highly optimistic about preclinical treatment potential and sees no change in enthusiasm.

Contradiction Point 1

Orforglipron Pricing Strategy

It involves differing statements about the pricing strategy for orforglipron, which is crucial for market positioning and competitive dynamics.

Will the launch of orforglipron focus on consumers or traditional payers? - Geoffrey Meacham (Citigroup Inc.)

2025Q3: Orforglipron will be similar to Zepbound in offering consumer-centric options alongside traditional payer negotiations. - Ilya Yuffa(COO)

What is your pricing strategy for orforglipron, and how do you position tirzepatide against semaglutide competition? - Seamus Christopher Fernandez (Guggenheim)

2025Q2: We will continue offering consumer-level pricing where coverage gaps exist. - David Ricks(CEO)

Contradiction Point 2

Orforglipron's Role in Weight Maintenance

It concerns the potential role of orforglipron in weight maintenance, which impacts the drug's clinical use and market positioning.

好的，我需要处理用户提供的这个任务。首先，用户希望我作为专业的金融文章作者，总结并精简来自美股上市公司财报电话会议的问答环节的问题。用户强调要保持原意，同时让问题简洁、精准，去除多余的装饰词，并符合美式英语习惯。输出要仅包含简化后的问题，并且以问号结尾。现在来看具体的问题例子：“How does the ATTAIN-MAINTAIN trial impact orforglipron's commercial opportunity?” 我需要分析原问题的结构和核心信息。原问题询问的是ATTAIN-MAINTAIN试验对orforglipron商业机会的影响。这里的关键词是ATTAIN-MAINTAIN trial、impact、orforglipron、commercial opportunity。可能用户觉得原问题有些冗长，比如“impact orforglipron's commercial opportunity”可以更简洁地表达。首先，考虑“impact”这个词，是否可以用更直接的动词替代，比如“affect”或者“influence”。但原问题用的是“impact”，可能更符合正式场合的用法。另外，原问题的结构是“How does... impact...”，这在英语中是常见的，但可能可以简化为“What impact does... have on...”。不过用户要求不改变原意，所以可能需要保留“impact”这个词的位置。接下来，“orforglipron's commercial opportunity”可以简化为“orforglipron's commercial prospects”吗？因为“prospects”在商业语境中常用来指未来的可能性，比“opportunity”更常见。但需要确认是否改变了原意。原问题中的“commercial opportunity”指的是商业机会，而“prospects”可能更侧重于未来的前景，但两者在语境中可能相近。不过用户要求不改变原意，所以可能需要保留原词。另外，原问题中的“ATTAIN-MAINTAIN trial”是否需要保持大写？在正式文档中，试验名称通常首字母大写，所以应该保留。而“orforglipron”作为药物名称，可能需要小写，除非有特定的命名规则。这里可能需要保持原样，但用户没有特别说明，所以保持原拼写。综合来看，原问题可以简化为：“How does the ATTAIN-MAINTAIN trial impact orforglipron's commercial opportunity?” 这里可能已经比较简洁了，但用户可能希望进一步缩短。例如，是否可以去掉“How does”中的“does”，但这样会改变句子的结构，变成陈述句而不是疑问句。所以必须保留疑问结构。另一个可能的简化是：“What is the impact of the ATTAIN-MAINTAIN trial on orforglipron's commercial opportunity?” 但原问题使用的是“how”，而用户可能希望保持“how”开头，因为问题结构不同。不过用户要求的是不改变原意，所以两种结构都是可以的，但原问题用的是“how”，所以可能需要保留。因此，最终的简化问题可能是：“How does the ATTAIN-MAINTAIN trial impact orforglipron's commercial opportunity?” 这里已经比较简洁，可能用户认为“impact”可以替换为更直接的词，但根据用户的要求，不能改变原意，所以保持原词。此外，检查是否符合美式英语习惯，比如使用“impact”作为动词是正确的，没有拼写错误。确认输出是否仅包含问题，并且以问号结尾。原问题的结尾已经有问号，所以简化后也必须保留。因此，最终的简化问题就是原问题本身，可能用户认为已经足够简洁，或者需要进一步缩短。但根据用户提供的例子，可能原问题已经足够简洁，所以输出与原问题相同。但用户可能希望更简短，比如去掉“how does... impact”中的“how”部分，但这样会改变问题的结构。因此，可能用户提供的例子中的问题已经是简化后的版本，或者需要进一步调整。再仔细检查原问题：“How does the ATTAIN-MAINTAIN trial impact orforglipron's commercial opportunity?” 是否有冗余的词？例如，“impact”是否必要，或者可以换成“affect”？但用户要求不改变原意，所以必须保留“impact”。另外，“commercial opportunity”是否可以简化为“commercial prospects”？如果用户允许，但需要确认是否改变原意。假设原问题中的“commercial opportunity”指的是市场机会，而“prospects”可能更广泛，但可能可以接受。不过用户可能希望保持原词，所以最终决定保持原问题不变，因为已经足够简洁。因此，最终的简化问题就是原问题，可能用户认为已经符合要求，所以输出与原问题相同。但用户提供的例子中可能希望更简短，例如：“What impact does the ATTAIN-MAINTAIN trial have on orforglipron's commercial opportunity?” 但用户要求不 - Alexandria Hammond (Wolfe Research, LLC)

