禮來公司 (LLY) 2025 Q2 法說會逐字稿

Thank you for holding. We look forward to talking with you soon. Please hold the line and we'll be right back with you.

謝謝你的支持。我們期待很快與您交談。請稍候，我們馬上回覆您。

Ladies and gentlemen, thank you for standing by and welcome to the Lilly Q2 2025 earnings conference call. (Operator Instructions) I would now like to turn the conference over to your host, Mike Czapar, Senior Vice President of Investor Relations. Please go ahead.

女士們，先生們，感謝你們的支持，歡迎參加禮來公司 2025 年第二季財報電話會議。（操作員指示）現在，我想將會議交給主持人、投資者關係高級副總裁 Mike Czapar。請繼續。

Good morning. Thank you for joining us for Eli Lilly Company's Q2 2025 earnings call. I'm Mike Czapar, Senior Vice President of Investor Relations. Joining me on today's call are Dave Ricks, Lilly's Chair and CEO; Lucas Montarce, Chief Financial Officer; Dr. Dan Skovronsky, Chief Scientific Officer and President of Lilly Immunology; Anne White, President of Lilly Neuroscience; Ilya Yuffa, President of Lilly USA and Global Customer Capabilities; Jacob Van Naarden, President of Lilly Oncology; Patrik Jonsson, President of Lilly International; and Ken Custer, newly appointed President of Lilly Cardiometabolic Health. We're also joined by Mark Human, [Susan Hedgeland], and [White Wong] of the Investor Relations team.

早安.感謝您參加禮來公司 2025 年第二季財報電話會議。我是投資者關係資深副總裁 Mike Czapar。參加今天電話會議的還有禮來公司董事長兼首席執行官戴夫·里克斯 (Dave Ricks)、首席財務官盧卡斯·蒙塔斯 (Lucas Montarce)、禮來免疫學首席科學官兼總裁丹·斯科沃倫斯基 (Dan Skovronsky) 博士、禮來神經科學總裁安妮·懷特 (Anne White)、禮來美國和全球客戶能力總裁伊利亞·尤納·尤納 (Jacoba)、禮登Naarden)、禮來國際總裁 Patrik Jonsson 以及新任禮來心臟代謝健康總裁 Ken Custer。我們也邀請了投資人關係團隊的 Mark Human、[Susan Hedgeland] 和 [White Wong] 參加。

During this call, we anticipate making projections and forward-looking statements based on our current expectations. Our actual results may differ materially due to several factors, including those listed on slide 4. Additional information concerning factors that could cause actual results to differ materially is contained in our latest Form 10-K and subsequent filings with the SEC.

在本次電話會議中，我們預計將根據目前預期做出預測和前瞻性陳述。我們的實際結果可能因多種因素而存在重大差異，包括投影片 4 中列出的因素。有關可能導致實際結果出現重大差異的因素的更多信息，包含在我們最新的 10-K 表格以及隨後向美國證券交易委員會提交的文件中。

The information we provide about our products and pipeline is for the benefit of the investment community. It is not intended to be promotional and is not sufficient for prescribing. As we transition to our prepared remarks, please note our commentary will focus on our non-GAAP financial measures.

我們提供的有關我們的產品和管道的資訊是為了投資界的利益。它不以促銷為目的，也不足以作為處方。當我們轉到準備好的評論時，請注意我們的評論將集中於我們的非公認會計準則財務指標。

Now I'll turn the call over to Dave.

現在我將把電話轉給戴夫。

Thanks, Mike. Q2 is a strong quarter. We delivered robust revenue growth, shared top line clinical data from multiple Phase 3 programs, and invested in several initiatives that will support our future growth. Today, we shared positive top line data from the ATTAIN-1 orforglipron trial in people with obesity.

謝謝，麥克。第二季表現強勁。我們實現了強勁的收入成長，分享了多個 3 期計畫的頂級臨床數據，並投資了多項支持我們未來成長的計畫。今天，我們分享了針對肥胖人群的 ATTAIN-1 orforglipron 試驗的積極頂線數據。

In ATTAIN-1, patients taking the highest dose of orforglipron lost more than 27 pounds, or 12.4% of their body weight. In addition, the safety and tolerability in ATTAIN-1 was consistent with the injectable GLP-1 class. Orforglipron also met all secondary endpoints in the study, improving key markers of metabolic health, such as blood pressure, cholesterol, and inflammation. This is the second positive Phase 3 trial for orforglipron we reported this year, and we're encouraged by these results.

在 ATTAIN-1 研究中，服用最高劑量 orforglipron 的患者體重減輕了 27 磅以上，即體重的 12.4%。此外，ATTAIN-1 的安全性和耐受性與注射用 GLP-1 類一致。Orforglipron 也滿足了研究中的所有次要終點，改善了代謝健康的關鍵指標，如血壓、膽固醇和發炎。這是我們今年報告的第二次積極的 orforglipron 第三階段試驗，這些結果令我們感到鼓舞。

Our goal from the beginning was to create a medicine that has a clinical profile consistent with approved GlP-1s while offering the convenience of a once-daily pill and the production flexibility of small molecule chemistry to meet global demand. We believe this medicine has the potential to make a significant impact on human health, and we will now work with urgency to submit orforglipron around the world to meet the global challenge of obesity.

我們從一開始的目標就是創造一種具有與已批准的 GlP-1 一致的臨床特性的藥物，同時提供每日一次服用的便利性和小分子化學的生產靈活性，以滿足全球需求。我們相信這種藥物有可能對人類健康產生重大影響，我們現在將緊急努力在世界各地提交奧格列丙酸（ORG）以應對肥胖這一全球挑戰。

On slide 6, we list key Q2 financial metrics and highlight progress related to our strategic deliverables. Revenue grew 38% compared to Q2 2024, driven by our key products. These include Ebglyss, Jaypirca, Kisunla, Mounjaro, Omvoh, Verzenio, and Zepbound.

在第 6 張投影片上，我們列出了第二季的關鍵財務指標，並重點介紹了與我們的策略交付成果相關的進展。受我們主要產品的推動，營收與 2024 年第二季相比成長了 38%。其中包括 Ebglyss、Jaypirca、Kisunla、Mounjaro、Omvoh、Verzenio 和 Zepbound。

In the US, we continue the robust uptake of Zepbound and Mounjaro, and Lilly gained market share in the incretin analog class for the fourth quarter in a row. Mounjaro also recently became the market leader in the US in total prescriptions within the type 2 diabetes incretin market.

在美國，Zepbound 和 Mounjaro 繼續保持強勁成長勢頭，禮來公司連續第四個季度在腸促胰島素類似物領域獲得了市場份額。Mounjaro 最近也成為美國 2 型糖尿病腸促胰島素市場總處方量的領導者。

Outside the US, we continue to launch Mounjaro in new countries. These include Mexico and Brazil most recently. We have now launched Mounjaro in most major markets.

除美國以外，我們也將繼續在新的國家推出 Mounjaro。最近，這些國家包括墨西哥和巴西。我們現在已經將在大多數主要市場推出 Mounjaro。

Q2 is also a quarter of continued investment for Lilly. In addition to increasing commercial activities to support our newest medicines, we started multiple new clinical programs. While the company is experiencing rapid revenue growth, we're also increasing our R&D investment as early phase program data continues to impress us and to support our future growth of the company.

第二季也是禮來公司持續投資的季度。除了增加商業活動來支持我們的最新藥物外，我們還啟動了多個新的臨床計畫。在公司收入快速成長的同時，我們也增加研發投入，因為早期專案數據持續讓我們留下深刻印象，並支持公司未來的成長。

Our financial performance in the first half of 2025 was strong, and as a result, we raised our revenue and earnings per share guidance. Lucas will cover this in more detail during the financial update.

我們在 2025 年上半年的財務業績表現強勁，因此，我們提高了營收和每股盈餘預期。盧卡斯將在財務更新期間更詳細地介紹這一點。

In addition to the results from ATTAIN-1, we achieved several key milestones since our last earnings call. These include the US FDA approval of a new dosing schedule for Kisunla; a positive European CHMP opinion for Kisunla; announced positive results in the SURPASS-CVOT Phase 3 trial for Tirzepatide in people with Type 2 diabetes and heart disease. We announced positive results in the BRUIN CLL-314 Phase 3 trial of pirtobrutinib in CLL and SLL. And we launched the two highest doses of Zepbound in vials in the United States.

除了 ATTAIN-1 的成果之外，自上次收益電話會議以來，我們還實現了幾個重要的里程碑。其中包括美國 FDA 批准 Kisunla 的新給藥方案；歐洲 CHMP 對 Kisunla 的積極評估；宣布 Tirzepatide 在 2 型糖尿病和心臟病患者中的 SURPASS-CVOT 3 期試驗中取得積極結果。我們宣布了吡托替尼治療 CLL 和 SLL 的 BRUIN CLL-314 第 3 期試驗的正面結果。我們在美國推出了兩種最高劑量的 Zepbound 小瓶裝藥物。

We announced and closed the acquisition of SiteOne Therapeutics, which expands Lilly's pain portfolio and adds a clinical-stage non-opioid pain program to our mix; and Verve Therapeutics, which adds new genetic medicines for cardiovascular disease with potential to only be administered once in a person's lifetime.

我們宣布並完成了對 SiteOne Therapeutics 的收購，這擴大了禮來的疼痛治療產品組合，並為我們的產品組合增加了臨床階段的非阿片類疼痛治療項目；以及 Verve Therapeutics，這增加了用於治療心血管疾病的新型基因藥物，有可能在人的一生中只需使用一次。

We made progress in Q2 and throughout the first half of 2025 to bring new manufacturing capacity online. We produced more than 1.6 times the amount of salable encrypted doses during the first half of 2025 when compared to the first half of 2024. This includes a significant step-up in capacity from our recently constructed facility in Research Triangle Park, North Carolina.

我們在第二季以及整個 2025 年上半年取得了進展，實現了新的製造能力上線。與 2024 年上半年相比，我們在 2025 年上半年生產的可銷售加密劑量增加了 1.6 倍以上。這包括我們最近在北卡羅來納州三角研究園建造的設施的產能大幅提升。

We will continue to bring more capacity online in the second half of 2025 and expect our production capabilities to increase further. We also plan to announce the location of two of our new U.S. manufacturing facilities later this quarter. During the quarter, we distributed $1.3 billion in dividends and executed approximately $700 million in share repurchases.

我們將在 2025 年下半年繼續增加產能，並預計我們的生產能力將進一步提高。我們還計劃在本季稍後宣布兩家新的美國製造工廠的所在地。本季度，我們發放了 13 億美元的股息，並執行了約 7 億美元的股票回購。

Before I turn the call over to Lucas, I'd like to offer some perspective on the drug pricing reform discussion that's going on. While we support the administration's position that medical research costs need to be shared more equitably across developed countries, it's also true that the US pharmaceutical market has significant defects, which shift cost to consumers and increase red tape. These problems also require urgent reform and make apples-to-apples comparisons of [exacti] pricing inaccurate and misleading.

在我將電話轉給盧卡斯之前，我想就正在進行的藥品定價改革討論提供一些看法。雖然我們支持政府的立場，即已開發國家需要更公平地分擔醫療研究成本，但美國醫藥市場也確實存在重大缺陷，將成本轉嫁給消費者並增加了繁文縟節。這些問題也需要緊急改革，並使得[精確]定價的同類比較變得不準確和誤導。

At Lilly, we've already implemented several initiatives, which directly lower patient costs for our most commonly used medicines. We operate a direct-to-consumer model at scale through LillyDirect, which provides more affordable access to Lilly medicines. This includes our leading weight loss medications Zepbound at a discount of more than 50% of the list price.

