Lilly Q4 2022 Earnings Call Mounjaro Recap

SAVINGS CARD

- They were designed as a “BRIDGE PROGRAM” (their words) to get people on the medication. - They adjusted the card to focus on diabetic patients only, at that time also making adjustments to promote revenue at the end of 22 into 2023 - Stated goal of MJ driving revenue in 23 as COVID treatments dwindle, this is what gives me little hope for any meaningful card moving forward. - Switching to PAYER (patients and insurance co) covered scripts (paid scripts VS no paid) - In 2022 payer paid scripts only accounted for 40% of MJ sales outside of the $25 copay card - CEO said on CNBC ahead of call that the changes were to protect diabetics who were being denied access because of supply constraints. Conveniently this also helped close some of the gap in December with their earnings shortfall OVERALL BAD NEWS FOR COPAY ASSIST AS THEIR STATED PROFIT TARGETS ARE RELYING ON MJ TO PICK LILLY UP FROM DIMINISHING COVID TREATMENTS PRICING MOVING FORWARD - A LOT OF COMPARISON TO TRULICITY (DULAGLUDITE LILLY’S OTHER GLP-1 INJECTABLE) - 75% of MJ users are new to incretins, which hints at an overall huge demand moving forward - Trulicity price sits currently at $930.88 vs MJ’s $1,023. They see MJ as a better performing drug than Trulicity especially as it relates to surmount 3 studies and its potential effects on BP/ Apnea / Lipids / Heart Failure, so they expect payers to accept a higher cost of MJ over Trulicity - Surmount 4 studies showing that obese people love the appetite suppression of MJ and that it returns when the treatment is stopped. This would indicate a long term use of the drug for patients, leading to sustained demand for the drug. Another upward pressure on price. DONT EXPECT MJ TO BE AVAILABLE ON THE CHEAP ANY TIME SOON, WE HAVE TO BE ADVOCATING NOW WITH OUR EMPLOYERS AND REPRESENTATIVES ACCESS AND ADVOCACY - Estimate that 100,000,000 people in the US need help with obesity, and billions worldwide. - Estimate the 40,000,000 Americans currently have access to obesity medications via insurance (leaving 60% without access), but they see these numbers as strong in business terms - Lilly continues to advocate for passage of Treat & Reduce Obesity Act and it’s passage. - People who are obese “have an important voice for advocacy” - They are excited by what they see in the obesity community as it relates to advocacy with employers and legislatures (we have covered these well on our channel, with the cost shift to payers VS copay assist it has never been more important to get on the ball with your employers and advocate for adding obesity medicine coverage) - On the topic of FDA guidelines for medical treatment for obesity in children, Lilly continues to advocate for intervention but stopped short of saying there are currently ongoing trials in this area - Obesity patients may have a backdoor into MJ approved scripts if they are able to achieve a Priority Review Voucher from the FDA based on the phase 3 trials for sleep apnea - Phase 3 Tirzepatide for weight loss expedited to wrap up second half of the year (FDA approval to follow) (CEO interview on MSNBC) - The IRA (individual responsibility account) copay caps will increase access to GLP-1 meds and benefit diabetes patients with Medicare part D CONTINUE TO ADVOCATE WITH YOUR EMPLOYERS, SEND THEM A LETTER, MEET WITH HR ABOUT ADDING OBESITY COVERAGE. SIGN THE PETITION!

SUPPLY - Not a ton of new info here - Keeping FDA informed, who continues to update via their website (5/10mg affected) - Plans to increase their manufacturing capacity by 50% still online for 2023 - New plant in NC on schedule as well as new plants in Concord, Indianapolis and Ireland - Using the same autoinjector across treatment platforms will be a strategic advantage in keeping up with supply LILLY IS WORKING TOWARDS MASSIVE EXPANSION IN THE INCRETIN INJECTABLES MARKET AND SUPPLY IS GOING TO LEVEL OUT IN THE NEXT YEAR. OTHER OBESITY TREATMENTS - Referred to Retatrutide a couple of times but never got into any specifics above and beyond what was covered in the last call. - Orforglipron as an oral GLP-1 is Lilly’s first attempt in the stated goals of having an oral option that meets the safety and efficacy of injecable GLP-1’s, with an eye towards developing multi-acting agents like Mounjaro and Retatrutide - There was talk about whether Orforglipron could stand up against more generic DPB4 medications (Januvia) which came off patent in 2022 and will theoretically be available on the cheap. Broadly, DPB4 inhibitor medications are considered an incretin treatment like GLP-1’s and came out in the early 2000’s. They work by blocking dipeptidyl peptides 4 which results in increased levels of GLP-1. - Continuing R&D on additional incretins plus Non-Mitochondrial Uncoupling meds:

LOTS OF EXCITING THINGS IN THE PIPELINE FOR OBESITY MEDICINE AND OUR DISCUSSIONS ABOUT COUPONS, SUPPLY WILL BE REPLACED WITH ACCESSIBILITY. CONTINUE TO ADVOCATE!