禮來公司 (LLY) 2026 Q3 法說會逐字稿

Ladies and gentlemen, thank you for standing by and welcome to the Eli Lilly third quarter 2026 earnings conference call. (Operator Instructions)

各位女士、先生，感謝您稍候，歡迎參加禮來（Eli Lilly）2026 年第三季財報電話會議。(接線員指示)

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

現在我想將會議交給本次主持人——投資人關係資深副總裁 Mike Sapar。請開始。

Good morning. Thank you for joining us for Eli Lilly and Company’s Q3 2026 earnings call. I’m Mike Sapar, Senior Vice President of Investor Relations.

各位早安。感謝各位參加禮來公司 2026 年第三季（Q3）財報電話會議。我是投資人關係資深副總裁 Mike Sapar。

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 Lilly Oncology and Head of Business Development; Patrik Jonsson, President of Lilly International; and Ken Custer, President of Lilly Cardiometabolic Health.

今天與我一同出席電話會議的有：禮來董事長暨執行長 Dave Ricks；財務長 Lucas Montarce；首席科學與產品長 Dan Skovronsky 博士；禮來免疫學總裁 Adrienne Brown；禮來神經科學總裁 Carole Ho 博士；禮來美國與全球客戶能力總裁 Ilya Yuffa；禮來腫瘤學總裁暨商務發展主管 Jake Van Naarden；禮來國際總裁 Patrik Jonsson；以及禮來心代謝健康總裁 Ken Custer。

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 is contained in our latest Form 10-K and subsequent filings with the SEC.

在本次電話會議中，我們預期將根據目前的預期提出預測與前瞻性陳述。由於多項因素（包括投影片 4 所列因素），我們的實際結果可能與預期有重大差異。關於可能導致實際結果不同的因素之更多資訊，載於我們最新的 Form 10-K 以及其後向美國證券交易委員會（SEC）提交的文件中。

The information we provide about our products and pipeline is for the benefit of the investment community. It is not intended to be promotional or otherwise influence prescribing decisions. Our commentary will focus on our non-GAAP financial measures.

我們提供的產品與研發管線資訊係為投資社群之利益而提供。其目的並非用於促銷或以其他方式影響處方決策。我們的評論將聚焦於非 GAAP 財務衡量指標。

Now I’ll turn the call over to Dave.

現在我把電話交給 Dave。

Thank you, Mike. Q3 was another quarter of solid execution. We delivered strong financial results, raised our full-year financial guidance, advanced our pipeline, and expanded our manufacturing footprint.

謝謝你，Mike。第三季是另一個執行穩健的季度。我們交出強勁的財務成果、上調全年財務指引、推進研發管線，並擴大製造版圖。

Revenue grew nearly $7 billion compared to Q3 2025, and our key product revenue increased by over $6 billion. Within key products, revenue from our oncology, immunology, and neuroscience portfolio doubled versus last year.

與 2025 年第三季相比，營收增加近 70 億美元，而我們的關鍵產品營收增加超過 60 億美元。在關鍵產品中，我們腫瘤、免疫與神經科學產品組合的營收較去年倍增。

We continued the global rollout of Foundayo, launching in the UK, Mexico, and Saudi Arabia for people with obesity; and in Mexico for people with type 2 diabetes. We achieved several key regulatory and pipeline milestones since our last call, including the US approval of our new weekly insulin and new indications for Inluriyo, Jaypirca, and Mounjaro.

我們持續推進 Foundayo 的全球上市，在英國、墨西哥與沙烏地阿拉伯為肥胖族群推出；並在墨西哥為第二型糖尿病族群推出。自上次電話會議以來，我們達成多項重要法規與研發管線里程碑，包括美國核准我們新的每週一次胰島素，以及 Inluriyo、Jaypirca 與 Mounjaro 的新適應症。

As part of the Medicare GLP-1 Bridge Program, we expanded access to obesity medicines in the US for approximately 20 million seniors. Since the July 1 launch, more than 0.5 million people have filled a prescription for Lilly medicine through this program. We’ve heard positive feedback from patients and physicians about the initial implementation.

作為 Medicare GLP-1 Bridge Program 的一部分，我們在美國擴大肥胖藥物的可近性，涵蓋約 2,000 萬名長者。自 7 月 1 日啟動以來，已有超過 50 萬人透過此計畫領取禮來藥品處方。我們已從病患與醫師端聽到對初期導入的正面回饋。

Within the GLP-1 Bridge Program, the Lilly portfolio is performing well. Among new Bridge patients, 7 out of 10 are starting on a Lilly obesity medicine. We’re encouraged to see the strong uptake of the Bridge Program and believe it has the potential to both improve outcomes for seniors and save costs for Medicare.

在 GLP-1 Bridge Program 中，禮來產品組合表現良好。在新的 Bridge 病患中，每 10 人就有 7 人開始使用禮來的肥胖用藥。我們很高興看到 Bridge Program 的強勁採用率，並相信它有潛力同時改善長者的健康結果並為 Medicare 節省成本。

A recently published paper from the University of Southern California’s Schaeffer Center for Health Policy and Economics estimated the expansion of anti-obesity medications in Medicare could deliver over $20 billion of cumulative savings over 10 years. This is an encouraging indicator of the magnitude of savings the GLP-1 Bridge Program could generate.

南加州大學（University of Southern California）Schaeffer 健康政策與經濟中心近期發表的一篇論文估計，在 Medicare 中擴大使用抗肥胖藥物，10 年累計可帶來超過 200 億美元的節省。這是 GLP-1 Bridge Program 可能產生節省規模的一項令人鼓舞的指標。

We added to our pipeline through business development this quarter, acquiring AtaiBeckley and Merida Biosciences. We also progressed our manufacturing build-out to support our long-term growth outlook. We broke ground on two new manufacturing facilities, a $6.5 billion facility in Houston, Texas; and a $5 billion facility in Richmond, Virginia.

本季我們透過商務發展擴充研發管線，收購 AtaiBeckley 與 Merida Biosciences。我們也推進製造擴建，以支撐長期成長展望。我們為兩座新製造設施動土：位於德州休士頓、投資 65 億美元的設施；以及位於維吉尼亞州里奇蒙、投資 50 億美元的設施。

We distributed $1.5 billion in dividends in the third quarter and executed $400 million in share repurchases. We launched the Lilly Change the Course commitment. Through this new initiative, we set a new goal: reach as many people in resource-limited settings who have obesity and related diseases as in high-income countries prior to 2040.

第三季我們發放 15 億美元股利，並執行 4 億美元庫藏股回購。我們啟動 Lilly Change the Course 承諾。透過這項新倡議，我們設定新的目標：在 2040 年之前，於資源有限地區觸及的肥胖及相關疾病患者人數，要與高收入國家相當。

Lastly, we announced Patrik Jonsson, President of Lilly International, will retire at the end of 2026. Ilya Yuffa will expand his responsibilities to include Lilly International as part of a newly created role called President of Lilly Global Markets. I want to thank Patrik for his many contributions over a successful 36-year career at Lilly.

最後，我們宣布禮來國際總裁 Patrik Jonsson 將於 2026 年底退休。Ilya Yuffa 將擴大職責，納入禮來國際，並擔任新設職位「禮來全球市場總裁」（President of Lilly Global Markets）。我要感謝 Patrik 在禮來 36 年成功職涯中的諸多貢獻。

And now I’ll turn the call over to Lucas to review our Q3 results.

現在我把電話交給 Lucas，請他回顧我們第三季的業績。

Thanks, Dave. As shown on slide 7, Q3 was another quarter of industry-leading financial results. Revenue grew 39% compared to Q3 2025, driven by Mounjaro, Zepbound, and strong momentum across the therapeutic areas and geographies.

謝謝你，Dave。如投影片 7 所示，第三季再次繳出業界領先的財務成果。與 2025 年第三季相比，營收成長 39%，主要由 Mounjaro、Zepbound 帶動，並受惠於各治療領域與各地區的強勁動能。

Gross margin as a percentage of revenue increased 80 basis points to 84.4%, as favorable product mix and improved cost of production were partially offset by lower realized prices. Marketing, selling, and administrative expenses increased 14% as we invested in promotional activities to support current and planned product launches.

毛利率（占營收比重）上升 80 個基點至 84.4%，有利的產品組合與生產成本改善，部分被較低的實現價格所抵銷。行銷、銷售與管理費用增加 14%，因我們投入推廣活動以支援現有與規劃中的產品上市。

R&D expenses increased 23%, driven by investment in our growing pipeline of early- and late-stage programs and new molecules added through business development. Our non-GAAP performance margin was 54.2%, an increase of 5.9 percentage points from Q3 2025 driven by revenue growth.

研發費用增加 23%，主要因我們對日益成長的早期與後期研發計畫管線，以及透過商務發展新增的新分子加大投資。我們的非 GAAP 營運利潤率為 54.2%，較 2025 年第三季提高 5.9 個百分點，主要由營收成長帶動。

Non-GAAP earnings per share were $7.48, including acquired IPR&D charges of $4.57. This compares to $7.02 in Q3 2025, which included $0.71 of acquired IPR&D charges.

非 GAAP 每股盈餘為 7.48 美元，其中包含 4.57 美元的收購 IPR&D（取得之進行中研發）費用。相較之下，2025 年第三季為 7.02 美元，其中包含 0.71 美元的收購 IPR&D 費用。

On slide 8, we quantified the effect of price, rate, and volume on revenue growth. US revenue increased 34% in Q3, primarily driven by volume growth from Zepbound and Mounjaro, partially offset by a 7% decline in price.

在投影片 8，我們量化了價格、匯率與銷量對營收成長的影響。第三季美國營收成長 34%，主要由 Zepbound 與 Mounjaro 的銷量成長帶動，部分被價格下滑 7% 所抵銷。

US price benefited from a favorable adjustment to estimates for rebates and discounts. Excluding this adjustment, US price declined 10%. Europe revenue grew 29% in constant currency, driven by sustained strong volume growth of Mounjaro. Growth also benefited from a $410 million one-time milestone payment related to Jardiance. No additional Jardiance milestone payments remain under our agreement with Boehringer Ingelheim.

美國價格受惠於對回扣與折扣估計的有利調整。若排除此項調整，美國價格下滑 10%。歐洲營收以固定匯率計成長 29%，主要由 Mounjaro 持續強勁的銷量成長帶動。成長亦受惠於與 Jardiance 相關的一次性里程碑款 4.10 億美元。依我們與 Boehringer Ingelheim 的協議，已無其他 Jardiance 里程碑款可收取。

In Japan, revenue grew 26% in constant currency, driven by Mounjaro and Kisunla. Mounjaro posted robust volume growth as share of new patient starts increased to over 50%. In China, revenue grew 62% in constant currency, driven by the uptake of Mounjaro. Mounjaro is the first medicine in China to exceed $1 billion of revenue during its first full year.

在日本，營收以固定匯率計成長 26%，由 Mounjaro 與 Kisunla 帶動。隨著新病患起始用藥的市占提升至超過 50%，Mounjaro 的銷量成長強勁。在中國，營收以固定匯率計成長 62%，由 Mounjaro 的採用推動。Mounjaro 是中國第一個在上市後第一個完整年度營收即超過 10 億美元的藥品。

In rest of the world, revenue grew 87% in constant currency, driven by Mounjaro, primarily in Korea, Turkey, and Brazil. Q3 revenue was positively impacted by approximately $900 million of previously mentioned items, including milestones and changes to estimates for rebates and discounts.

