禮來公司 (LLY) 2025 Q3 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to the Lilly Q3 2025 earnings conference call. (Operator Instructions)

女士們、先生們，感謝各位的耐心等待，歡迎參加禮來公司 2025 年第三季財報電話會議。（操作說明）

I would now like to turn the conference over to your host, Mike Czapar, Senior Vice President of Investor Relations. Please go ahead.

現在我將把會議交給主持人，投資者關係高級副總裁邁克·查帕爾。請繼續。

Good morning. Thank you for joining us for Eli Lilly company's Q3 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; Jake Van Naarden, President of Lilly Oncology; Patrik Jonsson, President of Lilly International; and Ken Custer, President of Lilly Cardiometabolic Health. We're also joined by Marc Kemen, Susan Hedglin and Wes Taul, of the Investor Relations team.

早安.感謝您參加禮來公司2025年第三季財報電話會議。我是投資者關係高級副總裁麥克·查帕爾。今天與我一起參加電話會議的有：禮來公司董事長兼首席執行官戴夫·里克斯；首席財務官盧卡斯·蒙塔斯；首席科學官兼禮來免疫學總裁丹·斯科夫龍斯基博士；禮來神經科學總裁安妮·懷特；禮來美國及全球客戶能力總裁伊利亞·尤法；禮來腫瘤總裁傑克·範納爾登；禮來美國及全球客戶能力總裁伊利亞·尤法；禮來腫瘤總裁傑克·納爾登；投資者關係團隊的馬克·凱門、蘇珊·赫格林和韋斯·陶爾也加入了我們。

During this call, we anticipate making projections and forward-looking statements based on our current expectations. Our actual results could 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，我們預計將根據我們目前的預期做出預測和前瞻性陳述。由於多種因素，包括投影片 4 中列出的因素，我們的實際結果可能會與預期有重大差異。有關可能導致實際結果與預期結果存在重大差異的因素的更多信息，請參閱我們最新的 10-K 表格以及隨後向美國證券交易委員會提交的文件。

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 decisions. As we transition to our prepared remarks, please note that our commentary will focus on non-GAAP financial measures.

我們提供的產品和研發管線資訊是為投資界服務的。本資訊並非旨在進行推廣，也不足以作為處方決策的依據。在我們進入準備好的發言環節之前，請注意，我們的評論將側重於非GAAP財務指標。

Now I'll turn the call over to Dave. Dave, we'll turn the call over to you.

現在我把電話交給戴夫。戴夫，我們把電話交給你了。

Sorry. Thanks, Mike. Appreciate it. Q3 was another strong quarter for Lilly. We made progress across all our strategic deliverables. We delivered compelling financial results, advanced our pipeline and achieved key milestones to expand our manufacturing footprint. This is all shown on slide 6.

對不起。謝謝你，麥克。謝謝。第三季禮來公司業績依然強勁。我們在所有戰略目標上都取得了進展。我們取得了令人矚目的財務業績，推進了產品研發，並實現了擴大生產規模的關鍵里程碑。所有這些都顯示在第6張投影片上。

In Q3, revenue grew 54% compared to the same period last year. Revenue from key products more than doubled as our medicines continued to increase their global impact. In the US, Lilly gained market share in the incretin analogs market for the fifth consecutive quarter. Lilly medicines account for nearly 6 out of 10 prescriptions within this large and growing class. Outside the US Mounjaro performance accelerated, driven by robust uptake around the world.

第三季營收年增54%。隨著我們的藥品在全球範圍內的影響力不斷擴大，主要產品的收入翻了一番還多。在美國，禮來公司連續第五個季度在腸促胰素類似物市場獲得市場份額。在這龐大且不斷成長的藥品類別中，禮來公司的藥品佔處方藥總量的近 60%。在美國以外，Mounjaro 的表現加速成長，這得益於全球強勁的成長勢頭。

As a result of our strong financial performance, we raised our revenue and earnings per share guidance. Lucas will cover this in more detail later in the call. Since our last earnings call, we achieved several key milestones, including US FDA approval for imlunestrant under the brand name Inluriyo for ER+, HER2-, ESR1-mutated advanced or metastatic breast cancer.

由於財務業績強勁，我們提高了營收和每股盈餘預期。盧卡斯稍後會在電話會議中詳細介紹這一點。自上次財報電話會議以來，我們取得了幾個重要的里程碑，包括美國 FDA 批准 imlunestrant（商品名為 Inluriyo）用於治療 ER+、HER2-、ESR1 突變的晚期或轉移性乳癌。

The EU approved Kisunla for early symptomatic Alzheimer's disease. Positive results from Phase 3 trial of Jaypirca in treatment of naive CLL. Positive overall survival data for Verzenio in high-risk early breast cancer. Positive results from the second Phase 3 trial of orforglipron in obesity, enabling now global submissions to begin later this year.

歐盟批准 Kisunla 用於治療早期症狀性阿茲海默症。Jaypirca治療初治CLL的3期臨床試驗取得正面結果。Verzenio 在高風險早期乳癌患者中取得了積極的整體存活數據。orforglipron 治療肥胖症的第二項 3 期試驗取得了積極結果，使得今年稍後開始在全球範圍內提交申請成為可能。

Positive results from three additional Phase 3 trials of orforglipron in type 2 diabetes, including one trial that demonstrated head-to-head superiority versus oral semaglutide. We also made good progress executing our manufacturing expansion agenda. We announced plans to build two new US facilities that will make active pharmaceutical ingredients and the expansion of an existing facility in Puerto Rico.

奧福格列酮治療第 2 型糖尿病的三項 3 期臨床試驗均取得了積極結果，其中一項試驗表明，奧福格列酮在與口服索馬魯肽的直接比較中具有優越性。我們在執行生產擴張計劃方面也取得了良好進展。我們宣布了在美國新建兩座生產活性藥物成分的工廠，以及擴建波多黎各現有工廠的計畫。

The new facility in Virginia will support our bioconjugate and monoclonal antibody portfolio. And the new facility in Texas and the expansion in Puerto Rico will support our small molecule portfolio, including orforglipron. We plan to announce updates on our two remaining new US manufacturing facilities in the coming months. During the quarter, we distributed $1.3 billion in dividends and executed approximately $700 million in share repurchases.

位於維吉尼亞州的新工廠將為我們的生物偶聯物和單株抗體產品組合提供支援。德州的新工廠和波多黎各的擴建將支持我們的小分子產品組合，包括奧福格列酮。我們計劃在未來幾個月內公佈我們在美國剩餘兩家新製造工廠的最新進展。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。

Now I'll turn the call over to Lucas to review the Q3 results.

現在我將把電話交給盧卡斯，讓他來回顧第三季業績。

Thanks, Dave. As shown on slide 7, Q3 was another strong quarter of financial performance. Revenue grew 54% compared to Q3 2024, driven by our key products. Gross margin as a percentage of revenue was 83.6% in Q3, an increase of 1.4 percentage points versus the same quarter last year. This improvement was driven by favorable product mix, partially offset by lower realized prices.

謝謝你，戴夫。如投影片 7 所示，第三季財務業績表現強勁。受主要產品推動，營收較 2024 年第三季成長 54%。第三季毛利率佔營收的百分比為 83.6%，比去年同期成長了 1.4 個百分點。這項改善主要得益於有利的產品組合，但部分被較低的實際售價所抵銷。

Research and development expenses increased 27% driven by continued investments in our portfolio. We have initiated 16 new Phase 3 programs since the start of 2024 and continue to advance our pipeline. Marketing, selling and administrative expenses increased 31% as we continue to increase investment to support ongoing and future launches across therapeutic areas and geographies.

受對我們投資組合的持續投資推動，研發費用增加了 27%。自 2024 年初以來，我們已經啟動了 16 個新的 3 期臨床試驗項目，並將繼續推進我們的研發管線。由於我們不斷增加投資以支持在各個治療領域和地區開展的現有和未來產品上市，行銷、銷售和管理費用增加了 31%。

Our non-GAAP performance margin, which we define as gross margin less R&D, marketing, selling and administrative expenses as a percentage of revenue was 48.3%. Performance margin increased by more than 8 percentage points from Q3 2024, driven by revenue growth. At the bottom line, earnings per share increased to $7.02 inclusive of $0.71 of acquired IPR&D charges. This compares to $1.18 in Q3 2024, which included $3.08 of acquired IPR&D charges.

我們的非GAAP業績利潤率（定義為毛利減去研發、行銷、銷售和管理費用佔收入的百分比）為48.3%。受營收成長的推動，業績利潤率較 2024 年第三季提高了 8 個百分點以上。最終，每股收益增至 7.02 美元，其中包括 0.71 美元的收購智慧財產權研發費用。相比之下，2024 年第三季為 1.18 美元，其中包括 3.08 美元的收購智慧財產權研發費用。

On slide 8, we quantify the effect of price, rate and volume on revenue growth US revenue increased 45% in Q3, driven by strong volume growth of Zepbound and Mounjaro partially offset by a 15% decline in price. Price was negatively impacted by a favorable one-time adjustment to estimates for rebates and discounts in Q3 2024. Excluding this base period effect, US price declined by high single digits.

在第 8 張投影片中，我們量化了價格、費率和銷售量對營收成長的影響。美國第三季營收成長了 45%，這主要得益於 Zepbound 和 Mounjaro 的強勁銷量成長，但部分被價格下降 15% 所抵消。價格受到 2024 年第三季回扣和折扣預估的一次性有利調整的負面影響。剔除基期效應，美國價格下降了接近兩位數。

In Europe, revenue increased by over 100% in constant currency, reflecting the strong uptake of Mounjaro. Revenue was positively impacted by $380 million onetime benefit related to a milestone payment and business development. Excluding this impact, revenue grew 81% in constant currency. Japan, China and Rest of the World delivered constant currency revenue growth of 24%, 22% and 51%, respectively, driven by Mounjaro volume growth.

在歐洲，以固定匯率計算，營收成長超過 100%，反映出 Mounjaro 的強勁市場需求。3.8億美元的一次性收益（與里程碑付款和業務發展有關）對收入產生了積極影響。剔除此影響，以固定匯率計算，營收成長了 81%。受 Mounjaro 銷售成長的推動，日本、中國和世界其他地區的以固定匯率計算的收入分別成長了 24%、22% 和 51%。

On slide 9, we provide an update on the performance of our key products, which accounted for $12 billion of revenue within the quarter. Beginning with immunology, EBGLYSS delivered strong performance in atopic dermatitis as US total prescriptions increased by 41% compared to Q2 2025. We saw increased use in the first-line setting, which now accounts for more than 50% of new EBGLYSS patients.

在第 9 張投影片中，我們提供了主要產品的最新業績情況，這些產品在本季度創造了 120 億美元的收入。從免疫學領域開始，EBGLYSS 在異位性皮膚炎方面表現出色，與 2025 年第二季相比，美國處方總量增加了 41%。我們看到第一線治療的使用量增加，目前第一線治療患者佔 EBGLYSS 新患者的 50% 以上。

Omvoh continued a steady uptake and the newly published four-year data in ulcerative colitis show long-term safety and efficacy benefits. Within oncology, Jaypirca continued to build momentum both in the marketplace and with new data from Phase 3 trials. Dan will talk more about this later during the R&D update.

Omvoh 的銷量持續穩定成長，新近公佈的四年潰瘍性結腸炎數據顯示，該藥物具有長期安全性和有效性。在腫瘤領域，Jaypirca 在市場上和第 3 期試驗的新數據方面都持續保持著強勁的發展勢頭。Dan 將在稍後的研發進度報告中詳細介紹這一點。

Verzenio remains the market leader in the US for the node-positive, high risk early breast cancer population, reflective of its position as standard of care in this setting. In the US, prescription grew by 3% compared to Q3 2024 and international volume grew by 14%. In neuroscience, Kisunla total prescription grew by 50% compared to Q2 2025 and continue to increase share of market versus the competition. We also recently received marketing authorization by the European Commission, and we are in active reimbursement discussion across Europe and expect launches beginning this quarter and throughout 2026.

