禮來公司 (LLY) 2025 Q4 法說會逐字稿

Ladies and gentlemen, thank you for standing by, and welcome to the Lilly Q4 2025 earnings conference call. (Operator Instructions)

女士們、先生們，感謝你們的耐心等待，歡迎參加禮來公司 2025 年第四季財報電話會議。（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 Q4 2025 earnings call. I'm Mike Czapar, Senior Vice President of Investor Relations.

早安.感謝您參加禮來公司2025年第四季財報電話會議。我是投資者關係高級副總裁麥克·查帕爾。

Joining me on today's call are Dave Ricks, Lilly's Chair and CEO; Lucas Montarce, Chief Financial Officer; Dr. Dan Skovronsky, Chief Scientific and Product Officer; Adrienne Brown, President of Lilly Immunology; Dr. Carole Ho, President of Lilly Neuroscience; Ilya Yuffa, President of Lilly USA and Global Customer Capabilities; Jake Van Naarden, President of Nephrology and Head of Business Development; Patrick Jonsson, President of Lilly International; and Ken Custer, President of Lilly Cardiometabolic Health. We're also joined by Mark Heiman, Susan Hedlund, and Wes Tull of the Investor Relations team.

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；首席科學和產品官丹·斯科夫龍斯基博士；禮來免疫學總裁艾德里安·布朗；禮來神經科學總裁卡羅爾·何博士；禮來美國及全球客戶能力總裁伊利亞·卡斯特來；投資者關係團隊的馬克海曼、蘇珊赫德倫和韋斯圖爾也加入了我們。

During this conference 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.

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。

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. 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.

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。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。

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

在我們進入準備好的發言環節之前，請注意，我們的發言將重點放在我們的非GAAP財務指標。

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

現在，我把電話交給戴夫。

Thank you, Mike. 2025 was a strong year for Lilly. We delivered robust revenue growth, advanced our pipeline, expanded our manufacturing footprint, and helped over 70 million people on the world.

謝謝你，麥克。 2025年對禮來公司來說是業績強勁的一年。我們實現了強勁的營收成長，推進了產品線，擴大了生產規模，並幫助了全球超過 7,000 萬人。

The 2025 full-year revenue grew 45% compared to 2024, driven by our key products. We launched new medicines like Inluriyo, secured new indications for Omvoh and Jaypirca, and entered new markets as we completed the international rollouts of both Mounjaro and Kisunla.

2025 年全年營收比 2024 年成長了 45%，這主要得益於我們的核心產品。我們推出了 Inluriyo 等新藥，為 Omvoh 和 Jaypirca 獲得了新的適應症，並在完成 Mounjaro 和 Kisunla 的國際推廣後進入了新市場。

We generated positive clinical data in more than 25 Phase 3 trials, including registrational trials to support two new incretins, orforglipron and retatrutide. We submitted orforglipron for obesity in the US and in more than 40 countries globally.

我們在超過 25 項 3 期試驗中獲得了積極的臨床數據，其中包括支持兩種新的腸促胰素——奧福格列酮和瑞他曲肽的註冊試驗。我們已向美國和全球 40 多個國家提交了用於治療肥胖症的奧福格列酮上市申請。

We started 14 new Phase 3 programs over the past few months, including eloralintide and brenipatide. And we have one of the largest clinical stage pipelines in our company's history.

在過去的幾個月裡，我們啟動了 14 個新的 3 期項目，其中包括 eloralintide 和 brenipatide。我們擁有公司史上規模最大的臨床階段研發管線之一。

We executed 39 business development transactions across all our therapeutic areas and added multiple clinical stage assets through transactions, including Scorpion, Verve, SiteOne, Adverum and the upcoming acquisition of Ventyx.

我們在所有治療領域完成了 39 項業務發展交易，並透過交易增加了多個臨床階段資產，包括 Scorpion、Verve、SiteOne、Adverum 以及即將收購的 Ventyx。

We continue investing in artificial intelligence to discover and develop new medicines. In addition to our new supercomputer, we recently announced a new collaboration with NVIDIA to open a co-innovation AI lab. This project will combine Lilly's scientific expertise with NVIDIA's leading technology to accelerate drug discovery.

我們將繼續投資人工智慧，以發現和開發新藥。除了我們新購買的超級​​電腦之外，我們最近還宣布與 NVIDIA 展開新的合作，共同開設一個人工智慧創新實驗室。該計畫將結合禮來公司的科學專長和英偉達公司的領先技術，以加速藥物研發。

We progressed our manufacturing expansion efforts and announced plans to build multiple new manufacturing sites in the US and Europe. We increased our manufacturing capacity and began making medicine at our new sites in Wisconsin and North Carolina.

我們推進了生產擴張工作，並宣布計劃在美國和歐洲建造多個新的生產基地。我們提高了生產能力，並在威斯康辛州和北卡羅來納州的新廠址開始生產藥品。

We exceeded our goal to produce 1.8 times the number of incretin doses in the second half of '25 compared to the second half of '24. Since 2020, we've committed over $55 billion, the largest manufacturing build-out in company history.

與 2024 年下半年相比，我們在 2025 年下半年生產的腸促胰島素劑量數量超過了預期目標，達到了 1.8 倍。自 2020 年以來，我們已投入超過 550 億美元，這是該公司歷史上規模最大的製造擴建項目。

We announced an agreement with the US government to provide access to obesity medicines to millions of Americans with insurance through Medicare and Medicaid. We're proud of our ability to bring these important medicines to patients at a cost of only $50 per month out of pocket.

我們宣布與美國政府達成協議，透過聯邦醫療保險和醫療補助計劃，為數百萬有保險的美國人提供肥胖藥物。我們很自豪能夠以每月僅需 50 美元的自付費用，為患者提供這些重要的藥物。

The number of people engaging with our US direct-to-patient platform, Lilly Direct, increased over 1 million patients in 2025. Our most popular offering, Zepbound self-pay vials now makes up on-third of new patient starts who start on any brand of obesity medication.

到 2025 年，使用我們美國直接面向患者的平台 Lilly Direct 的患者人數增加了 100 多萬人。我們最受歡迎的產品 Zepbound 自費小瓶裝產品，目前佔所有開始服用任何品牌減肥藥的新患者的三分之一。

Lastly, we distributed $1.3 billion in dividends and $1.5 billion in share repurchases. We also strengthened our leadership team with the addition of two new executives. And I welcome both Carole Ho and Adrienne Brown to this call for the first time.

最後，我們發放了 13 億美元的股息，並回購了 15 億美元的股票。我們也新增了兩位高階主管，進一步加強了領導團隊。我非常歡迎 Carole Ho 和 Adrienne Brown 首次參加本次電話會議。

Now I'll turn it over to Lucas to review our Q4 results and share details on the 2026 guide.

現在我將把發言權交給盧卡斯，讓他回顧我們第四季的業績，並分享 2026 年發展規劃的詳情。

Thanks, Dave. We delivered robust financial performance in 2025. Our full-year revenue of $65.2 billion increased by 45% compared to 2024, and earnings per share grew by 86% to $24.21.

謝謝你，戴夫。我們在2025年實現了強勁的財務表現。我們全年營收為 652 億美元，比 2024 年成長了 45%，每股盈餘成長了 86%，達到 24.21 美元。

Q4 financial performance was also strong, as shown on slide 7. Revenue grew 43% compared to Q4 2024, driven by our key products. Gross margin as a percentage of revenue was 83.2%, consistent with Q4 2024. Favorable product mix and improved production costs were offset by lower realized prices.

如投影片 7 所示，第四季財務業績也十分強勁。受主要產品推動，營收較 2024 年第四季成長 43%。毛利率佔收入的百分比為 83.2%，與 2024 年第四季一致。有利的產品組合和改善的生產成本被較低的實際售價所抵消。

R&D expenses increased by 26% driven by continued investments in our early and late-stage portfolio. Marketing, selling, and administrative expenses increased 29%, driven by promotional efforts to support our ongoing and future launches.

研發費用增加了 26%，主要得益於我們對早期和後期專案組合的持續投資。行銷、銷售和管理費用成長了 29%，這主要得益於為支持我們正在進行和即將推出的產品而進行的促銷活動。

Our non-GAAP performance margin was 47.2%, an increase of 4.2 percentage points compared to Q4 2024. Our effective tax rate was 19.7%; and earnings per share were $7.54, inclusive of $0.52 of acquired IP R&D charges. This compares to earnings per share of $5.32 in Q4 2024, which included $0.19 of acquired R&D charges.

我們的非GAAP業績利潤率為47.2%，比2024年第四季成長了4.2個百分點。我們的實際稅率為 19.7%；每股收益為 7.54 美元，其中包括 0.52 美元的收購智慧財產權研發費用。相比之下，2024 年第四季每股收益為 5.32 美元，其中包括 0.19 美元的收購研發費用。

On slide 8, we quantify the effect of price, rate and volume on revenue. US revenue increased 43% in Q4, driven by volume growth of Mounjaro and Zepbound, partially offset by a 7% decline in price. Revenue growth was strong outside the US as well, driven by double-digit volume growth in Europe, Japan, and China. In Rest of the World, volume doubled driven by the launch of Mounjaro in new markets.

在第 8 張投影片中，我們量化了價格、費率和銷售量對收入的影響。第四季美國營收成長 43%，主要得益於 Mounjaro 和 Zepbound 的銷量成長，但部分被價格下降 7% 所抵銷。在美國以外，營收成長同樣強勁，這主要得益於歐洲、日本和中國兩位數的銷售成長。在世界其他地區，由於 Mounjaro 在新市場的推出，銷量翻了一番。

On slide 9, we provide an update on the performance of our key products, which contributed over $13 billion to revenue this quarter and grew by 91% compared to Q4 2024.

在第 9 張投影片中，我們提供了主要產品的最新業績，這些產品在本季度貢獻了超過 130 億美元的收入，與 2024 年第四季度相比增長了 91%。

Beginning with neuroscience, Kisunla recently became the US market leader in the amyloid-targeting therapy space, with more than 50% share of total prescriptions. Revenue was $109 million, driven by overall market growth, increased awareness and diagnosis of Alzheimer's disease, as well as increased prescriber adoption based on Kisunla's clinical profile.

從神經科學領域起步，Kisunla 近期已成為美國澱粉樣蛋白標靶治療領域的市場領導者，佔了超過 50% 的處方份額。營收達到 1.09 億美元，這得益於整體市場成長、人們對阿茲海默症的認識和診斷的提高，以及基於 Kisunla 的臨床表現而增加的處方醫生採用率。

In immunology, Ebglyss delivered solid performance in atopic dermatitis where US total prescriptions increased 25% compared to Q3 2025.

在免疫學領域，Ebglyss 在異位性皮膚炎方面表現出色，美國處方總量比 2025 年第三季成長了 25%。

Omvoh continued its uptake, and global revenue increased 55% compared to the fourth quarter in 2024. Jaypirca posted another strong quarter of sales performance, and global sales grew 30% compared to Q4 2024. We recently received an expanded US indication to include people previously treated with a covalent BTK inhibitor, significantly increasing the number of people who can benefit from this medicine.

Omvoh 繼續獲得市場認可，全球收入與 2024 年第四季相比成長了 55%。Jaypirca 又取得了強勁的季度銷售業績，全球銷售額比 2024 年第四季成長了 30%。我們最近獲得了美國擴大適應症的批准，將以前接受過共價 BTK 抑制劑治療的人納入其中，這大大增加了可以從這種藥物中受益的人數。

Verzenio global sales increased 3%, driven by volume growth outside the US. Verzenio remains the market leader in its early breast cancer indication. However, overall market penetration has reached a plateau, as reflected in US trends.

Verzenio全球銷售額成長3%，主要得益於美國以外地區的銷售成長。Verzenio 在早期乳癌適應症領域仍保持市場領先地位。然而，從美國的發展趨勢來看，整體市場滲透率已經達到飽和狀態。

Finally, in cardiometabolic health, Zepbound and Mounjaro both delivered strong results. Outside the US, the positive uptake trends of Mounjaro continued, particularly in our newest launch countries in Latin America and Asia. We have launched in all major markets and are now the increased share of market leader outside the US as well.