在世界其他地區，以固定匯率計算的營收成長87%，主要由 Mounjaro 帶動，尤其是在韓國、土耳其與巴西。第三季營收亦受到先前提及項目約9億美元的正面影響，包括里程碑款項，以及對回扣與折扣之估計變動。

On slide 9, we provide an update on the performance of our key products. Within immunology, Ebglyss worldwide revenue grew 59% compared to Q3 2025. In the US, Ebglyss continued to gain share of new prescriptions in the specialty dermatology market and is the fastest-growing medicine in atopic dermatitis.

在第9張投影片中，我們提供關鍵產品表現的最新進展。在免疫學領域，Ebglyss 全球營收較2025年第三季成長59%。在美國，Ebglyss 持續提升其在專科皮膚科市場新處方的市占，並且是異位性皮膚炎中成長最快的藥物。

In oncology, Jaypirca had another strong quarter, as worldwide revenue increased 59% compared to Q3 2025. In the US, Jaypirca was the fastest-growing BTK inhibitor as measured by total prescriptions. Inluriyo continued its impressive uptake in the metastatic breast cancer oral SERD market, exiting Q3 with more than 60% share of new US prescriptions and 40% of US total prescriptions.

在腫瘤學領域，Jaypirca 再度繳出強勁的一季，全球營收較2025年第三季成長59%。在美國，以總處方量衡量，Jaypirca 是成長最快的 BTK 抑制劑。Inluriyo 在轉移性乳癌口服 SERD 市場持續展現亮眼的導入動能，第三季結束時，美國新處方市占超過60%，且占美國總處方量的40%。

In neuroscience, Kisunla revenue grew 175% compared to Q3 2025. Kisunla maintained its leadership position in US amyloid-targeting therapies. Diagnostic testing momentum continues to build, and the number of p-tau217 blood tests more than doubled compared to Q3 2025, translating to more people being diagnosed with Alzheimer’s disease and accessing treatment.

在神經科學領域，Kisunla 營收較2025年第三季成長175%。Kisunla 維持其在美國類澱粉蛋白標的治療中的領先地位。診斷檢測動能持續增強，p-tau217 血液檢測數量較2025年第三季增加逾一倍，意味著更多人被診斷為阿茲海默症並獲得治療。

Finally, in cardiometabolic health, Mounjaro and Zepbound combined for more than $16 billion of revenue, contributing $6 billion of growth compared to Q3 2025.

最後，在心代謝健康領域，Mounjaro 與 Zepbound 合計營收超過160億美元，較2025年第三季貢獻60億美元的成長。

As seen on slide 10, total prescriptions in the US incretin market grew 32% compared to Q3 2025. Oral GLP-1s and the Medicare GLP-1 Bridge Program are expanding the number of people taking incretin therapy.

如第10張投影片所示，美國腸泌素（incretin）市場的總處方量較2025年第三季成長32%。口服 GLP-1 與 Medicare GLP-1 Bridge 計畫正在擴大使用腸泌素治療的人數。

In the US, total incretin prescriptions for obesity grew 82% in Q3. Approximately 6 out of 10 total prescriptions and more than 7 out of 10 injectable prescriptions were for a Lilly medicine.

在美國，用於肥胖的腸泌素總處方量於第三季成長82%。約每10張總處方中有6張、且每10張注射劑處方中有超過7張為禮來（Lilly）的藥品。

In the US, type 2 diabetes incretin total prescriptions grew 8% compared to Q3 2025, and the Lilly portfolio continues to lead here with more than 60% share of market. Outside the US, Lilly’s portfolio again performed well.

在美國，用於第二型糖尿病的腸泌素總處方量較2025年第三季成長8%，而禮來產品組合在此仍持續領先，市占超過60%。在美國以外地區，禮來的產品組合同樣再次表現出色。

Slide 11 shows aggregate trends in international incretins, which have increased by 53% since the same period last year as measured by IQVIA gross sales. Lilly is strengthening its leadership position outside the US, gaining nearly 4 percentage points of share compared to Q2 2026 to reach approximately 58%.

第11張投影片顯示國際腸泌素的整體趨勢；以 IQVIA 總銷售額衡量，較去年同期增加53%。禮來正在強化其在美國以外的領先地位，市占較2026年第二季提升近4個百分點，達到約58%。

Slide 12 provides an update on the Foundayo launch. In the US, total prescriptions and the share of new patients continue to rise. Approximately 4 in 10 patients starting on an oral obesity medicine choose Foundayo, and the number of new Foundayo patients in Q3 doubled from the previous quarter. We look forward to launching Foundayo in type 2 diabetes in the US and expect regulatory action in Q4.

第12張投影片提供 Foundayo 上市進展的最新資訊。在美國，總處方量與新病患占比持續上升。約每10位開始使用口服減重藥物的病患中有4位選擇 Foundayo，且第三季新增 Foundayo 病患數較前一季倍增。我們期待在美國推出用於第二型糖尿病的 Foundayo，並預期第四季將有監管機關的審查結果。

Outside the US, Foundayo has launched in four countries and is under regulatory review in more than 40 countries. We continue to expect a global rollout in all major markets in 2027.

在美國以外地區，Foundayo 已在四個國家上市，並在超過40個國家接受監管審查。我們仍預期於2027年在所有主要市場進行全球推廣。

On slide 13, we provide an update on year-to-date capital allocation.

在第13張投影片中，我們提供年初至今的資本配置最新進展。

Moving to slide 14 is our updated 2026 financial guidance. Based on strong underlying performance across our portfolio, we now expect full-year revenue to be between $91 billion and $92 billion. We saw strength in the US, driven by rapid uptake of the Medicare GLP-1 Bridge Program; and outside of the US from strong Mounjaro performance.

接著看第14張投影片，這是我們更新後的2026年財務指引。基於我們產品組合整體強勁的基本面表現，我們目前預期全年營收介於910億至920億美元。我們在美國看到強勁表現，主要由 Medicare GLP-1 Bridge 計畫快速導入所帶動；而在美國以外地區，則受惠於 Mounjaro 的強勁表現。

Given our updated revenue outlook, we now expect non-GAAP performance margin to be between 52% and 52.5%. We expect non-GAAP earnings per share of $35 to $36. This reflects an increase of $4.07 per share at the midpoint of the range before updates to the Q3 acquired IPR&D charges of $4.57 per share.

鑑於我們更新後的營收展望，我們目前預期非GAAP營業利益率介於52%至52.5%。我們預期非GAAP每股盈餘為35至36美元。以區間中點計算，這反映每股增加4.07美元（在更新第三季收購取得之進行中研發（IPR&D）費用每股4.57美元之前）。

We are pleased with our Q3 results and confident in our ability to deliver another year of industry-leading growth. We will share our 2027 financial guidance on our Q4 call in January. However, I will share highlights on our initial thoughts regarding some of the pushes and pulls that we expect to impact our 2027 financial outlook.

我們對第三季業績感到滿意，並對持續實現另一個產業領先的成長年度充滿信心。我們將在1月的第四季電話會議中分享2027年財務指引。不過，我會先分享我們對若干預期將影響2027年財務展望之利多與利空因素的初步看法重點。

Beginning with the US revenue, we expect sustained volume growth in the incretin market and the full-year impact of the Medicare GLP-1 Bridge access and the launch of Foundayo in type 2 diabetes. Outside the US, we expect Mounjaro’s leadership position to continue. We expect to launch Foundayo, which will drive additional market growth.

先從美國營收開始，我們預期腸泌素市場的量能成長將持續，並將反映 Medicare GLP-1 Bridge 可近性與 Foundayo 用於第二型糖尿病上市的全年影響。在美國以外地區，我們預期 Mounjaro 的領先地位將延續。我們預期將推出 Foundayo，進一步帶動市場成長。

Consistent with previous years, we expect net realized price to be a headwind, more than offset by volume growth. It is also worth noting that 2026 revenue benefited from approximately $2 billion of one-time items, primarily related to milestone payments and changes in estimates for rebates and discounts that we don’t expect to recur.

與過往年度一致，我們預期淨實現價格將構成逆風，但將被銷量成長所抵銷且抵銷幅度更大。同時值得注意的是，2026年營收受惠於約20億美元的一次性項目，主要與里程碑款項以及對回扣與折扣估計的變動相關，我們預期這些不會再度發生。

Now I will turn the call over to Dan to provide an update on our pipeline.

接下來我將把電話會議交給 Dan，由他提供我們研發管線的最新進展。

Thanks, Lucas. Since our last earnings call, we’ve made progress across Lilly R&D. I’ll begin in cardiometabolic health by recapping our most recent Phase 3 readout from our GIP/GLP-1 glucagon triple agonist, retatrutide.

謝謝你，Lucas。自上次財報電話會議以來，我們在禮來研發（R&D）各方面都取得進展。我將先從心代謝健康領域開始，回顧我們 GIP/GLP-1/胰高血糖素三重致效劑 retatrutide 最近一次第3期試驗的主要結果。

Just yesterday, we shared top-line results from TRANSCEND-T2D-2, a head-to-head trial of retatrutide versus semaglutide in people with type 2 diabetes. As shown on slide 15, retatrutide delivered greater A1C reduction and more than double the weight loss of 2-milligram semaglutide. Retatrutide reduced A1C by 2.2% compared to 1.8% on 2 milligrams semaglutide.

就在昨天，我們公布了 TRANSCEND-T2D-2 的主要結果；這是一項在第二型糖尿病患者中比較 retatrutide 與 semaglutide 的頭對頭試驗。如第15張投影片所示，retatrutide 帶來更大的 A1C 降幅，且減重效果超過2毫克 semaglutide 的兩倍。retatrutide 使 A1C 降低2.2%，相較之下，2毫克 semaglutide 為降低1.8%。

These data demonstrate retatrutide can provide even more glycemic control than an approved diabetes medicine, providing a potential new treatment option. What’s even more striking was the 20% to 21% weight loss achieved in people taking retatrutide compared to 9.4% weight loss in the semaglutide arm. For people with type 2 diabetes who struggle to lose weight, retatrutide continues to demonstrate powerful weight loss alongside compelling glycemic control in this difficult-to-treat population.

這些數據顯示，retatrutide 可提供比已核准糖尿病藥物更強的血糖控制，具備成為潛在新治療選項的可能性。更引人注目的是，使用 retatrutide 的受試者達到20%至21%的體重減輕，相較之下，semaglutide 組的減重為9.4%。對於第二型糖尿病且難以減重的患者而言，retatrutide 在這個治療困難族群中，持續展現強勁的減重效果並兼具具吸引力的血糖控制。

Moving to another Lilly triple agonist, at last month’s European Association for the Study of Diabetes meeting, we presented Phase 2 data for EloraTZP. EloraTZP is a combination of our selective amylin receptor agonist, laurelintide, and our GIP/GLP-1 dual agonist, tirzepatide.

再談另一項禮來的三重致效劑，上月在歐洲糖尿病研究協會（EASD）年會上，我們發表了 EloraTZP 的第2期數據。EloraTZP 是由我們的選擇性胺淀素受體致效劑 laurelintide 與我們的 GIP/GLP-1 雙重致效劑 tirzepatide 所組成的複方。

As shown on slide 16, EloraTZP delivered weight loss of 23.3% at 48 weeks in people with type 2 diabetes and obesity. In a population that struggles to lose weight, this powerful combination delivered 57% more weight loss compared to tirzepatide, the world’s most prescribed incretin.