Verzenio 仍然是美國淋巴結陽性、高風險早期乳癌患者的市場領導者，這反映了它在該領域作為標準治療的地位。在美國，處方量比 2024 年第三季成長了 3%，國際銷量成長了 14%。在神經科學領域，Kisunla 的總處方量與 2025 年第二季相比成長了 50%，與競爭對手相比，市佔率持續成長。我們最近也獲得了歐盟委員會的上市許可，目前正在積極與歐洲各地進行報銷談判，預計將從本季開始陸續推出產品，並持續到 2026 年。

Finally, moving to cardiometabolic health, Zepbound and Mounjaro both posted a strong global performance. Beginning outside the US Mounjaro performance was robust. We have now launched in 55 countries and all major markets. We have seen a strong reception globally and have gained significant share in most major markets as a result.

最後，在心血管代謝健康領域，Zepbound 和 Mounjaro 都取得了強勁的全球表現。在美國以外地區起步的蒙加羅表現強勁。我們目前已在55個國家和所有主要市場推出產品。我們在全球範圍內獲得了強烈的市場反響，並因此在大多數主要市場獲得了相當大的份額。

While obesity reimbursement remains limited internationally, we are encouraged by the strong uptake. Approximately 75% of Mounjaro revenue outside the US is coming from people with obesity, paying out of pocket, demonstrating a high level of clinical need and high willingness to pay.

儘管國際上對肥胖症的報銷仍然有限，但我們對強勁的報銷勢頭感到鼓舞。Mounjaro 在美國以外的收入約有 75% 來自肥胖人士，他們自費購買，這表明他們有很高的臨床需求和很高的支付意願。

Moving to the US, Zepbound prescription tripled in Q3 2025 compared to the same period last year. While the impact of the CVS template formulary change was disruptive to patients and physicians, the impact on Zepbound performance was modest. Share of total US prescription in the branded anti-obesity market declined by approximately 2 percentage points compared to Q2 2025.

移至美國，2025 年第三季 Zepbound 的處方量比去年同期增加了三倍。雖然 CVS 處方集變更對患者和醫生造成了乾擾，但對 Zepbound 的表現影響不大。與 2025 年第二季相比，美國品牌抗肥胖藥物處方總量的份額下降了約 2 個百分點。

However, performance is back to Q2 levels and Zepbound exited Q3 with 71% share of new prescriptions. We saw strong uptake of Zepbound in vials, which comprise approximately 30% of total US Zepbound prescriptions and over 45% of new prescriptions in Q3.

然而，業績已恢復到第二季水平，Zepbound 在第三季末的新處方市佔率達到 71%。我們看到 Zepbound 的瓶裝產品銷售強勁，約占美國 Zepbound 總處方量的 30%，佔第三季新處方量的 45% 以上。

Mounjaro posted robust Q3 in the US as total prescriptions grew by over 60%. Mounjaro also gained share of market in the type 2 diabetes incretin analog market, increasing by 4 percentage points compared to Q2 2025. Mounjaro is the most widely prescribed incretin for people with type 2 diabetes in the U.S.

Mounjaro 第三季在美國市場表現強勁，處方總量成長超過 60%。與 2025 年第二季相比，Mounjaro 在第 2 型糖尿病腸促胰島素類似物市場也獲得了市場份額，成長了 4 個百分點。在美國，Mounjaro 是治療第 2 型糖尿病最常用的腸促胰島素藥物。

As shown on slide 10, the combined US incretin analog market growth was strong, increasing by 36% in Q3 compared to the same period in 2024. Lilly incretin gained share of market compared to Q2 2025 and approximately two out of every three new prescriptions in the incretin analog market is a Lilly medicine.

如投影片 10 所示，美國腸促胰素類似物市場整體成長強勁，第三季比 2024 年同期成長了 36%。與 2025 年第二季相比，禮來公司的腸促胰素市佔率有所成長，腸促胰素類似物市場中大約每三個新處方中就有兩個是禮來公司的藥物。

On slide 11, we provide an update on capital allocation. Moving to slide 12. We share our updated expectations for Lilly's 2025 financial results. Based on the strong underlying performance and the favorable impact of foreign exchange rates, we are increasing the midpoint of our revenue range by over $2 billion and now anticipate our full year revenue will be between $63 billion and $63.5 billion.

第 11 頁，我們將提供資本配置的最新情況。切換到第12張投影片。我們在此分享我們對禮來公司 2025 年財務表現的最新預期。基於強勁的基本面表現和有利的匯率影響，我們將收入範圍的中點提高了 20 億美元以上，現在預計全年收入將在 630 億美元至 635 億美元之間。

Given our updated expectations for revenue growth and performance margin over the first nine months of the year, we now expect non-GAAP performance margin to be between 45% and 46% of revenue. At the bottom line, we have increased our outlook for non-GAAP earnings per share and expect EPS of $23 to $23.70.

根據我們對今年前九個月營收成長和業績利潤率的最新預期，我們現在預計非GAAP業績利潤率將佔營收的45%至46%。總而言之，我們提高了對非GAAP每股收益的預期，預計每股收益為23至23.70美元。

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，讓他專注於我們在研發方面的進展。

Thanks, Lucas. Lilly R&D had another productive quarter. I'll summarize progress by therapeutic area, beginning with cardiometabolic health. Since our last call, we announced results from four additional positive Phase 3 trials for orforglipron. Of note, one of those trials was attained too, in people with both obesity and type 2 diabetes.

謝謝你，盧卡斯。禮來研發部門又迎來了一個碩果累累的季度。我將按治療領域總結進展，首先從心血管代謝健康開始。自上次通話以來，我們公佈了 orforglipron 的四項額外的積極 3 期試驗結果。值得注意的是，其中一項試驗也在同時患有肥胖症和第 2 型糖尿病的人群中取得了成功。

As a reminder, patients with obesity and type 2 diabetes are less responsive to weight loss on GLP-1 monotherapy than those without type 2 diabetes. For example, in the STEP-2 clinical trial of people with obesity and type 2 diabetes, semaglutide at 2.4 milligrams and 1 milligram resulted in 10.6% weight loss and 7.6% weight loss, respectively.

需要提醒的是，與沒有第 2 型糖尿病的患者相比，患有肥胖症和第 2 型糖尿病的患者對 GLP-1 單藥治療的減重效果反應較差。例如，在 STEP-2 臨床試驗中，肥胖和 2 型糖尿病患者分別使用 2.4 毫克和 1 毫克司美格魯肽，體重分別減輕了 10.6% 和 7.6%。

As shown on slide 13, ATTAIN-2 demonstrated 10.5% weight loss and 7.8% weight loss at the 36-milligram and 24-milligram doses of orforglipron, respectively, aligned with our goal to deliver efficacy similar to injectable GLP-1 monotherapy in an easy-to-use daily pill. This trial completed the clinical package required to initiate global regulatory submissions for the treatment of obesity.

如投影片 13 所示，ATTAIN-2 研究顯示，服用 36 毫克和 24 毫克奧福格列酮後，體重分別減輕了 10.5% 和 7.8%，這與我們以易於使用的每日藥丸形式提供與注射型 GLP-1 單藥療法相似的療效的目標相一致。這項試驗完成了治療肥胖症所需的臨床資料收集工作，為啟動全球監管申報做好了準備。

These submissions are beginning imminently, and we anticipate launching orforglipron in the US for treatment of obesity next year. We also made great progress on orforglipron for type 2 diabetes since the last call, with positive results from ACHIEVE-2 and ACHIEVE-3. Orforglipron demonstrated superior glycemic control and weight loss compared to dapagliflozin and ACHIEVE-2 and compared to oral semaglutide and ACHIEVE-3.

這些申請即將開始，我們預計明年將在美國推出用於治療肥胖症的奧福格列酮。自從上次電話會議以來，我們在治療第 2 型糖尿病的 orforglipron 方面也取得了巨大進展，ACHIEVE-2 和 ACHIEVE-3 都取得了積極的結果。與達格列淨和 ACHIEVE-2 相比，奧福格列酮在血糖控制和體重減輕方面表現出更優異的療效；與口服索馬魯肽和 ACHIEVE-3 相比，奧福格列酮也表現出更優異的療效。

As shown on slide 14, in ACHIEVE-3, both the 12-milligram and 36-milligram doses of orforglipron were superior to the highest available dose of oral semaglutide on both A1c reduction and on weight loss. People taking orforglipron saw an average A1c reduction of 2.2% from baseline and lost nearly 20 pounds on the highest dose of orforglipron. We also announced results from ACHIEVE-5 which demonstrate that orforglipron has the potential to provide benefit as an add-on therapy to titrated insulin glargine.

如投影片 14 所示，在 ACHIEVE-3 研究中，12 毫克和 36 毫克劑量的 orforglipron 在降低 A1c 和減輕體重方面均優於最高可用劑量的口服索馬魯肽。服用奧福格列酮的人平均糖化血紅素A1c比基線降低了2.2%，服用最高劑量奧福格列酮的人平均減重近20磅。我們也發表了 ACHIEVE-5 研究的結果，結果表明，奧福格列酮作為胰島素甘精滴定療法的附加療法，具有潛在的益處。

With four positive Phase 3 diabetes trials now completed, we believe orforglipron has the potential to be a foundational treatment for type 2 diabetes. We now await results from ACHIEVE-4, which will trigger submission of orforglipron for treatment of type 2 diabetes anticipated in the first half of 2026.

目前已完成四項積極的 3 期糖尿病試驗，我們相信 orforglipron 有潛力成為第 2 型糖尿病的基礎治療藥物。我們現在等待 ACHIEVE-4 的結果，這將觸發 orforglipron 用於治療 2 型糖尿病的申請，預計將於 2026 年上半年提交。

With data from over 8,000 participants across six completed Phase 3 orforglipron trials, we've observed benefits across multiple cardiometabolic health measures as well as consistent safety and tolerability. Overall, orforglipron has delivered a profile consistent with our goal of developing an oral and scalable small molecule GLP-1 with efficacy, safety and tolerability comparable to injectable monotherapy GLP-1s for treatment of obesity and type 2 diabetes.

透過對 6 項已完成的 3 期 orforglipron 試驗中 8000 多名參與者的數據，我們觀察到在多種心血管代謝健康指標方面均有益處，並且具有一致的安全性和耐受性。總體而言，orforglipron 展現出的特性與我們開發口服且可規模化生產的小分子 GLP-1 的目標相符，其療效、安全性和耐受性與用於治療肥胖症和 2 型糖尿病的注射用 GLP-1 單藥療法相當。

Outside of the core registrational programs for these two important indications, we have several additional ongoing Phase 3 orforglipron trials shown on slides 15 and 16, including new Phase 3 starts for treatment of osteoarthritis pain and for treatment of stress urinary incontinence, a new indication that we think could benefit from weight loss seen with orforglipron.

除了針對這兩個重要適應症的核心註冊項目外，我們還有幾項正在進行的 orforglipron 3 期試驗，如幻燈片 15 和 16 所示，包括用於治療骨關節炎疼痛和治療壓力性尿失禁的新 3 期試驗，我們認為 orforglipron 的減肥效果可能會使壓力性尿失禁這一新適應症受益。

The next study to read out will be ATTAIN-MAINTAIN, a Phase 3 study of weight loss maintenance. This study is the first of its kind. It's designed to measure the impact of switching from injectable semaglutide or injectable tirzepatide to oral orforglipron. Our goal in this novel trial is to measure what level of weight loss patients can maintain after switching from an injectable incretin to orforglipron.