最後，在心血管代謝健康方面，Zepbound 和 Mounjaro 都取得了顯著成果。在美國以外，Mounjaro 的積極推廣趨勢仍在繼續，尤其是在我們最新的拉丁美洲和亞洲市場。我們已在所有主要市場推出產品，現在在美國以外的市場也佔據了越來越大的市場份額，成為市場領導者。

Moving to the US, as shown on slide 10 (inaudible) incretin analog market continued its robust growth trajectory with total prescriptions increasing by 33% compared to Q4 2024. As market penetration within the eligible population of people with obesity is only mid-single digits, we believe there is room for market expansion and sustained market growth in the quarters and years to come.

移至美國，如投影片 10 所示（聽不清楚），腸促胰素類似物市場持續保持強勁的成長勢頭，與 2024 年第四季相比，處方總量增加了 33%。由於符合條件的肥胖族群的市場滲透率僅為個位數，我們認為在未來幾季和幾年內，市場仍有擴張和持續成長的空間。

US Zepbound revenue more than doubled compared to Q4 2024. Zepbound continues to be the market leader in the branded obesity market with nearly 70% share of new prescriptions.

與 2024 年第四季相比，美國 Zepbound 的營收翻了一番還多。Zepbound 持續維持品牌減肥藥市場的領先地位，佔據近 70% 的新處方。

US total prescription growth for Zepbound was robust, both in auto injectors and vials. We are encouraged to see sustained growth uptake of Zepbound vials which represented approximately one-third of total Zepbound prescriptions and nearly 50% of new Zepbound prescriptions in Q4.

Zepbound 在美國的處方總量成長強勁，無論是自動注射器或藥瓶。我們很高興看到 Zepbound 小瓶的銷量持續成長，在第四季度，Zepbound 小瓶的銷量約佔 Zepbound 總處方量的三分之一，新 Zepbound 處方量的近 50%。

In the US, Mounjaro expanded market leadership in the type 2 diabetes incretin market, exiting the quarter with over 55% of new prescriptions. On slide 11, we provide an update on capital allocation.

在美國，Mounjaro 擴大了在第 2 型糖尿病腸促胰島素市場的領先地位，本季末新處方量超過 55%。第 11 頁，我們將提供資本配置的最新情況。

Moving to slide 12 and 13. We share our 2026 financial guidance and highlight key factors that will impact our financial outlook.

接下來請看第12和13張投影片。我們分享了 2026 年的財務預期，並重點介紹了將影響我們財務前景的關鍵因素。

We expect revenue to be between $80 billion and $83 billion. The midpoint of our revenue range is an increase of 25% compared to 2025. We expect to deliver industry-leading volume growth driven by our key products, partially offset by lower realized prices.

我們預計營收將在 800 億美元至 830 億美元之間。我們營收預期範圍的中點是比 2025 年成長 25%。我們預計，在主要產品推動下，銷售量將實現領先業界的成長，但部分將被較低的實際售價所抵銷。

Price is expected to be a drag on growth in the low to mid-teens. Three factors will impact US price: the government access agreement for obesity medicines, updated direct-to-patient Zepbound pricing, and lower Medicaid prices for later life cycle medicines.

預計價格將拖累經濟成長，成長速度將維持在十幾到五成左右。三個因素將影響美國的價格：政府對肥胖症藥物的准入協議、更新的直接面向患者的 Zepbound 定價以及針對晚期生命週期藥物的 Medicaid 價格降低。

Pricing outside the US will be impacted by Mounjaro's inclusion on China national reimbursement drug list for type 2 diabetes. We believe these price concessions will be more than offset by increased volume over time as we expand the number of people who can benefit from Lilly medicines.

蒙加羅被納入中國第2型糖尿病國家健保藥品目錄，這將影響美國以外地區的定價。我們相信，隨著受益於禮來藥品的人數不斷增加，這些價格讓步帶來的損失將隨著時間的推移而被銷售的成長所抵消。

As I shared earlier, we continue to see robust growth trends in the US incretin analog's markets, and we expect a similar trajectory to continue in 2026. As seen with other new launches, we expect the launch of oral GLP-1s to expand the addressable market.

正如我之前分享的那樣，我們繼續看到美國腸促胰素類似物市場強勁的成長趨勢，我們預計類似的成長軌跡將在 2026 年繼續保持。正如其他新產品上市所顯示的那樣，我們預計口服 GLP-1 的上市將擴大目標市場。

We expect our orforglipron to launch for chronic weight management in the US during the second quarter of 2026 and to launch in most international markets during 2027. We anticipate the new Medicare access to obesity medicines will become effective no later than July 1, 2026. While we anticipate a reduction in Medicaid access in 2026, due to key states like California removing obesity coverage, we expect new states will add coverage for people with Medicaid in 2027.

我們預計 orforglipron 將於 2026 年第二季在美國上市，用於慢性體重管理，並於 2027 年在大多數國際市場上市。我們預期新的醫療保險取得肥胖症藥物的途徑最遲將於 2026 年 7 月 1 日生效。雖然我們預計 2026 年 Medicaid 的覆蓋範圍會因加州等主要州取消肥胖症保險而縮小，但我們預計 2027 年會有新的州增加對 Medicaid 受益人的保險覆蓋範圍。

Within revenue, we anticipate Ebglyss, Jaypirca, Inluriyo, Kisunla, and Omvoh will all contribute to growth, where life cycle products like Trulicity, Taltz, and Verzenio are expected to be flat or decline. We expect our non-GAAP performance margin to be between 46% and 47.5%.

在收入方面，我們預計 Ebglyss、Jaypirca、Inluriyo、Kisunla 和 Omvoh 都將為成長做出貢獻，而 Trulicity、Taltz 和 Verzenio 等生命週期產品預計將保持平穩或下降。我們預計非GAAP業績利潤率將在46%至47.5%之間。

Across the P&L, there are pushes and pulls that we anticipate will impact our performance margin expectations. We expect gross margin will be relatively stable to slightly down compared to Q4 2025. We as favorable product mix and increased productivity are offset by price and new facilities coming online.

在損益表方面，我們預期各種推拉因素將影響我們的業績利潤率預期。我們預計毛利率將相對穩定或略低於 2025 年第四季。有利的產品組合和生產效率的提高被價格上漲和新設施投入使用所抵消。

Consistent with our strategy to invest in innovation, we expect R&D expenses will scale up in 2026. We have 36 active Phase 3 programs in our pipeline and plan to initiate even more new programs in 2026. With one of the largest clinical stage pipelines in company history, we are investing to maximize the impact of this potential new medicines.

與我們投資創新的策略一致，我們預計 2026 年研發支出將會增加。我們目前有 36 個正在進行的 3 期臨床試驗項目，並計劃在 2026 年啟動更多新項目。我們擁有公司歷史上規模最大的臨床階段研發管線之一，我們正在加強投資，以最大限度地發揮這些潛在新藥的影響。

Marketing, selling, and administrative expenses are expected to grow as we invest to support new launches across therapeutic areas. As we launch new medicines, we will fully invest in variable expenses while controlling fixed costs by leveraging our existing commercial footprint. We expect earnings per share of between $33.50 and $35, setting us up for another year of strong top line and bottom line growth.

隨著我們加大投資以支持各個治療領域的新產品上市，行銷、銷售和管理費用預計將會成長。隨著新藥的推出，我們將全力投入變動費用，同時利用我們現有的商業佈局來控制固定成本。我們預計每股收益將在 33.50 美元至 35 美元之間，這將使我們迎來另一個營收和利潤強勁增長的年份。

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. Since our last earnings call, we've made significant progress in R&D. I'll share updates by therapeutic area, including select data highlights from recent Phase 3 announcements, a final update on the 2025 key events, and the potential 2026 outcomes on which we are now focused.

謝謝你，盧卡斯。自上次財報電話會議以來，我們在研發方面取得了重大進展。我將按治療領域分享最新進展，包括近期 3 期臨床試驗結果的精選數據亮點、2025 年關鍵事件的最終更新，以及我們目前關注的 2026 年潛在成果。

Beginning with immunology. Just a few weeks ago, we released top line data from TOGETHER-PsA, a randomized controlled Phase 3b trial evaluating ixekizumab plus tirzepatide, as compared to ixekizumab alone, in people with psoriatic arthritis and obesity. This first-of-its-kind study assessed whether a concomitant treatment with an incretin would deliver additional efficacy when added to an existing immunology treatment.

從免疫學開始。就在幾週前，我們發布了 TOGETHER-PsA 的初步數據，這是一項隨機對照 3b 期試驗，評估了 ixekizumab 加 tirzepatide 與單獨使用 ixekizumab 治療銀屑病關節炎和肥胖患者的療效。這項開創性的研究評估了在現有免疫療法的基礎上，同時使用腸促胰素治療是否能帶來額外的療效。

As shown on slide 14, the combination not only achieved its primary endpoint, at least 50% reduction in psoriatic arthritis activity plus 10% weight reduction, but also showed a 64% relative increase in the proportion of patients achieving a 50% reduction in the psoriatic arthritis symptoms compared to ixekizumab alone.

如幻燈片 14 所示，此聯合療法不僅達到了其主要終點，即銀屑病關節炎活動度至少降低 50% 且體重減輕 10%，而且與單獨使用 ixekizumab 相比，達到銀屑病關節炎症狀降低 50% 的患者比例也相對增加了 64%。

The important finding from this study was the potential effect of tirzepatide when added to ixekizumab on psoriatic arthritis symptoms via both weight-dependent and also weight-independent mechanisms. These results further support existing treatment guidelines for psoriatic arthritis that recommend treatment of comorbid obesity.

這項研究的重要發現是，當 tirzepatide 添加到 ixekizumab 中時，可透過與體重相關的機制和與體重無關的機制對乾癬性關節炎症狀產生潛在影響。這些結果進一步支持了現有的乾癬性關節炎治療指南，該指南建議治療合併肥胖症。

We shed further light on how incretins may have a positive effect on other diseases independent from weight loss. We look forward to publishing these data in more detail in our peer-reviewed journal and presenting them at an upcoming medical meeting.

我們進一步闡明了腸促胰島素如何對其他疾病產生正面影響，而與減重無關。我們期待在同行評審期刊上更詳細地發表這些數據，並在即將舉行的醫學會議上進行展示。

With this important result in hand, we are encouraged about our ongoing trial studying ixekizumab and tirzepatide in psoriasis in two separate studies of (inaudible) disease and ulcerative colitis. We also advanced our new GIP/GLP-1 agonist, tirzepatide, into a Phase 2 study of asthma, another serious immunologic disease that we think may benefit from dual GIP/GLP-1 therapy.

有了這一重要結果，我們對正在進行的試驗感到鼓舞，該試驗在兩項獨立的研究中分別研究了 ixekizumab 和 tirzepatide 對銀屑病和潰瘍性結腸炎的療效。我們也推進了新型 GIP/GLP-1 激動劑 tirzepatide 的 2 期氣喘研究，氣喘是另一種嚴重的免疫疾病，我們認為它可能受益於雙重 GIP/GLP-1 療法。

Moving to oncology. The FDA granted full approval for pirtobrutinib, including the expanded indication for treatment of adults with relapsed or refractory CLL/SLL who have previously been treated with a covalent BTK inhibitor. This label update significantly increases the number of eligible patients and allows physicians to extend the use of BTK inhibitors to control disease longer.

轉入腫瘤科。FDA 已完全批准 pirtobrutinib，包括擴大適應症，用於治療先前接受共價 BTK 抑制劑治療的複發性或難治性 CLL/SLL 成年患者。此標籤更新顯著增加了符合條件的患者數量，並允許醫生延長 BTK 抑制劑的使用時間，以控制病情更長時間。

We also share detailed data from two Phase 3 pirtobrutinib trials, BRUIN CLL-313 and BRUIN CLL-314. As shown on the left side of slide 15, in BRUIN CLL-313, pirtobrutinib improved progression-free survival, reducing the risk of progression or death by 80% versus bendamustine plus rituximab in treatment-naive CLL/SLL patients. This risk reduction is among the most compelling ever observed for single-agent BTK inhibitor in a frontline CLL study.