如投影片16所示，EloraTZP在第2型糖尿病合併肥胖患者中，於48週達成23.3%的體重減輕。在一個減重困難的人群中，這項強效組合相較於tirzepatide（全球處方量最高的腸泌素藥物）帶來多57%的減重效果。

In addition, the highest dose combination of EloraTZP delivered A1C reduction of 2.9% at 48 weeks, and more than three out of four patients achieved an A1C below 5.7%, a level associated with normal blood glucose. Pending replication of these first-of-their-kind results in our Phase 3 trials, we believe this drug could meaningfully improve what is possible in the treatment of type 2 diabetes and obesity, and these data highlight the potential importance of treating with three physiologic hormones at once.

此外，EloraTZP的最高劑量組合在48週達成2.9%的A1C下降，且超過四分之三的患者A1C低於5.7%，此水準與正常血糖相關。在我們第3期試驗中複驗這些首創結果之前，我們相信此藥物有望實質提升第2型糖尿病與肥胖治療的可能性，而這些數據也凸顯同時以三種生理性荷爾蒙治療的潛在重要性。

Moving to slide 17, as one might expect, when rapidly escalating doses of a medicine with multiple mechanisms, the highest dose EloraTZP arm had a higher discontinuation rate due to adverse events. As we move into Phase 3, of course we will use a slower, optimized dose escalation schedule, which we anticipate will improve tolerability.

接著看投影片17，如同可預期的，當一種具多重機轉的藥物以快速方式遞增劑量時，EloraTZP最高劑量組因不良事件而停藥的比例較高。進入第3期後，我們當然會採用較慢且最佳化的劑量遞增時程，我們預期這將改善耐受性。

Note that monotherapy laurelintide showed excellent tolerability, with discontinuations due to adverse events lower than placebo. We look forward to beginning the Phase 3 trials of co-formulated EloraTZP imminently.

請注意，單藥laurelintide展現極佳的耐受性，因不良事件而停藥的比例甚至低於安慰劑。我們期待很快就能啟動共配方EloraTZP的第3期試驗。

We also presented results from ACHIEVE-4, the cardiovascular outcomes trial of orforglipron in people with type 2 diabetes and obesity with increased cardiovascular risk. As shown on slide 18, orforglipron met the primary endpoint of non-inferiority versus insulin glargine, reaffirming its cardiovascular safety profile.

我們也公布ACHIEVE-4的結果，這是一項在第2型糖尿病合併肥胖且心血管風險升高人群中，評估orforglipron的心血管結局試驗。如投影片18所示，orforglipron達成相較於insulin glargine的主要終點（非劣效性），再次確認其心血管安全性概況。

In additional pre-specified analysis, compared to insulin glargine, orforglipron showed a 16% lower risk of MACE-4. And for people fortunate enough to have been randomized to receive orforglipron in this trial, there was a 57% lower risk of all-cause death.

在額外的預先指定分析中，與insulin glargine相比，orforglipron的MACE-4風險降低16%。而在本試驗中有幸被隨機分派接受orforglipron的受試者，全因死亡風險降低57%。

These data complement the six previously presented Phase 3 trials for orforglipron and support the potential of orforglipron as a foundational daily oral treatment for people with obesity and people with type 2 diabetes.

這些數據補強先前已公布的六項orforglipron第3期試驗結果，並支持orforglipron有潛力成為肥胖患者與第2型糖尿病患者的基礎性每日口服治療。

Also in cardiometabolic health this quarter, in the US, we received two important FDA approvals. The FDA approved tirzepatide to reduce cardiovascular risk in adults with type 2 diabetes, and the FDA approved our once-weekly basal insulin, insulin efsitora alfa, for adults with type 2 diabetes under the brand name Onswik. Weekly basal insulin could significantly improve patient experience by reducing the number of injections compared to daily basal insulin.

本季在心腎代謝健康方面，在美國我們獲得兩項重要的FDA核准。FDA核准tirzepatide用於降低第2型糖尿病成人的心血管風險，並核准我們每週一次的基礎胰島素insulin efsitora alfa，以Onswik品牌用於第2型糖尿病成人。每週一次的基礎胰島素可透過相較每日基礎胰島素減少注射次數，顯著改善患者體驗。

Moving to oncology. The FDA approved pirtobrutinib for certain patients with previously untreated CLL or SLL based on the BRUIN CLL-313 Phase 3 trial. Pirtobrutinib reduced the risk of disease progression or death by 80% compared to bendamustine plus rituximab.

接著談腫瘤學。FDA根據BRUIN CLL-313第3期試驗，核准pirtobrutinib用於特定先前未治療的CLL或SLL患者。與bendamustine加rituximab相比，pirtobrutinib將疾病進展或死亡風險降低80%。

This approval underscores pirtobrutinib’s versatility across the CLL continuum of care. It can now be used in the first-line setting for appropriate patients, in addition to its valuable role in the relapsed or refractory post-covalent BTK inhibitor setting.

此項核准凸顯pirtobrutinib在CLL整體照護連續體中的多用途性。除其在既往使用共價型BTK抑制劑後復發或難治情境中的重要角色外，現在也可在適當患者的一線治療中使用。

The FDA also approved imlunestrant in combination with abemaciclib in ER-positive, HER2-negative, ESR1-mutated advanced breast cancer. The all-oral combination of imlunestrant and abemaciclib gives patients a treatment approach that targets the two central drivers of ER-positive breast cancer, with an evidence-based treatment approach, an established tolerability profile, and no new monitoring requirements. We look forward to the results from EMBER-4, the ongoing Phase 3 trial of imlunestrant in high-risk early breast cancer.

FDA也核准imlunestrant合併abemaciclib，用於ER陽性、HER2陰性、ESR1突變之晚期乳癌。imlunestrant與abemaciclib的全口服組合，為患者提供一種以實證為基礎的治療方式，可同時鎖定ER陽性乳癌的兩個核心驅動因子，具既有的耐受性概況，且不需要新增監測要求。我們期待EMBER-4（imlunestrant用於高風險早期乳癌的進行中第3期試驗）的結果。

Elsewhere in oncology, we initiated a Phase 3 trial with our PI3 kinase alpha inhibitor, tersalisib, in combination with a CDK4/6 inhibitor and endocrine therapy in advanced breast cancer. Tersalisib is a mutant-selective PI3 kinase alpha inhibitor intended to target the PI3 kinase mutations in breast cancer while sparing normal PI3 kinase in healthy tissue.

在腫瘤學的其他領域，我們啟動一項第3期試驗，評估我們的PI3 kinase alpha抑制劑tersalisib，合併CDK4/6抑制劑與內分泌治療，用於晚期乳癌。Tersalisib是一種突變選擇性的PI3 kinase alpha抑制劑，旨在鎖定乳癌中的PI3 kinase突變，同時保留健康組織中的正常PI3 kinase。

We believe this profile could lead to efficacy in the first-line metastatic setting without as much of the toxicity as seen with other agents. We now have eight new oncology medicines or major new indications that are in Phase 3 trials or will start Phase 3 shortly.

我們相信此一特性可在第一線轉移性治療情境中帶來療效，同時較其他藥物減少毒性。目前我們已有八項新的腫瘤藥物或重要新適應症正處於第3期試驗中，或將於近期啟動第3期。

Moving to neuroscience. We completed the acquisition of AtaiBeckley, adding a portfolio of neuroplastogens with potential to treat depression and other serious mental health conditions. We’re pleased to welcome the AtaiBeckley team to Lilly and look forward to advancing multiple clinical programs together.

接著談神經科學。我們完成對AtaiBeckley的收購，新增一系列具神經可塑性促進作用（neuroplastogens）的產品組合，具治療憂鬱症及其他嚴重精神健康疾病的潛力。我們很高興歡迎AtaiBeckley團隊加入Lilly，並期待共同推進多項臨床計畫。

Moving to immunology, we shared positive Phase 3 results for lebrikizumab in people with moderate to severe atopic dermatitis of the hands and feet. Hand and foot atopic dermatitis is painful and difficult to treat, and these data show lebrikizumab can be a new option for patients without the need for topical treatments. We’ve submitted these data to the FDA for a potential label update.

接著談免疫學，我們分享lebrikizumab在中度至重度手足異位性皮膚炎患者中的正向第3期結果。手足異位性皮膚炎疼痛且難以治療，而這些數據顯示lebrikizumab可成為患者的新選擇，且無需外用治療。我們已將這些數據提交FDA，申請可能的標籤更新。

We also shared 52-week results from Phase 3b trials of ixekizumab and tirzepatide used together in people with psoriasis or psoriatic arthritis and obesity. The ixekizumab and tirzepatide arm delivered greater improvements in skin and joint outcomes than ixekizumab alone, highlighting the importance of immunometabolic health.

我們也分享第3b期試驗的52週結果，評估ixekizumab與tirzepatide併用於乾癬或乾癬性關節炎合併肥胖的患者。ixekizumab與tirzepatide組在皮膚與關節結局上的改善優於單用ixekizumab，凸顯免疫代謝健康的重要性。

Earlier this month, we closed the acquisition of Merida Biosciences, which is developing MER511, a precision immunology therapy in Phase 1 for Graves’ disease and thyroid eye disease. This drug was designed to selectively degrade the disease-causing autoantibodies while preserving normal immune function. We’re excited about the potential to help patients here, and we’re pleased to welcome the Merida team to Lilly.

本月稍早，我們完成對Merida Biosciences的收購；該公司正在開發MER511，這是一項精準免疫學療法，目前處於第1期，用於葛瑞夫茲病（Graves’ disease）與甲狀腺眼病變。此藥物設計為選擇性降解致病自體抗體，同時保留正常免疫功能。我們對於在此領域幫助患者的潛力感到振奮，也很高興歡迎Merida團隊加入Lilly。

Slides 19 and 20 show pipeline movements since our last earnings call and the key events we expect in the remainder of 2026. We look forward to sharing more details about our pipeline at the upcoming Lilly Innovation Day on December 7. Although we won’t have time to share everything we’re working on, we’ll do our best to curate a few examples that illustrate the depth and breadth of our capabilities and our pipeline at Lilly.

投影片19與20顯示自上次財報電話會議以來的研發管線進展，以及我們預期在2026年剩餘期間的關鍵事件。我們期待在12月7日即將舉行的Lilly Innovation Day分享更多管線細節。雖然我們沒有時間分享所有正在進行的工作，但我們會盡力精選幾個例子，展現Lilly能力與研發管線的深度與廣度。

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

接下來我把電話交回Dave做結語。

Thanks, Dan. We were pleased with the progress in Q3 and throughout 2026. We delivered another quarter of strong financial results, advanced our pipeline through Lilly Research Labs and business development, and started building two new manufacturing facilities in the US to support our future growth.

謝謝你，Dan。我們對第三季以及整個2026年的進展感到滿意。我們再度交出一季強勁的財務成果，透過Lilly Research Labs與商業發展推進研發管線，並開始在美國興建兩座新的製造設施，以支持未來成長。

While we continue to make excellent progress during a period of industry-leading growth, we remain focused on investing now to support our long-term vision: redefine how a pharmaceutical company can improve human health at a global scale.

在產業領先的成長期間，我們持續取得卓越進展，同時仍專注於現在就進行投資，以支持我們的長期願景：重新定義一家製藥公司如何在全球規模上改善人類健康。

We’ve developed differentiated capabilities in R&D, manufacturing, and commercial operations, where we’re engaging directly with patients through platforms like LillyDirect, changing the way people access healthcare.

我們已在研發、製造與商業營運方面建立差異化能力；在商業端，我們透過 LillyDirect 等平台直接與病患互動，改變人們取得醫療照護的方式。

Given the depth of our incretin pipeline, we expect our leadership position in cardiometabolic health and broad pipeline of next-generation obesity medicines to have an impact on global health for decades to come.