接下來要發表的研究是 ATTAIN-MAINTAIN，這是一項關於體重減輕維持的 3 期研究。這項研究是同類研究中的首例。它旨在衡量從注射用索馬魯肽或註射以替拉帕肽換用口服奧福格列酮的影響。這項創新試驗的目標是測量患者從注射型腸促胰島素換用奧福格列酮後所能維持的減重水準。

Since the patients in this trial were previously escalated to a maximal tolerated dose of semaglutide or tirzepatide and treated for 72 weeks, this is a very ambitious trial. For those people switching from tirzepatide, maintaining weight loss after switching to orforglipron is a high bar given the strong efficacy of tirzepatide as a dual incretin agonist.

由於該試驗中的患者之前已接受過最大耐受劑量的索馬魯肽或替拉帕肽治療 72 週，因此這是一項非常雄心勃勃的試驗。對於那些從替拉帕肽換成奧福格列酮的人來說，考慮到替拉帕肽作為雙重腸促胰島素激動劑的強大療效，在換用奧福格列酮後保持減肥效果是一個很高的要求。

As this trial includes moving patients off of an active therapy onto a placebo maintenance arm ATTAIN-MAINTAIN allows patients who are randomized to placebo to switch to orforglipron as a rescue therapy if weight regain exceeds a specified threshold. This will be a rich data package, and we look forward to seeing the results in the coming months, either late this year or early next year.

由於該試驗包括將患者從活性治療轉移到安慰劑維持治療組，ATTAIN-MAINTAIN 允許隨機分配到安慰劑組的患者，如果體重反彈超過特定閾值，則轉而使用奧福格列酮作為補救治療。這將是一個內容豐富的資料包，我們期待在未來幾個月內看到結果，可能在今年年底，也可能在明年年初。

Moving to retatrutide, our GIP GLP-1 glucagon triple agonist. We expect results from up to 6 Phase 3 studies by the end of 2026 to support the obesity and related complications program called TRIUMPH and the type 2 diabetes program called TRANSCEND.

接下來是瑞他曲肽，我們的 GIP GLP-1 胰高血糖素三重激動劑。我們預計到 2026 年底將有多達 6 項 3 期研究的結果，以支持名為 TRIUMPH 的肥胖症及相關併發症計畫和名為 TRANSCEND 的第 2 型糖尿病計畫。

With its first-of-a-kind triple acting mechanism, we expect retatrutide can deliver deeper and more rapid weight loss than existing obesity medicines even more than tirzepatide. Of course, not all patients may need this potentially very high level of efficacy. And we believe retatrutide will likely be best suited for patients with a very high BMI or with obesity-related complications that require a high degree of weight loss. While the global development program for retatrutide includes people with a broad range of BMIs, spanning across overweight and obesity, we anticipate we'll be focused on the clinical profile of this medicine in patients where the clinical needs are at the highest.

憑藉其首創的三重作用機制，我們預計 retatrutide 能夠比現有的肥胖藥物帶來更深層、更快速的減肥效果，甚至比 tirzepatide 更有效。當然，並非所有患者都需要這種潛在的極高療效。我們認為，瑞他曲肽可能最適合體重指數非常高或患有肥胖相關併發症需要大幅減重的患者。雖然 retatrutide 的全球開發計劃涵蓋了 BMI 廣泛的人群，包括超重和肥胖人群，但我們預計我們將重點關注該藥物在臨床需求最高的患者群體中的臨床表現。

The first trial to readout TRIUMPH-4 compares retatrutide to placebo in patients with obesity and knee osteoarthritis pain. This 68-week study is designed primarily as a pain relief study to support an indication for treatment of knee osteoarthritis pain in combination with other trials in the TRIUMPH program. We look forward to sharing top line results from TRIUMPH-4 later this year.

首個公佈 TRIUMPH-4 結果的試驗將 retatrutide 與安慰劑在肥胖和膝骨關節炎疼痛患者中的療效進行了比較。這項為期 68 週的研究主要旨在緩解疼痛，以支持其用於治療膝骨關節炎疼痛的適應症，並與 TRIUMPH 計畫中的其他試驗相結合。我們期待在今年稍後與大家分享TRIUMPH-4的最終結果。

Given this is the first Phase 3 trial for retatrutide, we'll be cautious not to over extrapolate from these results. We have 7 more Phase 3 trials reading out in 2026 and 2027 and we'll likely need to see data from at least a few of these before we more fully understand the profile of this medicine across a wide range of patients. For the obesity indication specifically, we look forward to results from three additional Phase 3 studies in the second half of 2026.

鑑於這是 retatrutide 的首個 3 期試驗，我們將謹慎行事，避免過度推斷這些結果。2026 年和 2027 年，我們將公佈 7 項 3 期臨床試驗的結果，我們可能需要至少看到其中幾項試驗的數據，才能更全面地了解這種藥物在廣大患者群體中的表現。就肥胖症這種適應症而言，我們期待在 2026 年下半年獲得另外三項 3 期研究的結果。

Moving now to muvalaplin, which is our once-daily oral small molecule inhibitor of lipoprotein(a) or Lp(a). Lp(a) is a biomarker associated with increased cardiovascular risk. In Phase 2, muvalaplin demonstrated over 85% reduction of this biomarker at the highest dose compared to placebo. Based on these data, we've now initiated a Phase 3 study in people with elevated Lp(a) levels and atherosclerotic cardiovascular disease, known as the MOVE-Lp(a) trial. Muvalaplin is the first small molecule approach to Lp(a) and our second program in Phase 3 development against this important target.

接下來是 muvalaplin，它是我們每日一次口服的小分子脂蛋白(a)或Lp(a)抑制劑。Lp(a) 是一種與心血管風險增加相關的生物標記。在第二階段，與安慰劑相比，最高劑量的 muvalaplin 使該生物標記減少了 85% 以上。基於這些數據，我們現在已經啟動了一項針對 Lp(a) 水平升高和動脈粥樣硬化性心血管疾病患者的 3 期研究，即 MOVE-Lp(a) 試驗。Muvalaplin 是第一個針對 Lp(a) 的小分子療法，也是我們針對此重要標靶的第二個處於 3 期開發階段的項目。

In other updates from cardiometabolic health, we submitted our once-weekly insulin called insulin efsitora alfa in the US for treatment of type 2 diabetes and we announced plans to initiate 2 Phase 3 trials with baricitinib in type 1 diabetes. From the early phase portfolio, we look forward to presenting Phase 2 data from our selective amylin agonist eloralintide at Obesity Week in November.

在心血管代謝健康領域的其他最新進展中，我們已向美國提交了每週一次的胰島素產品－胰島素efsitora alfa，用於治療第二型糖尿病；此外，我們還宣布計劃啟動兩項針對1型糖尿病的baricitinib 3期臨床試驗。我們期待在 11 月的肥胖週上公佈我們早期階段產品組合中選擇性胰淀素激動劑 eloralintide 的 2 期數據。

Moving to oncology. We're very pleased to have received US FDA approval of imlunestrant under the brand name Inluriyo as a monotherapy for ER-positive, HER2-negative, ESR1 mutated metastatic breast cancer. Imlunestrant is also being studied in an ongoing Phase 3 trial called EMBER-4, which compares imlunestrant to the standard of care endocrine therapy in high-risk early breast cancer. This 8,000-patient trial is the largest oncology trial we've ever conducted, and it is on track to be fully enrolled by early 2026. The positive results in the metastatic setting provided an important signal that imlunestrant could have a role in early breast cancer, where we believe an oral SERD could have the largest patient impact.

轉入腫瘤科。我們非常高興地宣布，伊姆魯司特（imlunestrant）以 Inluriyo 為品牌名獲得美國 FDA 批准，可作為 ER 陽性、HER2 陰性、ESR1 突變轉移性乳癌的單藥療法。目前正在進行一項名為 EMBER-4 的 3 期試驗，對 Imlunestrant 進行研究，該試驗將 Imlunestrant 與高風險早期乳癌的標準內分泌療法進行比較。這項納入 8,000 名患者的試驗是我們迄今為止進行的最大規模的腫瘤學試驗，預計將於 2026 年初完成全部入組。在轉移性疾病治療中取得的正面結果，為伊穆那司坦在早期乳癌治療中可能發揮作用提供了一個重要的訊號，我們認為口服SERD藥物在早期乳癌治療中可能對患者產生最大的影響。

Also in oncology, we top lined the study readout from the third positive Phase 3 trial of pirtobrutinib in the BRUIN CLL development program. In BRUIN CLL-313, a trial of pirtobrutinib compared to chemoimmunotherapy in treatment naive CLL/SLL, pirtobrutinib demonstrated a highly statistically significant and clinically meaningful improvement in progression-free survival. Pirtobrutinib demonstrated the most compelling effect size ever observed for a single BTK inhibitor in a treatment-naive CLL study compared to this comparator.

在腫瘤學領域，我們發表了 BRUIN CLL 開發項目中 pirtobrutinib 的第三次陽性 3 期試驗的研究結果。在 BRUIN CLL-313 試驗中，對未經治療的 CLL/SLL 患者進行了 pirtobrutinib 與化療免疫療法的比較，結果顯示 pirtobrutinib 在無進展生存期方面具有高度統計意義和臨床意義的改善。在針對未經治療的 CLL 患者的研究中，與該對照藥物相比，Pirtobrutinib 展現了迄今為止單一 BTK 抑制劑所觀察到的最顯著的療效。

We look forward to sharing these data at an upcoming medical meeting. As we continue to build evidence supporting the potential role for pirtobrutinib in treatment-naive CLL, we expect these data in combination with BRUIN CLL-314 to form the basis of regulatory submissions globally.

我們期待在即將召開的醫學會議上分享這些數據。隨著我們不斷累積證據，支持皮托布替尼在未經治療的 CLL 中的潛在作用，我們預計這些數據與 BRUIN CLL-314 相結合，將成為全球監管申報的基礎。

We also presented updates from our early-stage oncology portfolio at the recent European Society for Medical Oncology meeting, including data on our mutant-selective PI3-kinase alpha inhibitor for people with advanced breast cancer and PI3 kinase alpha mutations, our folate-receptor alpha antibody drug conjugate for treatment of ovarian cancer vepugratinib, our FGFR3 selective inhibitor for FGFR3 altered metastatic bladder cancer. We continue to be encouraged by the emerging clinical profiles we've observed across each of these three programs. And we plan to initiate Phase 3 trials for these medicines in 2026, if not sooner.

在最近的歐洲腫瘤內科學會會議上，我們也介紹了我們早期腫瘤產品組合的最新進展，包括針對晚期乳腺癌和PI3激酶α突變患者的突變選擇性PI3激酶α抑製劑的數據、用於治療卵巢癌的葉酸受體α抗體藥物偶聯物vepugratinib以及用於治療FGFR3改變的轉移性膀胱癌的FGFR3選擇性抑製劑。我們對這三個項目中觀察到的新興臨床特徵感到持續鼓舞。我們計劃在 2026 年啟動這些藥物的 3 期臨床試驗，甚至可能更早。

In Neuroscience, we received the EU marketing authorization for Kisunla. Importantly, this approval came with the modified titration dosing in the label, which is also approved in the US and now approved in Japan. The modified dosing schedule is thus approved in most major geographies and we're pleased that it's being used to further lower the risk of ARIA.

在神經科學領域，我們獲得了Kisunla的歐盟上市許可。重要的是，此次批准附帶了標籤中修改後的滴定劑量方案，該方案在美國也獲得了批准，現在在日本也獲得了批准。因此，改良後的給藥方案已在大多數主要地區獲得批准，我們很高興它被用於進一步降低 ARIA 的風險。

Our Phase 3 trial with remternetug is also progressing well, and we've now completed enrollment in TRAILRUNNER-ALZ 3 which is evaluating subcutaneous remternetug in treatment of preclinical Alzheimer's disease with a similar time-to-event design as we are pursuing with the ongoing TRAILRUNNER 3 ALZ trial for donanemab.