在禮來公司，我們已經實施了多項舉措，直接降低了患者使用最常用藥物的成本。我們透過 LillyDirect 大規模營運直接面向消費者的模式，從而以更實惠的價格提供禮來藥品。其中包括我們主要的減肥藥 Zepbound，其折扣超過標價的 50%。

We also led in resolving insulin pricing issues in our country by reducing list prices by 70% and ensuring broad access to $35 monthly patient costs, including for Medicare. Negotiated prices in Europe come with broad access, low patient co-pays and without administrative hurdles like prior authorizations. There are also no intermediaries that distort price, and hospitals do not seek profit by selling medicines and marking them up.

我們還透過將標價降低 70% 並確保廣大患者（包括醫療保險患者）能夠享受每月 35 美元的費用，帶頭解決了我國的胰島素定價問題。歐洲的協商價格具有廣泛的覆蓋範圍、較低的患者共同支付額，並且沒有事先授權等行政障礙。也沒有中間商操縱價格，醫院也不透過藥品銷售加價牟取利潤。

If we import foreign price controls and insert them into a US system that isn't built to function for patients, we risk embracing the worst of two worlds: the low productivity and output of Europe's biopharma sector with the high out-of-pocket and distorted prices of the US insurance market. Both today's patients and the future of new cures and treatments will suffer along with the United States competitiveness.

如果我們引進外國的價格控制措施，並將其納入到並非為患者服務的美國體系中，我們就會面臨兩個世界中最糟糕的境地：歐洲生物製藥行業的低生產率和產出，以及美國保險市場的高昂自付費用和扭曲的價格。隨著美國競爭力的下降，當今的患者和未來的新療法和治療方法都將受到影響。

Of course, we will engage and are committed to work constructively with the administration to find solutions that both benefit patients while preserving the hope for tomorrow's cures and the scientific base that has made America the envy of all in global pharmaceutical innovation.

當然，我們將參與並致力於與政府進行建設性合作，找到既能造福患者，又能保留未來治癒希望的解決方案，以及使美國在全球醫藥創新領域備受羨慕的科學基礎。

Now I'll turn the call over to Lucas to review our Q2 results.

現在我將把電話轉給盧卡斯來回顧我們的第二季業績。

Thanks, Dave. As shown on slide 7, Q2 was another strong quarter of financial performance. Revenue grew 38% compared to Q2 2024, driven by our key products. Gross margin as a percentage of revenue was 85% in Q2, an increase of 3 percentage points versus the same quarter last year. The increase in gross margin was primarily driven by improved cost of production and favorable product mix, which were partially offset by lower realized prices.

謝謝，戴夫。如投影片 7 所示，第二季又是一個財務表現強勁的季度。受我們主要產品的推動，營收與 2024 年第二季相比成長了 38%。第二季毛利率為85%，較去年同期成長3個百分點。毛利率的成長主要得益於生產成本的改善和有利的產品組合，但被較低的實際價格部分抵銷。

Marketing, selling, and administrative expenses increased by 30% as we continue to increase investment to support our newest launches across therapeutic areas and geographies. R&D expenses increased 23%, driven by higher expenses for late-stage assets and additional investment in early-stage research.

由於我們繼續增加投資以支持我們在各個治療領域和地區的最新產品發布，行銷、銷售和管理費用增加了 30%。研發費用增加了 23%，這主要是由於後期資產費用增加和早期研究的額外投資。

Our non-GAAP performance margin, which is defined as gross margin less R&D, marketing, selling, and administrative expenses, as a percentage of revenue, was 45.9%. Performance margin increased by more than 6 percentage points from Q2 2024 driven by revenue growth. Our Q2 effective tax rate was 16.5%, consistent with Q2 2024.

我們的非公認會計準則績效利潤率（定義為毛利率減去研發、行銷、銷售和管理費用）佔收入的百分比為 45.9%。受營收成長的推動，業績利潤率較 2024 年第二季增加了 6 個百分點以上。我們第二季的有效稅率為 16.5%，與 2024 年第二季一致。

At the bottom line, earnings per share increased 61% to $6.31, including a negative impact of $0.14 from acquired IPR&D charges. This compares to $3.92 in Q2 2024, which also includes $0.14 of acquired IPR&D charges.

最終，每股收益成長 61% 至 6.31 美元，其中包括收購 IPR&D 費用的 0.14 美元負面影響。相比之下，2024 年第二季為 3.92 美元，其中還包括 0.14 美元的收購 IPR&D 費用。

On slide 8, we quantify the effect of price, rate, and volume on revenue growth. US revenue increased 38% in Q2 driven by strong volume growth of Zepbound and Mounjaro, partially offset by an 8% decline in price. In Europe, revenue grew 77% in constant currency, reflecting the strong uptick of Mounjaro. Japan revenue grew 7% in constant currency, driven by Mounjaro and Ebglyss.

在第 8 張投影片上，我們量化了價格、利率和數量對收入成長的影響。受 Zepbound 和 Mounjaro 銷量強勁增長的推動，美國第二季度收入增長了 38%，但價格下降 8% 部分抵消了這一增長。在歐洲，營收以固定匯率計算成長了 77%，反映了 Mounjaro 的強勁成長。在 Mounjaro 和 Ebglyss 的推動下，日本營收以固定匯率計算成長了 7%。

In China, revenue increased 19% in constant currency, driven by volume growth of Mounjaro. Revenue in the rest of the world decreased by 1% in constant currency, driven primarily by stocking in the base period related to Mounjaro launches in new markets. This impact was largely offset by volume growth of Mounjaro and Verzenio this year.

在中國，受 Mounjaro 銷售成長的推動，營收以固定匯率計算成長了 19%。以固定匯率計算，世界其他地區的收入下降了 1%，主要原因是基準期內與 Mounjaro 在新市場推出相關的庫存。這一影響在很大程度上被今年 Mounjaro 和 Verzenio 的銷售成長所抵消。

Slide 9 provides an update of the performance of our key products. Beginning with immunology, Ebglyss continues to perform well in atopic dermatitis. New patient starts and revenue trends are strong and total prescriptions have nearly doubled since Q1. We also made progress securing access and Ebglyss is now covered by all three of the largest pharmacy benefit managers that represent 90% of people with commercial insurance.

幻燈片 9 提供了我們主要產品性能的最新情況。從免疫學開始，Ebglyss 在異位性皮膚炎方面持續表現良好。新患者開始數量和收入趨勢強勁，自第一季以來處方總量幾乎翻了一番。我們還在確保訪問方面取得了進展，Ebglyss 現已被三大藥房福利管理機構覆蓋，這三個機構代表了 90% 的商業保險人群。

For Omvoh, we are one full quarter into the launch in Crohn's disease and are making progress in a competitive market. The new citrate-free formulation is available in most major markets and we are seeing positive trends in new patient starts in the US, Germany, Japan, and other international markets.

對於 Omvoh，我們已經推出克羅恩病藥物整整一個季度，並且在競爭激烈的市場中取得了進展。新的無檸檬酸鹽配方已在大多數主要市場上市，我們看到美國、德國、日本和其他國際市場的新患者開始出現正面趨勢。

Moving to oncology. Physician feedback on Jaypirca continue to be very positive. While still only approving later lines of CLL and MCL, we have seen a strong uptake within the label population and encouraging trends regarding time on therapy.

轉向腫瘤學。醫生對 Jaypirca 的回饋仍然非常積極。雖然仍然只批准 CLL 和 MCL 的後期治療，但我們已經看到標籤人群的強勁增長以及治療時間方面的令人鼓舞的趨勢。

We continue to generate additional data in Phase 3 trials that we believe will support an expanded label and use in early settings. We recently announced positive results of BRUIN 314 in CLL and SLL, is another positive step forward those goals.

我們將繼續在第 3 階段試驗中產生額外數據，我們相信這些數據將支援擴大標籤並在早期環境中使用。我們最近宣布了 BRUIN 314 在 CLL 和 SLL 治療中取得的積極成果，這是朝著這些目標邁出的另一個積極步伐。

Verzenio global sales grew 12% in Q2 driven by volume growth. Verzenio continued to be the NBRx and TRx market leader in the US and a standard-of-care in high-risk early breast cancer. US prescriptions grew by 4% in Q2 compared to Q2 2024, and international volume grew by 18%.

受銷量成長的推動，Verzenio 第二季度全球銷售額成長了 12%。Verzenio 繼續成為美國 NBRx 和 TRx 市場的領導者，並成為高風險早期乳癌的標準治療方法。與 2024 年第二季相比，美國第二季的處方量增加了 4%，國際處方量增加了 18%。

Within neuroscience, Kisunla is continuing a steady launch trajectory, and we are making significant progress in driving health care system readiness and adoption. In the US, we are seeing a strong diagnostic growth driven by PET and the acceleration of blood biomarker test.

在神經科學領域，Kisunla 繼續穩步發展，我們在推動醫療保健系統的準備和採用方面取得了重大進展。在美國，我們看到由 PET 和血液生物標記測試加速推動的強勁診斷成長。

This momentum is leading to more people being diagnosed and accessing treatment. Over 1,500 physicians and 150 of the top health care organizations have started patients on Kisunla. Outside the US, efforts are progressing as well with approval in 13 countries. In Europe, we anticipate approval and launch later this year following the recent CHMP positive opinion.

這種勢頭正在促使更多的人得到診斷和接受治療。超過 1,500 名醫生和 150 個頂級醫療保健組織已在 Kisunla 上接待患者。在美國以外，相關努力也正在取得進展，已獲得 13 個國家的批准。在歐洲，根據最近 CHMP 的正面評價，我們預計該藥物將在今年稍後獲得批准並上市。

Finally, moving to cardiometabolic drugs. Mounjaro and Zepbound both delivered impressive performance. Mounjaro posted $5.2 billion of global sales and exited the quarter with more than 50% of new Type 2 diabetes incretin prescriptions in the U.S.

最後，轉向心臟代謝藥物。Mounjaro 和 Zepbound 都表現出色。Mounjaro 的全球銷售額達到 52 億美元，本季佔美國 2 型糖尿病腸促胰島素新處方的 50% 以上。

Mounjaro also became the US market leader in total Type 2 diabetes incretin prescriptions in July and has gained 8 percentage points in total prescription share of market during the first seven months of 2025. With the recently announced positive results from SURPASS CVOT, we look forward to submitting this data to global regulators to support our label cardiovascular indication.

7 月份，Mounjaro 也成為美國 2 型糖尿病腸促胰島素處方總量市場的領導者，並在 2025 年前 7 個月的市場總處方份額中增長了 8 個百分點。隨著 SURPASS CVOT 最近公佈的積極成果，我們期待將這些數據提交給全球監管機構，以支持我們的標籤心血管適應症。

Outside the US, tirzepatide is now launched in most major markets. As a reminder, Mounjaro's market as a single brand for both chronic weight management and Type 2 diabetes in all international markets except Canada and Japan. While the initial reception of recent launches in Mexico, Brazil, China, and India has been excellent, the commercial activities have been measured to ensure demand doesn't exceed supply and that patients and physicians have a good experience.

除美國以外，tirzepatide 現已在大多數主要市場上市。提醒一下，Mounjaro 作為慢性體重管理和 2 型糖尿病的單一品牌，在除加拿大和日本以外的所有國際市場上都有銷售。雖然最近在墨西哥、巴西、中國和印度推出的產品初期反應很好，但商業活動已進行衡量，以確保需求不超過供應，並確保患者和醫生擁有良好的體驗。

Zepbound performance was strong in Q2, contributing $3.4 billion of sales. Zepbound continues to be the US market leader in the branded and the obesity market with two-thirds of total patients taking Zepbound. We recently launched the 12.5- and 15-milligram single-use vials via LillyDirect. All doses of Zepbounds are not available in the vial presentation.