鑑於我們腸泌素（incretin）產品線的深度，我們預期在心臟代謝健康領域的領導地位，以及涵蓋下一代肥胖藥物的廣泛產品線，將在未來數十年對全球健康產生影響。

And with three-fourths of our clinical pipeline focused on diseases outside of obesity, we’re developing new medicines that have the potential to impact a broad range of disease and deliver diversified, durable growth for Lilly and our shareholders. Q3 was another strong quarter and another step toward our long-term goals.

此外，我們臨床產品線中有四分之三聚焦於肥胖以外的疾病；我們正在開發有潛力影響廣泛疾病的新藥，並為禮來及股東帶來多元化且可持續的成長。第三季是另一個強勁的季度，也是朝向我們長期目標邁進的又一步。

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

現在我把電話交給 Mike，由他主持問答環節。

Great. Thank you, Dave. We’d like to take questions from as many callers as possible. So to that end, consistent with prior quarters, please limit yourself to one question. Operator, please provide the instructions for how to join the queue, and then we’re ready for the first caller.

很好。謝謝你，Dave。我們希望盡可能讓更多來電者提問。因此，與前幾季一致，請各位僅限提一個問題。接線員，請提供如何加入提問隊列的說明，然後我們就準備接第一位來電者。

(Operator Instructions) Chris Schott, JP Morgan.

(接線員指示) Chris Schott，摩根大通。

Thanks so much, and congrats on all the progress. I guess, bigger picture one. You’ve raised guidance on the top line by roughly $10 billion year to date. I guess if you reflect on what’s happening here, just talk a little bit about what the biggest surprises have been as we think about US versus OUS, cash pay versus commercial, et cetera?

非常感謝，也恭喜你們取得這些進展。我想先問一個較宏觀的問題。你們今年迄今已將營收端（top line）指引上調約 100 億美元。回顧目前的情況，能否談談最大的意外驚喜是什麼？例如美國（US）相對於美國以外（OUS）、自費（cash pay）相對於商業保險（commercial）等面向？

And probably as importantly, just when you think about these dynamics going forward, are we just seeing a fundamentally larger incretin opportunity than you anticipated? Or is this more of a pull-forward of demand as we think about that longer addressable TAM for the company?

同樣重要的是，展望未來，當你們看待這些動態時，我們是否只是看到一個你們原先預期更大的腸泌素機會？還是說，這更像是需求提前釋放（pull-forward），就公司長期可觸及的總可服務市場（TAM）而言？

To talk a bit about guidance and our outlook for incretins in the future, we’ll go to Lucas.

關於指引以及我們對未來腸泌素的展望，我們請 Lucas 來回答。

And I think the starting point, if you go back when we set up the guide at the beginning of the year, you may remember that we have that slide with, again, the opportunities and still events that we had in front of us for 2026. We talked about the launch of Foundayo in Q2, we talked about starting the Medicare Bridge Program, and then of course we talked about the variable of the growth, in particular on the incretin out-of-pocket business, and the runway of that growth.

我想先從年初我們設定指引時談起。你可能記得我們有一張投影片，列出到 2026 年之前我們面前的機會與仍待發生的事件。我們談到第二季 Foundayo 的上市、談到啟動 Medicare Bridge Program，當然也談到成長的變數，特別是腸泌素自付（out-of-pocket）業務的成長，以及該成長的延伸空間（runway）。

Again, what you see now in the latest guidance that we just shared today is actually a confirmation that we are tracking well across all of them, even better than what we anticipated. So that’s, I think, a positive confirmation of the trends and the solid performance that we continue to see.

再次強調，你們今天在最新指引中看到的，其實是對我們在上述各項上都追蹤良好、甚至優於預期的確認。因此，我認為這是對趨勢以及我們持續看到的穩健表現的一個正面驗證。

Going back to your second part of the question about the runway of that, is that pulling forward or not, the way that we think about it, if you look at just the incretin business, we’re still scratching the surface on the number of patients that we can reach. You look at the US, and we’re talking about 1 out of 10 patients that we are reaching nowadays. And even ex-US, we are talking about 2 patients out of 100 patients.

回到你問題的第二部分：關於這段成長延伸空間是否屬於提前釋放。我們的看法是，如果只看腸泌素業務，我們在可觸及的病患數上仍只是觸及皮毛。以美國來看，我們目前大約只觸及 10 位病患中的 1 位。而在美國以外，我們談的是 100 位病患中僅 2 位。

So it’s actually a really low base, though the numbers seem really big. $16 billion this quarter in incretin business. The runway of opportunity of growth is still for many years to come from my perspective.

所以基礎其實非常低，儘管數字看起來很大。本季腸泌素業務達 160 億美元。以我的觀點，成長機會的延伸空間仍將持續很多年。

And on top of that, we continue to expand the breadth across all the therapeutic areas. Super also happy to report the 100% growth on the rest of the key products across oncology, immunology, and neuroscience. So that’s just to give you some color about the short term and how we think about also long term.

此外，我們也持續在所有治療領域擴大覆蓋廣度。也非常高興可以報告，在腫瘤、免疫與神經科學等其他關鍵產品上，我們看到 100% 的成長。以上提供一些我們對短期狀況以及長期思考方式的補充說明。

Great. Next question, please.

很好。請下一個問題。

Geoff Meacham, Citi.

Geoff Meacham，花旗。

I want to ask about what data you have on tirzepatide persistency and obesity just over the course of the past year or so. And importantly, when you look to next year, would you expect Foundayo and retatrutide to be different than that in terms of real-world experience?

我想問你們掌握的 tirzepatide 在肥胖適應症上的治療持續性（persistency）資料，回顧過去一年左右的情況。更重要的是，展望明年，你們是否預期 Foundayo 與 retatrutide 在真實世界使用經驗上會與此不同？

To talk about tirzepatide persistency in obesity and thoughts on the pipeline looking in the future, we’ll go to Ilya.

關於 tirzepatide 在肥胖上的治療持續性，以及對未來產品線的看法，我們請 Ilya 來回答。

What we’ve seen in persistency -- and actually before we launched Zepbound -- and we’ve had success with Trulicity in the past, and that was the standard of what is possible for chronic medicine for adherence, which ended up becoming around 16 to 18 months of adherence.

我們在治療持續性方面看到的情況——其實在我們推出 Zepbound 之前——我們過去在 Trulicity 上就有成功經驗；那也成為慢性用藥在依從性（adherence）方面可達成水準的標竿，最終大約可達 16 到 18 個月的依從性。

What we’re seeing with Zepbound is that in the covered space, we continue to see the trajectory of being just as beneficial in terms of adherence as we’ve seen in Trulicity. And even in the self-pay, we’re seeing that close to the covered market. And so the persistency, actually for a chronic medication, Zepbound is doing extraordinarily well.

我們在 Zepbound 上看到的是：在有給付（covered）的市場中，其依從性的走勢持續顯示，與我們在 Trulicity 上看到的一樣有利。即使在自費（self-pay）族群，我們也看到其表現接近有給付市場。因此，就慢性用藥而言，Zepbound 的治療持續性其實表現得非常出色。

Now expectations for oral, it’s still early. But as typical chronic medications as well, if you take a look at orals, they typically are lower adherence overall relative to weekly injectable therapies, and that’s what we expect to see.

至於口服劑型（oral）的預期，目前仍為時尚早。但如同一般慢性用藥的典型情況，如果你看口服藥，整體依從性通常會低於每週一次的注射療法，而這也是我們預期會看到的。

One additional data point that I think will be important as we look at even the success of Bridge -- early days in Bridge -- having a low out-of-pocket helps with that friction point. And we’re seeing improved adherence in Bridge. So that will all play out as part of the different friction points, both in terms of out-of-pocket as well as the benefits that people gain from these therapies.

另外還有一個我認為重要的資料點：當我們觀察 Bridge 的成功——Bridge 還在早期階段——較低的自付額（out-of-pocket）有助於降低摩擦點。我們也在 Bridge 中看到依從性有所改善。因此，這些都會在不同摩擦點的影響下逐步呈現，包括自付額，以及人們從這些療法中獲得的效益。

Thanks, Ilya. Next question, please.

謝謝你，Ilya。請下一個問題。

Seamus Fernandez, Guggenheim.

Seamus Fernandez，Guggenheim。

So I’m going to do the non-obesity question. Kisunla is actually starting to show the prospect of becoming a blockbuster product and starting to grow faster, maybe a little bit faster overseas. But I was hoping, Dan, you might weigh in on the prospects for TB3, the prospects for success, and how you see that program really evolving the treatment paradigm, should it succeed particularly in the context of some of the novel tau biomarkers that we’re starting to see.

那我來問一個非肥胖的問題。Kisunla 似乎開始展現成為重磅產品（blockbuster）的前景，且成長速度正在加快，海外可能還快一些。但我希望 Dan 你能談談 TB3 的前景、成功機率，以及若該計畫成功，你如何看待它真正改變治療典範（treatment paradigm）的方式，特別是在我們開始看到一些新型 tau 生物標記（biomarkers）的背景下。

I think there are a lot of questions from investors that we get on what really is the market opportunity here given the Kisunla uptake. But it does seem like some of those behaviors are changing.

我們從投資人那裡收到很多問題，想了解在 Kisunla 的採用（uptake）情況下，這裡的市場機會究竟有多大。但看起來其中一些行為正在改變。

Always welcome neuroscience questions. So we’ll go to Carole to talk about prospects for Kisunla and maybe even the neuroscience space more broadly.

一向歡迎神經科學相關問題。那我們請 Carole 來談談 Kisunla 的前景，甚至更廣泛的神經科學領域。

Yes, we’re very excited to see the growth of Kisunla over the last year. And this growth is both driven by our confidence in this product with its convenient 30-minute infusion time, once-monthly dosing, and the opportunity for treat-to-clear in this patient population.

是的，我們對 Kisunla 過去一年來的成長感到非常振奮。這項成長一方面來自我們對該產品的信心：便利的 30 分鐘輸注時間、每月一次給藥，以及在這類病人族群中「治療至清除（treat-to-clear）」的機會。

We’ve also seen a tremendous growth in the opportunity for diagnosis with blood-based biomarkers, with p-Tau217 becoming available. And we see this becoming a diagnostic that enables access to early diagnosis, potentially even in primary care offices in the future.

我們也看到以血液為基礎的生物標記在診斷機會上大幅成長，其中 p-Tau217 已開始可用。我們認為這將成為一項診斷工具，能促進早期診斷的可近性，未來甚至可能在基層醫療診所中使用。

As we look at TRAILBLAZER-3, which is our study looking at prevention in cognitively unimpaired people, looking at prevention of progression to early symptomatic Alzheimer’s disease, these biomarkers will certainly also enable early diagnosis for people that have risk concerns about their cognition before loss of their cognition.

當我們看 TRAILBLAZER-3（我們針對認知未受損人群、評估預防的研究），其目標是預防進展至早期有症狀的阿茲海默症時，這些生物標記也必然能協助早期診斷：讓那些在認知功能尚未下降前、就對自身認知風險有所疑慮的人能更早被辨識。

So we’re excited both about the growth in early symptomatic Alzheimer’s disease, but also, if TRAILBLAZER-3 reads out positively, really expanding this market to earlier stages of disease, where we already have preliminary evidence from our early symptomatic Alzheimer’s disease space that treating earlier will have a more significant impact on cognition.