我們也分享了兩項 3 期 pirtobrutinib 試驗的詳細數據，即 BRUIN CLL-313 和 BRUIN CLL-314。如投影片 15 左側所示，在 BRUIN CLL-313 中，吡布替尼改善了無惡化存活期，與苯達莫司汀加利妥昔單抗相比，在未經治療的 CLL/SLL 患者中，將進展或死亡風險降低了 80%。這種風險降低是迄今為止在 CLL 一線治療中，單藥 BTK 抑制劑觀察到的最顯著的風險降低之一。

In the second study, shown on the right side of slide 15, BRUIN CLL-314, pirtobrutinib was compared to a covalent BTK inhibitor, ibrutinib, in treatment-naive or BTK-inhibitor-naive patients. The study met the primary endpoint of noninferiority of overall response rate. And while progression-free survival data were immature, they trended in favor of pirtobrutinib.

在幻燈片 15 右側所示的第二項研究 BRUIN CLL-314 中，對未接受過治療或 BTK 抑制劑治療的患者，比較了 pirtobrutinib 與共價 BTK 抑制劑 ibrutinib 的療效。該研究達到了整體應答率不劣於對照組的主要終點。雖然無惡化存活期數據尚不成熟，但趨勢顯示吡托布替尼療效較佳。

Notably, in the early analysis of the treatment-naive subpopulation, as shown here, pirtobrutinib reduced the risk of progression or death by 76% compared ibrutinib. Both data sets were presented at the American Society of Hematology Annual Meeting and were simultaneously published in the Journal of Clinical Oncology. We submitted these results to regulatory authorities to potentially enable the use of pirtobrutinib in earlier lines of therapy.

值得注意的是，如這裡所示，在對未經治療的亞人群的早期分析中，與伊布替尼相比，吡托布替尼使疾病進展或死亡的風險降低了 76%。這兩個資料集均在美國血液學會年會上發表，並同時發表在《臨床腫瘤學雜誌》。我們已將這些結果提交給監管機構，以期使吡托布替尼能夠在更早的治療方案中使用。

Later this year, we expect results from an additional Phase 3 pirtobrutinib trial, BRUIN CLL-322. This trial evaluates pirtobrutinib in addition to a fixed-duration regimen of venetoclax and rituximab in previously treated CLL/SLL patients. If successful, this could form the basis for an additional regulatory submission later this year.

今年晚些時候，我們預計將獲得另一項 3 期 pirtobrutinib 試驗 BRUIN CLL-322 的結果。該試驗評估了在先前接受過治療的 CLL/SLL 患者中，除了維奈托克和利妥昔單抗的固定療程方案外，加上吡托布魯替尼的療效。如果成功，這可能成為今年稍後提交另一份監管文件的基礎。

We also presented updated combination data of imlunestrant with abemaciclib in metastatic breast cancer, which showed additional benefit compared to imlunestrant alone. We submitted these data to regulators and are seeking to expand the imlunestrant.

我們也展示了 imlunestrant 與 abemaciclib 合併治療轉移性乳癌的最新數據，結果顯示與單獨使用 imlunestrant 相比，合併治療具有額外的益處。我們已將這些數據提交給監管機構，並正在尋求擴大調查範圍。

While we're encouraged by these new data for patients with metastatic breast cancer, we're even more excited about the opportunity for imlunestrant in adjuvant breast cancer where ongoing 8,000-patient adjuvant breast cancer trial, EMBER-4, is fully enrolled and it will be the next Phase 3 readout of an oral SERD for patients with early breast cancer.

雖然我們對轉移性乳癌患者的這些新數據感到鼓舞，但我們更興奮的是imlunestrant在輔助乳癌治療中的機會，目前正在進行的8000名患者的輔助乳癌試驗EMBER-4已全部入組，這將是口服SERD治療早期乳癌患者的下一個3期結果。

In other oncology updates, we advanced sofetabart mipitecan, our next-generation antibody-drug conjugate targeting folate receptor alpha, into Phase 3 testing for women with platinum-resistant ovarian cancer. We believe this program has the potential to benefit a broad population of patients with ovarian cancer regardless of folate receptor alpha expression level. It may also offer improved tolerability compared to currently available antibody drug conjugates.

在其他腫瘤學進展方面，我們推進了針對鉑抗藥性卵巢癌女性的下一代抗體藥物偶聯物 sofetabart mipitecan 進入 3 期試驗。我們相信，無論葉酸受體α表現量如何，此方案都有可能使廣大卵巢癌患者受益。與目前可用的抗體藥物偶聯物相比，它也可能具有更好的耐受性。

We plan to initiate a study in platinum-sensitive ovarian cancer later this year. We're excited that this medicine received Breakthrough Therapy Designation from FDA earlier this year.

我們計劃於今年稍後啟動一項針對鉑金敏感卵巢癌的研究。我們很高興這種藥物在今年稍早獲得了FDA的突破性療法認定。

We also expect to initiate new Phase 3 programs for two other oncology small molecules. The first is tersolisimib (sic - tersolisib), our mutant-selective PI3-kinase alpha inhibitor. We believe this program could represent the next generation of PI3 kinase alpha-targeting agents by selectively targeting the pathway in cancers but not in healthy cells, thus overcoming a key limitation of currently available medicines.

我們也計劃啟動另外兩種腫瘤小分子藥物的3期臨床試驗計畫。第一個是 tersolisimib（原文拼字錯誤 - tersolisib），我們的突變選擇性 PI3-激酶 α 抑制劑。我們相信，該方案能夠選擇性地靶向癌細胞中的 PI3 激酶 α 通路，而不靶向健康細胞中的該通路，從而克服目前可用藥物的一個關鍵局限性，代表下一代 PI3 激酶 α 靶向藥物。

This approach could potentially offer better disease control through deeper pathway inhibition as well as improved tolerability. The second is vepugratinib, an FGFR3 inhibitor that we believe may improve on the tolerability profile of existing agents and enable combination therapy in first-line metastatic urothelial carcinoma.

這種方法有可能透過更深層的路徑抑制提供更好的疾病控制，並提高耐受性。第二種是 vepugratinib，一種 FGFR3 抑制劑，我們認為它可能會改善現有藥物的耐受性，並能夠在轉移性尿路上皮癌的一線治療中實現聯合治療。

In neuroscience, we began several trials exploring the use of incretins to treat substance use disorders and psychiatric conditions. Last quarter, we announced plans to initiate a Phase 3 program of brenipatide in alcohol use disorder. Since then, we began dosing patients in this trial.

在神經科學領域，我們進行了多項試驗，探索使用腸促胰島素治療物質使用疾患和精神疾病。上個季度，我們宣布計劃啟動布雷尼帕肽治療酒精使用疾患的 3 期臨床試驗計畫。從那時起，我們開始對參與這項試驗的患者進行給藥。

And we have also launched additional brenipatide Phase 2 trials in tobacco use disorder and bipolar disorder. We expect to initiate several more Phase 2 and Phase 3 trials in 2026, exploring how brenipatide may be able to treat other conditions, including a Phase 3 trial for major depressive disorder, testing if brenipatide can prevent relapse of disease.

此外，我們也啟動了針對菸草使用疾患和雙極性情感疾患的布雷尼帕肽第二期臨床試驗。我們預計將於 2026 年啟動更多 2 期和 3 期試驗，探索 brenipatide 如何治療其他疾病，包括一項針對重度憂鬱症的 3 期試驗，以測試 brenipatide 是否可以預防疾病復發。

In Alzheimer's disease, we continue to look forward to the results from TRAILBLAZER-ALZ 3, our study of donanemab in people with normal cognition, but a positive blood test for Alzheimer's disease. This trial screen volunteers with a blood test for P-tau and randomized participants to a nine-month course of treatment with donanemab.

在阿茲海默症方面，我們繼續期待 TRAILBLAZER-ALZ 3 的結果，這是一項針對認知能力正常但阿茲海默症血液檢測呈陽性的人群進行 donanemab 治療的研究。該試驗透過血液檢測 P-tau 對志願者進行篩選，並將參與者隨機分配接受為期九個月的 donanemab 治療。

By moving earlier in disease, even prior to individuals having any objective symptoms of Alzheimer's disease, the goal is to reduce the risks of them ever developing any impairments due to Alzheimer's. The primary completion is projected for 2027. However, the study will read out with the target number of progression events are accrued.

透過在疾病早期階段，甚至在患者出現任何阿茲海默症客觀症狀之前就進行幹預，其目標是降低他們因阿茲海默症而出現任何損害的風險。主體工程預計 2027 年完工。然而，當累積到目標進展事件數量時，該研究結果將會公佈。

Moving to cardiometabolic health, we had another busy quarter. We are excited to announce positive top line results from the ATTAIN-MAINTAIN, evaluating orforglipron for weight maintenance. This unique Phase 3 trial was designed to answer a common question from doctors and patients. Can people successfully maintain weight loss achieved on maximum tolerated dose of injectable incretins by switching to an oral GLP-1 therapy?

談到心血管代謝健康，我們又度過了一個忙碌的季度。我們很高興地宣布 ATTAIN-MAINTAIN 研究取得了積極的初步結果，該研究評估了 orforglipron 用於體重維持的效果。這項獨特的 3 期試驗旨在解答醫生和病人經常提出的一個問題。人們能否透過改用口服 GLP-1 療法，成功維持使用最大耐受劑量注射型腸促胰島素所取得的減重效果？

Participants ATTAIN-MAINTAIN were previously on injectable semaglutide or tirzepatide then switched to orforglipron or placebo. As shown on slide 16, orforglipron helped people maintain weight loss that they had achieved on injectable therapies, and the study met all primary and secondary endpoints.

ATTAIN-MAINTAIN 研究參與者之前曾接受過注射用索瑪魯肽或替拉帕肽治療，之後改用奧福格列酮或安慰劑。如投影片 16 所示，奧福格列酮幫助人們維持了透過注射療法所獲得的減肥效果，而研究達到了所有主要和次要終點。

People who switch from semaglutide to orforglipron maintained their previously achieved weight loss, with an average difference of just 0.9 kilograms. This suggests that as an oral GLP-1 therapy, orforglipron may provide similar weight loss maintenance as the maximum tolerated dose of the injectable GLP-1 therapy semaglutide.

從司美格魯肽換用奧福格列酮的患者維持了先前取得的減重成果，平均差異僅 0.9 公斤。這表明，作為一種口服 GLP-1 療法，奧福格列酮可能提供與注射 GLP-1 療法司美格魯肽最大耐受劑量類似的體重減輕維持效果。

As expected, those who switched for maximum tolerated doses of the dual GIP/GLP-1 agonist tirzepatide to oral GLP-1 inhibitor maintained much of their weight loss, although with a higher average difference of 5 kilograms. We expect to share detailed results later this year.

如預期的那樣，那些從最大耐受劑量的雙重 GIP/GLP-1 激動劑替澤帕肽換成口服 GLP-1 抑制劑的患者，雖然平均減重幅度更大（5 公斤），但大部分體重減輕效果仍然保持良好。我們預計將於今年稍後公佈詳細結果。

Other orforglipron updates since our last call include submission of orforglipron to the FDA for treatment of obesity with approval expected in Q2 of this year, submission of orforglipron for obesity and for type 2 diabetes in a number of other countries around the world, initiation of orforglipron Phase 3 cardiovascular outcomes trial, and initiation of orforglipron Phase 3 for treatment for peripheral artery disease. We look forward to completing the US regulatory submission of orforglipron for type 2 diabetes later this year after the ACHIEVE-4 trial is complete.