Zepbound 在第二季表現強勁，貢獻了 34 億美元的銷售額。Zepbound 繼續成為美國品牌和肥胖症市場的領導者，三分之二的患者服用 Zepbound。我們最近透過 LillyDirect 推出了 12.5 毫克和 15 毫克的一次性小瓶。並非所有劑量的 Zepbounds 都以小瓶形式提供。

While we work to secure broader reinvestment of anti-obesity medicines, we are encouraged by the uptick of Zepbound in vials. The cash-pay vials were approximately 20% of total US Zepbound prescriptions and over 35% of new prescriptions in Q2.

在我們努力確保對抗肥胖藥物進行更廣泛的再投資的同時，Zepbound 藥瓶銷量的上升令我們感到鼓舞。現金支付藥瓶約占美國 Zepbound 處方總量的 20%，佔第二季新處方的 35% 以上。

As a reminder, effective July 1, the CVS pharmacy benefit manager began excluding Zepbound as an offering for patients on its template formulary insurance plans. This has caused significant disruption to patients, and we strongly disagree with the decision to restrict access to medicines for patients.

提醒一下，自 7 月 1 日起，CVS 藥局福利管理器開始將 Zepbound 排除在其模板處方保險計劃的患者產品之外。這給患者帶來了極大的困擾，我們強烈反對限制患者取得藥物的決定。

As demonstrated in randomized clinical trials, incretin medicines for chronic weight management are not all the same. While it's still early, we have seen this decision negatively impact Zepbound prescriptions during July and expect it to be a headwind to the rate of volume growth in Q3. We remain confident in the long-term growth outlook for Zepbound as the most widely used incretin therapy in the branded anti-obesity market.

正如隨機臨床試驗所證明的那樣，用於慢性體重管理的腸促胰島素藥物並不都是相同的。雖然現在還為時過早，但我們已經看到這項決定對 7 月的 Zepbound 處方產生了負面影響，並預計它將對第三季的銷售成長率產生阻力。作為品牌抗肥胖市場上最廣泛使用的腸促胰島素療法，我們對 Zepbound 的長期成長前景充滿信心。

On slide 10, we provide a view on the US incretin analog market, which include prescription for both Type 2 diabetes and chronic weight management. Q2 was another quarter of steady market growth as total prescriptions grew by 41% compared to Q2 2024.

在第 10 張投影片上，我們介紹了美國腸促胰島素類似物市場的情況，其中包括針對 2 型糖尿病和慢性體重管理的處方。第二季度是市場穩定成長的另一個季度，與 2024 年第二季度相比，處方總量增加了 41%。

Lilly performance was, again, strong with share of market reaching above 57%, an increase of 3.8 percentage points compared to Q1 2025. While market growth continue to be robust, overall penetration into the addressable population is still low and we believe significantly more patients can benefit from incretin therapy.

禮來公司業績再次表現強勁，市佔率達到 57% 以上，與 2025 年第一季相比成長了 3.8 個百分點。儘管市場成長持續強勁，但對目標族群的整體滲透率仍然較低，我們相信更多的患者可以從腸促胰島素治療中受益。

On slide 11, we provide an update on capital allocation. Moving to slide 12, this is our updated expectation for our 2025 financial performance. We are encouraged by the underlying performance we saw across the business in the first half of the year.

在第 11 張投影片上，我們提供了有關資本配置的最新資訊。轉到第 12 張投影片，這是我們對 2025 年財務表現的最新預期。我們對上半年整個業務的基本表現感到鼓舞。

We are increasing the bottom and the top end of the revenue range as well as our expectation for performance margins and earnings per share. We now anticipate our revenue will be between $60 billion and $62 billion. This range reflects the strong performance and a tailwind from foreign exchange rates.

我們正在提高收入範圍的底線和上限以及對業績利潤率和每股收益的預期。我們現在預計我們的收入將在 600 億美元至 620 億美元之間。這一範圍反映了強勁的表現和外匯匯率的推動。

We will continue to invest to support our newest launches and to develop new medicines. Given our updated expectations for revenue growth, we now expect non-GAAP performance margin to be between 43% and 45.5% as a percentage of revenue.

我們將繼續投資支持我們的最新產品發布和新藥開發。鑑於我們對營收成長的最新預期，我們現在預計非 GAAP 業績利潤率佔收入的百分比將在 43% 至 45.5% 之間。

The potential effect of tariffs remains dynamic, and we will continue to update our estimate as the situation changes. We expect the 2025 impact of currently announced tariffs to be modest, and this has been factored into our 2025 guidance range.

關稅的潛在影響仍然是動態的，我們將隨著情況的變化不斷更新我們的估計。我們預計目前宣布的關稅對 2025 年的影響將很小，這已計入我們的 2025 年指導範圍。

At the bottom line, we have increased our outlook for non-GAAP earnings per share and expect EPS of $21.75 to $23. As Dave mentioned earlier, we exceeded our incretin sellable doses production in the first half of the year and expect to bring more capacity online during the second half of 2025. We expect to produce at least 1.8 times the number of sellable incretin doses in the second half of 2025 compared to the second half of 2024.

總體而言，我們提高了非 GAAP 每股盈餘預期，預計每股收益為 21.75 美元至 23 美元。正如戴夫之前提到的，我們在今年上半年的腸促胰島素銷售劑量產量已經超出預期，預計在 2025 年下半年將增加更多產能。我們預計，2025 年下半年可銷售的腸促胰島素劑量將至少是 2024 年下半年的 1.8 倍。

Now, I will turn the call over to Dan to highlight our progress on R&D.

現在，我將把電話交給丹，介紹我們在研發方面的進展。

Thanks, Lucas. We've made quite a bit of progress since our last earnings call. During just the past two weeks, we shared three Phase 3 readouts from some of our most important molecules. I'll start with these.

謝謝，盧卡斯。自從上次財報電話會議以來，我們已經取得了相當大的進展。僅在過去兩週內，我們分享了一些最重要的分子的三階段讀數。我先從這些開始。

Last week, we announced results from the tirzepatide SURPASS-CVOT trial, where tirzepatide demonstrated cardiovascular protection in a landmark head-to-head trial, which was the first ever cardiovascular outcomes trial comparing two incretin therapies in people with Type 2 diabetes and cardiovascular disease. It included over 13,000 participants across 30 countries and it is the largest and longest study of tirzepatide to date.

上週，我們公佈了 tirzepatide SURPASS-CVOT 試驗的結果，其中 tirzepatide 在具有里程碑意義的頭對頭試驗中證明了其心血管保護作用，這是有史以來第一次針對患有 2 型糖尿病和心血管疾病的患者比較兩種腸促胰島素療法的心血管結果試驗。該研究涉及來自 30 個國家的 13,000 多名參與者，是迄今為止最大、持續時間最長的 tirzepatide 研究。

As shown on slide 13, tirzepatide achieved the primary objective of the study, demonstrating noninferiority compared to Trulicity with an 8% lower rate of MACE 3 events. Tirzepatide showed consistent results across all three components of the MACE 3 composite endpoint.

如幻燈片 13 所示，tirzepatide 實現了研究的主要目標，與 Trulicity 相比表現出非劣效性，MACE 3 事件發生率降低了 8%。Tirzepatide 在 MACE 3 複合終點的所有三個組成部分中均表現出一致的結果。

We were particularly impressed to see the rate of all-cause mortality was 16% lower on tirzepatide versus dulaglutide. Because the trial did not include a placebo arm, we conducted a prespecified indirect comparison analysis of matched patient level data from the REWIND and SURPASS-CVOT studies.

我們特別驚訝地發現，與度拉糖肽相比，替澤帕肽的全因死亡率降低了 16%。由於該試驗沒有包括安慰劑組，我們對 REWIND 和 SURPASS-CVOT 研究中匹配的患者層級數據進行了預先指定的間接比較分析。

This analysis showed that tirzepatide reduced the risk of MACE 3 by 28% and reduced all-cause mortality by 39% compared to treated with placebo. We're very pleased with these results, which show that in addition to the well-established best-in-class weight loss and A1c control, tirzepatide now also provides a cardio-protective benefits and may provide more wide-reaching health improvements, including greater kidney protection and a reduced overall risk of debt.

該分析表明，與安慰劑治療相比，tirzepatide 將 MACE 3 的風險降低了 28%，並將全因死亡率降低了 39%。我們對這些結果非常滿意，這表明除了公認的最佳減肥和 A1c 控制之外，tirzepatide 現在還提供心臟保護益處，並可能提供更廣泛的健康改善，包括更好的腎臟保護和降低整體債務風險。

We look forward to detailed results being presented at the EASD Meeting in September and published in a peer-reviewed journal. We plan to submit these data to global regulators by the end of this year.

我們期待在 9 月的 EASD 會議上展示詳細結果並發表在同行評審期刊上。我們計劃在今年年底前將這些數據提交給全球監管機構。

The SURPASS-CVOT results reinforce our enthusiasm for SURMOUNT-MMO, which enrolled over 15,000 participants with obesity, and will assess the impact of tirzepatide on reducing morbidity and mortality. This is an event-based study and the rate of accrual will dictate the timing of the readout.

SURPASS-CVOT 結果增強了我們對 SURMOUNT-MMO 的熱情，該研究招募了超過 15,000 名肥胖患者，並將評估 tirzepatide 對降低發病率和死亡率的影響。這是一項基於事件的研究，累積率將決定讀數的時間。

While SURPASS-CVOT and SURMOUNT-MMO are likely the largest randomized trials we'll conduct with tirzepatide, we'll still explore additional indications for this molecule. And we're excited to have started a new Phase 3 trial in people with Type 1 diabetes.

雖然 SURPASS-CVOT 和 SURMOUNT-MMO 可能是我們利用 tirzepatide 進行的最大規模的隨機試驗，但我們仍將探索這種分子的其他適應症。我們很高興能夠針對第 1 型糖尿病患者開始新的 3 期試驗。

Moving on to orforglipron. As Dave mentioned, today, we're excited to announce top line results from our second orforglipron Phase 3 trial, ATTAIN-1. This trial included people with obesity, but without Type 2 diabetes.

繼續討論 orforglipron。正如戴夫所提到的，今天，我們很高興地宣布我們的第二個 orforglipron 第三階段試驗 ATTAIN-1 的頂線結果。這項試驗的參與者都是肥胖者，但沒有第 2 型糖尿病。

As shown on slide 14, patients in ATTAIN-1 lost on average between 7.8% and 12.4% of their body weight after 72 weeks depending on the dose. At the highest dose, the average participant on orforglipron lost more than 27 pounds and approximately 40% of people on this dose lost more than 15% of their body weight. We also saw notable improvements on important drivers of cardiovascular risk, including non-HDL cholesterol, triglycerides, and blood pressure.

如投影片 14 所示，ATTAIN-1 患者的體重在 72 週後平均減輕了 7.8% 至 12.4%，取決於劑量。在最高劑量下，服用 orforglipron 的參與者平均減重超過 27 磅，服用此劑量的人中約有 40% 減重超過 15%。我們也發現心血管風險的重要驅動因素（包括非高密度脂蛋白膽固醇、三酸甘油酯和血壓）有了顯著改善。

Moving to slide 15. We are very pleased with the safety profile of orforglipron in ATTAIN-1. The most commonly reported adverse events were gastrointestinal, which is consistent with the GLP-1 class. Discontinuations due to adverse events were low, with 5% to 10% of patients discontinuing orforglipron across doses. There were no hepatic safety signals. We look forward to sharing detailed results from ATTAIN-1 also at the EASD Meeting in September and in peer-reviewed publications.