因此，我們對早期有症狀阿茲海默症市場的成長感到興奮；同時，如果 TRAILBLAZER-3 的結果為正面，將能把市場真正擴展到更早期的疾病階段。我們在早期有症狀阿茲海默症領域已取得初步證據，顯示越早治療，對認知的影響越顯著。

Thanks, Carole. Our next question, please.

謝謝你，Carole。請下一題。

Evan Seigerman, BMO Capital Markets.

BMO Capital Markets 的 Evan Seigerman。

Bigger picture one here. So clearly the incretin franchise is becoming an enormous earnings driver, but also raises the question of what comes next. When you look beyond the cardiometabolic disease, where do you see the best opportunity to build Lilly’s next multi-billion-dollar growth pillar? And does recent BD activities suggest that neuroscience and immunology are emerging as higher strategic priorities?

我想從更宏觀的角度問一題。顯然，腸泌素（incretin）產品線正成為巨大的獲利驅動力，但也引發「下一步是什麼」的問題。當你們把視野放到心代謝疾病之外時，你們認為在哪些領域最有機會打造禮來下一個數十億美元級的成長支柱？另外，近期的 BD（商務開發）活動是否意味著神經科學與免疫學正成為更高的策略優先事項？

Thanks, Evan, for the question about the next big opportunity after incretins. We’ll go to Dan to talk a bit about some of the pipeline opportunities he’s excited about.

謝謝你，Evan，關於腸泌素之後下一個重大機會的提問。我們請 Dan 來談談他特別看好的幾個研發管線機會。

I would say that we’re excited about all three of our other therapeutic areas, which are immunology, neuroscience, and oncology. The BD activity reflects just our strategic intent to grow those areas, but the intersection of that strategic intent with assets that are actually out there and are attractive to us.

我會說，我們對另外三個治療領域都感到興奮：免疫學、神經科學與腫瘤學。BD 活動反映的是我們在策略上希望擴大這些領域；同時也反映這個策略意圖與市場上實際存在、且對我們具吸引力的資產之間的交集。

Oncology is probably the space where we’ve made the most progress, and we highlighted eight really important late-stage programs, several of which could be quite large in size. For example, the recent Kelonia acquisition, which targets myeloma, is a huge opportunity if the data continue to hold out the way we expect them to.

腫瘤學可能是我們進展最多的領域；我們也重點介紹了 8 個非常重要的後期研發計畫，其中有幾個的市場規模可能相當可觀。例如，近期收購 Kelonia（鎖定多發性骨髓瘤）就是一個巨大機會，前提是數據能如我們預期般持續成立。

Neuroscience, of course, is the area that has the largest unmet medical need and really the least progress in the pharmaceutical industry towards addressing that. We’re firmly committed to making a difference for patients in this space, and you can see our acquisitions in sleep and psychiatry combined with our in-house expertise in neurodegeneration are aimed to really grow that market on behalf of patients.

當然，神經科學是未被滿足醫療需求最大的領域，也是製藥產業在解決這些需求上進展最少的領域。我們堅定承諾要在此領域為病人帶來改變；你可以看到我們在睡眠與精神醫學方面的收購，加上我們在神經退化疾病的內部專長，目標都是為了代表病人真正擴大這個市場。

And then finally, immunology -- I think there’s been a lot of crowding in immunology on a few probably important targets, but we also see a great opportunity actually to raise expectations in immunology with breakthrough therapies that I think can deliver efficacy that’s never been seen before. And that’s what we’re trying to do with programs like the Merida acquisition or the Orna acquisition, which is aimed at immune reset. So lots of growth opportunities across those areas.

最後是免疫學——我認為免疫學在少數幾個可能很重要的標的上出現了相當擁擠的競爭，但我們也看到一個很大的機會：透過突破性療法來提高免疫學的療效期待，帶來前所未見的療效。這正是我們透過像 Merida 收購案或 Orna 收購案（目標是免疫重置）等計畫所要達成的。因此，這些領域都有許多成長機會。

Thank you, Dan. Next caller, please.

謝謝你，Dan。請下一位來電者。

Kerry Holford, Berenberg.

Berenberg 的 Kerry Holford。

I wonder if you can speak a little more about Medicare Bridge. How does the split between injectable and pill in that channel differ from others? It seems like the majority of Medicare demand is injectable. I wonder, has that surprised you with regard to your products in that space?

我想請你們再多談一點 Medicare Bridge。在那個通路中，注射劑與口服藥的占比，和其他通路相比有何不同？看起來 Medicare 的需求多數是注射劑。就你們在該領域的產品而言，這是否讓你們感到意外？

And also could you talk to what proportion of patients in that Medicare channel for the Bridge program specifically are naive versus existing patients transferring from other channels?

另外也想請你們談談，在 Medicare 通路、特別是 Bridge 計畫之下的病人中，有多少比例是新用戶（naive），相對於從其他通路轉入的既有病人？

We’ll go to Ilya to talk a bit about Bridge, the injectable versus pill split, as well as naive versus switches.

我們請 Ilya 來談談 Bridge：注射劑與口服藥的占比，以及新用戶與轉換用戶的情況。

You know, for Bridge, one, it performed extraordinarily well. I think we knew that it was going to be a significant benefit for seniors. The program itself is simple in understanding the criteria and a low out-of-pocket. And so all those things combined, we have seen about 3/4, 75%, of people coming into Bridge going into injectable therapy, 7 out of 10 in total choosing Lilly medicine. And so we’ve performed really well across Bridge.

你知道，就 Bridge 而言，第一，它的表現非常出色。我想我們知道它會為長者帶來顯著的好處。這個計畫本身在理解資格條件上很簡單，而且自付額很低。因此，這些因素加總起來，我們看到大約 3/4、也就是 75% 的人進入 Bridge 後選擇注射治療；整體而言有 7 成選擇禮來的藥物。所以我們在 Bridge 的表現非常好。

That is higher than maybe some of the self-pay segment. One of the components of that is the same low out-of-pocket and getting the greatest efficacy. And the standard of care that’s been established in obesity has favored Zepbound in particular. But we’re seeing good growth and uptake of orals and Foundayo as well.

這個比例可能高於部分自費族群。其中一個原因是同樣的低自付額，同時又能獲得最高的療效。而在肥胖症已建立的照護標準（standard of care）特別偏好 Zepbound。不過我們也看到口服藥以及 Foundayo 的良好成長與採用。

In terms of expanding the number of people actually being treated, after the first bolus of people coming into Medicare, we’re seeing now that about 80% of the people getting treatment under Bridge are naive or have not been on incretin therapy in the past. And so we see this as a significant driver of access long term and it’s still early days.

就擴大實際接受治療的人數而言，在第一波大量人群進入 Medicare 之後，我們現在看到在 Bridge 下接受治療的人當中，大約 80% 是新用戶，或過去未曾使用腸泌素（incretin）療法。因此我們認為，這將在長期成為推動可近性的重大驅動力，而目前仍在早期階段。

And while it’s performing above our expectations, we see continued opportunity here to expand access and utilization and not only improve care of seniors, but, as we shared earlier on independent study, also the potential of saving a significant amount for Medicare overall.

雖然它的表現超出我們的預期，但我們仍看到持續的機會可在此擴大可近性與使用率；不僅能改善長者照護，且如我們先前分享的獨立研究所示，也可能為整體 Medicare 節省相當可觀的金額。

Thank you. Next caller please.

謝謝。請下一位來電者。

Asad Haider, Goldman Sachs.

Goldman Sachs 的 Asad Haider。

Maybe just back to Foundayo. Thanks for the comments earlier, and I know that’s still very early in the trajectory. But just curious to hear any updated framing on how the launch is playing out both in the US as well as internationally in the context of both competitive dynamics versus Wegovy and then your own internal expectations.

我想回到 Foundayo。謝謝你們先前的評論，我也知道目前仍在非常早期的成長軌跡上。但我想了解你們是否能更新一下對上市進展的看法：無論是在美國或國際市場，在與 Wegovy 的競爭態勢之下，以及相對於你們內部預期，上市表現如何？

And then on the titration schedule for Foundayo, the two lower doses still represent about 75% to 80% of TRx in recent weeks. So where do you see that going at steady state?

另外，關於 Foundayo 的劑量遞增（titration）時程，最近幾週兩個較低劑量仍約占 TRx 的 75% 到 80%。你們認為在穩態（steady state）時會走向什麼樣的分布？

I think we’ll start maybe with international and go to Patrik to talk a bit about some of the ex-US launches. And then Ilya, maybe a couple of nuggets on the US as well.

我想我們先從國際市場開始，請 Patrik 談談一些美國以外的上市情況。接著 Ilya 也許再補充幾點關於美國市場的資訊。

We have now launched in four markets outside the US. We started with UAE very late in Q2. And the second half of Q3, we launched in UK, Saudi, and Mexico.

我們目前已在美國以外的四個市場上市。我們在第二季末才於阿聯酋（UAE）啟動。第三季後半段，我們在英國、沙烏地阿拉伯與墨西哥上市。

I would say that so far, the launch is very much in line with our expectations. There are a lot of similarities with the learnings from the US in terms of the orals are truly expanding the market. And we see a huge amount of patients actually being new to incretins.

我會說，到目前為止，上市進展非常符合我們的預期。就口服劑型確實在擴大市場這點而言，與我們在美國的經驗有許多相似之處。而且我們看到大量患者其實是首次使用腸泌素（incretins）。

In the Middle East, I think we have the political situation to take into account, but we have a market leader in UAE with competition from Wegovy. In Saudi, we have launched in both type 2 and chronic weight management; and we have a good uptake there.

在中東，我認為需要把政治情勢納入考量，但我們在阿聯酋是市場領導者，同時面臨 Wegovy 的競爭。在沙烏地，我們已在第二型糖尿病與慢性體重管理兩個適應症上市；且那裡的採用情況良好。

In UK, we have been subject to the pre‑vetting requirements by the MHRA, so we have actually not been able to fully promote until now in October. But the signs here are also that the orals are expanding the market.

在英國，我們受到 MHRA 的事前審查（pre‑vetting）要求影響，因此直到今年10月我們才真正能夠全面推廣。但這裡的跡象同樣顯示，口服劑型正在擴大市場。

Mexico, week six: a very good uptake and actually slightly above our expectations. But most importantly, I think we see that there is a lot of work to be done here and we need to do all of the work that has been done in the US as well.

墨西哥，第六週：採用情況非常好，實際上略高於我們的預期。但更重要的是，我認為我們看到這裡仍有大量工作要做，我們也需要把在美國所做的所有工作在這裡同樣落實。

We recently got the CHMP positive opinion that should hopefully result in a regulatory approval by year end, and we are ready to launch across chronic weight management and type 2 diabetes in more than 40 markets next year. But the initial focus is going to be on cash pay and chronic weight management since type 2 reimbursement will take some time.

我們最近獲得 CHMP 的正面意見，這應可望在年底前促成監管核准；我們也已準備好在明年於超過40個市場，針對慢性體重管理與第二型糖尿病同步上市。但初期重點將放在自費（cash pay）與慢性體重管理，因為第二型糖尿病的給付/報銷（reimbursement）需要一些時間。

In the US, we’ve made significant progress since last quarter. You’ve seen over 0.5 million TRx in the quarter, but fundamentals and some of the key indicators that we’ve been talking about as part of our initial launch have been moving in a really positive direction.

在美國，自上季以來我們已取得顯著進展。你們看到本季 TRx 超過50萬筆，但我們在初期上市時一直在談的基本面與一些關鍵指標，正朝非常正面的方向發展。

Consumer awareness and interest has improved with our investment and campaign with Martha Stewart. You’re seeing also number of trialists have more than doubled since last quarter, and so we’re seeing good progression of adoption from providers and that’s showing up in our share of market.

