Eli Lilly

Lilly received FDA approval for Kisunla (donanemab) for early symptomatic Alzheimer's disease, making it the second amyloid-targeting therapy approved after Leqembi. The approval came with a label that includes amyloid PET or CSF testing requirements and a boxed warning for ARIA, consistent with the class. This opens a second major non-GLP-1 revenue stream the company has been building toward for years.

Lilly's insulin business is basically invisible in the current narrative but it's worth noting they cut Humalog list prices by 70% and capped out-of-pocket costs at $35 per month back in 2023. That was a PR move but it also signals they're de-prioritizing insulin as a margin driver and betting everything on GLP-1 and neuroscience going forward.

Lilly's oral GLP-1 candidate orforglipron just showed compelling Phase 2 data — a small molecule that doesn't require injection and could be manufactured at much lower cost than peptide-based drugs. If Phase 3 data holds up this completely changes the addressable market because needle-averse patients and cost-sensitive markets like developing countries become accessible.

Something that doesn't get enough attention is Lilly's oncology business — Verzenio (abemaciclib) for HR+/HER2- breast cancer has been growing steadily and the early breast cancer adjuvant indication gave it a significant second wind. It's not a GLP-1 but it's a multi-billion dollar franchise quietly compounding in the background.

Lilly is trading at something like 50x forward earnings and that multiple is entirely built on GLP-1 demand staying red-hot forever. Any supply normalization, pricing pressure from PBMs, or a Medicare negotiation outcome that goes badly could shave 30% off this stock overnight. The valuation leaves zero margin for error.

Mounjaro and Zepbound together are on track to become the fastest products in pharma history to hit $10B in annual revenue. The tirzepatide franchise is doing things that even the most optimistic GLP-1 bulls didn't model two years ago. If the cardiovascular outcomes data holds up the way Novo's semaglutide data did, this stock has years of runway left.

Does anyone have a good read on how Lilly's manufacturing buildout is actually tracking? They've announced something like $9 billion in new US capacity across Indiana, North Carolina, and Wisconsin, but I keep hearing Zepbound is still rationed at some pharmacies. Are they actually going to close the supply gap by mid-2025?

How do people here think about the retatrutide (triple GIP/GLP-1/glucagon agonist) opportunity relative to tirzepatide? Phase 2 data showed even higher weight loss — around 24% at 48 weeks — but the program seems to have gone quiet. Did Lilly decide tirzepatide is good enough or is retatrutide still being developed?

Lilly's Q3 2024 revenue came in around $11.4 billion, up roughly 42% year over year, driven almost entirely by Mounjaro and Zepbound which together did about $4.4 billion in the quarter. The non-incretin portfolio is still growing. This is one of the few mega-cap companies actually accelerating revenue growth rather than decelerating, and the pipeline optionality is not even fully priced in.

Lilly and OpenAI announced a collaboration focused on using AI to accelerate drug discovery and clinical trial design, part of a broader industry trend of pharma companies embedding large language models into R&D workflows. This follows Lilly's existing AI partnerships with Evidation and their internal AIDD unit. Not a revenue event in the near term but signals where management is allocating innovation capital.

Compounding pharmacies have been filling tirzepatide prescriptions at a fraction of the brand price during the FDA shortage period and patients are getting used to paying $150-200 per month instead of $1000+. When Lilly eventually forces the shortage designation off and shuts down compounders, a lot of those patients are just going to fall off therapy rather than pay full price. The demand durability story has a hole in it.