移至投影片 15。我們對 orforglipron 在 ATTAIN-1 中的安全性非常滿意。最常見的通報不良事件是胃腸道不良事件，這與 GLP-1 類一致。由於不良事件而停藥的情況很少，只有 5% 至 10% 的患者在服用奧格列隆期間停藥。沒有肝臟安全訊號。我們期待在 9 月的 EASD 會議和同行評審出版物上分享 ATTAIN-1 的詳細結果。

With today's readout, we've now seen results from two large Phase 3 clinical trials involving over 3,600 participants and we're highly encouraged with what we've seen thus far. The data from these first two pivotal studies provide evidence that a once-daily oral GLP-1 can achieve efficacy and safety in line with injectable GLP-1s. Orforglipron has the potential to be a more convenient alternative to injectable treatments and to be utilized to support early disease intervention in the primary care setting.

根據今天的讀數，我們現在已經看到了兩項大型 3 期臨床試驗的結果，涉及 3,600 多名參與者，我們對迄今為止所看到的結果感到非常鼓舞。這兩項關鍵研究的數據證明，每日一次口服 GLP-1 可以達到與注射 GLP-1 相同的療效和安全性。Orforglipron 有可能成為注射治療的更便捷的替代品，並可用於支持初級保健環境中的早期疾病幹預。

With these data in hand, we're now working to move quickly towards our first regulatory submissions yet this year. We expect results from four additional orforglipron Phase 3 trials over the next five months; three trials in people with diabetes from our ACHIEVE program. and one additional trial from the ATTAIN program in people with diabetes and obesity. ATTAIN-1 and ATTAIN-2 will support global submissions for chronic weight management, which we expect in Q4.

有了這些數據，我們現在正努力快速提交今年的第一批監管文件。我們預計在未來五個月內將有四項 Orforglipron 第三階段試驗的結果；三項針對糖尿病患者的試驗（來自我們的 ACHIEVE 計劃）以及一項針對糖尿病和肥胖症患者的 ATTAIN 計劃的額外試驗。ATTAIN-1 和 ATTAIN-2 將支援慢性體重管理的全球提交，我們預計將在第四季度完成。

In addition to the ongoing Phase 3 trials for orforglipron in diabetes, obesity, weight maintenance, and obstructive sleep apnea, we initiated a new program for orforglipron this quarter, ATTAIN-Hypertension, focused on reducing systolic blood pressure at 36 weeks as the primary endpoint. This is the first study of orforglipron that includes patients with a baseline BMI as low as 25. We also announced plans to initiate a new Phase 3 trial in people with knee osteoarthritis pain and overweight or obesity starting later this year.

除了正在進行的 orforglipron 在糖尿病、肥胖症、體重維持和阻塞性睡眠呼吸中止症方面的 3 期試驗外，我們在本季度啟動了 orforglipron 的一項新計劃，即 ATTAIN-Hypertension，重點關注在 36 週時降低收縮壓作為主要終點。這是第一個針對基線 BMI 低至 25 的患者進行的 orforglipron 研究。我們也宣布計劃於今年稍後針對患有膝關節骨性關節炎疼痛和超重或肥胖的人啟動新的 3 期試驗。

Moving to pirtobrutinib. We announced positive results from the BRUIN CLL 314 Phase 3 trial of pirtobrutinib compared to ibrutinib in people with CLL SLL. This trial included treatment-naive patients, as well as patients previously treated but not with the BTK inhibitor.

轉向吡托布替尼。我們宣布了 BRUIN CLL 314 第 3 階段試驗的積極結果，該試驗比較了吡托替尼與伊布替尼在 CLL SLL 患者中的療效。該試驗包括未接受過治療的患者，以及先前接受過治療但未使用 BTK 抑制劑的患者。

Pirtobrutinib met the primary endpoint of response rate noninferiority compared to ibrutinib and had a nominal p-value for superiority that was less than 0.05. While progression-free survival data were immature, there was a positive trend in favor of pirtobrutinib. Additional testing for progression-free survival is planned as part of a future analysis.

吡托布替尼達到了與伊布替尼相比，緩解率非劣效性的主要終點，且優效性名目p值小於0.05。雖然無惡化存活期數據尚不成熟，但吡托布替尼呈現出正向的治療趨勢。作為未來分析的一部分，我們計劃進行無惡化存活期的額外測試。

Of note, the subpopulation of treatment-naive patients had a particularly pronounced progression-free survival trend in favor of pirtobrutinib. This subpopulation had the longest follow-up, which is encouraging for what we might see more broadly across the total study population over time.

值得注意的是，未接受過治療的患者亞群有特別明顯的無惡化存活趨勢，有利於吡托替尼。這個亞群的追蹤時間最長，這對於我們隨著時間的推移在整個研究人群中更廣泛地觀察結果而言是令人鼓舞的。

This is a second positive Phase 3 trial to read out for pirtobrutinib as we continue to build evidence supporting the potential role to this medicine in earlier settings. We look forward to the readout of BRUIN CLL 313, which assesses pirtobrutinib versus chemo-immunotherapy in treatment-naive CLL SLL later this year. We expect these data in combination with BRUIN CLL 314 to form the basis of regulatory submissions globally.

這是吡托替尼第二次取得積極的 3 期試驗結果，我們將繼續收集證據以支持該藥物在早期環境中的潛在作用。我們期待今年稍後 BRUIN CLL 313 的讀數，該研究將評估吡托替尼與化學免疫療法在初治 CLL SLL 中的療效。我們預計這些數據與 BRUIN CLL 314 結合將構成全球監管提交的基礎。

In addition to our recent Phase 3 readouts, we also have updates on several other important molecules, donanemab, retatrutide, and olomorasib. For donanemab, we had three important milestones since our last earnings call. First, we were pleased to receive a positive opinion from the CHMP in the EU. We look forward to approval and launch there later this year.

除了我們最近的第 3 階段讀數之外，我們還更新了其他幾種重要分子，donanemab、retatrutide 和 olomorasib。對於 donanemab 而言，自上次收益電話會議以來，我們取得了三個重要的里程碑。首先，我們很高興收到歐盟CHMP的正面評價。我們期待今年晚些時候獲得批准並推出。

Second, the modified dosing schedule was approved in the U.S., further strengthening the safety profile for donanemab, and we expect the modified dosing regimen to be part of the EU labeling at launch as well. Finally, we shared long-term extension data from TRAILBLAZER-ALZ 2, which demonstrated that, over three years, donanemab-treated participants showed increasing clinical benefit despite most participants having completed treatment within the first 18 months of the trial.

其次，修改後的給藥方案已在美國獲得批准，進一步加強了 donanemab 的安全性，我們預計修改後的給藥方案也將成為上市時歐盟標籤的一部分。最後，我們分享了 TRAILBLAZER-ALZ 2 的長期擴展數據，該數據表明，儘管大多數參與者在試驗的前 18 個月內完成了治療，但在三年內，接受 donanemab 治療的參與者表現出越來越強的臨床益處。

In a separate part of the extension study, patients initiating donanemab after 18 months of placebo also demonstrated disease slowing once they started donanemab. These data reinforce the value of early intervention and support the limited duration dosing approach with sustained and increasing long-term benefits for treatment.

在擴展研究的另一部分中，接受 18 個月安慰劑治療後開始使用 donanemab 的患者也表現出病情減緩。這些數據強化了早期介入的價值，並支持有限時間給藥方法，以持續和增加治療的長期益處。

For retatrutide, we started a new Phase 3 trial in chronic low back pain and overweight or obesity called TRIUMPH 7. This is our second pain study for retatrutide in addition to the ongoing study in osteoarthritis pain of the knee, TRIUMPH 4, from which we expect results later this year.

對於瑞他妥肽，我們啟動了一項新的針對慢性下背痛和超重或肥胖的 3 期試驗，稱為 TRIUMPH 7。這是我們對瑞他妥肽進行的第二項疼痛研究，此外我們還在進行膝關節骨關節炎疼痛研究 TRIUMPH 4，我們預計 TRIUMPH 4 的結果將在今年稍後公佈。

We are excited to announce plans to initiate a Phase 3 study in high-risk metabolic dysfunction associated steatotic liver disease or MASLD later this year. This trial includes both retatrutide and tirzepatide, and it will utilize noninvasive tests to enroll patients who are at high risk of major adverse liver outcomes, with a primary objective of reducing the occurrence of such outcomes. This novel trial design more closely mirrors how physicians diagnose this disease in clinical practice and will enable simultaneous development of both medicines each compared to placebo.

我們很高興地宣布，計劃在今年稍後啟動針對高風險代謝功能障礙相關脂肪變性肝病或 MASLD 的 3 期研究。該試驗包括瑞他曲肽和替澤帕肽，並將利用非侵入性測試招募有重大不良肝後果高風險的患者，主要目的是減少此類後果的發生。這種新穎的試驗設計更接近醫生在臨床實踐中診斷這種疾病的方式，並且與安慰劑相比，可以同時開發兩種藥物。

In a prior Phase 2 trial in MASLD, retatrutide reduced liver fat by over 80%. And in a Phase 2 trial in MASH, tirzepatide led to over half of patients meeting criteria for resolution of MASH without worsening fibrosis. We believe each of these medicines has the potential to make a profound impact on this disease, and we look forward to initiating the study later this year.

在先前的 MASLD 第 2 階段試驗中，瑞他妥肽使肝臟脂肪減少了 80% 以上。在 MASH 的 2 期試驗中，tirzepatide 使超過一半的患者達到 MASH 消退的標準，且纖維化沒有惡化。我們相信每一種藥物都有可能對這種疾病產生深遠的影響，我們期待在今年稍後啟動這項研究。

Moving to olomorasib. We started a Phase 3 trial in unresected adjuvant lung cancer. This marks the fourth indication we are simultaneously pursuing for olomorasib in KRAS G12C-mutant lung cancer as part of the SUNRAY-01 and SUNRAY-02 programs. We believe olomorasib, in combination with immuno-oncology agents in an early setting, could improve the standard of care for patients with KRAS G12C-mutant lung cancer.

轉向 olomorasib。我們開始了未切除的輔助肺癌的 3 期試驗。這是我們在 SUNRAY-01 和 SUNRAY-02 計畫中同時探索的奧洛莫拉西治療 KRAS G12C 突變型肺癌的第四個適應症。我們相信，在早期情況下，奧洛莫拉西布與免疫腫瘤藥物聯合使用可以改善 KRAS G12C 突變肺癌患者的治療標準。

I'm also excited that through business development, we've added new molecules to our portfolio and new colleagues to our team, and it's a pleasure to welcome new team members from SiteOne and Verve to Lilly this quarter. With SiteOne, we added a new pain asset into our neuroscience portfolio. STC-004 is a NAV 1.8 inhibitor that's shown encouraging early data to treat pain. We believe this molecule could be an important non-opioid therapy for pain in the future.