自上次通話以來，orforglipron 的其他更新包括：向 FDA 提交 orforglipron 用於治療肥胖症的申請，預計將於今年第二季度獲得批准；向世界其他一些國家提交 orforglipron 用於治療肥胖症和 2 型糖尿病的申請；啟動 orforglipron 3 期心血管結果的研究我們期待在 ACHIEVE-4 試驗完成後，於今年稍後完成 orforglipron 用於治療 2 型糖尿病的美國監管申請。

We also announced new data for our GIP/GLP-1 glucagon triple agonist, retatrutide. In the first Phase 3 trial to complete, TRIUMPH-4, we evaluated retatrutide in adults with obesity and knee osteoarthritis.

我們也公佈了我們的 GIP/GLP-1 胰高血糖素三重激動劑 retatrutide 的新數據。在首個完成的 3 期試驗 TRIUMPH-4 中，我們評估了 retatrutide 對患有肥胖症和膝骨關節炎的成年人的療效。

Participants taking retatrutide 12 milligrams lost an average of 29% of their body weight at 68 weeks. While many people will not need this level of weight loss, we see an important potential role for molecules such as retatrutide in helping people with higher baseline BMIs or with more severe obesity-related comorbidities.

服用 12 毫克 retatrutide 的參與者在 68 週時平均減掉了 29% 的體重。雖然許多人不需要達到這種程度的減肥效果，但我們認為像 retatrutide 這樣的分子在幫助基線 BMI 較高或患有更嚴重的肥胖相關合併症的人群方面具有重要的潛在作用。

Accordingly, we are pleased to see that retatrutide reduced WOMAC mean scores by an average of 4.5 points, representing a 76% reduction in pain. And this was accompanied by a significant improvement in physical function. Impressively, more than one in eight retatrutide-treated patients were completely free from knee pain at the end of this trial.

因此，我們很高興地看到，retatrutide 使 WOMAC 平均評分降低了 4.5 分，疼痛減輕了 76%。同時，身體機能也得到了顯著改善。令人印象深刻的是，在本次試驗結束時，超過八分之一接受 retatrutide 治療的患者完全擺脫了膝蓋疼痛。

The safety profile was generally consistent with other incretins with gastrointestinal events being most common. We observed higher discontinuation rates due to adverse events in people with lower baseline BMI, including participants who discontinued for perceived excessive weight loss.

該藥物的安全性與其他腸促胰島素藥物基本一致，最常見的不良反應是胃腸道反應。我們觀察到，在基線 BMI 較低的人群中，因不良事件而停止治療的比例較高，其中包括因感覺體重過度減輕而停止治療的參與者。

As shown on slide 17, patients with a baseline BMI of 35 or higher, which represented 84% of the trial population, had discontinuation rates due to adverse events, consistent with those observed in clinical trials of other injectable incretins. We expect to read out six additional Phase 3 trials for retatrutide in 2026, including the remainder of the core registration package for both the TRIUMPH obesity program and the TRANSCEND type 2 diabetes program.

如幻燈片 17 所示，基線 BMI 為 35 或更高的患者（佔試驗人群的 84%）因不良事件而中止治療的比例，與其他注射用腸促胰素的臨床試驗中觀察到的情況一致。我們預計將於 2026 年公佈 retatrutide 的六項額外的 3 期試驗結果，其中包括 TRIUMPH 肥胖症計畫和 TRANSCEND 2 型糖尿病計畫的核心註冊包的剩餘部分。

Also in Q4, we started a Phase 3 trial in high-risk metabolic dysfunction-associated steatotic liver disease, MASLD, studying retatrutide as well as tirzepatide for treatment of this disease. We're planning to submit the results of the core TRIUMPH program in 2026 to support applications for overweight and obesity, obstructive sleep apnea, and osteoarthritis of the knee for retatrutide.

同樣在第四季度，我們啟動了一項針對高風險代謝功能障礙相關脂肪肝病 (MASLD) 的 3 期試驗，研究 retatrutide 和 tirzepatide 治療該疾病的療效。我們計劃在 2026 年提交 TRIUMPH 核心計畫的結果，以支持 retatrutide 用於治療超重和肥胖、阻塞性睡眠呼吸中止症和膝關節骨關節炎的申請。

Based on the data we've seen so far, pending these upcoming data readouts, we believe retatrutide may have the potential to become (inaudible) treatment option for patients with significant weight loss with certain complications.

根據我們目前所看到的數據，在即將公佈的數據結果出來之前，我們認為 retatrutide 有可能成為（聽不清楚）治療某些併發症的體重顯著減輕患者的治療選擇。

Moving to tirzepatide, we're pleased that Zepbound was recently approved in the US in a multiuse quick pen device. This presentation of tirzepatide is already available in many countries around the world as a convenient offering that includes four doses in a single pen. We look forward to launching this new Zepbound offering in the US within the next few weeks.

說到替拉帕肽，我們很高興 Zepbound 最近在美國獲批，它是一種多用途快速注射筆。這種形式的替澤帕肽已經在世界許多國家上市，它是一種方便的產品，一支筆中包含四劑。我們期待在未來幾週內在美國推出這項新的 Zepbound 產品。

Slide 18 shows pipeline movements since our last earnings call, and slide 19 shows the full list of key events achieved in 2025. Notably, we achieved positive outcomes for nearly all R&D key events in 2025, a rare set of results in this industry.

第 18 頁顯示了自上次財報電話會議以來管道的變化，第 19 頁顯示了 2025 年實現的關鍵事件的完整清單。值得一提的是，我們在 2025 年幾乎所有研發重點活動中都取得了積極成果，這在業界實屬罕見。

Slide 20 shows key events expected in 2026 with potential for data readouts and regulatory actions across our therapeutic areas. In addition to the substantial progress we're making in immunology, neuroscience, and oncology, I want to take a moment to reflect on our growing incretin and obesity portfolio.

第 20 張投影片展示了 2026 年預計發生的關鍵事件，以及我們各個治療領域可能出現的數據公佈和監管行動。除了我們在免疫學、神經科學和腫瘤學領域的實質進展之外，我還想花點時間回顧我們不斷增長的腸促胰島素和肥胖症產品組合。

Of course, there's been a lot of focus on tirzepatide and orforglipron, which I think is well warranted. Now excitement is growing for retatrutide as well. I see each of these as an example of a leading model within its own class.

當然，目前人們對替拉帕肽和奧福格列隆的關注度很高，我認為這是完全合理的。現在人們對瑞他曲肽也越來越感興趣了。我認為這些都是各自領域的佼佼者。

Behind these three incretin innovations, we have a robust pipeline of further inventions with potential to address patient needs, including our selective amylin agonist, eloralintide, which is currently in Phase 3; as well as our next-generation GIP/GLP-1 dual agonist, brenipatide, which is also now in Phase 3 trials. Behind these, we have a number of earlier-stage molecules that could similarly lead within new mechanisms and new classes of therapeutics for treatment of obesity.

在這三項腸促胰素創新背後，我們還有強大的研發管線，有望滿足患者的需求，其中包括我們目前處於 3 期臨床試驗階段的選擇性胰淀素激動劑 eloralintide；以及我們目前也處於 3 期臨床試驗階段的下一代 GIP/GLP-1 雙重激動劑 brenipatide。除此之外，我們還有一些早期階段的分子，它們同樣可以引領新的機制和新的肥胖症治療藥物類別。

We've built a substantial scientific lead in this field and aim to widen the distance through our R&D. This past year was busy and productive, and we expect more of the same in 2026 as we continue to create meaningful medicines on behalf of the patients that need us.

我們在該領域建立了巨大的科學領先優勢，並計劃透過研發進一步擴大領先優勢。過去的一年既忙碌又富有成效，我們預計 2026 年也會如此，我們將繼續為需要我們的患者研發有意義的藥物。

I'll now turn the call back to Dave for questions.

現在我將把電話轉回給戴夫，回答他的問題。

Okay. Thanks, Dan. We're pleased with all the progress in Q4 and throughout 2025. It was a year of strong execution for Lilly. We delivered exceptional business results, invested in our future, and helped millions of people around the world improve their health.

好的。謝謝你，丹。我們對第四季以及2025年全年的所有進展感到滿意。對禮來公司來說，這是執行力強勁的一年。我們取得了卓越的業務成果，投資於未來，並幫助世界各地數百萬人改善了健康狀況。

Now I'll turn the call over to Mike to moderate the Q&A session.

現在我將把電話交給麥克，由他來主持問答環節。

Thanks, Dave. We'd like to take questions from as many callers as possible. So consistent with prior quarters, we will respond to one question per caller and end the call promptly at 11:00. If you have more than one question, you can reenter the queue and we will get your question if time allows.

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的一個問題，並在 11:00 準時結束通話。如果您有多個問題，可以重新排隊，我們會在時間允許的情況下處理您的問題。

Paul, please provide the instructions for the Q&A session; and then we are ready for the first caller.

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) Evan Seigerman, BMO Capital Markets.

（操作員說明）Evan Seigerman，BMO 資本市場。

Congratulations. So a year from now on this call, I'd love for you to characterize what you would (inaudible) for orforglipron launch. Specifically, what are some of the metrics that you're looking to meet? I know you're not going to give guidance, but some qualitative commentary would be most helpful.

恭喜。所以，一年後的今天，在這次電話會議上，我希望您能描述一下您對奧格列酮上市的看法（聽不清楚）。具體來說，您希望達到哪些指標？我知道你不會給予具體的指導，但一些定性的評論會非常有幫助。

Great. You cut out a little bit, but I think you were just asking about a year from now, what are some things we'll be tracking on for orforglipron? So I think for that question, maybe we'll go to Ken to maybe talk about some things that we'll be looking at.

偉大的。你省略了一些內容，但我認為你只是在問一年後，我們會專注在orforglipron的哪些方面？所以我覺得對於這個問題，或許我們應該去找肯，跟他談談我們將要研究的一些事情。

Sure. Thanks for the question about orforglipron. We're really excited to have this medicine submitted not just in the US, but now 40 countries and looking forward to launches beginning this year.

當然。感謝您提出關於奧福格列酮的問題。我們非常高興這款藥物不僅在美國，而且現在還在 40 個國家提交了申請，並期待今年開始上市。

As I think about success factors for us going forward maybe towards the end of the year, we'll be looking at a few things. First of which is to get expansion. We're very encouraged by what we're seeing with oral Wegovy as it validates our belief that there's a substantial number of people with overweight and obesity who've been sitting on the sidelines waiting for an oral option. It was like these are mostly new starts. That means it's expanding the market, and that's good news for Lilly.

當我思考我們未來可能成功的因素時，也許到了年底，我們會考慮以下幾個面向。首先是獲得擴張。我們對口服 Wegovy 的效果感到非常鼓舞，因為它證實了我們一直以來的想法，即有大量超重和肥胖的人一直在等待口服藥物的出現。感覺這些大多都是新的開始。這意味著它正在擴大市場，這對禮來公司來說是個好消息。

We feel really good about the competitiveness of our profile. We've talked about that a lot on previous calls. So I think we're at the point now where we're going to pivot to how do the rules of world results play out. We think this is going to be about patient satisfaction and our profile, which is simple with no restrictions on food and water intake, could make a big difference in the real world.

我們對自身資質的競爭力感到非常滿意。我們在之前的幾次通話中已經多次討論過這個問題。所以我覺得我們現在要討論的重點是：世界比賽結果的規則將如何執行。我們認為這將關乎患者滿意度，而我們這種對食物和水的攝取量沒有限制的簡單模式，可能會在現實世界中產生很大的影響。

So we're excited to get off to the races here, see this market expand, and really look at overall patient satisfaction scores and real-world efficacy with these agents.

所以我們很高興能在這裡大展拳腳，見證這個市場的擴張，並真正關注這些藥物的整體患者滿意度評分和實際療效。

Great. Paul, raise the next question.

偉大的。保羅，請提出下一個問題。

Courtney Breen, Bernstein.

