Eli Lilly and (LLY) Q3 2026 Earnings Call: Q&A Summary

Q: Christopher Schott with JPMorgan asked if the $10 billion guidance raise year-to-date reflects a fundamentally larger incretin opportunity or a pull-forward of demand.

A: Lucas Montarce stated that trends are tracking better than anticipated, but the company is still "scratching the surface on the number of patients that we can reach." He noted that the runway for growth remains long and the company is seeing strong performance across oncology, immunology, and neuroscience.

Q: Geoffrey Meacham with Citi asked about tirzepatide persistency in obesity and how Foundayo and retatrutide might compare.

A: Ilya Yuffa explained that Zepbound adherence is performing similarly to Trulicity, which had 16 to 18 months of adherence. While oral therapies typically have lower adherence than injectables, the low out-of-pocket costs in the Bridge program are helping improve adherence.

Q: Seamus Fernandez with Guggenheim asked about the prospects for TRAILBLAZER 3 and the broader neuroscience market given Kisunla's growth.

A: Carole Ho noted that growth is driven by convenient dosing and better diagnostic tools like p-tau217 blood tests. TRAILBLAZER 3 aims to prevent progression in cognitively unimpaired people, potentially expanding the market to earlier disease stages.

Q: Evan Seigerman with BMO Capital Markets asked what the next multibillion-dollar growth pillar is and if neuroscience and immunology are higher priorities.

A: Daniel Skovronsky stated that all three areas, oncology, neuroscience, and immunology, are priorities. Oncology has eight important late-stage programs, neuroscience addresses the largest unmet needs, and immunology offers opportunities to raise expectations with breakthrough therapies.

Q: Kerry Holford with Berenberg asked about the split between injectable and pill in the Bridge channel and the proportion of naive versus switch patients.

A: Ilya Yuffa reported that about 75% of Bridge patients choose injectable therapy, and 80% of those receiving treatment are naive to incretin therapy. The program is performing above expectations and is a significant driver of long-term access.

Q: Asad Haider with Goldman Sachs asked about the Foundayo launch trajectory globally and steady-state expectations for titration.

A: Patrik Jonsson and Ilya Yuffa noted that international launches are in line with expectations, with orals expanding the market. In the U.S., 25% of patients are at maintenance doses, which is higher than Wegovy pill, and the company expects to launch in type 2 diabetes soon.

Q: Steve Scala with TD Cowen asked why financial guidance has not been a good predictor of results and when the surprise factor might end.

A: Lucas Montarce and Dave Ricks explained that the company uses a bottom-up model but is operating in a unique, rapidly expanding category. Dave Ricks noted, "We prefer to give a posture that investors can rely on versus one that is more speculative."

Q: Terence Flynn with Morgan Stanley asked about the status of the long-acting incretin programs.

A: Kenneth Custer stated the company is evaluating several competing platforms to find the best product. They have multiple efforts in the clinic and will decide which to advance to Phase III based on data.

Q: Trung Huynh with RBC asked if the U.S. channel mix will evolve in 2027 and create pricing pressure.

A: Ilya Yuffa said commercial access should remain stable, but the segment mix will shift toward Medicare and Medicaid, which have lower net prices. The company expects a "modest and disciplined approach" to pricing.

Q: Akash Tewari with Jefferies asked about ex-U.S. pricing stability and the size of the middle-income cash pay market.

A: Patrik Jonsson and Dave Ricks noted that the company takes a disciplined approach to pricing outside the U.S. and sees willingness to pay for differentiated products. The goal is to maintain a "much tighter band of pricing" on obesity medicines globally.

Q: Umer Raffat with Evercore asked about the odds of early stoppage for the imlunestrant trial and how the effect size compares to competitors.

A: Jacob Van Naarden stated the study is expected to read out in 2027. The trial setting is more real-world, including patients on modern standard-of-care CDK4/6 inhibitors, making it highly relevant to clinical practice.

Q: Carter Gould with Cantor asked if there is confidence the Bridge program will be extended or transitioned to Part D.

A: Dave Ricks expressed optimism due to strong uptake and cost-effectiveness data. The goal is to transition the program into the Part D benefit for the 2028 calendar year.

Q: Michael Breen with UBS asked how consumers will choose between different products like retatrutide and amylin.

A: Kenneth Custer explained that the company is pursuing a portfolio approach because different molecules fill different roles. The goal is to offer a consistent experience so patients can "start, switch and step up to any Lilly medicine that works best for them."

Q: Courtney Breen with Bernstein asked how the company balances risk-reward in M&A.

A: Jacob Van Naarden stated, "Risk is really our friend here." The company's strong commercial performance allows it to take calculated risks on early-stage deals to create value for the next decade.