我也很高興透過業務發展，我們為我們的產品組合添加了新的分子，並為我們的團隊添加了新的同事，並且很高興本季度歡迎來自 SiteOne 和 Verve 的新團隊成員加入禮來公司。透過 SiteOne，我們在神經科學產品組合中增加了一項新的疼痛資產。STC-004 是一種 NAV 1.8 抑制劑，其在治療疼痛方面的早期數據令人鼓舞。我們相信這種分子將來可能成為一種重要的非鴉片類疼痛治療方法。

Through the acquisition of Verve Therapeutics, we added several genetic medicines for cardiovascular disease that may only need to be given once in a lifetime. The most advanced programs are VERVE-102, which targets PCSK9, and VERVE-201, which targets ANGPTL3.

透過收購Verve Therapeutics，我們增加了幾種可能一生只需要服用一次的心血管疾病基因藥物。最先進的項目是針對 PCSK9 的 VERVE-102 和針對 ANGPTL3 的 VERVE-201。

And in our early-phase portfolio, we advanced nisotirostide, our PLY analog agonist into a Phase 2 trial in people with diabetes. And we initiated Phase 1 clinical trials for glucose-sensing insulin, a PTK7 antibody drug conjugate in oncology and a next-generation triple agonist in cardiometabolic health. We also discontinued two Phase 2 programs, KV1.3 antagonist for psoriasis and mazisotine for pain, and two Phase 1 programs itaconate mimetic in immunology and [Scaptus iRNA] in MASH.

在我們的早期產品組合中，我們將 PLY 類似物激動劑尼索羅肽推進到糖尿病患者的 2 期試驗階段。我們啟動了葡萄糖感應胰島素、腫瘤學中的 PTK7 抗體藥物偶聯物和心臟代謝健康中的下一代三重激動劑的 1 期臨床試驗。我們也停止了兩個 2 期研究項目，即用於治療牛皮癬的 KV1.3 拮抗劑和用於治療疼痛的馬齊索汀，以及兩個 1 期研究項目，即用於免疫學的衣康酸類似物和用於 MASH 的 [Scaptus iRNA]。

It was a productive period since our last earnings call, and we still have an ambitious R&D agenda for the last five months of 2025. I'll now turn the call back to Dave for some closing remarks.

自上次收益電話會議以來，這是一個富有成效的時期，我們對 2025 年最後五個月仍有一個雄心勃勃的研發計劃。現在我將把電話轉回給戴夫，請他發表一些結束語。

Thanks, Dan. We're really pleased with all the progress in Q2 across our strategic agenda. We've had another quarter of strong financial results. We continued the build-out of our manufacturing footprint and advanced our pipeline, as Dan just highlighted, with external and internal R&D projects.

謝謝，丹。我們對第二季戰略議程的所有進展感到非常高興。我們又取得了一個季度的強勁財務表現。正如丹剛才強調的那樣，我們透過內部和外部研發專案繼續擴大我們的製造足跡並推進我們的產品線。

We have good momentum as we enter the second half of 2025, and we're focused on execution with our currently marketed products, and we're investing in the next wave of medicines that we expect will drive growth in the near and more distant future.

進入 2025 年下半年，我們勢頭良好，我們專注於當前銷售產品的執行，並正在投資下一波藥物，我們預計這些藥物將在近期和遠期推動增長。

So now let me turn the call over to Mike to moderate a Q&A session.

現在，讓我將電話轉給麥克主持問答環節。

Thanks, Dave. We would like to take questions from as many callers as possible. So consistent with prior quarters, we will respond to one question per caller, and we'll end the call promptly at 9:30. Please provide the instructions for the Q&A session, and then we are ready for the first caller.

謝謝，戴夫。我們希望回答盡可能多的來電者的問題。因此，與前幾季一致，我們將回答每位來電者的一個問題，並將於 9:30 準時結束通話。請提供問答環節的說明，然後我們就可以準備接聽第一位來電了。

(Operator Instructions) Chris Schott, JPMorgan.

（操作員指示）摩根大通的 Chris Schott。

Just wanted to kick off with orforglipron. There's obviously a bit of a debate out there this morning on the weight loss profile you're showing for the product, which clearly looks efficacious but maybe a touch below Wegovy. Can you just help put the data into context and just, in general, your thinking of where orfo fits into the treatment landscape versus Zepbound and Wegovy now that you have these results in hand?

只是想從 orforglipron 開始。今天早上，顯然大家對您所展示的產品的減肥效果有一些爭論，該產品顯然看起來很有效，但可能略遜於 Wegovy。您能否幫助將數據放在背景中，並且，總體而言，您認為現在您已經掌握了這些結果，與 Zepbound 和 Wegovy 相比， orfo 在治療領域處於什麼位置？

Great. Thanks, Chris. We'll go to Ken to answer the question about the orforglipron program.

偉大的。謝謝，克里斯。我們將請肯來回答有關 orforglipron 計劃的問題。

Yes. Thanks, Chris, for the question about orforglipron. We're really pleased with the data we've disclosed this morning, really, the idea that you can get 27 pounds of weight loss from a single pill and also get really encouraging effects on other important biomarkers, things like blood pressure, lipids, inflammatory biomarkers, and fasting glucose.

是的。謝謝克里斯提出關於 orforglipron 的問題。我們對今天早上披露的數據感到非常滿意，事實上，一粒藥丸就能減輕 27 磅體重，而且對其他重要的生物標誌物（如血壓、血脂、發炎生物標記和空腹血糖）也產生了非常令人鼓舞的效果。

Those are a lot of the things that HCPs are really managing when they think about preventative care. Now you're getting that all from a single oral pill, but we can manufacture at scale.

這些都是 HCP 在考慮預防性照護時真正要管理的事情。現在，您只需一顆口服藥就能獲得所有這些功效，但我們可以大規模生產。

We also know that simplicity matters in this space and the instructions for use here are going to be pretty simple. Take it once a day without regard to food and water. Of course, the data we're sharing today are in patients with overweight and obesity, but we are evaluating orforglipron in a lot of other settings that includes other disease areas like diabetes and obstructive sleep apnea and OA knee pain.

我們也知道在這個領域簡單性很重要，這裡的使用說明將會非常簡單。每天服用一次，無需考慮食物和水。當然，我們今天分享的數據是針對超重和肥胖患者的，但我們正在許多其他環境中評估奧格列龍，其中包括糖尿病、阻塞性睡眠呼吸中止症和 OA 膝蓋疼痛等其他疾病領域。

We're also evaluating in other context for the treatment of obesity. Right now, we have the ATTAIN and MAINTAIN study ongoing, which is also testing orforglipron as a potential maintenance therapy for patients who have lost drugs -- who lost weight on drugs like Zepbound, to see whether they can keep that weight off. So we really see a wide-ranging opportunity for orforglipron and couldn't be more pleased with the totality of the profile we disclosed this morning.

我們也會在其他情況下對肥胖症的治療進行評估。目前，我們正在進行「ATTAIN」和「MAINTAIN」研究，該研究還測試了奧格列酮作為一種潛在的維持療法，用於已服用減肥藥（例如 Zepbound）減肥的患者，以查看他們是否能夠保持體重。因此，我們確實看到了 orforglipron 的廣泛機會，並且對我們今天早上披露的全部資訊感到非常滿意。

Seamus Fernandez, Guggenheim.

謝默斯·費爾南德斯，古根漢美術館。

Mine's actually on pricing and the pricing environment going forward. I was just hoping, Dave, you could discuss a little bit more your views on the path for price with orforglipron and the growing number of assets coming to market.

我實際上關注的是定價和未來的定價環境。我只是希望，戴夫，你可以進一步討論你對 orforglipron 的價格走勢以及越來越多的資產進入市場的看法。

I think that's been probably the number one overhang, especially as it relates to the continued availability of compounding. So just trying to get a better understanding of where you see price going and maybe if you can provide some thoughts on compounding in that context and how you maintain tirzepatide compounding off-market when it's being ignored with semaglutide.

我認為這可能是最大的懸而未決的問題，特別是因為它與複合的持續可用性有關。因此，我只是想更好地了解您認為的價格走勢，也許您可以提供一些關於這種背景下的複合的想法，以及當 semaglutide 被忽視時，您如何維持 tirzepatide 的場外複合。

Thanks, Seamus. Dave, we'll go to you to talk about the broader pricing environment and potentially weaving in some compounding commentary.

謝謝，西莫斯。戴夫，我們將與您討論更廣泛的定價環境，並可能融入一些複合評論。

Okay. Yes. Thanks, Seamus. As it relates to compounding, let me just deal with that first. We've always been concerned about this because of the patient safety risk that exists. And every day, we get calls from patients concerned that they are getting ill on a medicine they think is ours, and it's not.

好的。是的。謝謝，西莫斯。由於它與複合有關，讓我先處理一下。由於存在患者安全風險，我們一直對此感到擔憂。每天，我們都會接到患者的電話，他們擔心服用了我們生產的藥物後會生病，而他們以為這些藥物是我們的，但實際上不是。

This, of course, was allowed during drug shortage. There's no drug shortage. And we really think that regulators and law enforcement officers in the US need to step up their game to really eliminate this. That's why we have an FDA and a structured regulatory process in the US. And so we want to see that, and mostly because people are being harmed.

當然，在藥品短缺的情況下，這是允許的。不存在藥品短缺。我們確實認為，美國的監管機構和執法人員需要加強，真正消除這種現象。這就是為什麼美國有 FDA 和結構化的監管流程。我們希望看到這一點，主要是因為人們正在受傷。

We see robust growth in the marketplace in the US, 42% total incretin growth over last year, good sequential growth. And of course, Lilly's growth is more than double that. So we're -- the business is fine. But people shouldn't be harmed.

我們看到美國市場強勁成長，腸促胰島素總量比去年成長了 42%，實現了良好的連續成長。當然，禮來公司的成長率是這個數字的兩倍以上。所以我們的生意很好。但人們不應該受到傷害。

That said, I think on pricing, we've always had a philosophy across all medicines, including with incretins, to price to value. And given the profile we present to consider offsetting other health care costs, including medicines, the value to the patient, the value in the economy as well. And here with GLP-1 and incretin mechanisms, we're seeing profound value, frankly.

話雖如此，我認為在定價方面，我們對所有藥物（包括腸促胰島素）始終秉持一種定價理念，即按價值定價。鑑於我們目前的情況，考慮抵消其他醫療保健成本，包括藥物、對患者的價值以及經濟價值。坦白說，透過 GLP-1 和腸促胰島素機制，我們看到了深遠的價值。

So we're noticing a difference in when we offer consumerable pricing outside of insurance. But inside of the health care system, which is most of the business, we think that we'll expect single-digit erosion like we do other chronic medications in net pricing, while maintaining a value point on list that makes good sense. That's not considering any new policy environment, but that's our philosophy going forward.

因此，我們注意到，當我們提供保險以外的消費者定價時存在差異。但在醫療保健系統內部（即大部分業務），我們認為，我們預計淨價格將出現個位數的侵蝕，就像我們對其他慢性藥物的淨價格所做的那樣，同時在清單上保持一個合理的價值點。這並沒有考慮任何新的政策環境，但這是我們未來的理念。

So as we have a suite of products with somewhat, perhaps, more value in patients with more complicated obesity, or those that may be have less complicated obesity, but medicines like orforglipron that could reach the masses. Of course, we'll consider those factors in price-setting at the list level and then the net will find its level in negotiations.

因此，我們有一系列產品，可能對肥胖症較為複雜或不太複雜的患者更有價值，但像 orforglipron 這樣的藥物可以惠及大眾。當然，我們會在清單層面定價時考慮這些因素，然後網路會在談判中找到自己的水平。

And you can continue to expect Lilly to offer consumer level pricing as long as we have such a large hole in coverage in our country for important chronic disease like obesity that should be covered. Those are our views on pricing.