Courtney Breen，Bernstein。

Just building on the question around orforglipron, you mentioned that you have submitted in 40 countries. Traditionally, you tend to think about a full year cycle for most approvals in many countries around the world.

繼續討論關於奧福格列酮的問題，您提到您已向 40 個國家提交了申請。傳統上，在世界許多國家，大多數審批流程都需要一整年的時間。

Can you just help us understand if you're anticipating any accelerated pathways that you might be able to access in these ex-US countries that would enable launch in 2026 for orforglipron similar to some of the pathways that are available in the US and you've been able to garner one of them?

您能否幫助我們了解一下，您是否預期在這些美國以外的國家/地區可以獲得任何加速審批途徑，從而使奧福格列酮能夠在 2026 年上市，類似於美國的一些審批途徑，並且您已經獲得了其中一種途徑？

Thanks, Courtney. And so for the question about how we're thinking about OUS approval time lines, we'll go to Patrick.

謝謝你，考特尼。所以，關於我們如何考慮 OUS 審批時間表的問題，我們請 Patrick 來解答。

As I think we shared in the prepared remarks, outside of the US, it's mainly going to be a matter of launch in the first half of 2027. There will be a few markets in late '26 and a few exceptions for countries like, for example, UAE that might reference an FDA approved of orforglipron. So mainly a play late '26 in international markets.

正如我們在準備好的演講稿中所提到的，在美國以外，主要問題在於 2027 年上半年的發布。2026 年底會有一些市場出現這種情況，但像阿聯酋這樣的國家可能會有一些例外，這些國家可能會參考 FDA 批准的 orforglipron。所以主要是在2026年末在國際市場上進行交易。

Next caller, please.

請下一位來電。

Chris Schott, JPMorgan.

克里斯‧肖特，摩根大通。

Congrats on all the progress here. Can I just ask about international Mounjaro. It seemed like this is a very significant upside driver, at least relative to street numbers in 2025.

恭喜你們取得的所有進展。請問一下國際版的蒙加羅山（Mounjaro）的情況？這似乎是一個非常重要的上行驅動因素，至少相對於 2025 年的街頭銷售而言是如此。

And I'm just interested in your thoughts on the ramp from here as we think about the $3.3 billion 4Q results you just reported. I know last year was about a lot of new market launches. Now, you're in those markets. Like how do we think about sequential growth from these levels?

我只是想聽聽您對接下來發展方向的看法，因為我們正在考慮您剛剛公佈的 33 億美元的第四季度業績。我知道去年有很多新產品上市。現在，你已經進入這些市場了。我們如何看待從這些層級開始的連續成長？

Great. For the question on OUS Mounjaro performance and the ramp from here, we'll go back to Patrick.

偉大的。關於 OUS Mounjaro 的表現以及接下來的發展，我們再請 Patrick 來解答。

Well, you are right, Q4 was a very strong quarter for Mounjaro outside the US. And as Lucas referred to, we became a shadow market leader for total incretins also internationally.

沒錯，第四季對於Mounjaro在美國以外的市場來說是一個非常強勁的季度。正如盧卡斯所提到的，我們也成為了國際上腸促胰素總含量的市場領導者。

When you look at 2026, I would just reflect back on '25 with major launches more or less in the every quarter with the exception of Q4. So I would actually look forward as a base for the 2026 growth, but also consider that there was a slight impact in Q4 driven by the NRDL listing in China effective 1/1/2026, which slightly impacts the purchasing pattern in China in December. So see Q4 as a base of 2026.

展望 2026 年，我只想回顧 2025 年，除了第四季之外，幾乎每季都會有重大產品發表。因此，我實際上會將 2026 年的成長作為基準，但也要考慮到 NRDL 於 2026 年 1 月 1 日在中國上市，對第四季度造成了輕微影響，這將對 12 月份中國的購買模式產生輕微影響。所以，請將第四季作為 2026 年的基準。

Moving forward, our business now OUS. is 75% chronic rate management, and that's pretty much out of pocket. 25% is reimbursed for type 2 diabetes. So the priorities for 2026 will pretty much be market expansion, driving more penetration through patient activation when it comes to chronic weight management.

展望未來，我們目前在美國境外開展的業務中，75%是慢性病管理，這部分費用基本上需要患者自付。 25%的費用可由報銷，用於治療第2型糖尿病。因此，2026 年的重點將放在市場擴張上，透過提高患者在慢性體重管理方面的積極性來推動市場滲透。

And for type 2, we are leaning in to gain reimbursement in more countries. We're currently reimbursed in nine with the last one being China with the NRDL. And we will do that with a maintained discipline in terms of pricing. So I think overall, we are well positioned for a continued growth for Mounjaro outside the US in 2026.

對於第 2 型糖尿病，我們正在努力爭取在更多國家獲得醫療保險報銷。我們目前在九個國家獲得報銷，最後一個是中國的NRDL。我們將以嚴格的定價策略來實現這一目標。因此，我認為總體而言，我們已經做好充分準備，Mounjaro 將在 2026 年繼續在美國以外地區實現成長。

Next question, please, Paul.

保羅，請問下一個問題。

Seamus Fernandez, Guggenheim.

西莫斯·費爾南德斯，古根漢美術館。

Great. So I'm actually going to ask a non-obesity question. So while you can't take your eye off the ball on obesity, just wondering why you couldn't attack immunology broadly in the same way as you have obesity, investing earlier, faster, and more aggressively, given the substantial categorization that we're starting to see from the overall portfolio.

偉大的。所以我其實要問一個與肥胖無關的問題。所以，雖然你不能忽視肥胖問題，但我只是想知道，為什麼你不能像對待肥胖問題一樣廣泛地從免疫學角度入手，更早、更快、更積極地進行投資，考慮到我們開始從整體投資組合中看到的實質分類。

What are the issues that would prevent you from doing something like this, whether it be by your internal efforts or perhaps a more aggressive business development approach, just because it seems like this is a cash-driven opportunity where there's a lot of spend but a huge amount of upside opportunity with $170 billion of total market out there to access?

是什麼問題會阻止你做這樣的事情？無論是透過內部努力，還是採取更積極的業務拓展方式，因為這似乎是一個現金驅動的機會，需要投入大量資金，但同時也蘊藏著巨大的成長機會，因為有 1700 億美元的市場規模等待進入？

Great. And extra credit for the non-obesity question. We'll go to Dan to talk about our approaches on attacking immunology early.

偉大的。如果回答的不是肥胖問題，則可以獲得額外加分。我們將和丹討論我們早期攻擊免疫學的方法。

It's a great question. And actually -- I'll come to immunology in a second, but let me just first point out that across our non-obesity work, which is, of course, oncology, neuroscience, and immunology, we have our thumb on the scale for investment decisions. We see lots of good opportunities in those areas, and we're reinvesting some of the proceeds from the obesity opportunity to make sure we can further accelerate growth in those promising areas.

這是一個很好的問題。實際上——我稍後會談到免疫學，但首先我想指出，在我們非肥胖領域的工作中，當然包括腫瘤學、神經科學和免疫學，我們在投資決策中都擁有一定的影響力。我們看到這些領域有很多很好的機會，我們將從肥胖症領域獲得的部分收益再投資，以確保我們能夠進一步加速這些有前景領域的成長。

Today, you heard me talk a lot about the oncology portfolio, which I think is really blossoming right now. I have high hopes for immunology behind it. I think there's really promising breakthrough science, including treating immunologic diseases earlier; and our research labs are doing everything in our power to harness that science.

今天，你們聽到我談了很多關於腫瘤產品組合的事情，我認為它現在正蓬勃發展。我對背後的免疫學原理寄予厚望。我認為有很多非常有希望的突破性科學進展，包括更早治療免疫疾病；我們的研究實驗室正在盡最大努力利用這些科學成果。

Today, I talked a little bit about some trials that are ongoing for incretins and immunology, which I think is promising, as our number of other combination therapies that we now have in our late-stage clinical trials. So I'm excited both early and later (inaudible) immunology.

今天，我稍微談到了一些正在進行的腸促胰素和免疫學試驗，我認為這很有前景，就像我們目前處於後期臨床試驗階段的其他一些聯合療法一樣。所以我對早期和後期（聽不清楚）免疫學都感到興奮。

Next caller, Paul.

下一位來電者，保羅。

Terence Flynn, Morgan Stanley.

Terence Flynn，摩根士丹利。

Great. Congrats on the quarter. I had a question on guidance high level, Lucas. Just wondering if you can talk about what's embedded for Medicare volume ramp in the back half of the year and how that might drive the range we're seeing on the revenue side, and then if that's had any impact on employer opt-ins on the commercial side.

偉大的。恭喜你本季取得佳績。盧卡斯，我有一個關於高層指導的問題。我想問一下，您能否談談今年下半年 Medicare 業務量增長的具體情況，以及這可能會如何影響我們目前在收入方面看到的範圍，還有這是否對商業保險方面的雇主選擇加入產生了任何影響。

I know you guys previously talked about how that might have some impact to get some of the other employers over the hurdle on coverage. So I'm just wondering if you're starting to see that yet.

我知道你們之前討論過，這可能會對幫助其他一些雇主克服醫療覆蓋範圍方面的障礙產生一些影響。所以我想知道你是否已經開始意識到這一點了。

Thanks, Terence, for the question on guidance and Medicare ramp in the back half of the year as well as if there's any commercial opt-in. We'll go to Lucas.

謝謝 Terence 提出的問題，關於下半年的指導和 Medicare 逐步增加的計劃，以及是否有任何商業選擇加入計劃。我們去找盧卡斯。

Yeah. Maybe starting with Medicare, as highlighted in the context, basically, we are expecting that access to be granted no later than July 1. And as I mentioned all along, this will take time to build over time, but we feel very, very positive about the opportunity to bring anti-obesity medications to patients in Medicare.

是的。或許可以先從醫療保險開始，正如上下文所強調的那樣，我們基本上預計最遲在 7 月 1 日就能獲得這項服務。正如我一直提到的，這需要時間來逐步實現，但我們對將抗肥胖藥物帶給聯邦醫療保險患者的機會感到非常非常樂觀。

As I mentioned, again, the co-pay $50 for the patients will be a compelling value proposition as well. There is a bolus of patients that we have nowadays in Eli Lilly Direct business that we believe are also Medicare patients. So expect that bolus, I think it's between 10% to 20%, will actually move into the Medicare space.

正如我之前提到的，患者只需支付 50 美元的共同支付費用，這也將是一個極具吸引力的價值主張。目前，我們在禮來直接業務中擁有大量患者，我們認為他們也是聯邦醫療保險（Medicare）的患者。所以預計這部分資金（我認為在 10% 到 20% 之間）實際上會進入聯邦醫療保險領域。

I think that will happen relatively fast, and we will continue to build on top of that. So that's the drivers that you think about, again, the penetration. But we'll build over time. We think about, again, more about the size of the opportunity in Medicare thinking about 2027 as well.

我認為這種情況會很快發生，我們將繼續在此基礎上發展。所以，你需要考慮的驅動因素就是滲透率。但我們會逐步發展。我們再次思考，展望 2027 年，醫療保險領域蘊藏多大的機會。

The second part of your question was about the employer opt-in tin. I have Ilya right next to me here as well to talk about it. But as said, of course, again, the practice on physicians prescribing this medicine will become more natural, more broader in the anti-obesity medications. And physicians will be, again, more broadly basically also thinking about prescribing this in commercial.

你問題的第二部分是關於雇主選擇加入的錫罐。伊利亞就在我旁邊，我們可以一起討論這件事。但正如前面所說，當然，醫生開這種藥的做法將會變得更加自然，在抗肥胖藥物領域也會更加廣泛。而且，醫生們也會更廣泛地考慮在商業處方中開立這種藥。

How that will then impact the employer side, I think the message is clear, right? Again, there is a clear recognition of the class as a chronic disease. And basically, that, in my eyes, will propel also employers also to think about, again, this class and also employees to look for this class of medicines as well to be covered as well. But I don't know if it's anything else that you would like to add, Ilya.