在我們的投入以及與 Martha Stewart 的行銷活動帶動下，消費者認知與興趣已有所提升。你們也看到試用者（trialists）數量較上季增加逾一倍，因此我們看到醫療提供者端的採用進展良好，並反映在我們的市占率上。

So our NBRx share of market is approaching around 4 out of 10, and so good progress overall for the growth of Foundayo in the oral segment. And even in the sequential growth of orals from Q2 to Q3, we’re taking 45% of that growth with Foundayo.

因此，我們的 NBRx 市占率正接近約10分之4，整體而言 Foundayo 在口服細分市場的成長進展良好。即使就口服產品從第二季到第三季的序列成長而言，我們以 Foundayo 拿下了其中45%的成長。

In terms of the titration, it’s expected that it takes time to titrate to the maintenance doses, but we’ve actually seen good progress on maintenance doses. We have multiple maintenance doses, so about 25% of people are at one of our maintenance doses. That’s actually higher than what you see on Wegovy pill.

就劑量遞增（titration）而言，達到維持劑量需要時間是預期之內，但我們在維持劑量上的進展其實不錯。我們有多個維持劑量，因此約有25%的人已處於我們的某一個維持劑量。這其實高於你在 Wegovy 口服藥上看到的情況。

And so we’re encouraged by that. Of course, that’s something to continue to monitor. But the experience overall that we’re seeing both from provider and consumer has been positive.

因此我們對此感到鼓舞。當然，這仍是需要持續監測的事項。但整體而言，無論是醫療提供者端或消費者端，我們看到的使用體驗都是正面的。

I would just add, we’re under review for type 2 diabetes and we see that as an extraordinary opportunity for Foundayo as well. Remembering today in the US, roughly half the volume of GLP‑1s is in diabetes. So that’s a big market expansion. Of course, it needs access and reimbursement when we get that. But that’s very promising, another leg to the stool here for the Foundayo performance.

我再補充一點：我們針對第二型糖尿病的適應症仍在審查中，而我們也將其視為 Foundayo 的一個極佳機會。要記得，目前在美國，GLP‑1 的用量大約有一半是在糖尿病領域。因此這將帶來很大的市場擴張。當然，前提是我們取得可近性與給付/報銷。但這非常有前景，將成為 Foundayo 表現的另一個支柱。

Thank you all. Next question, please.

謝謝各位。請下一題。

Steve Scala, TD Cowen.

TD Cowen 的 Steve Scala。

This is a follow up to Chris’s earlier question and with all due respect. Lilly’s financial guidance hasn’t been a good predictor on ultimate results. And I’m curious, what is the most frequent source of the surprise? So specifically, has it tended to be positive unit developments or has it been lack of negatives on price or is it some desire to just lean incredibly cautiously on guidance? And if it’s the latter, why is that?

這是針對 Chris 先前問題的追問，恕我直言。禮來（Lilly）的財務指引並不是最終結果的良好預測指標。我很好奇，最常見的「意外」來源是什麼？具體來說，通常是正向的銷量/單位數發展，還是價格面沒有出現負面因素，或是你們在指引上刻意採取極度保守的態度？如果是最後者，原因是什麼？

A key for investors I think is to determine when the surprise factor runs its course. So any color would be appreciated. Thank you.

我認為投資人關鍵在於判斷這種「意外因素」何時會告一段落。因此若能提供一些說明將不勝感激。謝謝。

Thanks, Steve, for the good direct question. We’ll go to Lucas to maybe provide a little extra color on guidance. And Dave, if you want to add anything, feel free to as well.

謝謝你，Steve，這是一個很直接也很好的問題。我們請 Lucas 來補充一些關於指引的說明。Dave，如果你也想補充，請隨時加入。

I think in terms of the variables that I described on the first question are still again the variables that we had when we started the year that -- of course again now, with yesterday newspaper, you think about that again, we are performing way much better than what we had initially guided to. But if you look at the runway of that growth across the US and OUS has been all the events we were public about, again the unknowns associated with that -- starting with the bridge program, when that bridge program will start, the uptake of that as well, the progression of all US markets both in share and also penetration. And those all played out better than what we anticipated.

我想，就我在第一個問題中描述的變數而言，這些仍然是我們在年初所面對的變數——當然，事後回頭看（with yesterday newspaper），你會覺得我們的表現遠遠好於最初的指引。但如果你看美國與美國以外（OUS）的成長跑道，包含我們公開談過的所有事件，以及與之相關的未知數——從 Bridge 計畫開始、Bridge 計畫何時啟動、其採用情況，以及美國各市場在市占與滲透率上的進展。而這些結果都比我們原先預期更好。

So still the drivers are those ones. Again, we continue to guide to what we forecast in our internal bottom‑up approach that we have on our forecasting model and try to be as public as possible about how we see the projections. And now, we provided some perspective into 2027 as well.

所以驅動因素仍然是那些。同樣地，我們會依據內部自下而上（bottom‑up）的預測方法與預測模型，持續給出我們所預測的指引，並盡可能公開我們如何看待這些推估。而且我們現在也提供了對2027年的一些觀點。

So I think from my perspective, we continue to drive again a very thorough process every single quarter and be public about again the variables that could affect positively or negatively as well our guidance projections.

因此從我的角度來看，我們每一季都會持續推動一個非常嚴謹的流程，並公開說明哪些變數可能對我們的指引推估帶來正面或負面的影響。

You’ve followed the company a long time. You know, our goal is to give as accurate a projection as we can. But of course, you know, there’s asymmetry with missing on the downside. That’s like everyone’s impulse.

你追蹤這家公司很久了。你知道，我們的目標是提供盡可能準確的預測。但當然，你也知道，在下行失準方面存在不對稱性。那幾乎是每個人的本能反應。

But let’s remember, like, we’re in the middle of the largest new category expansion in the history of the pharmaceutical industry, and Lilly’s leading that. So there’s a number of things that have never actually happened before that we’re trying to project. And we prefer to give a posture that investors can rely on versus one that is more speculative.

但請記得，我們正處於製藥產業史上最大的新類別擴張之中，而禮來正引領這一波。因此有許多事情其實是前所未有、從未發生過的，而我們必須嘗試去做預測。我們更傾向於採取一種投資人可以依賴的立場，而不是更偏向推測性的立場。

At the JPMorgan conference at the beginning of the year, I said there’s two big variables this year. If I knew the answer to, we would have had a tighter range. One was the uptake in Bridge, which we didn’t really know. We weren’t even sure about the start time of Bridge at that point.

在年初的摩根大通（JPMorgan）會議上，我說今年有兩個重大變數。如果我知道答案，我們就能給出更窄的區間。其中之一是 Bridge 的採用情況，我們當時其實不太清楚。在那個時間點，我們甚至不確定 Bridge 的啟動時間。

And the other was the depth of the consumer purchasing internationally and whether we were really just skimming very high net worth individuals in these out‑of‑pocket markets or if more middle‑income households would be interested in improving their health and losing weight at scale. And I think both of those this year turned out to be positive for us, thus the roughly $10 billion improvement over first‑time guide.

另一個因素是國際消費者購買的深度：我們究竟只是觸及這些自費市場中的超高淨值族群，還是會有更多中等收入家庭也有興趣以規模化的方式改善健康並減重。我認為今年這兩點對我們而言都呈現正向，因此相較於首次指引，約有100億美元的改善。

As time goes on, I suspect we’ll have fewer and fewer of those never‑before‑done things and the guidance can become more predictable. So appreciate the question, but that’s how I’ve seen it over the last three years. And we’re beating on the up. That’s better than missing on the down.

隨著時間推移，我猜我們會遇到越來越少那種前所未有、從未做過的事情，指引也能變得更可預測。所以謝謝你的提問，但這就是我過去三年的觀察。而我們是往上超預期。這總比往下不如預期要好。

And I think that’s good news mostly not because of the earnings beats, but because we’re actually executing against a really scaled opportunity and performing well.

我認為這多半是好消息，不是因為獲利超預期本身，而是因為我們確實在執行一個規模非常大的機會，且表現良好。

Great. Thank you. Dave and Lucas, next question please.

很好。謝謝。Dave 和 Lucas，請下一題。

Terence Flynn, Morgan Stanley.

Morgan Stanley 的 Terence Flynn。

Maybe one on the pipeline for Dan. There’s been a growing focus on longer‑acting incretins. You guys recently said you have three different programs in the clinic. So just wondering if we can expect any clinical data at the R&D day on these programs or if you can tell us what the stage is of development because I think that is probably the only hole you have in your incretin pipeline.

想請 Dan 談一下研發管線。市場對更長效的腸泌素（incretins）關注度正在提高。你們最近提到有三個不同的計畫在臨床階段。想請問在研發日（R&D day）上，這些計畫是否會有任何臨床數據可分享？或你們能否說明目前的開發階段？因為我認為這大概是你們腸泌素管線中唯一的缺口。

Thanks, Terence. We’ll actually go to Ken to talk about long‑acting approach and if there’s anything to share beyond what’s been public.

謝謝你，Terence。我們其實會請 Ken 來談長效策略，以及是否有任何超出公開資訊可分享的內容。

As we discussed previously, we do see an opportunity for longer‑acting incretins, particularly in a category this big with such a consumer emphasis.

如同我們先前討論過的，我們確實看到長效腸泌素的機會，特別是在這麼大的品類、且高度以消費者為核心的情境下。

We’re taking the same approach we usually do when we see an important square on the board that we want to fill, which is baking off several competing platforms to see which one provides the best product possible. This is a space where we think that molecule properties are really going to matter, and so that’s why we haven’t signaled anything yet. But it is true we have multiple efforts in the clinic.

我們採取的方式與以往相同：當我們看到棋盤上有一個重要的空格需要補上時，就會讓多個相互競爭的平台同台比較，看看哪一個能提供最佳的產品。我們認為在這個領域，分子特性將非常關鍵，因此我們目前尚未釋出任何明確訊號。但確實，我們有多個項目正在臨床中。

Those are a range of different technological approaches, including existing time‑extension technologies as well as ones that could be part of the future. And then we have other efforts that we’ve disclosed in business development around formulation technologies. Again, we’ll look at all these data and make an informed decision on which effort or efforts to advance to phase three.

這些涵蓋一系列不同的技術路徑，包括既有的延長作用時間技術，以及可能屬於未來的一些技術。此外，我們也在商務開發（business development）方面揭露了其他與製劑技術相關的工作。同樣地，我們會檢視所有這些數據，並做出有根據的決策，決定將哪一個或哪些項目推進到第三期。

Thank you, Ken. Next question, please.

謝謝你，Ken。請下一題。

Trung Huynh, RBC.

RBC 的 Trung Huynh。

So as you look to ’27, what are you seeing in terms of opt‑in trends for GLP‑1 coverage amongst the larger employers in the US? And with those dynamics in mind and Bridge continuing to ramp, could your US channel mix meaningfully evolve next year so it potentially creates additional pricing pressure amongst the mid‑teens decline that you’ve absorbed in ’26? Or could we see pricing headwinds in the same range for ’27?

展望到 2027 年，你們看到美國大型雇主在 GLP-1 給付（coverage）方面的選擇加入（opt-in）趨勢如何？在這些動態之下，且 Bridge 持續放量的情況下，你們明年的美國通路組合是否可能出現顯著變化，從而在你們於 2026 年已吸收的「中十幾個百分點」降幅之外，帶來額外的定價壓力？或者 2027 年的定價逆風仍會落在相近區間？

We’ll go to Ilya to talk about 2027 early opt‑in trends and maybe the broader access environment as well as we look the next year.

