Ilya Yuffa: Sure, first, thanks for the question. From a trulicity standpoint, we had healthy growth coming into later part of last year. And we’ve been pretty transparent with both physicians as well as regulators that due to the tight supply, we are encouraged not to start new patients. We continue with that, to be transparent. We think it’s the right thing to do. And as we think about the growth in incretin, we’re looking as we build up capacity, as David mentioned. As we increase capacity both in the single use vial and introduce Mounjaro in additional markets as we have in Australia and we will continue over the next number of weeks and months in other markets and then transition towards a multi-use platform in quick time in introducing Mounjaro. And so the overall growth in incretin will be mainly driven by as we are able to launch Mounjaro in new markets that’s probably will go get the growth. Thank you for the question.
Joe Fletcher: Thanks Ilya, Paul. Next question?
Operator: The next question is coming from Umar Rafat from Evercore. Umar, your line is live.
Umer Raffat: Hi, guys. Thanks for taking my question. I realize Mounjaro has not approved in obesity yet. But I’m just very curious how you’re thinking about the pros and cons heading into that pricing decision, if there is any, because Novo does have that price premium, as you know, on Wegovy or Ozempic. So on the one hand, while Mounjaro price could be the same because the dose is the same, but on the other hand, Novo has this dynamic where it can offer a lot more rebate for the obesity indication than you can, if you leave the price unchanged. I’m just curious what your thought process is heading into that.
Joe Fletcher: I’ll hand over to Mike.
Michael Mason: Yeah, thanks for the question. Obviously, we’re not going to talk about price prior to approval. We’re evaluating every scenario. We will make the right decision for patients who live with obesity. Thanks,
Joe Fletcher: Paul, next question.
Operator: The next question is coming from David Risinger from Leerink. David, your line is live.
David Risinger : Yes, thanks very much. And thanks for all the updates today. So some major payers seem to under appreciate the broad health savings potential that incretins offer the non-diabetic obese population, and instead focus on criticizing drug pricing. So ahead of the results from Mounjaro’s morbidity and mortality outcomes trial in 2027, how does Lilly plan to better inform payers about Mounjaro’s health economics benefits in non-diabetic obese patients? Thanks very much.
Joe Fletcher: Thanks, Dave for the question. Mike, do you want to talk a little bit about that, about the longer term appreciation for the broader health benefits of medicines, like tirzepatide?
Michael Mason: Yeah, no, David, it’s a good question. One that we’ve obviously spent a ton of time on and done a lot of internal analysis and a lot of planning on. We will have a whole suite of real world evidence and pragmatic trials so that we can answer this question clearly, for payers and other stakeholders. In our conversations with payers, while they’re concerned about the short term budget impact, they do understand that losing weight will have benefits. It’s not that hard of a sale, because they do understand the benefits are intuitive. If you look at the total number of like obesity rate of complications, there’s over 200. And you look at some of these are just really devastating and very costly, like type 2 diabetes, coronary heart disease, hypertension, dyslipidemia.
And then when you look at the cost of these, on the U.S. alone, there’s $370 billion in direct medical costs associated with obesity-related comorbidities, and over a trillion in indirect annual cost. When payers see that, people living with obesity and overweight, drive 2.7 times greater healthcare costs, than normal individuals, that data does get their attention. And so I think over time will continue to provide health economics data, but also I think the voice of those living with obesity will be very important in this. This is a disease that, that really materially impacts someone’s both health and mental functioning. And is really important for people who live with obesity. Their goal is to is to lose weight and maintain that so they can help their long term health benefits.
And they’re going to have a loud voice in this. I think both in commercial insurance as well as in states and the federal government. And so I do — I am confident over time that we will see increase in access. I think the most recent report shows that there’s 50 million people in the U.S. that has access to obesity medication. So it will take time, but I think — do think more and more payers are appreciating the value that anti-obesity medications especially when we get approval for tirzepatide will offer them. Thanks.
Joe Fletcher: Thank you, Mike. Paul, next question.
Operator: The next question is coming from Evan Seigerman from BMO Capital Markets. Evan, your line is live.
Evan Seigerman: Hi, thank you so much for giving me the question and congrats on the progress. So given the executive changes announced in October, how should we think about the direction of the immunology business now with Dan at the helm? Thank you guys.
Joe Fletcher: Thanks, Evan. Dave, do you want to take that?
David Ricks: Sure, I can start and let Dan comment. Look, we’ve been really pleased with this business, which I think is important to take the long view here. I mean, I was involved in creating this like 10 years ago, and both [indiscernible] and now mirikizumab, and hopefully soon Lebrikizumab will form a really core portfolio for us, really exploiting ideas that we had some time ago. What’s next, and you see here today advancing another checkpoint agonist into Phase 2 is a lot of decisions about, okay, what’s next to take immunology to the next level. And that’s largely going to be about key decisions, both internal portfolio and potentially externally, like with our DICE acquisition, to find a new set of either single agent or combinations that can raise the standard of care in tough immunology diseases, noting, in particular in IBD and RA, the standard of care is hardly satisfied today.
We measure real pretty low performance status of success. So that’s the mission that Dan and we’ve hired Mark Genovese to the company and others to really build a portfolio the future. So I don’t Dan, if you want to.