2025Q3: ATTAIN-MAINTAIN is a novel study measuring patient weight maintenance. - Kenneth Custer(COO)

Can you compare orforglipron's position in the treatment landscape to Zepbound and Wegovy and provide context for the data? - Christopher Thomas Schott (JPMorgan)

2025Q2: It offers simplicity with once-daily pill use. We are evaluating it in various disease areas including diabetes and obstructive sleep apnea. - Kenneth L. Custer(COO)

Contradiction Point 3

Orforglipron Launch Strategy and Pricing Positioning

This contradiction involves differing perspectives on the pricing strategy and launch approach for orforglipron, potentially impacting market positioning and competitive dynamics.

Are you seeking a Priority Review Voucher for orforglipron, and how do you plan to launch it considering the voucher? - Terence Flynn(Morgan Stanley)

2025Q3: We're interested in getting orforglipron to patients as fast as possible. We will pursue 'all of the above' strategies to expedite the medicine's launch. We believe orforglipron meets multiple criteria for the voucher program. - David Ricks(CEO)

How does orforglipron’s pricing compare to injectables with similar profiles? Can this provide leverage in PBM negotiations? - Terence Flynn(Morgan Stanley)

2025Q1: We don't comment on pricing until launch. However, we have a portfolio approach that could provide strength, including potential treatments for BMIs above 27. This could create a foundation for chronic weight management. - Patrik Jonsson

Contradiction Point 4

CVS Formulary Decision Impact and Market Strategy

This contradiction involves differing viewpoints on the impact of CVS's formulary decision and how it affects Lilly's market strategy and competitive positioning.

Will recent PBM business model changes impact you more than expected? - James Shin(Deutsche Bank AG)

2025Q3: Cigna's move is good for innovators, patients, and payers. We want more transparent bases of competition. This kind of model should enhance clinical differentiation rather than rebate-driven formulary placement. We hope others follow, and this transition will benefit everyone. - David Ricks(CEO)

How is CVS's formulary favoring Wegovy over Zepbound affecting your business, and what is your strategy for navigating PBM dynamics in obesity? - Asad Haider(Goldman Sachs)

2025Q1: We're not surprised by this kind of announcement, as we're in a replacement cycle with Tirzepatide gaining market share. Our focus remains on expanding choice and access for patients, not reducing it. - Dave Ricks(CEO)

Contradiction Point 5

Orforglipron's Market Positioning and Launch Strategy

It involves the company's strategic positioning and launch plans for Orforglipron, which are crucial for market penetration and commercial success.

Are you seeking a National Priority Review Voucher for orforglipron, and how will the voucher influence its launch strategy? - Terence Flynn(Morgan Stanley)

2025Q3: Orforglipron is an oral with GLP-1 efficacy, targeting patients with needle fears and those not needing maximum weight loss. - Patrik Jonsson(President of Lilly Cardiometabolic Health and Lilly USA)

Can you clarify Orforglipron’s role as a single-injection GLP-1 therapy? - Courtney Breen(Sanford C. Bernstein & Co., LLC)

2024Q4: Orforglipron is an oral with GLP-1 efficacy, targeting those with needle fears or not needing maximum weight loss. - Daniel Skovronsky(Chief Scientific Officer)