那麼，這將對雇主方面產生怎樣的影響呢？我認為訊息很明確，對吧？再次強調，人們已經明確地認識到該類疾病是一種慢性疾病。在我看來，這基本上也會促使雇主再次考慮這類藥物，並促使員工也希望這類藥物能被納入健保範圍。但我不知道你是否還有什麼要補充的，伊利亞。

Yeah. Maybe just some additional context, Terrence, on commercial opt-in. Obviously, we start the year roughly on balance, relatively stable. There are some employers adding coverage, some removing some coverage; but we're putting additional focus in the employer space.

是的。特倫斯，或許我需要補充一些關於商業選擇加入的背景資訊。顯然，我們年初的整體情況比較平衡，相對穩定。有些雇主增加了保險範圍，有些雇主減少了保險範圍；但我們正在將更多精力放在雇主領域。

We've stood up a team and also working with a number of third parties to actually provide alternative access channels to have some flexibility in design, transparency in the pricing. And the initial conversations and feedback has been positive.

我們已經組建了一個團隊，並與許多第三方合作，以提供替代存取管道，從而在設計上具有一定的靈活性，並在定價方面提高透明度。初步的溝通和回饋都是正面的。

Of course, a lot of those decisions are for the following year. We anticipate having some of those decisions and increased coverage over time in the employer space as we head into the back end of this year and mostly into 2027.

當然，很多決定都是針對來年的。我們預計，隨著今年下半年以及 2027 年的到來，雇主領域將出現一些此類決定和更多覆蓋範圍。

Next question, please, Paul.

保羅，請問下一個問題。

Geoff Meacham, Citi.

傑夫‧米查姆，花旗銀行。

Congrats on the quarter. Dan, I had one for you. The TOGETHER results are really super interesting. How are you thinking about the potential for combo therapies with Zepbound and either I&I or oncology or neuro? I wasn't sure what drives the investment priorities, whether it's the drug or the indication, and if there is a clear path to a labeling claim.

恭喜你本季取得佳績。丹，我為你準備了一份。TOGETHER 的結果真的非常有趣。您如何看待 Zepbound 與 I&I、腫瘤或神經系統疾病合併治療的潛力？我不確定投資重點是什麼，是藥物本身還是適應症，以及是否有明確的標籤聲明途徑。

Again, another non-obesity question. So a lot of extra credit on this call. We'll go to Adrienne to talk about some of the combination therapy approaches and some of the strategy there.

又是一個與肥胖無關的問題。所以這次通話有很多額外的加分項。我們將和艾德莉安討論一些聯合療法方案和一些治療策略。

Sure. We see this as a significant opportunity. Obviously, more than 1 billion people worldwide have immune diseases like atopic dermatitis, psoriasis, IBD, and asthma. But patients who have both immune diseases and obesity tend to have a higher disease burden. So we're really excited about the opportunity to find new ways to combat the underlying (inaudible) diseases and potentially unlock better, longer-lasting results for these patients.

當然。我們認為這是一個重要的機會。顯然，全球有超過10億人患有異位性皮膚炎、乾癬、發炎性腸道疾病和氣喘等免疫系統疾病。但同時患有免疫系統疾病和肥胖症的患者往往疾病負擔更重。因此，我們非常興奮有機會找到對抗潛在（聽不清楚）疾病的新方法，並有可能為這些患者帶來更好、更持久的療效。

So we have broad efforts underway to look at additional combinations. We have the TOGETHER PSO trial evaluating the use of Taltz and Zepbound for adults with moderate to severe plaque psoriasis and obesity or overweight. We expect those top-line results in the first half of 2026.

因此，我們正在廣泛地開展工作，以研究其他組合方案。我們正在進行 TOGETHER PSO 試驗，評估 Taltz 和 Zepbound 對患有中度至重度斑塊狀乾癬和肥胖或超重的成年人的療效。我們預計這些主要業績將在 2026 年上半年實現。

We're also looking at TOGETHER AMPLIFY PsA and TOGETHER AMPLIFY PSO studies assessing the effectiveness of adding Zepbound after starting Taltz for adults with PSA and moderate to severe plaque psoriasis.

我們也正在研究 TOGETHER AMPLIFY PsA 和 TOGETHER AMPLIFY PSO 研究，以評估在開始使用 Taltz 治療後添加 Zepbound 對患有 PSA 和中度至重度斑塊狀乾癬的成年人的療效。

We also have the Phase 3b COMMIT studies in both ulcerative colitis as well as Crohn's disease, where we're looking at the concomitant use of Omvoh and Zepbound in addressing outcomes for those patients; and then the Phase 2 study of brenipatide for people living with uncontrolled asthma. So we're excited to continue to pursue the applications of incretins in unlocking better outcomes for people with immune diseases.

我們也有針對潰瘍性結腸炎和克隆氏症的 3b 期 COMMIT 研究，旨在研究 Omvoh 和 Zepbound 聯合使用對改善這些患者預後的效果；此外，還有針對未控制氣喘患者的 brenipatide 2 期研究。因此，我們很高興能夠繼續探索腸促胰素在改善免疫疾病患者治療效果的應用。

Next caller, Paul.

下一位來電者，保羅。

Asad Heider, Goldman Sachs.

阿薩德海德，高盛集團。

Congrats on all the progress. Back to obesity with apologies, Mike. Maybe just given the focus on pricing dynamics, can you just talk about what you're seeing in the contracting environment, broadly speaking, across the incretin portfolio? And also, what's your view on price elasticity in the cash channel as the year progresses? .

祝賀你們取得的所有進展。抱歉，麥克，我們還是回到肥胖這個話題吧。鑑於我們關注的是定價動態，您能否談談您在整體上，針對 incretin 產品組合的合約環境方面所看到的總體情況？另外，隨著時間的推移，您如何看待現金管道的價格彈性？。

To go through pricing in the US and price elasticity, we'll go to Ilya.

為了深入了解美國的定價和價格彈性，我們請伊利亞來談談。

Yeah, sure. Maybe just for the first part in terms of the commercial access and contracting. Obviously, we start the year with similar coverages. As we ended 2025, we continue to have coverage for Zepbound in two of the three large PBMs.

當然可以。或許只是商業准入和合約簽訂的第一部分。顯然，我們年初的報道內容與往年類似。截至 2025 年底，Zepbound 在三大 PBM 中的兩家仍然有覆蓋。

We continue the conversations around expanding access in those PBMs for obviously the introduction of orforglipron in Q2. So we're in active discussions there.

我們將繼續討論擴大這些藥品福利管理機構 (PBM) 的准入範圍，顯然是為了在第二季度引入 orforglipron。所以我們正在積極討論這個問題。

From a pricing standpoint, we've been pretty transparent on pricing for 2026 as it relates to Part D as well as our direct-to-patient pricing, which we implemented at the end of December. And then we have ongoing conversations with improving and continuing access in the commercial segment.

從定價角度來看，我們對 2026 年的 D 部分定價以及我們在 12 月底實施的直接面向患者的定價一直保持著相當透明的態度。然後，我們持續探討如何改善並繼續在商業領域提供便利。

In terms of price elasticity, we've seen over time, both in the US and outside of the US, that affordability and opportunity on the entry as well as predictability of cost for patients matter. That's why the out-of-pocket in Part D of $50 is an affordable option as well as -- we've seen an increase in utilization of even Zepbound vial at the end of the year when we implemented improved entry price of $2.99 for Zepbound.

就價格彈性而言，我們已經看到，無論是在美國還是在美國以外，患者的負擔能力和准入機會以及成本的可預測性都很重要。這就是為什麼 D 部分自付 50 美元也是一個負擔得起的選擇——而且，我們看到，在年底我們將 Zepbound 的入門價格提高到 2.99 美元後，Zepbound 小瓶的使用量也有所增加。

So we continue to see that. And obviously, we're seeing significant and encouraging uptake in the oral market, which is expansive and bringing new patients to obesity treatment. And we're excited to launch orforglipron soon with the entry price being similar to oral semi.

所以我們繼續看到這種情況。顯然，我們看到口服藥物市場出現了顯著且令人鼓舞的成長，該市場規模龐大，為肥胖症治療帶來了新的患者。我們很高興即將推出 orforglipron，其入門價格與口服半成品類似。

Raise the next question, please, Paul.

保羅，請提出下一個問題。

Mohit Bansal, Wells Fargo.

莫希特·班薩爾，富國銀行。

So a strategic one. So I would like to understand, what is your latest thinking on the importance of getting obesity-related indications on the label?

所以這是一次策略性舉措。所以我想了解一下，您目前對在藥品標籤上標示與肥胖相關的適應症的重要性有什麼看法？

Because we get the mix message. It's a little bit of mixed message when we talk to payers because they think that these drugs are just for obesity for now with NASH. They're still coming for obesity with NASH. But do you think this could be an, over time, long-term differentiator here now that you are going into indications like I&I as well at this point?

因為我們接收到的訊息很混亂。當我們與支付方溝通時，會聽到一些模糊的訊息，因為他們認為這些藥物目前僅用於治療非酒精性脂肪性肝炎引起的肥胖症。他們仍然在用 NASH 來對抗肥胖症。但你認為，隨著你們現在也開始涉足 I&I 等適應症，從長遠來看，這會不會成為一個長期的差異化優勢呢？

So to think about and address our strategy on obesity and expansion of indications more broadly, we'll go to Ilya to go. And then, Ken, you can add if you have any other development thoughts.

因此，為了思考和解決我們關於肥胖症和更廣泛地擴大適應症的策略，我們將去找伊利亞。Ken，如果你還有其他開發方面的想法，也可以補充。

Sure. What we've seen thus far, even with Zepbound and looking at Medicare population around sleep apnea, we're seeing an increase in utilization and thinking about obesity beyond weight and looking at outcomes related to obesity and then a lot of comorbidities, as Dan had mentioned, even in our arthritis trial with Taltz.

當然。到目前為止，我們看到，即使使用 Zepbound 並觀察 Medicare 人群的睡眠呼吸中止症情況，我們也看到使用率有所上升，並且開始考慮肥胖問題，而不僅僅是體重，還要考慮與肥胖相關的結果，以及許多合併症，正如 Dan 所提到的，即使在我們與 Taltz 進行的關節炎試驗中也是如此。

When we talk to employers as well as payers, they think about the multiple aspects of obesity and what that means for coverage and cost long term. So we do see a growing body of evidence to support covering obesity medications for a population and having a positive impact to public health beyond just weight.

當我們與雇主和付款者交談時，他們會考慮肥胖的多個方面，以及這對長期保險覆蓋範圍和成本的影響。因此，我們看到越來越多的證據表明，為肥胖症患者提供藥物治療不僅能改善體重，還能對公眾健康產生正面影響。

Thanks for the question on other potential avenues of (inaudible) as it relates to complications and comorbidities. As our incretin portfolio and amylin portfolio expands, we're always facing the question of, do we spend our resources, replicating findings from previous incretins on comorbidities and complications where we know these drugs are efficacious or do we push into new areas in generating new evidence?

感謝您提出其他潛在途徑（聽不清楚）的問題，因為它與併發症和合併症有關。隨著我們的腸促胰素產品組合和胰淀素產品組合的擴展，我們始終面臨著這樣一個問題：我們是應該將資源用於複製先前腸促胰素在合併症和併發症方面的研究結果（因為我們知道這些藥物在這些方面是有效的），還是應該開拓新的領域以產生新的證據？

You've probably seen with orforglipron, we're actually starting to explore new ideas like stress urinary incontinence, peripheral artery disease, and hypertension. We'll continue to look for new class incretins in addition to what we've talked about in the I&I space.

您可能已經看到，使用奧福格列酮治療壓力性尿失禁、週邊動脈疾病和高血壓等疾病時，我們實際上已經開始探索新的治療方向。除了我們在 I&I 領域討論過的內容之外，我們將繼續尋找新的腸促胰素類藥物。

But we do also understand that with new molecules in new mechanisms, it's important to generate some data to continue to give prescribers and patients confidence that these medicines preserve the benefits of the previous class of medicine. So we continue to do that, too. but very pleased, I think, with our overall balance of investment across the incretin portfolio in both established and emerging mechanisms of diseases of interest.