只要我國對肥胖症等重要慢性疾病的覆蓋範圍存在巨大缺口，您就可以繼續期待禮來公司提供消費者層面的定價。這些就是我們對定價的看法。

Geoff Meacham, Citibank.

花旗銀行的傑夫‧米查姆。

Dan, on orforglipron, looking at the discontinuation rate, it looks competitive for ATTAIN and ACHIEVE. But can you talk about how the GI adverse event rates changed over the course of the studies? And were there common features among those with the highest adverse event rates? Obviously, thinking how this could play out from a commercial context.

丹，關於奧格列丙酮，從停藥率來看，它對 ATTAIN 和 ACHIEVE 來說似乎具有競爭力。但是您能談談在研究過程中胃腸道不良事件發生率是如何變化的嗎？不良事件發生率最高的族群中是否有共同特徵？顯然，從商業角度考慮這會如何發展。

Thanks, Geoff. Dan, we'll go to you to talk about some of the orfo profile over time.

謝謝，傑夫。丹，我們會和你討論奧福的一些概況。

Yes. Thanks, Geoff. No surprises in there. The GI profile was as expected for a GLP-1 agonist, which is to say, that most of the side effects occur early in the disease -- early in the treatment course or with dose escalations, and then they go down over time.

是的。謝謝，傑夫。沒什麼意外。胃腸道特徵與 GLP-1 激動劑的預期一致，也就是說，大多數副作用發生在疾病早期 - 在治療過程的早期或劑量增加時，然後隨著時間的推移而減少。

In terms of any specific patient characteristics that predicted, I don't believe we saw that in the study nor have we seen that in prior studies with GLP-1. So really no differences here that we thought were noteworthy versus monotherapy GLP-1 injectables.

就預測的任何特定患者特徵而言，我認為我們沒有在研究中看到這一點，也沒有在先前使用 GLP-1 的研究中看到這一點。因此，我們認為與單一療法 GLP-1 注射劑相比，這裡確實沒有什麼值得注意的差異。

Tim Anderson, Bank of America.

美國銀行的蒂姆·安德森。

I wanted to ask a compounding question in a way, I guess. Canadian generics for Novo's semaglutide, they're likely to launch in early '26. I think everyone can agree that tirzepatide is a better product, but won't this still cause a lot of trouble in the market where there's a big cash pay channel and where we already know that patients have proven themselves to be price-sensitive and willing to use a lesser product like a knockoff semaglutide?

我想，從某種意義上來說，我想問一個複合問題。加拿大 Novo 公司的 semaglutide 仿製藥預計將於 26 年初上市。我認為每個人都會同意 tirzepatide 是一種更好的產品，但這在市場上不會造成很多麻煩嗎？因為市場上有大量現金支付管道，而且我們已經知道患者對價格很敏感，願意使用像仿冒的 semaglutide 這樣的劣質產品。

Seems to me Canadian generics are just a replacement for that compounding channel, and they'll keep that headwind alive even if compounders get shut down. And we're talking about a product here that will have gone through a regulatory review cycle not by FDA, but by another regulator. So with that launch six months away, is that a headwind that we should expect may continue?

在我看來，加拿大仿製藥只是複合渠道的替代品，即使複方藥廠被關閉，它們仍將保持這種逆風。我們在這裡討論的產品不是由 FDA 進行監管審查週期，而是由另一個監管機構進行監管審查。那麼，距離新車發布還有六個月的時間，我們是否應該預期這種不利因素可能會持續下去？

Okay. Thanks, Tim, for the question on the Canadian generics impact. We'll go to Ilya to answer that one.

好的。謝謝蒂姆提出有關加拿大仿製藥影響的問題。我們將去找伊利亞來回答這個問題。

Thanks for the question. Maybe I'll touch on what we're currently seeing in the US market and (inaudible) looking at the self-pay market, what we're seeing in vial performance and overall market is continuing to grow at rapid pace. We're seeing that our offering with the vial with Zepbound and the profile that we have with Zepbound is meeting a need for patients even in the context of noise, whether you have compounded or [sema] in the market.

謝謝你的提問。也許我會談談我們目前在美國市場看到的情況，（聽不清楚）看看自付費市場，我們看到小瓶性能和整體市場正在繼續快速成長。我們看到，我們提供的 Zepbound 小瓶產品以及 Zepbound 的特性能夠滿足患者的需求，即使在噪音環境下，無論您在市場上使用的是複合藥物還是 [sema]。

If you take a look at just the growth that we've seen in Q2, we've generated over 1 million TRx in vial in Q2. And we recently launched last week, the highest doses of vial available for Zepbound. And we're continuing to see health in that market.

如果您只看一下我們在第二季度看到的成長情況，我們在第二季度已經產生了超過 100 萬個 TRx。我們上週剛推出了 Zepbound 最高劑量的藥瓶。我們繼續看到該市場的健康發展。

Roughly 20% of our overall TRx is coming from the cash pay market and we continue to see strength overall, both in self-pay and in covered. We're seeing around 65% share market in new therapy starts for Zepbound overall. So we see health in the market and where Zepbound provides a greater value.

我們整體 TRx 的約 20% 來自現金支付市場，我們繼續看到整體實力強勁，無論是自付還是承保。我們看到 Zepbound 在新療法市場的整體份額約為 65%。因此，我們看到市場健康，並且 Zepbound 能夠提供更大的價值。

Dave Risinger, Leerink Partners.

Dave Risinger，Leerink Partners。

So I was hoping to better understand the evolution of US employer coverage for anti-obesity medicines and the prospects. So my understanding is that coverage has been pretty flat on a net basis over the last 18 months, let's say, since January of '24, meaning the net covered lives has been flattish. If you can confirm that that's correct.

因此，我希望更了解美國雇主對抗肥胖藥物的覆蓋範圍的演變和前景。所以我的理解是，在過去 18 個月中，比如說自 24 年 1 月以來，覆蓋率在淨基礎上一直保持平穩，這意味著淨覆蓋率一直保持穩定。如果您能確認這是正確的。

And then can you talk about the outlook for the net change in US employer coverage for anti-obesity medicines over the next six months or so for January of '26?

然後，您能否談談 2026 年 1 月以後六個月左右美國雇主對抗肥胖藥物承保的淨變化前景？

Thanks, Dave, for the question. We'll go to Ilya to talk about the progress in the Zepbound employer coverage opt-in.

謝謝戴夫提出這個問題。我們將與 Ilya 討論 Zepbound 雇主保險選擇加入的進展。

Sure. Thanks for the question, Dave. As we take a look at inventory coverage, we (technical difficulty) it's important for us to grow coverage over time. What we've seen in different offerings across the different plans, and some are more complex than others, and we've seen an increase, overall, but it has been steady around 50% to 55% employer opt-in coverage.

當然。謝謝你的提問，戴夫。當我們查看庫存覆蓋率時，我們（技術難度）隨著時間的推移擴大覆蓋率對我們來說很重要。我們在不同的計劃中看到了不同的產品，有些比其他的產品更複雜，而且我們看到總體上有所增加，但雇主選擇加入的覆蓋率一直穩定在 50% 到 55% 左右。

At the same time, we are seeing new benefit designs, like, for instance, [Evernorth], a cap on out-of-pocket for employees that make the prior authorization simplified, and that may grow employer opt-ins over time. That's something that we're working through. Our outlook is that as evidence grows and we find new ways and also different plan designs are available to different employers, that will continue.

同時，我們看到了新的福利設計，例如 [Evernorth]，對員工自付費用設定了上限，簡化了事先授權，並且隨著時間的推移可能會增加雇主的選擇。這是我們正在努力解決的問題。我們的觀點是，隨著證據的不斷增加，我們找到新的方法，並且為不同的雇主提供不同的計劃設計，這種情況將會繼續下去。

Terence Flynn, Morgan Stanley.

摩根士丹利的特倫斯弗林。

Congrats on all the progress. Just wondering on orforglipron in light of the ATTAIN-1 data, if you can just frame expectations for us down for the upcoming ATTAIN-2 Phase 3 data. And then any early insights into the potential CMMI obesity, Medicare/Medicaid pilot that I think we saw some press reports about?

祝賀你取得的所有進展。我只是想知道，根據 ATTAIN-1 數據，您是否可以為我們降低對即將到來的 ATTAIN-2 第 3 階段數據的預期。那麼，對於潛在的 CMMI 肥胖症、醫療保險/醫療補助試點，我認為我們看到了一些新聞報道，對此有什麼早期見解嗎？

I think that we'll go to Ken to answer the question on expectations for ATTAIN-2.

我認為我們會請肯來回答有關 ATTAIN-2 期望的問題。

Thanks, Terence, for the question on ATTAIN-2. We're very pleased with what we disclosed this morning in ATTAIN-1, which is our first Phase 3 study in obesity without diabetes. And of course, we integrate result with ACHIEVE-1 in patients with diabetes.

謝謝 Terence 提出 ATTAIN-2 的問題。我們對今天上午在 ATTAIN-1 中披露的結果感到非常高興，這是我們針對非糖尿病肥胖症進行的首次 3 期研究。當然，我們將結果與糖尿病患者的 ACHIEVE-1 結合。

So as we look ahead to ATTAIN-2, we expect similarly encouraging results. The exciting thing about ATTAIN-2 is that -- our third Phase 3 study, and it sets us up to submit to in obesity by the end of this year. So really no change in expectations here. The team's full speed ahead preparing for submission by year-end and a potential approval next year.

因此，展望 ATTAIN-2，我們期待同樣令人鼓舞的結果。ATTAIN-2 令人興奮的是——這是我們的第三階段 3 期研究，它將使我們在今年年底前提交肥胖症研究報告。因此這裡的預期實際上沒有變化。該團隊正全力準備在年底前提交申請並可能在明年獲得批准。

Courtney Breen, Bernstein.

考特尼·布林，伯恩斯坦。

Just coming back to another question on orfo. As we looked at comparing the data between ATTAIN-1 and ACHIEVE-1, we do see that nausea, vomiting constipation all appear a bit higher in this ACHIEVE-1 study. Can you talk a little bit about the differences in those data points that we're seeing between those two studies and what that might mean for adherence in the real world?

剛剛回到關於 orfo 的另一個問題。當我們比較 ATTAIN-1 和 ACHIEVE-1 之間的數據時，我們確實發現在這項 ACHIEVE-1 研究中，噁心、嘔吐和便秘的發生率都略高一些。您能否稍微談談我們在這兩項研究中看到的數據點的差異以及這對現實世界中的依從性意味著什麼？

Courtney, thanks for the question on comparing ACHIEVE versus ATTAIN. I think, Dan, maybe a couple of quick comments?

考特尼，謝謝你提出比較 ACHIEVE 和 ATTAIN 的問題。丹，我想您能簡單評論幾句嗎？

Yes, sure. Thanks, Courtney. I think the side effect profile in both of these trials was consistent with past experience for GLP-1 monotherapy in these populations, which are different, as you're pointing out, that profiles can be different in people with Type 2 diabetes versus people without Type 2 diabetes and with obesity. So I think we feel quite confident overall about the profile here.

是的，當然。謝謝，考特尼。我認為這兩項試驗的副作用情況與過去這些人群使用 GLP-1 單一療法的經驗一致，正如您所指出的，這些人群的情況有所不同，患有 2 型糖尿病的人與沒有 2 型糖尿病和肥胖的人的情況可能有所不同。所以我認為我們對這裡的概況總體上還是很有信心的。

Of course, I think I'd just emphasize once again this is a GLP-1 monotherapy. We know that dual agonism with GLP-1 and GIP-1 can offer superior results. We have that as an injectable as tirzepatide. But I think, actually, this is as good as it gets for GLP-1 monotherapy here in a once-a-day small molecule, we're also -- been pretty excited with the profile.

