The Ledger
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Ricks: Insurers initially refused to cover Eli Lilly's discounted generic insulin
“In the first year, no formularies covered this. So it was really only for that cash payer. No insurance company picked it up, even though it was dramatically cheaper. Now it's about half of the volume, but still half not because that model of this margin sprea…”
Ricks: Machine-designed drugs haven't reached clinical trials yet, but are coming
“I don't know of one that's come through the machine driven discovery process, which is really machine plus human that's made it to the clinic yet, but they're coming.”
Ricks: Cardiovascular trial rules added five years to diabetes drug development
“The Evandia one, we know well, we work in diabetes, actually caused a policy change, and the policy change was you must rule out cardiovascular risk prior to market entry, and as you may know some conditions like diabetes have a more continuous variable you're…”
Ricks: ICER found tirzepatide and semaglutide cost-effective at current pricing
“They just analyzed our medicines, trisepatide and semaglutide, and they said, actually, they're both cost effective at current pricing. In fact, Zepbound or Trisepatide was, the threshold they have is to save a 100,000 dollars per person per year in downstream…”
Ricks: Medicine accounts for only 10 cents of every US healthcare dollar
“In the US, the most expensive healthcare system in the world, we spend 10 cents on the dollar on medicine. The other 90 cents go through everything else that medicine's trying to prevent.”
Ricks: Lilly's net insulin price stayed near $30 despite $275 list price
“Our actual net on insulin really hasn't changed. It's like 30 or 40 dollars, but the list price got up to two 75.”
Ricks: Early-stage biotechs pitch 80% to 100% of revenue from the US
“If you fund, if you went out and said, hey, I want to back some biotechs, and they sent you their business plan, 80 to a hundred percent of the revenue in return they'll pitch you on is the US. Meaning there is no return outside the US if you start at the poin…”
Ricks: Eli Lilly's chronic knee pain study is going to work
“We have a study reading out toward the end of this year in chronic knee pain. It's going to work.”
Ricks: Taltz plus Zepbound trial is certain to boost psoriasis efficacy
“So we're doing a study with our psoriasis drug, Taltz, and ZepBound. That will read out this fall. And I'm certain we'll show a boost in efficacy with the weight loss.”
Ricks: Developing a drug costs $4B, with over 60% spent in Phase 3
“The final stage of testing, the average drug costs three and a half, four billion to make more than 60% of that is the last step.”
Ricks: US cancer trial enrollment is 4% versus over 25% in Spain
“Only four percent of patients who have cancer in the US are in clinical trials, whereas in Spain and Australia, it's over 25%.”
Ricks: Lilly develops clinical drugs in under 7 years versus industry average
“Drug development time in the industry, It's about 10 years in the clinic, a little less right now. We're running a little less than seven at Lilly”
Ricks: Current GLP-1 drug pricing will fall amid competition and pressure
“And the current pricing isn't going to stay. Let's be honest. There'll be more competition. The government wants to lower our prices.”
Ricks: Non-Lilly large pharma multiples are at a 20-year low
“If you look at the large cap farmers, not Lilly, but the other ones, the multiples, the most compressed it's been in 20 years. If you look at biotech, the XBI, I think half of the XBI is trading below cash. And then if you look at. Venture. Half of the rounds …”
Ricks: Drugs lose 97% of their pricing when patents expire
“Typically a generic event, you'll lose 97% of your pricing the day your patent expires.”
Ricks: Most major hospital systems have failed price transparency compliance
“Compliance is terrible. Most major hospital systems have not complied. Or if they have, they put on a website somewhere a coded database that is impossible to interpret with ICD-X codes and price points that consumers cannot digest.”
Ricks: China had Pfizer-BioNTech vaccine rights but never approved it
“They had rights to the BioNTech-Pfizer vaccine for almost the entirety of their pandemic. They never approved it.”
Ricks: Virtually no generic pharmaceuticals are manufactured in the US
“There are no generics manufactured in the U.S. Really.”
Ricks: Generic small-molecule medicines face no regulatory efficacy requirement
“There is no requirement For small molecule chemical medicine to show proof of efficacy of any kind. So you can do pretty simple laboratory experiments and absorption experiments in a small number of people.”
Ricks: Self-pay Zepbound is the #1 prescribed form of GLP-1s
“Actually, the number one prescribed form of these medications is Zep-bound self-buy. We sell more than that than our insured business, a new patient starts, and more than all of we go.”
Ricks: LillyDirect annualizes in billions as largest online prescription platform
“Today we'll annualize, you know, in the billions of dollars. I think it's the largest Prescription platform online in terms of revenue. We run it on Stripe, I think, and going north from here.”
Ricks: Eli Lilly captures 70-75% of new US GLP-1 starts
“Right now in the US, across all forms of GLP-ONE, on new patient capture, we're basically 70, 75% right now.”
Ricks: Lilly will spend nearly 25% of revenue on R&D this year
“We'll spend almost 25% of sales this year.
John Collison: I liked your way of putting us that you spend more on medical R&D than Germany does.
Dave Ricks: Yes.
Dave Ricks: Yeah.
Dave Ricks: We're at the nation state level. It'll be, you know, fourteen billion …”
Ricks: Around 80 GLP-1 drug candidates are in clinical pipelines globally
“We only have two right now, but there's probably 80 in clinical pipelines right now globally. We have 11 others, but there's probably 70 others not coming from Lilly.”
Ricks: The US and China hold 70% of global diagnostic capacity
“The US and China have something like 70% of all diagnostic capacity in the world.”
Ricks: Over half of approved drugs originate in biotech, but few finish
“While it's true that the origin of, I think it's a little more than half of medicines approved in the last 10 years have come from biotech, hardly any of those traveled all the way through biotech.”
Ricks: 80% of effective COVID treatments were produced in US
“Basically, 80% of the medicines and vaccines that worked were produced in the United States.”
Ricks: Marketing halves medical adoption time from 16 to eight years
“And there's been studies on this of medical inventions that are not promoted... It's about a sixteen-year path to full adoption. With the medicine promoted, it's half that. We have an internal goal to half that again, to get to four years, to full whatever it …”
Ricks: There are roughly 2,000 approved synthetic medicines across 400 mechanisms
“We probably have 2000 manmade approved medicines versus natural products or vitamins or other things, and maybe 400 unique mechanisms.”
Ricks: Lilly's 400-person San Diego hub produced one-third of its medicines
“We built a monoclonal antibody biotech hub there. It's produced like a third of the medicines we've made since we started. Hugely successful. There's 400 employees.”
Ricks: Tirzepatide's US patent extends into the late 2030s
“I think Terseptide's U.S. Patent is late thirties or foregrip on the oral beyond that.”
Ricks: Lilly R&D spend is growing ~20% while headcount grows single digits
“So we're growing R&D high teens, early low twenties. We're growing headcount in R&D single digits.”
Ricks: Lilly has had 11 CEOs in 150 years, only one external
“We've had a 150 years of that, and I'm the 11th CEO of the company. That's one less than Pope's in that period of time. So that's, it was a special honor, actually, and it's not a lifetime appointment. I can be fired any day, but the first four were family mem…”