我們的 remternetug 3 期試驗進展順利，目前已完成 TRAILRUNNER-ALZ 3 的入組，該試驗正在評估皮下注射 remternetug 治療臨床前阿茲海默症的效果，其事件發生時間設計與我們正在進行的 donanemab TRAILRUNNER 3 ALZ 試驗類似。

Separately, we're pleased to announce that we've initiated our Phase 3 program in alcohol use disorder with brenipatide, the GIP/GLP-1 dual agonist that we believe could have the optimal properties for neuroscience indications. Growing evidence from real-world clinical studies suggest that incretin therapies may reduce cravings, an observation that is supported by nonclinical studies that show decreased dopamine release in reward pathways after treatment with incretin therapy.

另外，我們很高興地宣布，我們已啟動了針對酒精使用障礙的 3 期臨床試驗項目，試驗藥物為 brenipatide，這是一種 GIP/GLP-1 雙重激動劑，我們認為它可能具有治療神經科學疾病的最佳特性。來自真實世界臨床研究的越來越多的證據表明，腸促胰島素療法可以減少渴望，非臨床研究也支持這一觀察結果，這些研究表明，在接受腸促胰島素療法治療後，獎賞路徑中的多巴胺釋放減少。

Given the data we've observed thus far with brenipatide, we believe it has the potential to treat a range of diseases. We expect to initiate several additional Phase 2 and Phase 3 trials in the coming months, including testing this medicine in important but extremely challenging unmet medical needs, such as opioid use disorder.

根據我們目前觀察到的布雷尼帕肽數據，我們認為它有潛力治療多種疾病。我們預計將在未來幾個月內啟動幾項額外的 2 期和 3 期試驗，包括測試這種藥物在重要但極具挑戰性的未滿足醫療需求（例如阿片類藥物使用障礙）方面的療效。

In addition to neuroscience applications, we will test brenipatide in immunologic disease including a Phase 2 trial in asthma, which has recently begun enrolling patients. Also in immunology, new data were presented for lebrikizumab at the 2025 Fall Clinical Dermatology Conference. Lebrikizumab delivered durable disease control in people with moderate to severe atopic dermatitis, when dosing was reduced from once every 4 weeks to once every 8 weeks, reducing the number of maintenance doses to as few as six doses per year could provide flexibility and reduce the treatment burden on patients.

除了神經科學應用外，我們還將測試 brenipatide 在免疫疾病中的應用，包括最近開始招募患者的氣喘 2 期試驗。在免疫學領域，2025 年秋季臨床皮膚病學會議上公佈了 lebrikizumab 的新數據。Lebrikizumab 在中度至重度異位性皮膚炎患者中實現了持久的疾病控制，當給藥頻率從每 4 週一次減少到每 8 週一次時，維持劑量減少到每年 6 次，可以提供靈活性並減輕患者的治療負擔。

We've now submitted these data to the FDA for a potential label update and continue to explore opportunities for even less frequent dosing of this medicine for people with atopic dermatitis. While we continue to pursue innovative modalities across several immunological disorders, we're also developing combination therapies with the potential to deliver differentiated efficacy.

我們已將這些數據提交給 FDA，以進行潛在的標籤更新，並繼續探索減少異位性皮膚炎患者服用此藥頻率的機會。在持續探索多種免疫疾病的創新療法的同時，我們也正在開發具有差異化療效潛力的聯合療法。

We recently began two new studies combining mirikizumab with tirzepatide in people with ulcerative colitis and people with Crohn's disease. These two new studies complement the previously initiated TOGETHER studies of ixekizumab plus tirzepatide in people with psoriasis and psoriatic arthritis. We expect the first data from the TOGETHER trials to read out in the next six months.

我們最近開始了兩項新的研究，將mirikizumab與tirzepatide聯合用於治療潰瘍性結腸炎患者和克隆氏症患者。這兩項新研究是對先前啟動的 ixekizumab 加 tirzepatide 治療乾癬和乾癬關節炎患者的 TOGETHER 研究的補充。我們預計 TOGETHER 試驗的首批數據將在未來六個月內公佈。

Slide 16 shows additional milestones and updates to our clinical portfolio. It has been a very productive period since our last earnings call, and we still have an ambitious R&D agenda for the last two months of 2025. Slide 17 shows the remaining list of potential key events expected yet this year.

第 16 張投影片展示了我們臨床產品組合的其他里程碑和更新。自上次財報電話會議以來，我們取得了非常豐碩的成果，並且在 2025 年最後兩個月仍然制定了雄心勃勃的研發計劃。第 17 張幻燈片顯示了今年預計發生的其餘潛在重大事件清單。

I'll now turn the call back to Dave for some closing remarks.

現在我將把電話轉回給戴夫，請他做些總結發言。

Thanks a lot, Dan. A lot to talk about there in the pipeline. We're pleased with all the progress in 2025, and we've had another quarter of really strong execution both in driving the business results and making investments that will help us discover and develop new Lilly medicines to help more people around the world.

非常感謝，丹。有很多項目正在籌備中，值得一提。我們對 2025 年取得的所有進展感到滿意，並且在過去一個季度中，我們在推動業務成果和進行投資方面都取得了非常強勁的執行力，這將有助於我們發現和開發禮來的新藥，以幫助世界各地更多的人。

Now I'll turn the call over to Mike, who will moderate our Q&A session. Mike?

現在我將把電話交給麥克，他將主持我們的問答環節。麥克風？

Yes. Thanks, Dave. We'd like to take questions from as many callers as possible. So consistent with prior quarters, we will respond to 1 question per caller and end the call probably by 11. If you have more than 1 question, you can enter the queue, and we will get to you as time allows. Paul, please provide instructions for the Q&A and then we're ready for the first caller.

是的。謝謝你，戴夫。我們希望盡可能接受來電者的提問。因此，與前幾季一樣，我們將回答每位來電者提出的問題，並可能在 11 點結束通話。如果您有多個問題，可以進入隊列，我們會盡快回覆您。保羅，請提供問答環節的說明，然後我們就可以迎接第一位來電者了。

(Operator Instructions) Terence Flynn, Morgan Stanley.

（操作說明）特倫斯·弗林，摩根士丹利。

Hi, thanks so much for taking the question. I really appreciate it and congrats on the quarter. A lot of focus obviously on orforglipron and path to market. I was surprised that it wasn't on the first list of the Commissioner's National Priority Review Voucher program. And so maybe you could just comment on kind of if you guys are seeking that voucher?

您好，非常感謝您回答這個問題。非常感謝，也恭喜你本季取得佳績。顯然，許多關注點都集中在奧福格列酮及其上市路徑上。令我驚訝的是，它竟然不在專員國家優先審查券計畫的第一批名單上。所以，你們能不能簡單說一下，你們是否在尋求那張優惠券？

And then if not, why not? And then how to think about time lines for launch and some of the puts and takes as we think about maybe consensus expectations for 2026. Thank you.

如果不行，為什麼不行？然後，我們需要考慮發佈時間表，以及在考慮 2026 年的共識預期時，需要考慮的一些利弊。謝謝。

All right. Great. Thanks for the question, Terence. We'll go to Dave to talk a bit about orforglipron.

好的。偉大的。謝謝你的提問，特倫斯。我們將請Dave談談orforglipron。

Yeah, hi, Thanks, Terence, for the call. I think as we've said before, we're interested in getting orforglipron to as many patients around the world as fast as we can, including those in the US. So without commenting on specific vehicles, I think investors can expect us to be pursuing in all of the above strategy to get the medicine out more quickly.

嗨，謝謝你，特倫斯，打電話過來。我認為正如我們之前所說，我們希望盡快讓世界各地的患者，包括美國的患者，都能使用奧福格列酮。因此，在不評論具體工具的情況下，我認為投資者可以預期我們將採取上述所有策略，以更快地將藥物推向市場。

Also, I'd point out that if you look at this new voucher program, I think orforglipron checks, at least three or four of the boxes laid out. So yes, we'll see. It's obviously government decision about which pathway they choose and the review time itself. But we're focused on speed here and we're ready to launch. So the package will go in, in the quarter, and we hope to get approval as soon as we can after that.

另外，我想指出的是，如果你看一下這個新的代金券計劃，我認為 orforglipron 至少符合其中三到四項要求。所以，我們拭目以待。很顯然，選擇哪一條路徑以及審查時間是由政府決定的。但我們目前關注的是速度，我們已經準備好發布了。所以，我們會在本季提交申請，並希望之後能盡快獲得批准。

Great. Thank you, Dave, we'll wait for the next question, Paul.

偉大的。謝謝你，戴夫，我們等你下一個問題，保羅。

Chris Schott, JP Morgan.

克里斯‧肖特，摩根大通。

Great, thank you so much for the question. I just wanted to touch base a bit more on the Mounjaro international ramp. It's obviously had a pretty impressive step up in sales these past two quarters. Can you just elaborate a little bit more on how some of these new country launches are trending relative to your expectations?

太好了，非常感謝你的提問。我只是想再多談談蒙加羅國際坡道的情況。顯然，該產品在過去兩個季度的銷售額取得了相當顯著的成長。您能否再詳細說明一下，這些新國家的上線情況與您的預期相比如何？

How to think about growth off of this new higher base? And is just there any meaningful stocking as we appreciate kind of look at these numbers? Just a little bit more color on what's been driving this big step-up. Thank you.

如何在這個更高的新基礎上考慮成長？那麼，從這些數字來看，是否有任何有意義的囤貨策略呢？再詳細說說促成這巨大飛躍的因素。謝謝。

Thanks, Chris. Thanks for the question. On Lilly International, we'll go to Patrik for that to talk a bit about Mounjaro uptake, new country launches, growth.

謝謝你，克里斯。謝謝你的提問。關於禮來國際，我們將請 Patrik 談談 Mounjaro 的市場接受度、新國家的推出以及成長情況。

Thank you very much, Chris. I think we are very encouraged by what we're seeing outside of the US. And the business, as we shared earlier, is 75% out-of-pocket and 25% type 2 diabetes. What we have seen is, of course, an initial stocking in those markets where we launched, and we refer to the big ones being in Q2 being China, Brazil, Mexico and India. Since then, we have seen a lift in the performance also in those markets in Q3 and a continued very strong performance globally.

非常感謝你，克里斯。我認為，我們在美國以外地區看到的情況令人鼓舞。正如我們之前提到的，該業務中 75% 是自費項目，25% 是第 2 型糖尿病項目。當然，我們看到的是在我們推出產品的那些市場中出現了初步的庫存，我們所說的第二季的主要市場是中國、巴西、墨西哥和印度。自那以後，我們在第三季這些市場的業績也有所提升，並且在全球範圍內繼續保持強勁的業績。

Looking forward, I think the major opportunity is, number one, in type 2. We have reimbursement currently in eight markets, and we'll continue those efforts across all of the US markets, but that's going to take some time.

展望未來，我認為最大的機會在於第二類領域。目前我們在八個市場實現了報銷，我們將繼續努力，爭取在美國所有市場實現報銷，但這需要一些時間。

Secondly, the big opportunity when it comes to obesity is really about patient activation, and we will lean in on all of those efforts also in 2026. When you look at international, it's important to -- while it's one line in the income statement, we are referring to more than 55 countries and there are different market dynamics, different buying patterns. So as we have seen over the last several quarters, it's not going to be a straight line, but there are significant opportunities outside of the US also moving forward across type 2 and chronic weight management.

其次，在肥胖問題上，真正的機會在於病人的積極參與，我們將在 2026 年繼續加大這方面的投入。從國際角度來看，雖然國際業務在損益表中只是一行，但我們指的是超過 55 個國家，而這些國家的市場動態和購買模式各不相同。正如我們在過去幾季所看到的，這不會是一條直線，但在美國以外，2 型糖尿病和慢性體重管理領域也存在著巨大的發展機會。

Okay, thank you, Patrick. We'll go to the next question, Paul.

好的，謝謝你，派崔克。保羅，我們進入下一個問題。

Seamus Fernandez, Guggenheim.

西莫斯·費爾南德斯，古根漢美術館。

Thanks so much for taking the question. So mine is actually on some of the behaviors that we're seeing in the market around M&A and how the competitors' dynamics are playing out and how you, Dave and Dan see the market evolving from here. You've commented on retatrutide, perhaps segmenting the heavier patient population with greater comorbidities.