當然，我想我只想再次強調這是一種 GLP-1 單一療法。我們知道 GLP-1 和 GIP-1 的雙重激動作用可以提供更好的效果。我們有 tirzepatide 作為注射劑。但我認為，實際上，對於每日一次的小分子 GLP-1 單一療法來說，這已經是最好的了，我們對其概況也感到非常興奮。

Mohit Bansal, Wells Fargo.

富國銀行的 Mohit Bansal。

Dan, if you could comment on the gender split in the orforglipron study, if there was any difference versus any other trials for GLP-1 that you want to highlight here?

丹，您能否評論一下 orforglipron 研究中性別分佈的情況？與其他 GLP-1 試驗相比，是否存在任何您想要在此強調的差異？

Thanks, Mohit, for the detailed question. We'll go to Ken to talk about the gender split, if there's anything to flag.

謝謝 Mohit 提出的詳細問題。如果有什麼值得關注的事情，我們會去找肯討論性別比例議題。

Thanks, Mohit. Gender split for baseline population in ATTAIN-1 was about 64% across the board, well balanced across -- or 64% female across all arms, balanced. Nothing really to remark on here.

謝謝，Mohit。ATTAIN-1 中基線人口的性別比例約為 64%，各組間均衡－或所有組別的女性佔比為 64%，均衡。這裡確實沒有什麼好評論的。

Asad Haider, Goldman Sachs.

高盛的阿薩德·海德爾 (Asad Haider)。

Congrats on the quarter. Just going back to channel dynamics. On the LillyDirect channel, clearly, Zepbound growth has been getting a lot of momentum with the new-to-brand prescriptions. Where do you think this could stabilize? And how is that segment changing the landscape on pricing?

恭喜本季取得佳績。回到通路動態。顯然，在 LillyDirect 頻道上，Zepbound 的成長隨著新品牌處方的出現而獲得了巨大的動力。您認為這種情況在哪裡可以穩定下來？那麼該部分如何改變定價格局？

And then related, I think, Lucas, you previously framed this DTC offering for Zepbound as a hedge or a bridge solution as you continue to grow access in the reimbursed channel. So any evolution in your thinking on that front given DTC offerings are now getting framed as one way to satisfy the administration's demands on drug pricing?

然後相關的是，盧卡斯，我認為，您之前將 Zepbound 的這個 DTC 產品設計為對沖或橋樑解決方案，因為您繼續在報銷管道中增加訪問量。那麼，鑑於 DTC 產品現在被視為滿足政府對藥品定價要求的一種方式，您在這方面的想法有什麼變化嗎？

Okay. Thanks for the question, Asad. Lucas, you want to give some commentary on the LillyDirect evolution and outlook from here?

好的。謝謝你的提問，阿薩德。盧卡斯，您想對 LillyDirect 的發展和前景發表一些評論嗎？

Yes, sure. Thanks, Asad, for your question. First of all, I just wanted to highlight the great products that we see in LillyDirect. I think Lilly (technical difficulty) about total TRx prescription that we see in the second quarter, [1.1 million] TRx. Fantastic growth.

是的，當然。謝謝阿薩德的提問。首先，我只想強調一下我們在 LillyDirect 看到的優秀產品。我認為禮來（技術難度）關於我們在第二季度看到的 TRx 總處方量為 [110 萬] TRx。驚人的增長。

And now we are adding the 12.5 and 15 milligrams launch as well. So great progress that we are seeing and you see that data as well that you have access, Asad, in terms of the number of total TRx as a percentage of the total Zepbound business.

現在我們也將推出 12.5 毫克和 15 毫克的產品。我們看到的巨大進步，而且 Asad，您也可以看到您所訪問的數據，即 TRx 總量佔 Zepbound 業務總量的百分比。

So progressing very nicely, very pleased with that. You mentioned about, again, the hedge. Yes, I shared that with you a time ago. That's the way that we think about it, going back to the previous questions about employer. As we see that progressing, we always thought that it would be a gradual progression on the employer access we see the LillyDirect as an option to bridge that, right, as a hedge strategy to bridge that.

進展非常順利，我對此非常滿意。您再次提到了對沖。是的，我之前和你分享過這個。這就是我們思考這個問題的方式，回到之前關於雇主的問題。正如我們所看到的，我們一直認為這將是雇主准入的一個逐步進展，我們將 LillyDirect 視為彌合這一差距的一種選擇，對，作為彌合這一差距的一種對沖策略。

So we still see it the same way, but is progressing very nicely and it's growing very -- is actually contributing to our performance this quarter and for the rest of the year as well. So that's more of the commentary and the color that we can provide today on that.

因此，我們仍然以同樣的方式看待它，但進展非常好，而且成長非常快——實際上對我們本季度以及今年剩餘時間的業績做出了貢獻。這就是我們今天可以提供的更多評論和見解。

Umer Raffat, Evercore.

烏默·拉法特（Umer Raffat），Evercore。

I'm just still trying to get my head around the orforglipron data. On the one side, I see your efficacy F demand at 11.5%, placebo adjusted, being very consistent with what Novo showed with their oral sema data in OASIS-4. But on the more important ITT-like treatment F demand, orfo is tracking at 9% placebo adjusted. Oral sema is almost 14% placebo adjusted. And I'm just trying to understand what explains that delta? And does it prompt the need for a 45-milligram cohort considering how the safety is tracking?

我只是仍在努力理解 orforglipron 數據。一方面，我看到您的療效 F 需求為 11.5%，安慰劑調整後，與 Novo 在 OASIS-4 中顯示的口服血清數據非常一致。但在更重要的 ITT 類治療 F 需求方面，奧福的追蹤率為 9% 安慰劑調整後。口服血清素經安慰劑調整後幾乎達 14%。我只是想了解該如何解釋這個差異？考慮到安全性追蹤情況，這是否需要 45 毫克的劑量？

Thanks, Umer. We'll go to Dan to provide maybe some final commentary on the same.

謝謝，烏默爾。我們將請丹就此做出最後的評論。

Yes. Thanks, Umer. I'm not sure I tracked exactly with your numbers. But look, I think overall, the profile here landed pretty much where you could expect a GLP-1 monotherapy to land. It's tough to compare different trials done at different time periods in different populations. But I think overall, given the patients we enrolled and the trial we ran, this is what GLP-1 agonism can give you.

是的。謝謝，烏默爾。我不確定我是否準確地追蹤了您的數字。但是，我認為總體而言，這裡的概況與 GLP-1 單一療法預期的結果基本一致。要比較不同族群在不同時間段進行的不同試驗是很困難的。但我認為總的來說，考慮到我們招募的患者和進行的試驗，這就是 GLP-1 激動劑可以為您帶來的效果。

I don't see this as any issue at all in the real world or in -- for patients or doctors. I know Wall Street is focused on the exact numbers here in making cross-trial comparisons, but I don't think that carries over to the real world at all.

我認為這在現實世界中，或者對於患者或醫生來說，根本不是問題。我知道華爾街在進行交叉試驗比較時關注的是確切的數字，但我認為這根本不適用於現實世界。

Steve Scala, TD Cowen.

史蒂夫·斯卡拉 (Steve Scala)，TD Cowen。

With what is widely viewed as disappointing orforglipron data, it seems injectables are where it's at for the foreseeable future. On the Q1 call, Lilly said the likely impact of the Novo deal with CVS would be modest.

人們普遍認為 orforglipron 的數據令人失望，看來在可預見的未來，注射劑仍將是治療藥物。在第一季電話會議上，禮來公司表示，Novo 與 CVS 的交易可能產生的影響不大。

But today, you are saying there could be an impact in Q3. And for Lilly to call it out in the prepared remarks, it must be pretty meaningful. So can you tell us what changed in the marketplace for the injectables?

但今天您說這可能會對第三季產生影響。而對莉莉來說，在準備好的發言中提到這一點，一定意義重大。那麼您能告訴我們注射劑市場發生了哪些變化嗎？

Thanks, Steve. Thanks for the question. Maybe to give some commentary on CVS, we'll go to Ilya.

謝謝，史蒂夫。謝謝你的提問。也許為了對 CVS 做一些評論，我們會去找 Ilya。

Sure. Thanks, Steve, for the question. As we take a look at our Q2 performance and the health of both the market and where Zepbound has gained share and we added around 1.7 million TRx in Q2, the overall impact, I think what we've discussed prior is a couple of hundred thousand TRx volume that may vary. It's still early in the transition to CVS and, obviously, that creates frustration for employers, for providers, for patients, and we don't agree and disappointed with CVS decision.

當然。謝謝史蒂夫提出這個問題。當我們回顧第二季度的業績和市場健康狀況以及 Zepbound 的份額增長情況時，我們在第二季度增加了約 170 萬 TRx，我認為整體影響是，我們之前討論過的幾十萬 TRx 的交易量可能會有所不同。向 CVS 過渡仍處於早期階段，顯然，這給雇主、服務提供者和患者帶來了挫折感，我們不同意 CVS 的決定，並且對此感到失望。

At the same time, in terms of impact, you'll have some medical exceptions, and overall, in the context of growing [1.7 million] TRx, we view -- and you look at July TRx as a proxy where, on average, it's back to around May average TRx, we see continued growth and very good performance across all segments for Zepbound both in covered as well as our cash pay market.

同時，就影響而言，您將擁有一些醫療例外，總體而言，在增長的 [170 萬] TRx 背景下，我們認為 - 並且您將 7 月份的 TRx 作為代理，平均而言，它回到了 5 月份的平均 TRx 左右，我們看到 Zepbound 在覆蓋範圍和現金支付市場的所有領域都持續增長並且表現非常好。

And so we expect continued growth. I think the commentary is more about the rate of growth. So obviously, some new patient starts related to CVS template only may have some impact on growth. But overall, the growth is healthy across all other segments.

因此我們預計其將繼續增長。我認為評論更多的是關於增長率。因此顯然，一些與 CVS 模板相關的新患者開始可能會對成長產生一些影響。但總體而言，其他所有領域的成長都是健康的。

Alex Hammond, Wolfe Research.

沃爾夫研究公司的亞歷克斯·哈蒙德。

Another one on orforglipron. So I noticed you included the total discontinuation rates in the PR when you normally don't. Does that suggest that you think there was an underlying driver of these unusually elevated drop rates across all arms? And could they have impacted efficacy?

另一個是關於 orforglipron 的。所以我注意到您在 PR 中包含了總停產率，而通常您不會這樣做。這是否表示您認為所有兵種的掉率異常高是有潛在原因的？它們會影響療效嗎？

Thanks, Alex. We'll go to Ken to talk about the inclusion of the overall discontinuation rates and how that may have been in some other press releases as well.

謝謝，亞歷克斯。我們將與肯恩討論整體停產率的納入情況，以及在其他一些新聞稿中可能出現的情況。

Yes. Thanks, Alex, for the question on discontinuation rates. What we disclosed, of course, with the rate of discontinuation in ATTAIN-1 for placebo of 29.9%, and then for orforglipron, ranging from 22% to 24%. We don't think there's anything remarkable there. And we've disclosed these information on previously programs. I think on SURMOUNT-1, we did.