我們請 Ilya 來談談 2027 年初期的 opt-in 趨勢，以及展望明年時更廣泛的可近性（access）環境。

Yeah. Overall, obviously there’s been noise around a number of employers opting out of coverage. At the same time, we’re having positive discussions through our Employer Connect and other channels on improving access there as well.

是的。整體而言，顯然市場上對於一些雇主選擇退出給付有不少雜音。同時，我們也透過 Employer Connect 以及其他管道，就改善可近性進行了正向的討論。

Our expectation is that overall access on the commercial side will maintain relatively stable through 2027. Obviously, we continue to have conversations to improve on that. The main access improvements overall for ’27 will most likely be predominantly growth of Medicare and Medicaid as opportunities for expanded coverage.

我們的預期是，商業保險端（commercial side）的整體可近性在 2027 年將維持相對穩定。當然，我們仍持續對話以進一步改善。就 2027 年而言，整體可近性的主要改善，最可能主要來自 Medicare 與 Medicaid 的成長，作為擴大給付的機會。

That will have a segment mix more towards a lower net price -- not about decreasing the price overall but more just a segment mix, as well as some level of self‑pay in the lower net price per TRx. And in terms of commercial overall pricing, I would expect modest and disciplined approach around pricing and access to maintain, but overall stable in the commercial and increased coverage in Medicare and Medicaid.

這會使客群組合更偏向較低的淨價——並不是說整體價格下降，而是更多是客群組合的變化；同時也會有一定程度的自費（self-pay），其每張處方（TRx）的淨價也較低。至於商業端的整體定價，我預期我們會以溫和且有紀律的方式處理定價與可近性以維持現況；整體而言，商業端大致穩定，而 Medicare 與 Medicaid 的給付覆蓋將增加。

Thank you, Ilya. Next question please.

謝謝你，Ilya。請下一題。

Akash Tewari, Jefferies.

Jefferies 的 Akash Tewari。

So your team’s talked about generally predictable and consistent GLP‑1 pricing declines in the US out to the end of the decade. How does that look ex-US? Could we see more stability there than maybe investors expect? And how do you think about the net price per patient in the US versus international markets ex-China evolving over time? It currently seems quite similar.

你們團隊談到，美國的 GLP-1 定價下滑在本十年末之前大致可預測且一致。那在美國以外（ex-US）看起來如何？那邊是否可能比投資人預期更穩定？另外，你們如何看待美國與國際市場（不含中國，ex-China）每位病患的淨價隨時間演變？目前看起來兩者相當接近。

And Dave, you mentioned something interesting. Can you talk a bit more about the size of this emerging middle‑income cash‑pay international market opportunity relative to what we’ve seen in the US so far?

另外 Dave，你提到一個很有意思的點。你能否再多談一些：這個正在浮現的「中等收入、自費」國際市場機會，其規模相較於我們迄今在美國看到的情況大概如何？

Thanks, Akash. Sounds like questions for Patrick. So we’ll talk a bit about pricing expectations, on the cadence from here thinking about net price US versus ex US and anything about the emergence of a middle‑income cash‑pay market.

謝謝你，Akash。聽起來這些問題適合請 Patrick 回答。所以我們會談一下定價預期、從現在起的節奏（cadence），以及美國與美國以外的淨價走勢，還有中等收入自費市場的興起。

You know, we are taking a very disciplined approach to pricing OUS, and I think we’ve seen that both providers, consumers, and payers are willing to pay for a differentiated product. And we’ve seen that even after the launch of generics in India, Brazil, and Canada, we’re holding our shares and continue to grow. And that’s a discipline that we will continue to apply.

你知道的，我們在美國以外（OUS）的定價上採取非常有紀律的做法；而且我們看到，無論是醫療提供者、消費者或支付方，都願意為具差異化的產品付費。我們也看到，即使在印度、巴西與加拿大學名藥上市之後，我們仍能守住市占並持續成長。這種紀律我們會持續貫徹。

In terms of the out-of-pocket willingness, we actually see quite a big willingness to pay out of pocket OUS as well. Of course, when markets are getting further penetrated and like the UK where we launched more than two years ago and where we have a penetration very much along the lines of the US, we see a lower growth as we expected.

就自費意願而言，我們其實也看到在美國以外（OUS）同樣存在相當強的自費支付意願。當然，當市場滲透率進一步提高時——例如英國，我們在那裡上市已超過兩年，且滲透率與美國非常接近——我們會如預期看到成長放緩。

But I think overall, taking into account where we are penetration-wise, low single digit, long term, we see a tremendous opportunity OUS for the incretins. And we will continue our efforts as well to gain type 2 reimbursement, which is very important. And we made some progress in Q3 here, now having nine European markets covered. But we will continue those efforts and continue to take a disciplined approach in terms of pricing.

但我認為整體而言，考量我們目前的滲透率仍在低個位數，長期來看，我們在美國以外（OUS）的腸泌素產品仍有巨大的機會。我們也會持續努力爭取第二型糖尿病（type 2）的給付，這非常重要。我們在第三季已取得一些進展，目前已有九個歐洲市場納入給付。但我們會持續推進這些工作，並在定價方面維持有紀律的做法。

Maybe just to comment on the ex-US versus US. I mean our goal, because of the consumer nature of this, is to have a much tighter band of pricing on obesity medicines than maybe you’ve seen historically in other medicine categories.

也許就針對美國以外市場（ex-US）相對於美國市場補充說明一下。我的意思是，因為這是一個偏消費者導向的市場，我們的目標是讓肥胖藥物的定價區間比你們過去在其他藥物類別中歷史上看到的更為緊密。

Thanks, Dave and Patrick. Next question, please.

謝謝你，Dave 和 Patrick。請下一題。

Umer Raffat, Evercore.

Umer Raffat，Evercore。

I wanted to spend a quick second on a potentially sizable opportunity in early breast cancer for imlunestrant. And I understand there’s a planned interim for you guys, a competitor trial stopped on interim. A, how should we think about early stoppage odds for your trial?

我想花一點時間談談 imlunestrant 在早期乳癌上可能相當可觀的機會。我理解你們有規劃中的期中分析，而有一個競品試驗在期中分析時就停止了。第一，你們的試驗提前停止的機率，我們應該怎麼看？

And perhaps more importantly, if you could put the effect size comparisons versus LIDERA in perspective knowing that the treatment setting for you is a little more real world with meaningful post-CDK4.

另外也許更重要的是，若考量到你們的治療情境更貼近真實世界、且在 CDK4 後線仍具實質意義，你能否把相對於 LIDERA 的效果量比較放在一個脈絡下說明？

We’ll go to Jake to talk a bit about EMBER-4.

我們請 Jake 來談談 EMBER-4。

Super excited about Inluriyo both in its current actual commercial performance where it’s doing great and helping lots of people with monotherapy and new combination with Verzenio; and as you mentioned, the real big opportunities in the adjuvant setting with the EMBER-4 study.

我們對 Inluriyo 非常興奮：不論是目前實際的商業表現（表現非常好），以單藥治療幫助了很多人；或是與 Verzenio 的新併用方案；以及如你所提到，在輔助治療（adjuvant）情境中、透過 EMBER-4 研究所帶來的真正重大機會。

We’ve not talked about interim analyses on these study. On this study, we’ve been pretty consistent that we expect the study to read out in 2027 next year. So we’re sticking with that. That is what we expect.

我們尚未談到這些研究的期中分析。就這項研究而言，我們一直相當一致地表示，預期研究會在 2027 年、也就是明年讀出結果。所以我們會維持這個說法。這就是我們的預期。

I think you’re raising a good point. The treatment setting that we’re exploring is much more real world, I think, than what was examined in LIDERA, both in the context of the prevalent population that exists that may want to switch from existing endocrine therapy to new oral SERD and a study run in the context of modern standard of care of CDK4/6 inhibitors like Verzenio, which our study had and theirs didn’t.

我認為你提出了一個很好的觀點。我們正在探索的治療情境，我認為比 LIDERA 所檢視的更貼近真實世界；這包括現存的盛行族群（prevalent population），他們可能想從既有的內分泌治療轉換到新的口服 SERD；也包括在現代標準治療（standard of care）下、使用像 Verzenio 這類 CDK4/6 抑制劑的研究情境——我們的研究有納入，而他們的沒有。

So a bunch of differences. I think when our study does read out successfully, I hope it will be much more relevant to clinical practice and easy to understand how to slot it in. I don’t want to comment on anticipated effect sizes because we just need the study to read out and see what it shows us. But excited to get to that point.

所以差異很多。我認為當我們的研究成功讀出時，我希望它會更貼近臨床實務，也更容易理解應該如何把它納入治療路徑。我不想評論預期的效果量，因為我們需要等研究讀出，看看結果告訴我們什麼。但很期待走到那一步。

Thank you, Jake. Next question, please.

謝謝你，Jake。請下一題。

Carter Gould, Cantor.

Carter Gould，Cantor。

Maybe just to go back to the Bridge Program, have you had conversations with the admin or the various Plan D sponsors that give you confidence this program will either be extended or balance will be revisited in a different iteration? I guess to the point just your confidence that there won’t be a disruption at the end of '27?

也許回到 Bridge Program（橋接計畫）這點：你們是否與政府部門或各個 Part D 計畫贊助者有過對話，讓你們有信心這個計畫會被延長，或是以不同版本重新檢視其結構？我想問的是，你們對於在 2027 年底不會出現中斷，有多大信心？

We'll go to Dave to talk a bit about discussions with the administration.

我們請 Dave 來談談與政府部門的討論。

Well, I think we’re pretty optimistic about expansion I think for three reasons, Carter. One is the early uptake is strong and I think you see both demand and appropriate on-label use of the medications.

我想我們對於擴大推行相當樂觀，Carter，我認為有三個原因。第一，早期採用（uptake）很強勁，我想你也看到需求，以及藥物在核准適應症（on-label）上的適當使用。

The administration did a fantastic job implementing the PA criteria in a way that was not over-indexed or under-indexed. And I think if we look at the people using the medicines, relatively high BMI, comorbid people, and that leads to the second point which is cost effectiveness.

政府部門在落實 PA（事前授權）標準方面做得非常好，既沒有過度嚴格，也沒有過度寬鬆。而且如果我們看使用這些藥物的人群，他們的 BMI 相對較高、且有共病，這就引出第二點：成本效益（cost effectiveness）。

And I think we highlight today the independent study from USC that estimates not just breakeven but massive cost savings for Medicare due to this program. CMS will, because it’s being done as a pilot program, do their own analysis. But I think all signals now point to pretty successful cost effectiveness which could yield either a legislative or a regulatory shift in the coverage permanently.

我想我們今天也強調了 USC 的一項獨立研究，估計這個計畫不僅能打平，甚至能為 Medicare 帶來巨大的成本節省。CMS 因為這是以試點計畫（pilot program）方式進行，會做他們自己的分析。但我認為目前所有訊號都指向相當成功的成本效益，這可能帶來立法或監管上的變動，讓給付能永久化。

In the meantime, I think there’s a lot of energy with the people running CMS at the current point to continue this, and the right way to do that is put this into the Part D benefit. So I would expect, and it’s probably a good conversation to have on our Q1 call, this to then shift to working with the carriers for the 28th calendar year.

