Eli Lilly (LLY) Q2 FY26 earnings call: guidance and Q&A

How does Lilly envision expanding its treatment opportunity through consumer engagement, and what are the similarities/differences between U.S. and international self-pay markets?

Lilly sees significant opportunity in obesity treatment, with only mid-single-digit utilization. They are increasing consumer awareness and expanding LillyDirect offerings. The international self-pay market is mainly out-of-pocket, and Lilly is replicating U.S. practices while adapting to local regulations.

“I think the overall market, if you think about just obesity in general, in the U.S. and globally, we're still have single -- mid-single digit in terms of utilization or treatment of obesity. And so there's still a significant opportunity ahead of us after more patients in terms of access.”

asked by Seamus Fernandez · answered by Ilya Yuffa

What factors contribute to the slower-than-anticipated U.S. Foundayo launch curve, and when is an inflection expected? What are the competitive dynamics ex-U.S. given Novo's oral pill launches?

U.S. Foundayo launch is progressing with increased physician education, access (CVS, Medicare Bridge), and consumer awareness. An inflection point was observed in late July, with volume doubling in a month. Ex-U.S. launches (UAE) show strong starts, with orals expanding the market and Lilly's combined incretins holding steady despite competition. Supply is not a gating factor for ex-U.S. launches.

“And what we've seen in terms of overall growth and inflection is that the last week of July, we're seeing inflections. So the -- we're doubling the volume that we had just a month ago. And we're starting to see new starts coming in nearly around 1 out of 4 starting on Foundayo.”

asked by Asad Haider · answered by Ilya Yuffa

Can you clarify the requirements and milestones for Retatrutide's BLA pathway, and whether this will be unique to Retatrutide or applicable to other incretins?

Lilly believes Retatrutide qualifies for a BLA due to its amino acid count and protein-like nature. They are in active litigation with the FDA but hope for a conclusion to support a BLA application. All clinical data is available, but CMC data is still being gathered. The submission is planned for Q1 2027.

“As you mentioned, we've been pursuing this for a little while because we believe retrade is a biologic application both in terms of amino acid count rule as well as analogous to a protein. So that's our position.”

asked by Courtney Breen · answered by David Ricks

Elaborate on the Medicare obesity rollout, including learnings, surprises, ramp curve, and oral vs. injectable dynamics.

The Medicare GLP-1 bridge program is expanding access to 35% more Americans. It's early days, but a significant inflection point is seen. CMS is educating stakeholders, and the prior authorization process is working well. There's a preference for injectables (~80%), but new patients are coming in for both, with 60-70% being new to treatment.

“The approximate -- we're seeing a significant preference towards injectable, probably around 80% of people that are getting treatment are injectable, but we're seeing new patients for both. And we have approximately around 60% to 70% being new people that are coming in that have not had access before.”

asked by Christopher Schott · answered by Ilya Yuffa

Lilly's guidance implies a deceleration in revenue growth in H2 2026 despite Medicare Bridge and Foundayo commercial access. Is there anything missing, or is the guidance conservative?

The guidance factors in one-off prior-period adjustments for rebates/discounts that won't continue. The comparison base for H2 2025 included significant Mounjaro launch volumes in new U.S. markets, which won't recur. Future growth will be driven more by OUS penetration. Seasonality in Europe (Q3 vacations) and U.S. T2D (Q4) is also factored in.

“When you look at actually the growth that we expect to see in dollars, not in percentage of growth, we expect to continue to drive significant growth in the second part of the year as well. Of course, again, that bolus of new countries, as all along I highlighted, has already happened, will not happen again.”

asked by Akash Tewari · answered by Lucas Montarce

Zebbound's net price is higher than cash pay and Wegovy. How sustainable is this, especially with CVS access, and does it drive favorable rebate adjustments?

Lilly provides transparency on pricing across channels (LillyDirect $299-$449, Bridge $245). Medical exceptions and script size impact the commercial price. With CVS access, the goal is open access, and net price is expected to go down, but this is embedded in guidance and will be offset by volume growth. Medical exception is seen as a short-term factor.

“We are happy actually. And all along, our goal is to have access. The medical exception is maybe a short-term thing and our all along view is to have open access for all the patients -- so expect that price will actually go down for sure because of this, but it's very much embedded in our guide and it's basically reset on, again, our expectations.”

asked by Umer Raffat · answered by Lucas Montarce

Can psychiatry and vaccines scale as high-priority areas, or are these acquisitions more one-off, driven by intriguing science?

These areas share immense unmet needs, which is a core driver for Lilly's internal and BD work. The acquisitions were opportunistic, based on impactful technologies at disciplined prices. While not committing to specific future build-outs in these areas, Lilly remains excited about the potential and will continue to be opportunistic.

“I think with these 2 areas have in common is just the immense unmet need that still remains and that really is the through line of all of the work that we do, both internally and through business development.”

asked by Jason Gerberry · answered by Jacob Van Naarden

Given strong UAE sales, what is Foundayo's ex-U.S. obesity potential? Will it be better reimbursed for diabetes ex-U.S. due to potentially lower pricing than tirzepatide?

Early UAE results are encouraging, but it's very early days with inventory build. There's a clear need for an oral incretin for both obesity and T2D, with many naive patients. The major ex-U.S. rollout will be in early 2027. Foundayo is likely better positioned for T2D reimbursement ex-U.S. due to its oral nature and appealing value proposition, but reimbursement always takes time. Focus at launch will be on chronic weight management.

“Yes, I think we're probably slightly better positioned with an oral for Type 2 reimbursement. And the data we have seen so far for forging with 3 head-to-head trials, it's quite an appealing value proposition.”

asked by David Risinger · answered by Patrik Jonsson