是的。謝謝 Alex 提出關於停藥率的問題。當然，我們揭露，ATTAIN-1 中安慰劑組的停藥率為 29.9%，而奧格列酮組的停藥率為 22% 至 24%。我們認為那裡沒有什麼特別之處。我們在之前的節目中已經披露了這些資訊。我認為在 SURMOUNT-1 上我們做到了。

Maybe to put this in a little bit of context, if you look at analogous studies in obesity, really, placebo rates are in the 20s. If you take maybe step one, 22% placebo rate for discontinuation and about 5 points lower for active comparator. That's exactly what we see here on the delta. So really nothing remarkable here.

也許可以稍微說明一下，如果你看一下肥胖症的類似研究，你會發現安慰劑率實際上在 20% 左右。如果您採取第一步，停藥的安慰劑率為 22%，而活性對照劑的停藥率則低約 5 個百分點。這正是我們在三角洲上看到的景象。所以這裡真的沒有什麼特別的。

The more important thing to look at, of course, patients can discontinue study for a whole host of reasons. They can just withdraw their consent because it doesn't fit with their life, maybe they're not getting the efficacy they need, and that's why we typically see lower rates in the active drugs, which is what we see here, or an adverse event.

當然，更重要的是，患者可能會因為各種原因而停止學習。他們可以撤回同意，因為這不適合他們的生活，也許他們沒有得到他們需要的療效，這就是為什麼我們通常看到活性藥物的費率較低，這就是我們在這裡看到的，或者不良事件。

Now the rates for adverse events, as Dan noted, a range between 5% and 10% for orforglipron. That's exactly where we'd expect to be for an oral GLP-1 single agonist. So really nothing remarkable here.

正如丹所指出的，奧格列酮的不良事件發生率在 5% 到 10% 之間。這正是我們對口服 GLP-1 單一激動劑的期望。所以這裡真的沒有什麼特別的。

Akash Tewari, Jefferies.

Akash Tewari，傑富瑞。

What's Lilly's appetite to committing to launching new products at net parity pricing between the US and Europe given a significant amount of your newly launched products in Europe are actually not getting reimbursed anyway?

鑑於禮來公司在歐洲新推出的大量產品實際上並未獲得報銷，禮來公司是否願意承諾以美國和歐洲之間的淨平價價格推出新產品？

And more broadly, it sounds like we're in an impact between the administration and the industry. What's your confidence we'd be able to get a bespoke solution with the administration absent new legislation?

更廣泛地說，這聽起來像是我們正處於政府和產業之間的影響。如果沒有新的立法，您是否有信心我們能夠從政府那裡得到量身定制的解決方案？

Great. Thank you, Akash. We'll go to Dave to talk on the engagement with the administration and new product launch strategy.

偉大的。謝謝你，阿卡什。我們將與戴夫討論與管理層的合作以及新產品發布策略。

Sure. Yes. I mean just on the discrete question you're asking, I think we believe, long-term, we should rebalance pricing between US and Europe in terms of who's bearing the cost for really the amortized R&D and the risk we took. That's a rational thing. And it's, in my career, gotten more and more out of whack. So I think I hear the President's right to call that out. The question is really how.

當然。是的。我的意思是，就您提出的離散問題而言，我認為從長遠來看，我們應該重新平衡美國和歐洲之間的定價，即誰來承擔攤銷的研發成本和我們承擔的風險。這是理所當然的事。而在我的職業生涯中，情況變得越來越不正常。所以我認為我聽到了總統有權利這樣說。問題實際上是如何。

And as you know, the European governments don't exactly -- they're not signing up to pay more for drugs. So we need trade tools to rebalance that equation. We've been very clear on that advocacy with both European and US governments.

如你所知，歐洲各國政府並沒有同意為藥品支付更多費用。因此我們需要貿易工具來重新平衡這個等式。我們已經向歐洲和美國政府明確表達了這個主張。

And in the US, we need to deflate the gross-to-net bubble because there's this huge artificial thing that needs to get deflated. The problem of doing that suddenly is all those cash flows into hospitals and premium support for seniors and Part D, et cetera, you can't collapse it all once. It will be very difficult, I think.

在美國，我們需要縮小總收入與淨收入之間的泡沫，因為有一個巨大的人為因素需要消除。這樣做的問題是，所有這些流入醫院的現金、老年人的保費支持以及 D 部分等，你不可能一下子把它們全部折騰掉。我認為這會非常困難。

So the idea of new products gives it a ramp, but we need these other structural changes on the US side and the gross-to-net environment in Europe in terms of the total reimbursement set up to get there. But we'd be excited to enter that world.

因此，新產品的想法為其提供了平台，但為了實現這一目標，我們需要美國方面進行其他結構性變革，並在歐洲建立總報銷額度的毛利到淨利環境。但我們很高興進入那個世界。

And actually, I'll point out in a few cases, we are narrowing the gap substantially on new products. And some of that's for the reason you point out, that some countries' reimbursement is just a tough equation. So what's the point of lowering that?

實際上，我想指出的是，在幾個案例中，我們在新產品上正在大幅縮小差距。部分原因正如您所指出的，有些國家的償還問題十分棘手。那麼降低這個值有什麼意義呢？

So watch that space. I think this is an area there could be progress under the President's agenda. And I think you'd see most pharma companies interested in moving in that direction. The question is how do you step into it.

因此請留意那個空間。我認為這是總統議程下可以取得進展的一個領域。我認為大多數製藥公司都對朝這個方向發展感興趣。問題是你如何進入這個領域。

We've got time for probably two more questions.

我們可能還有時間回答另外兩個問題。

Kerry Holford, Berenberg.

凱莉·霍爾福德，貝倫貝格。

Questions from me, please, on the cash channel. So yesterday, Novo stated it would make Ozempic available, (inaudible) later this year. Are you planning to do the same for Mounjaro? And if not, why not? And I'm not sure if you mentioned this earlier, but can you confirm whether you intend to use the cash channel for orforglipron on that aftermarket?

請問我在現金頻道提問。因此昨天，Novo 表示將在今年稍後推出 Ozempic（聽不清楚）。您是否計劃為 Mounjaro 做同樣的事情？如果不是，為什麼？我不確定您是否之前提到過這一點，但您能否確認您是否打算在售後市場上使用 orforglipron 的現金管道？

Great. Thanks, Kerry, for the question. We'll go to Ilya to comment on our thoughts on the cash channel.

偉大的。謝謝 Kerry 提出的問題。我們將向 Ilya 表達我們對現金管道的看法。

Sure. Well, first, I think we're learning a lot in the cash channel, LillyDirect. And a lot of that has to do with the consumer journey, and it's varied across different segments where you have significant coverage versus not. And with Mounjaro, we have significant coverage, so over 90% coverage in both commercial as well as Part D. And so I'm not sure if that necessarily provides an additional avenue.

當然。嗯，首先，我認為我們在現金管道 LillyDirect 學到了很多。這在很大程度上與消費者旅程有關，並且在覆蓋範圍較廣和覆蓋範圍較窄的不同細分市場中存在差異。有了 Mounjaro，我們的覆蓋範圍就變得很廣了，商業和 D 部分的覆蓋率都超過 90%。因此，我不確定這是否一定能提供額外的途徑。

With Zepbound, we see significant growth because we do have coverage gaps in commercial. And obviously, we also have coverage gaps without having the ability to cover anti-obesity medications in Part D. So we see this as an opportunity for us to meet that need.

借助 Zepbound，我們看到了顯著的成長，因為我們在商業領域確實存在覆蓋差距。顯然，我們的保險覆蓋範圍也存在缺口，沒有能力在 D 部分涵蓋抗肥胖藥物。因此，我們將此視為滿足這項需求的機會。

Of course, we'll evaluate as the brands that we put through LillyDirect. We have a number of avenues to come to LillyDirect on different brands to make sure that people can access the health care system in a better way. And so that's something that will evolve over time.

當然，我們會對透過 LillyDirect 投放的品牌進行評估。我們透過多種途徑將不同品牌引入 LillyDirect，以確保人們能夠更好地享受醫療保健系統。所以這會隨著時間而發展。

Evan Seigerman, BMO Capital Markets.

艾文‧塞格曼 (Evan Seigerman)，蒙特婁銀行資本市場。

A follow-up on the MFN conversation. I appreciate you're not going to share the details of your interaction with the administration. But can you provide some practical examples of what you and the industry can do to help achieve the goals of getting price parity globally?

關於最惠國待遇對話的後續行動。我很感激你沒有透露你與政府互動的細節。但是，您能否提供一些實際的例子來說明您和業界可以做些什麼來幫助實現全球平價的目標？

Thanks, Evan. We'll go to Dave to answer the question and to provide closing remarks.

謝謝，埃文。我們將請戴夫來回答這個問題並作最後的陳述。

Yes, sure. I don't have a lot to add to what I said to the prior question. I think, long-term, it makes sense to rebalance this. And having an on-ramp makes sense to me because a sudden change in either environment would be difficult to sustain or justify. So the idea of new products is a reasonable proposition provided that the reimbursement rates in Europe can rise really based on cost per quality analysis and other things, and the US gross-to-net situation can change, and eating into it seems to be rational thing to do.

是的，當然。對於之前的問題，我沒有太多要補充的。我認為，從長遠來看，重新平衡這一點是有意義的。對我來說，設立入口是有意義的，因為任何環境的突然變化都難以維持或證明其合理性。因此，如果歐洲的報銷率能夠根據品質成本分析和其他因素真正上升，並且美國的總收入與淨收入情況能夠發生變化，那麼新產品的想法就是一個合理的提議，而蠶食它似乎是合理的事情。

The other piece, which the DTC channel being suggested by the administration. And per the prior question, in addition to offering an outlet for people who don't have coverage, it does provide a real price transparency to consumers, employers and others. And that's a good thing. So we support that as well.

另一部分是管理部門建議的 DTC 管道。並且根據先前的問題，除了為沒有保險的人提供管道之外，它還為消費者、雇主和其他人提供了真正的價格透明度。這是一件好事。因此我們也支持這一點。

We'll have to see how this plays out. As I said, we're constructively engaging. Hopefully, some progress can be made. And I think it's in the industry's long-term interest to pull these things closer together, and we'll work hard to try to do that.

我們將拭目以待事情將如何發展。正如我所說，我們正在進行建設性的接觸。希望能夠取得一些進展。我認為將這些事情更緊密地結合起來符合產業的長遠利益，我們會努力做到這一點。

Thanks for being with us today, everyone, and for as many questions as we got to. I know there's always some we did not. So as in prior quarters, if you have unresolved questions, please contact our IR team. And we appreciate your interest in the company, as always, and look forward to future interactions. Have a great day.

感謝大家今天的到來，也感謝大家提出的問題。我知道總有一些事情我們沒有做到。因此，與前幾季一樣，如果您有未解決的問題，請聯絡我們的 IR 團隊。我們一如既往地感謝您對公司的關注，並期待未來的互動。祝你有美好的一天。

Thank you. And ladies and gentlemen, this does conclude our conference for today. This conference will be made available for replay beginning at 1:00 PM, today, running through September 11 at midnight.

謝謝。女士們、先生們，今天的會議到此結束。本次會議將於今天下午 1:00 開始重播，一直持續到 9 月 11 日午夜。

You may access the replay system at any time by dialing (800) 332-6854 and entering the access code 639732. International callers can call (973)-528-0005. Again, those numbers are (800) 332-6854 and (973)-528-0005, with the access code 639732.

您可以隨時撥打 (800) 332-6854 並輸入存取代碼 639732 來存取重播系統。國際電話可撥打 (973)-528-0005。再次重申，這些號碼是 (800) 332-6854 和 (973)-528-0005，接入碼為 639732。

Thank you for your participation. You may now disconnect your lines.

感謝您的參與。現在您可以斷開線路了。