The Ledger
Every statement that passed quotation and attribution checks. Mix any filter with any other: certainty 1/5, debate potential 5/5, or both at once.
why aren't all 71 resolved? a statement only gets an assessment when the public record can support or contradict it. opinions and what-ifs never can, and 2 checkable ones are still open, waiting for their date. predictions held up or didn't; assertions are supported or contradicted. on every card: ▮▮▮▮▮ certainty · ▮▮▮▮▮ debate potential. speakers are clickable
Eli Lilly CEO Dave Ricks says biotech venture capital is totally broken
“We can talk about venture and biotech in a second because it's totally broken.”
Dave Ricks: Consolidated pharmacy benefit managers make every decision for self-enrichment
“What happened is, you know, the, like any consolidated terminal state of an industry, what's the term, the in-ification of their service, is they just become so, every, every action they make is about their benefit, not the customer.”
Dave Ricks: Fully automated 'in silico' drug discovery is a long way off
“The idea that you're going to throw on, you know, turn a switch on a computer and it's going to think about something and event, you know, the next Prozac. I don't know. I think we're a long way from that day.”
Eli Lilly CEO: Tirzepatide surpassed Keytruda as best-selling drug ever
“And then terzepatide, which you asked how much money we're making, but in, actually in Q-two, we reported global sales, which surpassed Keytruda to becoming the best-selling drug in the world, actually the best-selling drug in the world of all time.”
Dave Ricks: Poor US insurance coverage drives patients to gray market GLP-1s
“We're not used to it in the United States. Because we, one, have a, for most people, a pretty good system to subsidize some of the benefit via the insurance markets, so there's not a lot of incentive to go outside the system. That's different for these drugs, …”
Dave Ricks: Competitors cannot match our manufacturing scale without Chinese state backing
“And unless some Chinese state-owned enterprise gets in this business, it'll be very hard for others to build that out and follow.”
Dave Ricks: Chinese entities use AI to reverse-engineer and hack chemical patents
“China's getting very good at patent hacking. So what they do is they look at that chemical structure. They work backwards, sometimes driven by AI. Algorithms define chemical structures that will behave similarly, but are outside the patent scope, and they go f…”
Dave Ricks: China's derivative biotech market significantly hurts global sector valuations
“So they're really quite a derivative biotech market, but that is also hurting biotech valuations in a significant way.”
Dave Ricks predicts competitor's GLP-1 dementia study likely won't be positive
“Our competitor is going to read out a study in a few months on dementia risk. It probably won't be positive. That's my guess, but it will probably be in the right direction.”
Dave Ricks: Low-dose GLP-1s could eventually be used to extend healthspan
“I think we're going to get to a point. We're taking pretty low doses for most people, say over 60, 58. It's not a terrible idea. It may help you live longer.”
Dave Ricks claims anti-fat, high-carb diets drove US obesity growth
“The anti-fat, high-carb diets, which we were feeding people for 30 years, and I think most people don't believe in that anymore, but it led to a big part of the obesity curve, glycemic index kind of thing.”
Dave Ricks supports reducing direct-to-consumer pharmaceutical advertising
“Well, I would be for a system where we don't have nearly as much drug advertising, to be clear.”
Ricks: Eli Lilly's GLP-1 drugs are undefeated in chronic disease trials
“So far in our studies, this category of medicine's undefeated. We've never had an unsuccessful study in measuring an outcome in a chronic disease.”
Ricks: Three-year Mounjaro trial showed 94% reduction in diabetes diagnoses
“We just read that study out with Manjaro, which showed that three years on our drug, 94% fewer new diagnosis of outright diabetes.”
Dave Ricks: Medicare rules prohibit covering weight-loss drugs unless patients have diabetes
“If you're say on Medicare, currently the rule of the federal government is they won't pay. For these medications. You have to get diabetes before you can get the drug.”
Under 5% of obese adults reach healthy weight via lifestyle changes alone
“Some studies show like less than five percent of people can reach a healthy body weight on diet and exercise once they're obese.”
Dave Ricks expects steady-state GLP-1 net pricing around $3,000 to $4,000 annually
“Probably net pricing for us, you know, is going to be something like three, 4000 dollars a year in the steady state per person, but I think we'll create more value than that. We'll save the system more money than that per year per user.”
Eli Lilly retains only one-third of gross drug prices after PBM cuts
“Two thirds of actually our gross price goes to PBMs and insurance companies. So of the gross price that's often quoted, the net for us is about a third of that.”
Dave Ricks: AI's primary drug discovery value is eliminating bad ideas
“It's a co-pilot model where the machine can do predictions. Probably now where we see the most value is Eliminating bad ideas that humans don't see, but in hindsight look obvious. So like, cause you can integrate a lot of multi source data and say the probabil…”
Dave Ricks estimates 20M people globally take prescription GLP-1 drugs
“I'd estimate around twenty million take prescription GLP-I's.”