非常感謝您回答這個問題。所以我的研究其實是關於我們目前在併購市場中看到的一些行為，以及競爭對手的動態是如何展開的，還有你、Dave 和 Dan 如何看待市場未來的發展趨勢。您曾評論過瑞他曲肽，或許可以針對病情較重、合併症較多的患者群進行細分。

You have orforglipron potentially targeting a maintenance and lower end portion of the market that's massively scalable and you also have tirzepatide kind of blowing the numbers out and potentially cornering the competitor to some degree in other markets.

orforglipron 可能瞄準的是市場中維護和低端部分，具有巨大的可擴展性；而 tirzepatide 的銷量卻非常驚人，並且有可能在其他市場中在某種程度上壓制競爭對手。

Just wanted to get a sense of if that behavior would be concerning to you, if you don't really spend much time thinking about it because you're so focused on your own business or if there are other considerations as you work to further segment the market and take a deeper leadership position? Thanks so much.

我只是想了解一下，這種行為是否會讓你感到擔憂？如果你因為專注於自己的業務而沒有花太多時間考慮這個問題，或者在你努力進一步細分市場並佔據更深層次的領導地位的過程中，是否還有其他需要考慮的因素？非常感謝。

Thanks for the very long and involved question there Seamus. I think we'll go to Dan actually to talk about that.

謝謝你提出的這麼長這麼複雜的問題，西莫斯。我想我們應該去找丹談談這件事。

Yes, sure. Thanks, Seamus for a good question. Of course, Lilly has been focused on the obesity opportunity for quite some time. We have a very strong R&D engine behind it. I think when you look at where the science leads us and sort of every kind of reasonable or logical target to pursue, we have robust programs against those targets. And in nearly every case, I think we have either a best molecule or first molecule or both, actually.

當然可以。謝謝Seamus提出的好問題。當然，禮來公司很早就開始關注肥胖症市場了。我們背後擁有非常強大的研發實力。我認為，當我們審視科學將我們引向何方，以及各種合理或合乎邏輯的目標時，我們已經針對這些目標制定了強有力的計劃。而且幾乎在所有情況下，我認為我們要么擁有最好的分子，要么擁有第一個分子，或者兩者兼而有之。

So I like our portfolio. Clearly, the late-stage clinical molecules that the Street is paying attention to, we like where they are. But behind it, I can assure you there's a robust pipeline that we like. No surprise then that every -- probably just about every other company in this industry looks at that and wants to improve their own position.

我很喜歡我們的投資組合。顯然，華爾街關注的後製臨床分子，我們很看好它們目前的發展狀況。但我可以向你保證，背後有一條我們非常看好的穩健的管道。因此，毫不奇怪，業內幾乎所有其他公司都會關注這一點，並希望改善自身的處境。

So that doesn't surprise us. We watch that and of course pay attention but we haven't seen anything that changes our view about the competitiveness of our portfolio or the lead that we have in this space, which we intend to maintain through robust investments, not just in research and development, but as you've seen today, in multiple Phase 3 trials and new indications.

所以這並不讓我們感到驚訝。我們一直在關注，當然也會留意，但我們還沒有看到任何改變我們對自身產品組合競爭力或我們在該領域領先地位的看法的事情，我們打算通過強有力的投資來保持這一領先地位，不僅在研發方面，而且正如你們今天所看到的，在多個 3 期試驗和新適應症方面也是如此。

Maybe just to add just I think that -- sorry, Mike, maybe just to add, I think that's a great answer. I think for a long time, we've all been saying we're focused on every logical target and pursuing the full extent of what these medicines can do for various conditions. I mean today's call highlights that with some of the new studies Dan highlighted. But it's also important to note, in addition to innovation, you need to execute. This is a highly scaled business and reaching potentially tens or even hundreds of millions of people. And here also, I think Lilly has really done well.

也許我只是想補充一點，我覺得——抱歉，麥克，也許我只是想補充一點，我覺得這是一個很棒的答案。我認為，很長一段時間以來，我們都在說，我們專注於每一個合乎邏輯的目標，並致力於充分發揮這些藥物對各種疾病的作用。我的意思是，今天的電話會議突顯了這一點，丹重點介紹了一些新的研究。但同樣重要的是，除了創新之外，你還需要執行。這是一個規模龐大的業務，潛在受眾可能達到數千萬甚至數億人。而且我覺得莉莉在這方面也做得非常好。

It's a combination of those 2 things that, I think, built the lead we have. And we are very focused on both of them, both innovation Dan talked about, but also executing with manufacturing build-out, in market performance, new ways to reach consumers. Of course, everybody would like to be in our position, but we're focused on defending it and mostly just executing the play we have. So it's a good question. We'll probably see more dynamics and noise from other pharmaceutical manufacturers, that's normal. What we need to do is run the strategy out that we've outlined. Thanks for the question.

我認為正是這兩件事的結合，才使我們取得了目前的領先優勢。我們非常關注這兩方面，既包括丹所提到的創新，也包括生產建設、市場表現以及接觸消費者的新方法。當然，每個人都想處於我們這樣的位置，但我們專注於防守，主要是執行我們所製定的戰術。所以，這確實是個好問題。我們可能會看到其他製藥廠商出現更多動態和波動，這是正常的。我們需要做的就是貫徹執行我們已經制定的策略。謝謝你的提問。

Great, thank you, Dave. Thank you, Dan. Paul, ready for the next question.

太好了，謝謝你，戴夫。謝謝你，丹。保羅，準備好回答下一個問題了。

James Shin, Deutsche Bank.

James Shin，德意志銀行。

Good morning. Thank you for the question. I got one for David. David, you previously mentioned narrowing the gap between list and net pricing. Cigna recently announced drug rebates would be replaced with GPO fees. And it sounds like it's going to lead to greater discounts as well as more employer opt-ins.

早安.謝謝你的提問。我買了一個給大衛。大衛，你之前提到要縮小標價和淨價之間的差距。信諾保險近日宣布，將以集團採購組織（GPO）費用取代藥品回扣。聽起來這將帶來更大的折扣，並吸引更多雇主加入。

So does that suggest greater GTM pressure than what you would normally have with rebates? Does this make clinical profiles more relevant to form like positioning or access? Like what kind of changes should we expect?

這是否意味著市場推廣壓力比通常透過返利方式所面臨的壓力更大？這是否使臨床特徵與體位或通道等形態更相關？我們應該期待哪些類型的變化？

Great. Thanks, James. We'll go to Dave to talk about some of the recent announcements from PBMs on business model.

偉大的。謝謝，詹姆斯。我們將請 Dave 談談藥品福利管理機構最近發布的一些關於商業模式的公告。

Yes. I think you're talking about the Cigna move, and there's also -- I'd also point out, increasing share in large employer market from kind of nontraditional PBMs, I guess we call them -- I applaud this. I think it's a good move for innovators. It's a good move for patients. It's a good move for payers, for the commercial payers and probably smart of Cigna to make this first move to recoup market share or gain market share.

是的。我想你指的是 Cigna 的舉措，另外——我還想指出，非傳統的藥品福利管理機構（我們姑且這麼稱呼它們）在大雇主市場中的份額也在不斷增加——我對此表示讚賞。我認為這對創新者來說是個好舉措。這對患者來說是個好舉措。對於支付方，尤其是商業支付方而言，這是一個不錯的舉措，而對於信諾保險公司來說，率先採取行動以奪回或獲得市場份額，可能也是明智之舉。

I think that everyone wants more transparency and lower out-of-pocket for patients. And this kind of model will produce both of those. And what we want is to make the basis of competition, one of clinical differentiation that doctors and patients both appreciate in a way, the nontransparent rebates and other behind the scenes activities that determine which medicine a patient gets is not in our interest.

我認為每個人都希望提高透明度，並降低患者的自付費用。這種模式會產生這兩種結果。我們希望將競爭的基礎建立在臨床差異化之上，讓醫師和病患都能從中獲得認可。然而，決定患者獲得哪種藥物的不透明回扣和其他幕後活動並不符合我們的利益。

So as an innovator, probably the leading spender on innovation in the sector coming up, we're for this. I think David and his team at Cigna did a good thing here. And we hope others follow and the market in the US can rapidly transition to such a system. I don't think that per se that reads through to some pricing effect.

所以身為創新者，而且可能是未來該領域創新投入最大的企業，我們支持這項措施。我認為大衛和他在信諾保險的團隊做得很好。我們希望其他國家也能效仿，美國市場能夠迅速過渡到這樣的體系。我不認為這本身會對價格產生影響。

What I hope is that more valuable medicines will have that value recognized in pricing and less valuable medicines will have a harder time competing now because you can't just rebate away some number and find formulary position ahead of a better medicine. So we're for this. And again, it's a good move. Hats off to David Cordani and the team. And hopefully, others rapidly follow.

我希望更有價值的藥品能在定價中體現其價值，而價值較低的藥品現在將更難參與競爭，因為你不能僅僅通過降低價格就能在更好的藥品之前獲得處方集排名。所以我們贊成。再次強調，這是個明智之舉。向大衛·科爾達尼和他的團隊致敬。希望其他國家也能迅速效法。

Great. Thanks, Dave. Next question please, Paul.

偉大的。謝謝你，戴夫。保羅，請問下一個問題。

Geoff Meacham, Citi.

傑夫‧米查姆，花旗銀行。

Morning, guys. Thanks so much for the question. Just had another one on orforglipron. When you guys think about commercial strategy, would you characterize it as more consumer-centric through LillyDirect? Or should we think about it as a more typical pharma launch with PBM and payer negotiations being really critical on day 1. And I guess the puts and takes of both of those. Thank you.

早上好，各位。非常感謝你的提問。服用奧福格列酮後又出現了一次。你們在考慮商業策略時，是否會將其描述為透過 LillyDirect 實現的以消費者為中心的策略？或者我們應該把它看作是一個更典型的藥品上市過程，其中藥品福利管理機構 (PBM) 和支付方的談判在第一天就至關重要。我想，這就是這兩者之間的賽局吧。謝謝。

Okay. Great. Thanks for the question, Geoff. Orforglipron kind of a US bench. So we'll go to Ilya to talk about some of the orfor launch thinking.

好的。偉大的。謝謝你的提問，傑夫。Orforglipron 有點像美國板凳。所以接下來我們將和伊利亞談談orfor的一些發布思路。

Sure, Geoff. Thanks for the question. Obviously, we're excited about the profile of Orforglipron and how to commercialize it in the US and outside the US as well. Obviously, we think about this similarly to how we've viewed Zepbound, where we need to drive great commercial and overall access for patients for accessibility, but we also recognize that there is significant demand in the consumer segment related to finding ways to get outside some of the frictions in the health care system.

當然可以，傑夫。謝謝你的提問。顯然，我們對 Orforglipron 的前景以及如何在美國和美國以外地區實現其商業化感到興奮。顯然，我們看待這件事的方式與我們看待 Zepbound 的方式類似，我們需要推動良好的商業發展，並為患者提供更好的整體可及性，但我們也意​​識到，消費者群體對尋找擺脫醫療保健系統某些摩擦的方法有著巨大的需求。

And so we see both looking at broad coverage as well as looking at expanding how we do our direct-to-consumer platform and ensuring that every patient has the ability to access medicines across the portfolio.

因此，我們既要著眼於廣泛的覆蓋範圍，也要著眼於擴大我們的直接面向消費者的平台，並確保每位患者都能獲得我們產品組合中的所有藥品。

Great, thanks. Next question please, Paul.

太好了，謝謝。保羅，請問下一個問題。

Steve Scala, TD Cowen.

史蒂夫·斯卡拉，TD Cowen。

Thank you so much. I know it's Lilly's policy not to comment on interims, but it's also a bit unusual for Lilly to speak about them in some detail. And Lilly has spoken in some detail about the TRAILBLAZER-ALZ 3 interim on both the Q1 '25 and Q4 '24 calls in likely other forms as well.