但我們也明白，對於作用於新機制的新分子而言，產生一些數據非常重要，這樣才能繼續讓處方醫生和患者相信這些藥物能夠保持先前一類藥物的益處。所以我們也繼續這樣做。但我認為，我們對在已確立和新興的疾病機制方面，腸促胰島素投資組合的整體投資平衡非常滿意。

Raise the next question, please, Paul.

保羅，請提出下一個問題。

Umer Raffat, Evercore.

Umer Raffat，Evercore。

Cash pay, I feel like, has been a very important driver of growth, among other drivers. And I'm just trying to think out loud what the long-term implications of that could look like, especially with all the competition coming.

我認為，現金支付是推動成長的重要因素，當然還有其他因素。我只是想把這件事的長期影響說出來，尤其是在競爭日益激烈的今天。

On the one side, obviously, there's going to be tremendous brand loyalty, which is very important cash pay. But on the other side, the traditional PBM contracts and rebate wall may not apply. So I'm just trying to think out loud how you're thinking about share retention and cash pay in the long run.

一方面，很顯然，品牌忠誠度會非常高，現金支付也非常重要。但另一方面，傳統的藥品福利管理合約和回扣障礙可能並不適用。所以，我只是想把你們對長期股權保留和現金支付的看法表達出來。

To discuss a bit about the cash pay dynamics, I'll ask actually Ilya and Patrick to discuss how it plays out internationally and as well in the US. So Patrick, do you want to start first?

為了討論一下現金支付的動態，我將請伊利亞和派崔克討論它在國際上以及在美國的運作情況。派崔克，你想先開始嗎？

I think what we have been building over the last couple of years learning a lot from the US has really been the consumer centricity. And I think it's a matter of building platforms along the lines, as we have done in the US with Lilly Direct, where we are providing the opportunity for patients both to seek, start, and statement. So I think that's the must that we need to continue to develop.

我認為，過去幾年我們從美國學到了很多東西，並一直在努力打造以消費者為中心的企業。我認為關鍵在於建立相應的平台，就像我們在美國透過 Lilly Direct 所做的那樣，為患者提供尋求、開始和發表聲明的機會。所以我認為這是我們繼續發展所必須具備的條件。

Yeah. Just to add on, I think we learned quite a bit. There are frictions in the system for a number of diseases in the US. And globally, obviously, we've seen that happen in obesity. What we've built within Lilly Direct is a pretty significant scaled direct-to-consumer platform that helps address some of the frictions.

是的。補充一點，我覺得我們學到了很多。美國在應對多種疾病方面存在系統性摩擦。顯然，在全球範圍內，我們已經看到肥胖問題出現了這種情況。我們在 Lilly Direct 內部建構的是一個相當重要的、規模化的直接面向消費者的平台，這有助於解決一些摩擦。

Of course, we can continue to think about how we evolve that consumer experience and make this more seamless, at the same time, growing access across the different segments. And so -- and both will play an important role. And we continue to look for ways for us to scale as well as improve on the experience over time.

當然，我們可以繼續思考如何改善消費者體驗，使其更加順暢，同時擴大不同細分市場的覆蓋範圍。因此——兩者都將發揮重要作用。我們將繼續尋找擴大規模的方法，並隨著時間的推移不斷改進用戶體驗。

Raise the next question, please, Paul.

保羅，請提出下一個問題。

Alex Hammond, Wolfe Research.

Alex Hammond，Wolfe Research。

One on eloralintide. So the weight loss results you guys presented last year look really strong. But given prescribers and patients see more interested in more favorable tolerability, how should we think about the potential for lower doses of elora and lower dose combos with tirzepatide potentially achieve a titration-free placebo-like tolerability with weight loss comparable to monotherapy GLP-1?

一項關於依洛拉林肽的研究。你們去年公佈的減肥成果看起來非常好。但鑑於處方醫生和患者對更佳的耐受性更感興趣，我們應該如何看待較低劑量的 elora 和較低劑量的 tirzepatide 組合，它們有可能在無需滴定的情況下達到與安慰劑類似的耐受性，並達到與 GLP-1 單藥治療相當的減肥效果？

We'll go to Ken to talk about the eloralintide development strategies and different ideas we're assessing.

我們將去找 Ken 討論 eloralintide 的開發策略以及我們正在評估的不同想法。

Thanks, Alex, on eloralintide and future avenues. We're really excited about the news we shared on obesity last week where patients achieved up to 20.1% weight loss for the eloralintide with excellent tolerability that was improved with titration. In fact, in the 3, 6, 9-milligram titration group, I think we only had one incidence of vomiting out of more than 50 patients. So that compares, we think, really favorable versus the existing incretin class.

謝謝 Alex，關於 eloralintide 和未來的發展方向。我們對上週分享的關於肥胖症的消息感到非常興奮，患者使用依洛林肽治療後體重減輕高達 20.1%，且耐受性極佳，隨著劑量調整，耐受性進一步提高。事實上，在 3、6、9 毫克滴定組中，我認為在 50 多名患者中只有 1 例出現嘔吐。因此，我們認為，與現有的腸促胰島素類藥物相比，這確實很有優勢。

So we see a big opportunity for eloralintide in patients who maybe just can't tolerate an incretin. We know that 5% to 10% of patients in our trials tend to discontinue on the incretin class, suggesting a pretty big opening given the size of the obesity market.

因此，我們看到，對於那些可能無法耐受腸促胰素的患者來說，eloralintide 具有很大的應用前景。我們知道，在我們的試驗中，5% 到 10% 的患者傾向於停止使用腸促胰素類藥物，考慮到肥胖症市場的規模，這表明市場還有很大的發展空間。

Of course, we're also interested in thinking about eloralintide in combination with other mechanisms of action and what you alluded to with GIP plus plus GLP1 plus amylin. It was a very physiological construct, three nutrient-stimulated hormones. And we've shared that we are exploring that idea in the clinic. Nothing to share yet, but stay tuned maybe towards the end of this year.

當然，我們也對將eloralintide與其他作用機制結合起來考慮感興趣，就像您提到的GIP加GLP1加胰淀素一樣。這是一個非常符合生理學的結構，由三種營養刺激激素所構成。我們已經透露，我們正在臨床上探索這個想法。目前還沒有什麼可以分享的，但敬請期待，或許今年底有消息公佈。

We're testing other possible combinations, including a GIP agonist, [mocupotide] with eloralintide as well. And so really just trying to understand the range of options. And like you said, is there really an optimal very simple permutation of mechanisms that could allow minimal or no titration with competitive efficacy?

我們正在測試其他可能的組合，包括 GIP 激動劑 [mocupotide] 與 eloralintide 的組合。所以，我只是想了解有哪些選擇。正如你所說，是否存在一種最佳的、非常簡單的機制組合，可以在保持競爭性療效的同時，最大限度地減少或避免滴定？

Paul, raise the next question, please.

保羅，請提出下一個問題。

James Shin, Deutsche Bank.

James Shin，德意志銀行。

One for David. For CMS' upcoming obesity demonstration, David, can you share any similarities or differences you foresee from what you went through previously during the Part D senior savings model for insulin's $35 co-pay rollout?

給大衛的一份。David，對於 CMS 即將開展的肥胖症示範項目，您能否分享一下，您預見到它與您之前在 D 部分老年人胰島素 35 美元自付額推廣過程中所經歷的儲蓄模式有何相似之處或不同之處？

Great. And I will welcome Dave to getting the box for the Q&A. Could you share any similarities on the CMS obesity pilot versus the Part D senior savings?

偉大的。我將歡迎戴夫來領取問答環節的盒子。能否分享一下CMS肥胖症試辦計畫與D部分老人節省計畫有哪些相似之處？

Yeah. I mean, I think there are quite a number of analogies to draw. I mean, first, arriving at what would be perceived as a relatively low out-of-pocket is an important fact by itself. And while we know, in this case, we're not moving from high out-of-pocket to low, only moving from covered plus low out-of-pocket.

是的。我的意思是，我認為這裡有很多可以類比的地方。我的意思是，首先，能夠達到相對較低的自付費用本身就是一個重要的事實。雖然我們知道，在這種情況下，我們並不是從高自付額轉向低自付額，而只是從有保障加上低自付額轉向低自付額。

And I think patients who may be using GLP-1 and the data we have is that seniors are using these drugs at a lower rate than the general population, maybe because income, in particular, will benefit from that lower cost every month at $50. I think that's very expansionary to the class, and we'll draw a lot of interest from primary care prescribers who are concerned about the comorbidities of lifetime overweight and obesity, which tend to manifest after 65 at a much higher rate.

我認為，使用 GLP-1 的患者，根據我們掌握的數據，老年人使用這些藥物的比例低於一般人群，這可能是因為收入較低，尤其是老年人，每月只需花費 50 美元，就能從中受益。我認為這對課程來說是一個非常大的拓展，我們將吸引很多關注終生超重和肥胖並發症的初級保健處方醫生的興趣，這些並發症往往在 65 歲以後以更高的速度顯現出來。

The second thing is the consistent variance. And I think when we negotiated this with the government, we wanted to make sure that we weren't just building a program that went into the normal Part D math in terms of out-of-pocket cost. But had that consistency. Independent of the absolute amount people pay, they get very frustrated with different amounts month-to-month. So I think that's another important feature.

第二點是持續的變異數。我認為，當我們與政府協商此事時，我們希望確保我們建立的不僅僅是一個按照正常的D部分計算自付費用的項目。但他一直保持著這種一致性。無論人們支付的絕對金額是多少，他們對每月不同的金額都會感到非常沮喪。所以我認為這是另一個重要的特點。

Thirdly, like the insulin deal, it's open to all innovators. And I think that's an important concept that the doctor and the patient choose the best therapy, which could be one from us, one from our competitor. It could be oral, could be injectable, could include future therapies from Lilly or others like retatrutide or eloralintide when they're approved.

第三，就像胰島素交易一樣，它對所有創新者開放。我認為這是一個重要的概念，即醫生和患者選擇最佳療法，而這種療法可能來自我們，也可能來自我們的競爭對手。它可能是口服的，也可能是注射的，未來禮來公司或其他公司研發的療法，如瑞他曲肽或依洛林肽，一旦獲得批准，也可能包括這些療法。

So I think that also has a parallel to what we did with insulin. If you look back at that insulin pilot, utilization rates increased pretty dramatically in Part D and frustration levels with that issue basically disappeared. I think this program has similar profits to be both enormously popular, drive a lot of new uptake.

所以我認為這和我們對胰島素所做的工作也有相似之處。回顧那項胰島素試點項目，D 部分的胰島素使用率大幅提高，而人們對這個問題的不滿情緒也基本上消失了。我認為這個項目如果能獲得類似的利潤，將會非常受歡迎，並帶動大量新用戶的加入。

As I said, it's suppressed in the senior population who could probably benefit most, at least in the short term, from GLP-1 therapy. And I believe, and I know that CMS does as well, that within a few years will demonstrate significant cost savings to the Medicare program.

正如我所說，老年人群體中這種物質受到抑制，而老年人群體可能最能從 GLP-1 療法中受益，至少在短期內是如此。我相信，而且我也知道美國醫療保險和醫療補助服務中心（CMS）也這麼認為，幾年之內，這將為醫療保險計劃節省大量成本。

So that is different than the insulin part, but that's associated with new products being added. So we're excited to get going. We expect this to be effective by July 1, working through the details with the administration now. And you'll hear more maybe on our Q1 call.

所以這與胰島素部分不同，但這與新產品的加入有關。所以我們很高興能開始行動。我們預計這項措施將於7月1日生效，目前正與政府部門討論細節。或許您會在我們的第一季財報電話會議上聽到更多消息。

Raise the next question, please, Paul.