Dave Ricks says Eli Lilly's GLP-1 weight-loss pill launches in 2026
“Yeah, that's ours. Coming next year.”
Eli Lilly reduced out-of-pocket GLP-1 medication costs to $499
“We've led in reducing the out-of-pocket costs, but from, it was originally a thousand dollars, now it's four 99 from us.”
Eli Lilly expects single-digit annual GLP-1 price deflation over time
“We've told the street, expect single digit deflation in this category over time.”
Eli Lilly employs 4,200 PhD scientists, matching MIT and Harvard combined
“We currently have about 4200 PhD scientists at Lilly. By the way, it's about the same as MIT and Harvard combined.”
Dave Ricks: Annual biotech venture funding collapsed from $20B to $5B
“Peak got to about twenty billion in new checks a year into biotech. We're now about five.”
Dave Ricks: Half of public biotech companies trade at or below cash
“Half of biotech that's publicly traded is trading at or below cash.”
Eli Lilly is starting trials for a brain-focused GLP-1 targeting mental health
“So we are now, right now, starting studies in bipolar disorder and major depressive disorder, along with these addictive hedonic pathways where you're sort of self-medicating and with a new GLP one, a different one, that probably, that has a little less weight…”
Dave Ricks expects to launch a mental health GLP-1 in 3-4 years
“So we'll get that drug in three or four years if it works, and I think it could really change some of these terrible mental health conditions.”
Dave Ricks: Most primary care doctors are too busy to stay updated
“Most primary care doctors are way too busy to even attend a continuing education, even know what's happening.”
Dave Ricks: AI drug information is mostly accurate and substantially improved
“Mostly it's accurate, and they've It's gotten better over the last two years. I'd say substantially better.”
Eli Lilly is transitioning its employee prescription coverage to a transparent PBM
“Actually, our company is moving to one.”
Dave Ricks predicts the next major therapeutic surprise will be brain disease
“It's hard to predict that, but I would say probably a brain disease.”
Dave Ricks: Two-thirds of US calories are ultra-processed vs 35% in Europe
“In the U S we're now eating two thirds of our calories in our country are ultra processed. And that compares to like 35% in Europe.”
Dave Ricks: India's obesity rate projected to reach 30% within 20 years
“India, I think is 11% of the population's obese, but projected to go as much as 30% in the next 20 years.”
Epic study links GLP-1 drug use to remarkably lower clinical depression rates
“There's an interesting study done by Epic. You know, they're the big health record company. Which is retrospective and not tightly controlled, but it showed people on GLP-I drugs, incretins, had remarkably lower rates of new clinical depression diagnoses, whic…”
Dave Ricks: About 50% of employer-sponsored health plans cover GLP-1 weight-loss drugs
“Right now about 50% of the employer-sponsored insurance plans cover it.”
Dave Ricks: Walmart study shows GLP-1 users buy 30% fewer calories
“Last year Walmart did this sort of what's in the cart study for people in Ozempic or Manjaro and it showed They were buying about a third less calories. So that's a lot, but that's consistent with how the drugs work. But interesting also, fewer salty snack foo…”
Dave Ricks: 10 to 11 million Americans currently take GLP-1 drugs
“We only have 10 or eleven million Americans on these drugs.”
Ricks: Eli Lilly GLP-1 launched at 20% discount to Novo Nordisk
“We launched at a 20% discount to Nova's product, even though we have better efficacy data, and we've only cut the price since then.”
Dave Ricks: CAR-T and gene therapies are difficult to scale to millions
“Those two techniques, CAR T and gene therapy, it's hard to think of like super scaled millions of people benefiting.”
Ricks: Leaders cannot change corporate culture, only amplify positive traits
“When you're running a big ship like this, probably changing the culture is like beyond your capability. But what you can do is like extend, turn up the things that are good and turn down the things That are less good.”
Eli Lilly spends $14.2 billion on R&D, equal to 25% of sales
“We spent 25% of sales on R&D. This year that'll be 14.2 billion dollars.”
Dave Ricks: Pharma companies lack enduring franchises due to patent cliffs
“In pharma, all our, we have no enduring franchise. Everything we make goes to zero because of the patent system.”
Dave Ricks predicts Mounjaro revenues will drop to zero in the 2030s
“So, in 20, 30 something, Manjaro will go to zero.”
Eli Lilly is building six US plants and announcing four more
“We're currently constructing six plants. We're going to announce four more in the next six months.”
Eli Lilly's Mounjaro demonstrated a 93% reduction in pre-diabetes conversion
“So we did that with Manjaro and showed a 93% reduction in conversion from pre-diabetes to diabetes.”