太感謝了。我知道禮來公司的政策是不評論中期業績，但禮來公司詳細談論這些業績也有些不尋常。莉莉在 2025 年第一季和 2024 年第四季的電話會議上，以及可能以其他形式，詳細談到了 TRAILBLAZER-ALZ 3 的中期情況。

So with that said, has the TRAILBLAZER-ALZ 3 interim already been taken? The initiation of remternetug in the same setting would not seem the best sign for donanemab in Alzheimer's prevention.

那麼，TRAILBLAZER-ALZ 3 中期試驗已經進行了嗎？在同一環境下啟動 remternetug 似乎不是 donanemab 在預防阿茲海默症方面的最佳跡象。

Thank you.

謝謝。

Great. Well, thanks, Steve, and thanks for the question on Alzheimer's. We'll go to Anne to talk about some of our clinical trials in early Alzheimer's.

偉大的。謝謝你，史蒂夫，也謝謝你提出的關於阿茲海默症的問題。我們將和安妮談談我們在早期阿茲海默症方面的一些臨床試驗。

Great. Well, thanks for the question. Yes, I think we're all looking forward to these results. As you know, we tend not to comment on interims. As we've shared previously, we have completed enrollment in TRAILBLAZER-3.

偉大的。謝謝你的提問。是的，我想我們都很期待這些結果。如您所知，我們通常不會對中期報告發表評論。正如我們之前分享的那樣，我們已經完成了 TRAILBLAZER-3 的招生工作。

So now it just continues to be a matter of reaching the sufficient number of events, and this is an event-based trial. In clinicaltrials.gov, we listed date of 2027, though it could be earlier than that. We are pleased, though, and this is what I think we commented on to see momentum and awareness in the space. I think that was really evidenced by the enthusiastic enrollment in our remternetug preclinical study as well.

所以現在的問題仍然是達到足夠的事件數量，這是一項基於事件的試驗。在 clinicaltrials.gov 網站上，我們列出的日期是 2027 年，但實際日期可能會更早。不過，我們感到欣慰，我認為我們之所以評論這一點，是為了看到該領域的發展勢頭和認知度。我認為，我們 remternetug 臨床前研究的積極參與也充分證明了這一點。

And as Dan mentioned, what we have the opportunity there is to innovate with a subcu dosing formulation as well as a monthly dosing in a -- and again, in a fixed duration dosing paradigm. So we continue to innovate in the Alzheimer's space, and you'll see us continue to commit to that even as we build on the foundation of a very strong Kisunla performance. There's a couple of things that we're doing right now to make sure that we're ready for this readout, I will mention in preclinical because it does require a few fundamental shifts.

正如丹所提到的那樣，我們有機會創新皮下給藥配方以及每月給藥方案——而且，再次強調，是在固定持續時間的給藥模式下。因此，我們將繼續在阿茲海默症領域進行創新，您會看到，即使我們以 Kisunla 的出色表現為基礎，我們也會繼續致力於此。為了確保我們為這次結果公佈做好準備，我們目前正在做一些事情，我會在臨床前階段提到，因為這確實需要一些根本性的轉變。

It requires awareness and education on the importance of treating in that earlier stage of disease and the need to be proactive really around brain health. And very importantly, it requires a simple and accessible blood test to make the diagnosis in the preclinical space, which is also referred to as Stage 1 and 2. So there's quite a bit to do. So you'll hear us continue to talk about the readiness work that we need to do to get ready for this readout, but more to come in the future.

這需要人們認識到在疾病早期階段進行治療的重要性，並需要積極主動地維護大腦健康。非常重要的一點是，在臨床前階段（也稱為第 1 階段和第 2 階段）進行診斷只需要簡單易行的血液檢測。所以有很多事情要做。所以，你們也會繼續聽到我們談論為準備這次發表會所需做的準備工作，但未來還會有更多相關內容。

Great, thank you, Anne. And next question please, Paul.

太好了，謝謝你，安妮。保羅，請問下一個問題。

Mohit Bansal, Wells Fargo.

莫希特·班薩爾，富國銀行。

Great, thank you very much for taking my question and Congrats on all the progress. I would love to understand or think through your thoughts around evoke trial and GLP, GIPs in general for Alzheimer's disease. How do you think about this space evolving? And could brenipatide the new GLP/GIP be a drug for Alzheimer's given that this has neuro properties?

太好了，非常感謝您回答我的問題，也祝賀您的所有進展。我很想了解或思考您關於誘發試驗和 GLP、GIP 等阿茲海默症相關問題的想法。您認為這個領域未來會如何發展？鑑於布瑞帕肽（一種新型 GLP/GIP 受體激動劑）具有神經特性，它是否有可能成為治療阿茲海默症的藥物？

Great. Thanks, Mohit, for the question about evoke as well as just brenipatide. So we'll go to Dan to take both of those.

偉大的。謝謝 Mohit 提出關於 evoke 以及 brenipatide 的問題。所以我們會去找丹，讓他把這兩樣東西都拿走。

Yes. Thanks, Mohit. Obviously, we follow this space closely. I think we are leaders in Alzheimer's disease and also leaders in incretin therapy. You correctly point out that brenipatide has got some of the attributes that make us excited about it for use for CNS indications that could be inclusive of Alzheimer's disease, although we haven't laid out any plans there yet.

是的。謝謝，莫希特。顯然，我們會密切關注這一領域。我認為我們在阿茲海默症領域處於領先地位，在腸促胰素療法領域也處於領先地位。您正確地指出，brenipatide 具有一些特性，讓我們對其用於治療中樞神經系統疾病（可能包括阿茲海默症）感到興奮，儘管我們還沒有製定任何相關計劃。

We're sort of on the verge of seeing, I believe, evoke data. That will be very informative. I think given our strength in our portfolio, almost regardless of that outcome, we have opportunities to build there and create something that could potentially be more meaningful for patients. So we'll wait, we'll see that, and then you can expect us to talk in more detail about our next steps.

我認為，我們即將看到喚起數據。那將非常有幫助。我認為，鑑於我們產品組合的實力，幾乎無論結果如何，我們都有機會在此基礎上發展壯大，創造出對患者更有意義的東西。所以我們會等等看，之後再詳細討論下一步的計畫。

Thanks, Dan. Next question please, Paul.

謝謝你，丹。保羅，請問下一個問題。

Courtney Breen, AllianceBernstein.

Courtney Breen，AllianceBernstein。

Okay, thank you so much for the question today. I wanted to loop back to orforglipron, which I know has lots of focus on. You seem to be preparing for a very large-scale launch. And by our calculations on the basis of some of the comments you've made, you could have enough doses to support at least 5 million patients for a full year based on the inventory already built.

好的，非常感謝您今天提出的問題。我想再回到奧福格利普隆（orforglipron）這個話題上來，我知道它受到了很多關注。你們似乎正在準備一場大規模的記者會。根據您提出的一些意見，我們計算得出，按照目前已建立的庫存，您擁有的劑量足以支持至少 500 萬名患者使用一整年。

And I think, Dave, you've mentioned kind of this could be the GLP-1 for all. Can you help us understand kind of the potential for expansion to the market with orfo? And should we expect to see a slowdown in getting new starts during the initial period of that orfo launch.

戴夫，我覺得你剛才也提到過，這可能是適用於所有人的 GLP-1。您能否幫助我們了解orfo在市場擴張方面的潛力？我們是否應該預期在orfo啟動初期，新專案的啟動速度會放緩？

Yes. Courtney, it was a little hard to hear, but I think some of the questions was thinking about how to expand the market for orfo in different indications, different opportunities. So we'll go to Ken to talk a bit about some of our ambitions for orforglipron.

是的。Courtney，雖然有點難聽，但我認為其中一些問題是在思考如何擴大orfo在不同適應症、不同機會下的市場。所以接下來我們將和 Ken 談談我們對 orforglipron 的一些期望。

Sure, Courtney. Thanks for the question. Now with 6 Phase 3 studies in hand, I think we really understand the profile of this emerging medicine. It continues to recapitulate the efficacy and safety of injectable GLP-1s. In fact, Dan recapped some of that during the early part of the call, recapping the ATTAIN-2 data, which seemed very consistent with STEP-2 as well as the ACHIEVE-3 data showing superiority versus oral semaglutide.

當然可以，考特尼。謝謝你的提問。現在，我們已經完成了 6 項 3 期研究，我認為我們真正了解了這種新興藥物的特徵。它繼續總結了注射 GLP-1 的療效和安全性。事實上，丹在電話會議的早期部分回顧了其中的一些內容，回顧了 ATTAIN-2 數據，該數據似乎與 STEP-2 非常一致，以及 ACHIEVE-3 數據，顯示其優於口服索馬魯肽。

So we think this is a great profile. You're getting glucose benefits, weight benefits, improvements in blood pressure, lipids, inflammatory markers, all that in a simple once-daily pill with no restrictions on food and water and of course, which we can manufacture and distribute at scale.

所以我們認為這是一個很棒的個人資料。服用這種藥丸，您就能獲得血糖改善、體重改善、血壓、血脂、發炎指標改善等諸多益處，而且每日只需服用一次，無需限制飲食和飲水。當然，我們也可以大規模生產和分銷這種藥丸。

So we tend to think at a different magnitude about the opportunity here than historically what we've done with incretins. In the United States, there's probably 8 million or 8.5 million people on incretins out of maybe 170 million who might benefit. And globally, that's a much bigger number, probably measured in the high hundreds of millions or even billions.

因此，我們對這裡的機會的思考方式與我們過去對腸促胰素的處理方式有所不同。在美國，可能有 1.7 億人會受益於腸促胰素，但其中大約有 800 萬到 850 萬人正在接受腸促胰素治療。而從全球來看，這個數字要大得多，可能高達數億甚至數十億。

So this is now, I think, the generational opportunity to figure out how to get an incretin to a much larger group of people. We can do that to the simplicity of the profile, which is also easier to manufacture and distribute.

所以，我認為，現在正是這一代人有機會弄清楚如何讓更多的人接觸到腸促胰素的時候。我們可以簡化型材，使其更易於製造和分銷。

So really, our plan will be about accomplishing that at an international level, getting it out there as quickly as possible. Of course, we're also developing orforglipron in a lot of other settings beyond obesity and diabetes. Dan recapped some of those new NILEX that we've announced.

所以，我們的計劃實際上是在國際層面上實現這一目標，並儘快將其推廣出去。當然，除了肥胖症和糖尿病之外，我們還在許多其他領域開發奧福格列酮。Dan 回顧了我們宣布的一些新的 NILEX 產品。

And of course, just to recap as well, we see an opportunity not just as a starter incretin here with orforglipron, but also something that could potentially be used for patients to continue the success they've had with a drug like Wegovy or Zepbound. We're assessing that now in the ATTAIN-MAINTAIN study and look forward to sharing those data later this year.

當然，我們也要總結一下，我們認為 orforglipron 不僅是一種起始腸促胰島素藥物，還有潛力幫助患者延續使用 Wegovy 或 Zepbound 等藥物所取得的成功。我們目前正在 ATTAIN-MAINTAIN 研究中對此進行評估，並期待在今年稍後分享這些數據。

Great, thank you, Ken. Paul, we're ready for the next question, please.

太好了，謝謝你，肯。保羅，我們準備好回答下一個問題了。

Asad Haider, Goldman Sachs.

阿薩德·海德爾，高盛集團。

Great, thanks for taking the question and congrats on all the ongoing progress. Just sticking with orforglipron, maybe given it's importance, just a high-level question on pricing and volume dynamics ahead of the launch. So the cash pay channel is where you're continuing to see the most rapid growth in the obesity market. Zepbound vials are now almost 40% of new scripts. And related on ex US price elasticity, you saw a shift in volumes in the UK when Mounjaro prices increase.