同時，我認為目前在 CMS 負責推動的人員對於延續這件事有很高的動能，而正確的做法是把它納入 Part D 給付福利中。所以我預期——這也許是我們在第一季電話會議上可以好好討論的——接下來會轉為與保險業者合作，為 2028 年曆年做準備。

And we’ll certainly work with the administration and all our partners who supply Part D coverage to have good access across our portfolio and continue the success of the program so far.

我們也一定會與政府部門以及所有提供 Part D 給付的合作夥伴一起努力，確保我們整體產品組合有良好的可近性，並延續目前為止這個計畫的成功。

Thanks Dave. We’ll try to squeeze in two more if we could, please. Next question please.

謝謝 Dave。我們如果可以的話，盡量再塞兩題。請下一題。

Michael Yee, UBS Securities.

Michael Yee，UBS Securities。

Maybe just a long-term portfolio question around obesity and how you view a consumerism-driven market where people will gravitate towards differentiated or different options within your portfolio. So I’m thinking about retatrutide and Amylin. Can you maybe just put on your prediction hat about what that portfolio would look like and how consumers would choose between these different products given various competition and price declines?

也許是一個關於肥胖長期產品組合的問題：在一個由消費者主導的市場中，你們如何看待人們會在你們的產品組合內，因差異化或不同選項而做出選擇？我想到的是 retatrutide 和 Amylin。你能否戴上「預測帽」談談，你認為那個產品組合會長什麼樣子，以及在各種競爭與價格下滑的情況下，消費者會如何在這些不同產品之間做選擇？

We’ll go to Ken to talk about the breadth of the obesity portfolio and how to think about what patients each are for.

我們請 Ken 來談談肥胖產品組合的廣度，以及如何思考各自適用的病人族群。

I mean, maybe let’s start with -- the size of the problem we’re confronting here is 110 million or so people living in the US with obesity or overweight and internationally that number has a B at the start of it. That’s why we’re pursuing a portfolio approach, knowing that many individuals will seek out and find over time what works best for them.

我的意思是，也許先從——我們正在面對的問題規模談起：在美國，大約有 1.1 億人處於肥胖或過重；在國際上，這個數字前面是以「十億」（billion）開頭。這就是為什麼我們採取產品組合（portfolio）策略，因為我們知道許多人會隨著時間推移去尋找並找到最適合自己的方案。

Each of the molecules in our growing portfolio, they have unique features and probably each of them can fill multiple roles. We’ve talked about how Foundayo as a great on-ramp for patients earlier in the weight loss journey, but can be a great maintenance option as well. Tirzepatide, we see as a cornerstone with a growing body of evidence to support it, including SURMOUNT-MMO very soon.

我們不斷擴大的產品組合中，每一個分子都有其獨特特性，而且很可能每一個都能扮演多種角色。我們談過 Foundayo 是病人在減重旅程早期很好的「入門」選項，但也可以是很好的維持治療選項。Tirzepatide 我們視為基石（cornerstone），而且支持它的證據體系正在擴大，包括 SURMOUNT-MMO 很快就會有結果。

And then as we focus on reta, this is a medicine that looks like it could do a lot of jobs, on the high end, delivering tremendous power; lower end, delivering a lot of simplicity and really differentiated responses in some important subpopulations, including men and type 2 diabetics, where it’s the first agent that’s ever shown greater than 2% or -- excuse me, 20% weight lowering.

接著談到 reta：這是一種看起來可以做很多事情的藥物；在高端，它能提供非常強的效力；在低端，它能提供很高的簡便性，並且在一些重要的次族群中呈現真正差異化的反應，包括男性與第二型糖尿病患者——它是第一個在這些族群中顯示超過 2% 或——抱歉，是 20% 體重下降的藥物。

Beyond that, we have our selective Amylin portfolio, which opens up a new pharmacological axis that can offer incretin-like weight lowering with really more placebo-like GI tolerability. And then last but not least, the EloraTZP.

除此之外，我們還有選擇性 Amylin 產品組合，這開啟了一條新的藥理軸線（pharmacological axis），能提供類 incretin 的降重效果，同時在腸胃道（GI）耐受性方面更接近安慰劑（placebo-like）。最後但同樣重要的是 EloraTZP。

We see this as sort of the most physiological approach yet to weight loss that could also, again, play a lot of roles in this, including providing really differentiated HbA1c lowering in patients with type 2 diabetes. So again, all of these agents, we think they can play a lot of roles.

我們認為這可能是目前為止最符合生理機制（most physiological）的減重方式，同樣也能在其中扮演多種角色，包括在第二型糖尿病患者中提供真正差異化的 HbA1c 降幅。所以再說一次，我們認為所有這些藥物都能扮演很多角色。

We probably can’t a priori stipulate for any individual patient what’s going to work best for them. But what’s important to us is that we offer all of them. We offer choice. We put them on really a platform with a consistent experience that allows patients to start, switch, and step up to any Lilly medicine that works best for them. And overall, no matter which one they choose, they’ll still be on a Lilly medicine.

我們可能無法先驗地為任何一位個別病患預先規定什麼對他們最有效。但對我們而言重要的是，我們把所有選項都提供給他們。我們提供選擇。我們讓他們使用一個具一致體驗的平台，使病患能夠開始使用、切換，並逐步升級到任何最適合他們的禮來藥物。而且整體而言，不論他們選哪一種，他們仍然會是在使用禮來的藥物。

Great. Thanks, Ken. We’ll go to the last question, please.

很好。謝謝你，Ken。我們請進最後一個問題。

Courtney Breen, Bernstein.

Courtney Breen，Bernstein。

I know we’ve spoken a little bit about the pipeline, but I instead wanted to think about other sources of innovation and namely the M&A that you’ve been doing and licensing that you’ve been doing externally to support your pipeline.

我知道我們已經稍微談過研發管線，但我想改從其他創新來源來思考，特別是你們一直在做的併購（M&A）以及你們在外部進行的授權，以支援你們的研發管線。

Obviously, there’s been a rapid pace for the first part of this year. Can you just help us understand where you believe you’re at in terms of the risk-reward balance across your portfolio, the types of areas that might be of interest to continue adding, and how you’re ensuring that you’re keeping the bar high as you continue to take on and broaden this pipeline beyond what we see in Phase 2 right now?

顯然，今年前半段的節奏非常快。你能否協助我們理解：就你們的產品組合而言，你認為目前在風險—報酬平衡上處於什麼位置、哪些領域可能值得持續加碼，以及在你們持續承接並擴大這條研發管線（超出我們目前在第二期看到的範圍）時，你們如何確保持續維持高門檻？

We’ll go to Jake to talk a bit about the kind of BD strategy, the process to assess different transactions and kind of the interest across the board.

我們請 Jake 來談談商務開發（BD）策略、評估不同交易的流程，以及整體各方面的興趣分布。

You know, it’s funny you mentioned risk-reward. Risk is really our friend here. Risk allows us to actually create value. And one of the ways we can deploy that or the reasons we can is because we don’t need revenue tomorrow.

你提到風險—報酬，這很有意思。在這裡，風險其實是我們的朋友。風險讓我們能夠創造價值。而我們之所以能夠部署這點、或能這麼做的原因之一，是因為我們不需要明天就有營收。

I think we have this opportunity, while the incretin business and the rest of the commercial businesses are doing so well, to plan for the next decade or two ahead, which allows us to take more risk in a calculated way. And some of that is very early stage deal making, which oftentimes are not really even press released by us. So some of them, you don’t maybe know as much about.

我認為，當腸泌素（incretin）業務以及其他商業化業務表現都非常好的同時，我們有機會去規劃未來一到兩個十年，這讓我們能以可計算的方式承擔更多風險。其中一部分是非常早期階段的交易，這些交易我們往往甚至不會發布新聞稿。所以有些你們可能不太了解。

And we’ve done a bunch of, I would say clinical stage, but not super late stage clinical deals this year where we see enough risk still within the program for us to create value, but enough de-risking for us to feel confident that there’s a real medicine or maybe more than one medicine there. And we can point to a handful of deals even on the year, this year, that fit that paradigm.

而今年我們也做了不少我會稱之為臨床階段、但不是非常後期的臨床交易；在這些專案中，我們看到仍有足夠的風險讓我們能創造價值，同時也有足夠的去風險化，讓我們有信心那裡確實有一個真正的藥物、甚至可能不只一個。我們甚至可以指出今年內就有幾筆交易符合這種模式。

So I think you’ll see more of both of those categories from us across all the therapeutic areas. We’re not solving for any one given therapeutic area. We’re just solving for great products, great science, and great people that we can bring into the company and fuel growth into the decades to come.

所以我認為，你們會看到我們在所有治療領域中，持續在這兩類交易上都有更多動作。我們不是要解決任何單一特定治療領域的問題。我們要追求的是優秀的產品、優秀的科學，以及優秀的人才，把他們帶進公司，為未來數十年的成長注入動能。

I think that gives us a competitive advantage, frankly, in how we look for what we want to take inside relative to our peers. So we have a pretty rigorous process to stay disciplined on a deal by deal basis. And I’m excited about what we’ve done so far and what’s to come.

坦白說，我認為這讓我們在相較同業、判斷要把什麼納入公司時，具備競爭優勢。因此，我們有一套相當嚴謹的流程，能在逐案層面保持紀律。我對我們迄今為止所做的，以及接下來將要做的，都感到很振奮。

A couple of closing comments.

幾點結語。

Okay, excellent. Thanks for joining us for today’s call. Obviously, a strong quarter for the company.

好的，非常好。感謝各位參加今天的電話會議。顯然，這對公司而言是一個強勁的季度。

I want to take a moment though to promote an upcoming event which is our December 7 Investor Day. This will really be an R&D and pipeline-focused day. We’ll have other sections in that as well. And I hope all of you can join us live or, if not, remotely for that event.

不過我想花一點時間宣傳一個即將到來的活動，也就是我們 12 月 7 日的投資人日。這將會是一個真正以研發與研發管線為重點的一天。我們也會包含其他段落。我希望各位都能親自參與，或若不便，也能以遠端方式參加該活動。

I also want to take a minute just to again congratulate Patrik on a great career. And I think this will be your last earnings call with us. You played a big part in our success over the last, well, 30 years of your career, but certainly the most recent six or seven. So thank you Patrik, for everything.

我也想再花一點時間，再次祝賀 Patrik 擁有精彩的職涯。我想這將是你與我們一起參與的最後一次財報電話會議。在你職涯過去——嗯——30 年中，你對我們的成功扮演了重要角色，尤其是最近六、七年更是如此。所以，Patrik，謝謝你所做的一切。

Please follow up with the IR team if you have additional questions we didn’t get to, and look forward to seeing everyone in early December.

若各位還有我們未能在會中回答的其他問題，請與投資人關係（IR）團隊後續聯繫，也期待在 12 月初與大家見面。

Thank you. This does conclude our conference for today. This conference will be made available for replay beginning at 1:00 PM today and running through 11:26:26 at midnight. You may access the replay system at any time by dialing 800-332-6854 and entering the access code 938904. International dialers can call 973-528-0005. Again, those numbers are 800-332-6854 and 973-528-0005 with the access code 938904.

謝謝。今天的電話會議到此結束。本次會議的重播將於今日下午 1:00 起提供，並持續至午夜 11:26:26。你可於任何時間撥打 800-332-6854 並輸入存取碼 938904 以進入重播系統。國際撥入者可撥打 973-528-0005。再次提醒，電話號碼為 800-332-6854 與 973-528-0005，存取碼為 938904。

Thank you for your participation, and you may now disconnect your lines.

感謝各位的參與，現在您可以掛斷電話線。