保羅，請提出下一個問題。

Steve Scala, TD Cowen.

史蒂夫·斯卡拉，TD Cowen。

2026 revenue guidance is $15 billion to $20 billion, higher than that delivered in 2025. Mounjaro and Zepbound are doing great, but we can see their trajectory. Are there scenarios where these incremental sales can be delivered without orforglipron being a $5 billion product in 2026? And does the guidance tell us that Lilly believes orals will grow the market and not cannibalize?

2026 年營收預期為 150 億美元至 200 億美元，高於 2025 年的營收。Mounjaro 和 Zepbound 目前發展勢頭良好，但我們可以看到它們的未來發展軌跡。是否存在這樣的情況：即使奧格列酮在 2026 年的銷售額沒有達到 50 億美元，也能實現這些增量銷售額？該指導意見是否顯示禮來公司認為口服藥物將促進市場成長而不是蠶食市場？

Great. Thanks, Steve, for the great questions as always. We'll go to Lucas to talk a bit about the revenue guide and some of the moving parts that are contained within that.

偉大的。謝謝史蒂夫，你提出的問題一如既往地精彩。我們將和盧卡斯談談收入指南以及其中包含的一些動態部分。

Yeah. Thinking about the guide -- again, you can do the math on that perspective. But when we think about the process, maybe start from there, as always, we do a bottom-up approach on what we see in the marketplace and then across all the therapeutic areas and geographies as well.

是的。想想這份指南——同樣，你可以從這個角度來計算。但當我們思考這個過程時，或許可以從這裡開始，像往常一樣，我們採取自下而上的方法，觀察我們在市場上看到的情況，然後考慮所有治療領域和地域的情況。

And we have, again, a point of the guidance as what is our goal for the year to start with. There are many multiples, pushes and pulls -- and I described that during the call text as well talking about, again, the expansion in Medicare that Dave just covered, talking about the launch of orforglipron as well and a continuation of growth that we expect to see both in the US and our US market.

我們再次強調，指導方針中有一個要點，那就是我們今年的目標是什麼。有很多因素、推動因素和拉動因素——我在通話短信中也描述了這一點，再次談到了戴夫剛才提到的醫療保險的擴張，以及奧福格列隆的上市，以及我們預計在美國和我們的美國市場將繼續保持增長。

I think it's fair to go back as well about the -- basically the price component as well that is embedded into the guide as well. That's another component that is going to be actually accelerated in 2026, that erosion versus 2025. And I call out basically the low to mid-teens. That's a new component to basically some of the math that you were thinking about 2025 that you need to factor as when you're doing those forecasting and models that you described.

我認為有必要回顧一下——基本上也包括指南中嵌入的價格部分。這是 2026 年將會加速的另一個因素，即侵蝕作用相對於 2025 年將會加劇。我基本上把範圍定在十幾分到五幾分之間。這是你在考慮 2025 年的一些數學問題時需要考慮的一個新因素，當你進行你所描述的預測和建模時，需要將其納入考慮範圍。

In terms of your orforglipron question, I think it's important to highlight, looking at even just the last four weeks of the data of the competitor launch is mainly expansion of the market. So we are very, very encouraged from, again, the first month of seeing that data; and it's very much consistent with our expectations and our guide. We will see how much again that class will continue to grow over the years, and we will update our guy throughout the year depending on that.

關於您提出的奧福格列隆的問題，我認為需要強調的是，即使只看競爭對手產品上市的最後四周的數據，也主要體現在市場擴張上。因此，看到第一個月的數據，我們感到非常鼓舞；而且這與我們的預期和指導方針非常吻合。我們將觀察這個班級在未來幾年會發展到什麼程度，並根據情況在這一年中不斷更新我們的人員安排。

We have time for a couple quick ones, so the next question, please, Paul.

我們還有幾個簡短的問題可以回答，所以請問下一個問題，保羅。

Akash Tewari, Jefferies.

阿卡什‧特瓦里，傑富瑞集團。

So Dave, you've mentioned that investors who really understand Lilly recognize it to consumer stock. Can you talk about some consumer analogs you point investors towards when you're thinking about long-term penetration for both the US and ex-US for your weight loss product.

戴夫，你曾提到真正了解禮來公司的投資人會將其視為消費品股。在考慮減重產品在美國及美國以外地區的長期滲透率時，您能否談談您會向投資人推薦哪些消費者類比？

And then maybe just on the cannibalization point. Is it fair to say your guide isn't expecting meaningful cannibalization of the oral and injectable obesity products versus what we've seen with Novo? .

然後或許就只是在同類相食這一點上。可以這樣說嗎？您的指南預計口服和注射減肥產品不會像諾和諾德那樣受到實質的蠶食？。

Definitely a two-parter there, Akash. So we'll get Dave to talk about consumer analogs.

阿卡什，這肯定是個分成兩部分的故事。所以我們會請戴夫談談消費領域的類似案例。

Well, I think Lucas covered the cannibalization based on what we're seeing right now and versus what we really expect. In a way, though, just strategically, it doesn't really matter to us.

我認為盧卡斯已經根據我們目前看到的情況和我們真正預期的情況，闡述了蠶食現象。但從某種戰略角度來看，這對我們來說並不重要。

I think we're interested in having people on the medicine that they think and their doctor think is best for them. And if it comes from Lilly, that's our goal. So we're not too concerned about that. But I don't actually expect a ton of cannibalization to be honest.

我認為我們希望患者服用自己和醫生都認為最適合他們的藥物。如果是禮來公司生產的，那就是我們的目標。所以我們並不太擔心。但說實話，我並不認為會出現大量的互相蠶食現象。

In terms of the consumer analogs, it's a difficult question. We -- I'd be open to your feedback on this. We spent a lot of time modeling out the trajectory of the out-of-pocket business. Patrik and Ilya commented on that. I think at the JPMorgan conference, I spoke about this.

就消費者群體而言，這是一個很難回答的問題。我非常樂意聽取您的回饋意見。我們花了大量時間模擬自費業務的發展軌跡。派崔克和伊利亞對此發表了評論。我想我在摩根大通的會議上談到過這個問題。

I think it is a bit of a wild card in our short and midterm outlook because I am hard-pressed to think of an analog where you have this many people paying out of pocket for prescription medication. People can look back at the [PDE wars] and the ED drugs, we were part of that. We've learned some things from that, but it's not the same as this.

我認為這會對我們的短期和中期前景造成一些不確定因素，因為我很難想到有類似的例子，會有這麼多人自費購買處方藥。人們可以回顧[PDE 戰爭]和 ED 藥物，我們也是其中的一部分。我們從中吸取了一些東西，但這和這件事不一樣。

You can look at cosmetics and aesthetics where it's quite common, but that also has some overlap, but not complete. Because here, you have really profound health benefits and noticeable results that really drives a success cycle for people and their lives is different.

你可以看看化妝品和美學領域，那裡的現象相當普遍，但這兩者之間也有一些重疊，但並不完全重疊。因為在這裡，你會獲得真正深遠的健康益處和顯著的效果，這真正能為人們帶來成功循環，他們的生活也會因此而改變。

So I think it's hard for us to think about that. What we can do is take learnings from other industries that were able to reduce consumer friction, unlock the power of first-party data in marketing, consider a platform and an interface with consumers that allows us to bring our really robust and deep pipeline that Ken has been talking about to market in a way that might be quite differentiated over time, play with pricing opportunities, subscription models, these kinds of things.

所以我覺得我們很難去想這個問題。我們可以藉鑒其他行業減少消費者摩擦的經驗，釋放第一方數據在營銷中的力量，考慮建立一個平台和與消費者的界面，使我們能夠將 Ken 一直談論的強大而深入的渠道推向市場，並隨著時間的推移，以一種可能相當差異化的方式，嘗試定價機會、訂閱模式等等。

All that is in our future. And I think Lilly Direct direct discussion, out-of-pocket business, all enables those things. It's pretty interesting strategically because I don't think there's a good analog in our industry. And we're working through that and excited by the potential as we already see 1 million people in the US, hundreds of thousands more outside the US, choosing this way to buy a medicine like Zepbound and Mounjaro.

這一切都屬於我們的未來。我認為禮來直銷、直接溝通、自掏腰包的業務，所有這些都促成了這些事情的發生。從策略角度來看，這很有意思，因為我認為我們這個產業裡沒有很好的類似案例。我們正在努力解決這個問題，並對這種潛力感到興奮，因為我們已經看到美國有 100 萬人，美國以外還有數十萬人選擇這種方式購買 Zepbound 和 Mounjaro 等藥物。

Great. I will do one last question, and then we'll have to close the call.

偉大的。我最後一個問題，然後我們就得結束通話了。

Michael Lee, UBS.

瑞銀集團的麥可李。

Great. Just wanted incretisto ask your expectation on the orfor launch, general view of unit volume scripts vis-a-vis the tirzepatide launch, and how you think either access or other channels are different here versus tirzepatide and how you think about the launch share versus tirzepatide for orfor.

偉大的。我只是想問您對 Orfor 上市的預期，您對 Orfor 的單位銷售腳本與 Tirzepatide 上市的總體看法，以及您認為 Orfor 的獲取渠道或其他渠道與 Tirzepatide 有何不同，以及您如何看待 Orfor 與 Tirzepatide 的上市份額。

We'll go to Ilya to talk a bit about the orfor launch.

我們將和伊利亞談談奧福爾的記者會。

Yes. Obviously, we're excited about launching for orforglipron assuming in Q2. As we think about the overall market, in every launch in this space, you're launching in a larger market and more, greater consumer and provider awareness. We recognize that, and we look for learning from how we've launched previously.

是的。顯然，我們對在第二季推出 orforglipron 感到非常興奮。從整體市場角度來看，在這個領域，每一次產品發布都意味著進入一個更大的市場，消費者和供應商的認知度也會更高。我們體認到這一點，並且將從以往的創業經驗中吸取經驗教訓。

I think what's different here, and people on the call have discussed this, is that there is a -- typically in the cycle of launches, you start with access, build access over time, and you see gradual uptake. What we've seen in this space, in particular -- and obviously, we have a scale direct-to-consumer platform as part of that.

我認為這裡不同的地方，也是電話會議上討論過的地方，是——通常在產品發布週期中，你會先獲得訪問權限，隨著時間的推移逐步建立訪問權限，然後你會看到用戶逐漸接受。我們在這個領域，尤其是——顯然，我們擁有一個規模化的直接面向消費者的平台——看到了這一點。

You also have a significant self-pay and consumer awareness in this category. And so our expectations are high in terms of what we expect for orforglipron in our launch. And we -- again, we expect this to be market expansive and bring new people to therapy for obesity. So that's our expectation for orforglipron over time.

在這個類別中，自費使用者和消費者的意識也相當高。因此，我們對orforglipron的上市抱有很高的期望。我們再次預計，這將擴大市場，並為肥胖症治療帶來更多新患者。這就是我們對奧格列酮長期療效的預期。

Thanks, Ilya. Dave, over to you for the close.

謝謝你，伊利亞。戴夫，接下來就交給你來總結了。

Great. Well, as always, we appreciate your participation in today's earnings call and, of course, your interest in Eli Lilly and Company. Please follow up with the IR team if you have any questions that we did not address today. And otherwise, have a great rest of your day.

偉大的。和往常一樣，我們感謝您參加今天的財報電話會議，當然，也感謝您對禮來公司的關注。如果您還有任何我們今天沒有解答的問題，請與投資者關係團隊聯絡。祝您今天餘下的時間過得愉快。

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 March 10 at midnight. You may access the replay system at any time by dialing 800-332-6854 and entering the access code 331160. International dialers can call 973-528-0005. Again, those numbers are 800-332-6854 and 973-528-0005 with the access code 331160. Thank you for your participation. You may now disconnect your lines.

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 3 月 10 日午夜。您可以隨時撥打 800-332-6854 並輸入存取碼 331160 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 331160。感謝您的參與。現在您可以斷開線路了。