太好了，謝謝你回答這個問題，也恭喜你所取得的所有進展。就奧福格列酮而言，鑑於其重要性，我想在上市前就其定價和銷售動態提出一個高層次的問題。因此，現金支付管道仍然是肥胖症市場中成長最快的管道。Zepbound 藥瓶現在幾乎佔新處方藥的 40%。與美國價格彈性相關的是，當蒙加羅價格上漲時，英國的銷售量也發生了變化。

So I guess what are the learnings from this for the orforglipron ramp next year as it relates to the elasticity of demand across different price points? And I guess my question is specifically related to how you're thinking about US versus OUS volume unlocks for orforglipron as launches -- as it launches in a world of potential MFN equilibrium prices?

那麼，對於明年奧福格列酮的增產，我們能從中學到哪些經驗教訓，尤其是在不同價格點的需求彈性方面？我想問的問題具體是關於您如何看待奧福格列酮在美國和美國境外上市時的銷量解鎖情況——尤其是在潛在的最惠國待遇均衡價格環境下上市的情況下？

Thank you.

謝謝。

Okay. Thanks, Asad. I think we'll -- maybe we'll start with Ilya to discuss some of the US dynamics? And then maybe, Patrik, if you want to make a couple of brief comments about some of the OUS learnings from the UK as well.

好的。謝謝你，阿薩德。我想我們──或許我們可以先和伊利亞討論美國的一些動態？然後，派崔克，如果你也想就美國從英國學到的一些經驗發表幾句簡短的評論的話。

Yes. Thank you for that question. Obviously, we have experienced significant growth overall in the total market. So we've seen sequential growth in the covered. Overall the sequential growth is 15%. But we're seeing significant more volume go through a direct-to-consumer platform with LillyDirect, which says a lot about, one, what consumers and patients as well as providers see as the benefit of Zepbound in particular and also the ability to remove some of the friction and the ability to have accessibility to medicine. And so we see this channel as a significant channel now and into the future.

是的。謝謝你的提問。顯然，整個市場都經歷了顯著成長。因此，我們看到覆蓋範圍持續成長。整體而言，環比成長率為 15%。但我們看到，透過 LillyDirect 這樣的直接面向消費者的平台，銷量明顯增加。這充分說明了，一方面，消費者、患者以及醫療服務提供者都認為 Zepbound 特別具有優勢；另一方面，Zepbound 能夠消除一些摩擦，使人們能夠更便捷地獲得藥物。因此，我們認為這個管道現在和將來都是一個重要的管道。

And then as part of that, obviously having more offerings, whether you include being able to pick up your Zepbound vial at a local Walmart, which we announced yesterday or expanding the offering on having another treatment like orforglipron. That's an important element for us to expand the ability for patients to get treated. That is the main goal that we have is to improve overall health outcomes, and we have multiple medicines and different platforms to achieve that.

作為其中的一部分，顯然需要提供更多選擇，例如昨天我們宣布的可以在當地沃爾瑪購買 Zepbound 小瓶，或者擴大選擇範圍，提供像 orforglipron 這樣的其他治療方案。這是我們擴大患者接受治療機會的重要因素。我們的主要目標是改善整體健康狀況，我們擁有多種藥物和不同的平台來實現這一目標。

Patrik?

派崔克？

Maybe just a few additions from an OUS perspective. I think, first and foremost, in the UK with a raise in price that was effective September 1, I think we learned pretty much what we expected to learn. What we did was just to take the UK price at the level of -- raise it to the level of a European price. And even if there were regulations in the UK, we actually saw export of medicines out of UK to other markets. So that has probably stopped with intervention we did put in place.

從美國海外聯盟（OUS）的角度來看，或許可以補充幾點。我認為，首先，在英國，隨著9月1日生效的價格上漲，我們基本上了解到了我們預期會了解到的情況。我們所做的就是將英國的價格水準提高到歐洲的價格水準。即使英國有相關法規，我們實際上也看到藥品從英國出口到其他市場。所以，隨著我們採取的干預措施，這種情況可能已經停止了。

Secondly, we're also learning something about consumer pricing elasticity. So that exists. But most importantly, I think orforglipron will meet a slightly different need of the marketplace. We know that obesity is a heterogeneous disease.

其次，我們也了解到一些關於消費者價格彈性的知識。所以這種東西確實存在。但最重要的是，我認為orforglipron將滿足市場略有不同的需求。我們知道肥胖是一種異質性疾病。

And for people with a BMI below 35 and that might not need a weight loss drug like tirzepatide, we believe there is a significant opportunity in OUS. And also driven by the other features that Ken referred to earlier, the opportunity to scale here and to reach other patient populations and with no need of refrigeration, et cetera. So we see those as being very complementary in the OUS business setting as well.

對於 BMI 低於 35 且可能不需要像替澤帕肽這樣的減肥藥物的人來說，我們認為 OUS 存在著巨大的機會。此外，正如 Ken 前面提到的其他特點，也促成了在這裡擴大規模並接觸其他患者群體的機會，而且無需冷藏等等。因此，我們認為這在海外商業環境中也具有很強的互補性。

Great. Thank you both. Next question please, Paul.

偉大的。謝謝你們兩位。保羅，請問下一個問題。

Tim Anderson, Bank of America.

提姆安德森，美國銀行。

Thank you. I have a question on GLP-1 pricing. So with Novo's sema, we get an IRA negotiated price within the next month. My sense from talking to some industry folks is that, that negotiated price may be more favorable than the investment community is expecting, meaning less degradation to the current net price.

謝謝。我有一個關於GLP-1定價的問題。因此，憑藉 Novo 的 sema，我們可以在下個月獲得 IRA 協商價格。我從與一些業內人士的交談中感覺，協商後的價格可能比投資界預期的更有利，這意味著對當前淨價的損害較小。

And that, of course, would be good for everyone in the space. What is Lilly picking up on this? And whatever that level of discount ends up being, would you agree that it quite likely has a direct impact on pricing of Lilly's own products in 2027? Or do you think sema's negotiated price just won't translate across?

當然，這對太空領域的每個人都有好處。莉莉從中察覺到了什麼？無論最終折扣幅度是多少，您是否同意這很可能會對禮來公司2027年的自有產品定價產生直接影響？還是你認為 SEMA 協商的價格根本無法轉換過來？

Okay. Thanks for the question, Tim. We'll go to Ilya talk a bit about just some of the broad thinking about sema IRA negotiations acknowledging we're not part of the discussion.

好的。謝謝你的提問，提姆。我們將和伊利亞談談關於 SEMA IRA 談判的一些總體想法，並承認我們並不參與討論。

Sure. Thanks, Tim, for the question. Obviously, we're -- we don't know the price is being negotiated at the same time. There are several things that are important to note. One, that it only applies to sema in Part D beginning in 2027. Overall, if you take a look at our volumes, Medicare Part D is a small proportion of our overall volume. Obviously, predominantly in type 2 diabetes since there's lack of coverage in obesity.

當然。謝謝提姆的提問。顯然，我們——我們不知道價格是否正在協商中。有幾點要注意。第一，它僅適用於 2027 年開始的 D 部分中的 sema。整體而言，如果你看一下我們的業務量，你會發現 Medicare Part D 在我們總業務量中所佔比例很小。顯然，主要集中在第 2 型糖尿病患者，因為肥胖症患者的治療覆蓋率不足。

Probably the most important element to include here is that tirzepatide has demonstrated superior efficacy versus sema in head-to-head trials, which is a strong foundation for any value-based discussions that we have with payers, not only in our data, but you see that as well in provider preference as well as patient preference that you see in the market.

這裡最重要的一點是，tirzepatide 在頭對頭試驗中已證明其療效優於 sema，這為我們與支付方進行任何基於價值的討論奠定了堅實的基礎，這不僅體現在我們的數據中，而且也體現在市場上的醫療服務提供者和患者的偏好中。

Great. And then Dave, do you want to add a couple of comments?

偉大的。戴夫，你還有什麼要補充的嗎？

I think he covered it well. Maybe just one thing because we've been talking about orforglipron and its upcoming launch. We think about single-acting GLP-1s as one category and double and triple acting as others.

我覺得他解釋得很好。也許就一件事，因為我們一直在討論奧福格列酮及其即將上市。我們將單效 GLP-1 類藥物視為一類，將雙效藥物和三效藥物視為其他類別。

And probably both weight loss and clinical value will be quite different between these medicines. And of course, we're paying close attention to the sema price. But as Ilya said, it's a Part D-only channel. So let's let it all play out. I think we're in a good position because we have so many options.

而且，這些藥物在減肥效果和臨床價值方面可能都會大不相同。當然，我們密切關注著SEMA價格。但正如伊利亞所說，這是一個只播放D部分內容的頻道。那就讓我們拭目以待吧。我認為我們處境不錯，因為我們有很多選擇。

Great. Thank you both. The next caller.

偉大的。謝謝你們兩位。下一位來電者。

Alex Hammond, Wolfe Research.

Alex Hammond，Wolfe Research。

Thanks for taking the question. Can you walk us through the importance of the upcoming ATTAIN-MAINTAIN trial to orforglipron's commercial opportunity? And is there an outcome that might meaningfully change your view on how quickly orforglipron's launch may scale.

感謝您回答這個問題。您能否為我們介紹一下即將進行的 ATTAIN-MAINTAIN 試驗對 orforglipron 商業化前景的重要性？是否存在某種結果，可能會顯著改變您對奧福格列酮上市規模擴張速度的看法？

Great. Thanks, Alex, for the question on ATTAIN-MAINTAIN, we'll go to Ken.

偉大的。謝謝 Alex 提出關於 ATTAIN-MAINTAIN 的問題，我們請 Ken 回答。

Sure. Thanks for the question, Alex. on ATTAIN-MAINTAIN. This is a really first of its kind study, and we're looking forward to these data later this year. We took advantage of the opportunity to rerandomize patients for the SURMOUNT-5 study who were maximally tolerated on either semaglutide or tirzepatide and randomized them to orforglipron or placebo, and we're going to measure the percentage of the weight that they lost over the course of 72 weeks that they keep off while taking orforglipron.

當然。感謝 Alex 提出的問題，關於 ATTAIN-MAINTAIN。這是一項史無前例的研究，我們期待今年稍後能獲得這些數據。我們利用這個機會，將 SURMOUNT-5 研究中對 semaglutide 或 tirzepatide 耐受性達到最大值的患者重新隨機分組，並將他們隨機分配到 orforglipron 組或安慰劑組，我們將測量他們在服用 orforglipron 期間，在 72 週內減掉百分比的體重中，有多少百分比能夠保持下去。

Of course, this is a first of its kind study. We don't know exactly what the results will be, but we're hopeful that orforglipron will provide a simple once-daily oral option that lets patients keep the majority of their weight off.

當然，這是一項史無前例的研究。我們尚不清楚具體結果會如何，但我們希望奧福格列隆能夠提供一種簡單的每日一次口服方案，讓患者能夠保持大部分體重不反彈。

And so we think this is really an opportunity to expand the market even further for orforglipron. Of course, we have very bullish expectations for it as a first-line starter incretin, but also this is an opportunity to continue to grow that.

因此，我們認為這確實是一個進一步擴大奧福格列酮市場的機會。當然，我們對它作為一線啟動腸促胰素藥物抱有非常樂觀的期望，但這也是繼續發展壯大它的機會。

I don't think -- as we think about orforglipron, we don't think about sort of cannibalization in that way. This is an opportunity to grow the market at a very different rate, and we think the data from ATTAIN-MAINTAIN could be really just an exciting boost and allow us to have some medical information to disseminate to physicians about how they can help patients switch from drugs like Wegovy and Zepbound. But of course, we also know that all weight management drugs are, of course, indicated for maintenance. So these are just data to help HCPs and patients guide between these medicines.

我認為——當我們考慮奧福格列隆時，我們不會想到那種形式的蠶食效應。這是一個以截然不同的速度發展市場的機會，我們認為 ATTAIN-MAINTAIN 的數據確實可以帶來令人興奮的推動作用，並使我們能夠獲得一些醫學信息，以便向醫生傳播，幫助他們幫助患者從 Wegovy 和 Zepbound 等藥物中轉換過來。當然，我們也知道所有減肥藥物都適用於維持效果。所以這些數據只是為了幫助醫護人員和病人在這些藥物之間做選擇。

So excellent, thanks again. Next question please.

太好了，再次感謝。下一個問題。

Umer Raffat, Evercore.

Umer Raffat，Evercore。

Morning, guys. I just wanted to touch up on GLP pricing. And on the one hand, there's a lot of commentary on some of the expectations you've laid out on orforglipron pricing framework. If you could expand on that.

早上好，各位。我只是想簡單介紹一下GLP定價。一方面，對於您在奧福格列酮定價框架中提出的一些預期，有很多評論。如果您能詳細解釋一下就太好了。

But then also, on the other hand, there's a lot of actions and changes at your main competitor over the last few months. And I almost wonder, do you think they will stay a mature player from a pricing front? Or will that no longer be a base case for us? Thank you.

但另一方面，在過去的幾個月裡，你的主要競爭對手也採取了許多行動和進行了不少變化。我甚至有點懷疑，你認為他們在定價方面會保持成熟嗎？或者說，這不再是我們的基本考量了？謝謝。

Great. Thanks, Umer, for the question on GLP-1 pricing. Maybe we'll hear from Lucas to weigh in on those dynamics.

偉大的。謝謝 Umer 提出關於 GLP-1 定價的問題。或許我們會聽到盧卡斯對這些動態發表看法。

Yes. Thank you for the question, Umer. Maybe just thinking about the pricing dynamics when you actually unpack our Q3 performance, you see that actually, our pricing continued to perform as what we expected, right? So I think it's a good data going after the CVS move that we didn't see again, a significant price erosion, but actually was very much in line to what we said early in the year for the full year as well.

是的。謝謝你的提問，烏默。也許當你仔細分析我們第三季的業績時，只要想想定價動態，你就會發現，實際上，我們的定價表現繼續符合我們的預期，對吧？所以我認為，在 CVS 的舉措之後，我們沒有再次看到價格大幅下降，這是一個很好的數據，但實際上與我們年初對全年的預測非常吻合。

So maybe just had a good data point that you can take from that perspective. And thinking more broadly about the competition in the marketplace, again, we always pay close attention on the competition in the marketplace, but also how we differentiate both commercially, but also on the level of the product. And Ilya, Dan, Ken mentioning about the differentiation. And you see that in the marketplace.

所以，或許你可以從這個角度來獲得一些有用的數據點。從更廣泛的角度考慮市場競爭，我們始終密切關注市場競爭，同時也關注我們如何在商業以及產品層面實現差異化。伊利亞、丹、肯都提到了這種差異。這一點在市場上也能看到。

So if you take, for example, a good proxy that for me is LillyDirect we have been priced over the last maybe six months already at that starting point at $349 going to $499 and maintain that price and you see the penetration and the competition is placed at the same level as well. So we don't see materially changing the dynamics that we see from that perspective and as we continue to penetrate the market and mobilize patients to seek more treatment.

例如，以 LillyDirect 為例，在過去的六個月裡，我們的定價一直維持在 349 美元的起始價，然後漲到 499 美元，並保持這個價格，你會發現市場滲透率和競爭對手也處於同一水平。因此，從這個角度來看，我們看不到任何實質的變化，隨著我們繼續滲透市場並動員患者尋求更多治療，這種變化仍然存在。

Great. Thanks, Lucas. Next question please, Paul.

偉大的。謝謝你，盧卡斯。保羅，請問下一個問題。

Akash Tewari, Jefferies.

阿卡什‧特瓦里，傑富瑞集團。

Hey, thanks so much. So at the All-In Summit, Dave, you noted if orfo was priced at $100 a month, there'd be no incentive for new medicines in that category to kind of create the next big thing. A few weeks later in Chicago, you mentioned how Lilly has already made billions of doses for orfo and it could have an impact on human health at a global level.

嘿，非常感謝。所以，戴夫，在全員高峰會上，你指出如果orfo定價為每月100美元，那麼該類別的新藥就沒有動力去創造下一個重大突破。幾週後在芝加哥，你提到禮來公司已經生產了數十億劑orfo，這可能會對全球人類健康產生影響。

Can Lilly achieve both goals of kind of preserving continuous innovation in obesity and having orfo be a drug for hundreds of millions of patients with the parity pricing model between the US and rest of world?

禮來公司能否實現這兩個目標：既保持肥胖症領域的持續創新，又使 Orfo 成為數億患者的藥物，並採用美國與世界其他地區價格一致的定價模式？

Thanks, Akash. We'll go to Dave to address those two comments.

謝謝你，阿卡什。我們將請戴夫回應這兩則評論。

Yes. Thanks, and thanks for tuning into all my podcasts and public event. So I mean, yes, our strategy is to bridge both. We think, as you're pointing out, that flatter pricing between US and other developed countries is important. But there's like three ways that this works.

是的。謝謝，也謝謝大家收聽我的所有播客和參加我的公開活動。所以我的意思是，是的，我們的策略是將兩者結合起來。正如您所指出的，我們認為美國與其他已開發國家之間價格趨於一致非常重要。但這種方法大概有三種途徑。

And I think one important thing here that just to point out on all these pricing questions that is different in this GLP-1 category is the consumer self-pay channel. We haven't really seen that at scale in other categories. And it certainly is a channel here, partly because of under insurance, but partly because the benefits of these medicines manifest so consistently. There really aren't that many nonresponders at all and produce a very desirable short-term effect in addition to enhancing long-term health benefits.

我認為這裡需要指出的一點是，在所有這些定價問題中，GLP-1 類別與其他類別不同的是消費者自費管道。我們還沒有在其他類別中大規模地看到這種情況。這當然是一個管道，部分原因是保險不足，部分原因是這些藥物的益處如此明顯。事實上，無反應者不多，除了增強長期健康益處外，還能產生非常理想的短期效果。

It really is a unique situation. So we have seen price elasticity, as was mentioned, and that it's, on the one hand, in our interest to offer consumers a compelling price where they can afford to self-pay. It's also in our interest to continue to build out indications for chronic disease, as Ken and Dan were outlining earlier. And we are committed to doing both, having a strong consumer offering, but also proving the health benefit. And that should not compete for consumer dollars, but for health care dollars, either government or from private payers.

這確實是一個特殊的情況。如同前面所提到的，我們已經看到了價格彈性，一方面，為消費者提供他們能夠負擔得起的有吸引力的價格符合我們的利益。正如 Ken 和 Dan 之前概述的那樣，繼續完善慢性病適應症也符合我們的利益。我們致力於兩方面都做到最好，既要提供強大的消費者產品，也要證明其對健康的益處。而且，醫療保健資金（無論是政府資金還是私人支付資金）不應該與消費者資金競爭，而應該與政府資金競爭。

So it's a both end, and I do think these can bridge because we have so much evidence coming of long-term benefit, we should compete with other classes of medicines in chronic diseases or even create whole new classes. And at the same time, we'll probably continue to see consumer self-pay demand, whether it be for prevention or there are other needs.

所以這是一個雙向的過程，而且我認為這些可以彌合差距，因為我們有大量證據表明長期療效，我們應該與其他類別的藥物在慢性病領域展開競爭，甚至創造全新的藥物類別。同時，我們可能會繼續看到消費者自費需求，無論是為了預防疾病還是其他需求。

So I think it's entirely possible to do both. And I think Ken mentioned earlier some of the numbers that we are literally just scratching the surface of global treatment here. And there really is a tremendous opportunity to reach tens or even hundreds of millions of more people in the coming years, and that's our goal.

所以我認為兩者兼顧是完全可能的。我認為肯之前提到過一些數據，顯示我們目前對全球治療的了解還只是冰山一角。未來幾年，我們確實有巨大的機會接觸到數千萬甚至數億人，而這正是我們的目標。

Great, thanks, Dave. Paul will try to squeeze in at least one more quick one.

太好了，謝謝你，戴夫。保羅會盡量擠出時間再快速拍一張。

Evan Seigerman, BMO Capital Markets.

Evan Seigerman，BMO資本市場。

Hi guys, thank you so much for taking my question. Dan, you recently commented that you were super excited about your presymptomatic Alzheimer's program. I appreciate that you don't want to comment on an interim look, but could you expand on what drives this view and how it has changed since the initiation of the program?

大家好，非常感謝你們回答我的問題。丹，你最近說過你對你的阿茲海默症前驅期計畫感到非常興奮。我理解您不想對中期情況發表評論，但您能否詳細說明一下這種觀點的驅動因素以及自該專案啟動以來這種觀點發生了哪些變化？

Okay. Great. I double back on the presymptomatic Alzheimer. So we'll go Anne to talk a bit about that.

好的。偉大的。我重新審視了阿茲海默症的早期症狀。那麼，接下來請安妮談談這件事。

Sorry, you take it. Apologies. No, go ahead.

抱歉，你收下了。抱歉。不，繼續吧。

I didn't say super excited on this call. I'm still super excited about the Alzheimer's opportunity here to treat in the preclinical space. The reasons for my excitement go back to the data that we saw actually in TRAILBLAZER-1 and TRAILBLAZER-2.

我在這次通話中並沒有說自己非常興奮。我仍然對在臨床前領域治療阿茲海默症的機會感到非常興奮。我興奮的原因可以追溯到我們在 TRAILBLAZER-1 和 TRAILBLAZER-2 中實際看到的數據。

In both of those trials where we're treating symptomatic patients, we saw the largest treatment effect on patients who were the earliest in their disease course, whether you measure early disease course by symptoms or pathology, et cetera, that's where the drug had the biggest effect.

在這兩項針對有症狀患者的試驗中，我們發現，對於疾病早期階段的患者，治療效果最為顯著。無論你用症狀或病理等來衡量疾病早期階段，藥物在這些階段都發揮了最大的作用。

And in fact, we looked at prevention of progression as an outcome in that trial in those patients, we have really profound results. I actually expect the same in TRAILBLAZER-3 as well as TRAILRUNNER-3, which is the trial with remternetug. So I remain extremely excited. No change here at all to my level of enthusiasm or confidence and success.

事實上，我們在該試驗中將這些患者的病情進展預防作為一項結果指標，我們取得了非常顯著的成果。實際上，我希望 TRAILBLAZER-3 和 TRAILRUNNER-3 也能如此，這是與 remternetug 的嘗試。所以我仍然非常興奮。我的熱情、自信和成功程度絲毫沒有改變。

Great. Thanks. With that, we'll close the Q&A. And Dan -- I go to Dave for you for a couple of closing remarks.

偉大的。謝謝。問答環節到此結束。丹，我請戴夫替你做最後總結發言。

Thanks, Mike, and thanks to everyone who called in today and for the excellent questions from the sell-side community. We appreciate everyone's participation here. And as always, follow up with our excellent IR team if you have questions that didn't get answered today. And have a great rest of your day. Take care.

謝謝麥克，也感謝今天所有來電的人，以及賣方專家們提出的精彩問題。感謝大家的參與。像往常一樣，如果您還有今天沒有得到解答的問題，請聯絡我們優秀的投資人關係團隊。祝您今天餘下的時間過得愉快。小心。

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 December 4 at midnight.

謝謝。女士們、先生們，我們今天的會議到此結束。本次會議將於今天下午 1 點開始提供回放，並持續到 12 月 4 日午夜。

You may access the replay system at any time by dialing (800) 332-6854 and entering the access code 797327. International dialers can call (973) 528-0005. Again, those numbers are (800) 332-6854 and (973) 528-0005 with the access code 797327.

您可以隨時撥打 (800) 332-6854 並輸入存取碼 797327 來存取重播系統。國際撥號者可以撥打 (973) 528-0005。再次說明，這些號碼是 (800) 332-6854 和 (973) 528-0005，接入碼為 797327。

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。