David A Ricks, Chair and Chief Executive Officer of Eli Lilly and Company

[Music] so our special guest is Dave Ricks who since 2017 has been the uh CEO and chairman of Eli Lily which is now the most valuable pharmaceutical company in the entire world and um company as I mentioned earlier that uh has had its market capitalization increase by about 860 since he became CEO and the stock price is up a little bit more than a th% so pretty good we've been working hard yeah let's talk about the phenomenon that's changed the world to some extent which is the anti-obesity drug now to make sure everybody's on the

same page lines what is the name of your anti-obesity drug okay so uh the name is Zep bound the active ingredient is called tepati yeah okay so by the way who comes up with these names where do you get these names not me David not me no it's uh it's more complicated than we want to talk about here but we can't have names that are similar to each other because doctors make prescribing errors we can't have names that make claims about what the drug does and we can't have names that only work in English so

we end up with these strange sounding names okay yeah so as I understand it uh number of years ago you can tell us how many uh somebody was working on a diabetes related drug and that drug ultimately got to be but that actually helps you when was that discovered and was that ever the intention when the drug was being developed yeah pretty early on so we launched the first gop1 medication in the world in 2005 it was called exenatide it was a twice daily injection and it was indicated for people with diabetes um like a

lot of things in medicine there's like iterative steps of improvement that occurred but that was the first effort on the cover of our the next year our annual report is a woman who was using the drug and she said my diabetes is under control and I noticed I'm losing a little weight actually 2006 it's a cover of our annual report but we had to improve the medicines um to really make them effective for weight loss one big Improvement was to uh make them weekly that's a convenience benefit but even more important um the the action

of the medicine flatter meaning more consistent through the day and night when we had it twice a day there were ups and downs and one effec of gop1 medications is they cause nausea and other GI distress that's a function of the up and down in your system so when we made a weekly it was flatter and we could dose higher to see more weight loss so that was sort of an accidental breakthrough of trying to make a more convenient form okay so now there's another company that is sort of in the same business no vo

nordis yes which is uh in uh U Denmark and they have a similar product and they have a product that does the same thing one is for uh obesity anti-obesity and one is for diabetes and correct are is there really any difference between the two of your drugs in terms of the drugs there are there's no difference really between the name the drug that's named for diabetes versus named for obesity for either company we do that for insurance reasons we could talk about but tepati is the latest version it has two modes of action so

um and by the way we're having a conversation about uh weight loss medications right after you just ate lunch and I know that that may cause some anxiety but um right now because you just ate lunch your um GI track is communicating with the rest of your body it's communicating with hormones or proteins and telling it that you've been fed and you need to absorb nutrients and other things that are essential to life because food is essential to life um what we're doing is boosting some of those signals with these medications they're boosting the signal

that you're full boosting the signal that you no longer want to eat more and boosting signals that you should absorb nutrients that you've consumed and so ours does that with two two different hormones one called gp1 another a new one called GP OIC or semaglutide just uses gp1 but what the drug does is what it tells your body you're full when you're maybe not as full as you used to be yeah so well so it it tells your body you're full um and it does that to the brain to sense of sey probably we've learned

over time our sense of fullness becomes conditional so as people eat more habitually that signal kicks in later and later and that's a a cause and consequence of obesity um it does other things too it actually makes your stomach Fuller because it slows gastric motility so it slows down your nutrients which is seems counterintuitive but when you eat in the when our ancestors were alive 10,000 years ago meals were rare and you want to absorb all the nutrients out of it so that signal said absorb the nutrients all right I don't want to confuse people

but there are four different names that people should know for these drugs now you have an anti-cd drug which is called what zound zound and then you have a diabetes drug which is called mararo same medicine different name different names and then Novo nordis nordis has two drugs their names are OIC and we GOI all both are semaglutide same medicine two different names but the confusing thing is OIC is like a it's like a generic name people say I'm on OIC OIC is not the anti-obesity drug it's the uh diabetes diabetes drug so why is

it why don't people get the right names I don't should we blame the media I don't know um I it it was the first um drug that used off label for obesity um and it again it was a flat once a week and people discovered if I just give take more than prescribed I can lose more weight and then Novo did a study credit to them that showed clinically that people lose clinically meaningful weight their on their medicine you lose you know 13 to 15% of your body weight on ours you lose you know 20

to 26% well let me go through that again because there was a study was just came out a couple days ago I think that said 101 comparing the two uh you you your drug anti-obesity drug loses weight more rapidly for people than the other product is that right rapidly and more so 47 % more so on after a year and a half roughly people on our drug lost 17 more pounds than on we why do people need to lose so much weight in this country uh our country has as I got it right 75% of

the people are overweight and 42% are obese correct when did that happen when we went to no fat frood or what when did all of a sudden we become so obese yeah if you look at the epidemiology charts it really seems to have started in the 60s uh growth in overweight and obesity in the country and really accelerated in the 80s and 90s so um what are the reasons how we live certainly is one of them and enry energy expenditure has to be part of the story what we eat though has is probably a more

important reason not just the quantity which has risen modestly through that period of time but actually what's in our food has changed and I think that's also attributed to this all right so back to the drug uh when you realized they could lose weight uh did you get the FDA to say yes it can be prescribed for losing weight or it still you can't get that prescribed for you no no as of last year we ZB launched it's for weight loss for people who have high body weight yeah and do insurance companies reimburse people for

the cost of these drugs some do more should um so um as of today uh the federal government government actually has a Prohibition on reimbursing any of these drugs um which is a problem I think although the Biden Administration just as advanced Ru making to change that that's good news and we hope the next Administration will continue that process 17 States uh in their Medicaid Program have decided to step outside of that Federal Rule and reimburse them anyway so California just started uh for instance Massachusetts other states and then about 60% of employers um have

some form of reimbursement so if losing weight makes you healthier why would people who care about insurance reimbursement Medicare and other not insist on get paying for this because it would make you healthier and therefore you don't have other diseases you have that they have to reimburse you for I think in four or five years we'll look back and say yeah that's what should have happened and it's silly that we don't pay for what is already known to be a primary contributor to poor health which is excess body weight but you know people have different

motives and incentives as you know we reenroll in Commercial Insurance every year so unfortunately I don't think insurance companies have your best interest at heart maybe that's um tough to say but um they really think about it in one-year increments and the benefits surely will play out over a longer period of time maybe your employer has a stronger interest in your long-term Health um that's probably why many have stepped forward and then evidence our job is to make the evidence produce the evidence that we're not just having people lose weight but losing weight with our

medicine causes improved health and we have many studies out this year that are demonstrating that so to take this medicine you have to inject yourself correct or less why not just go to a pill a great idea D yeah um we're working on that um uh the the injection you have to inject because it's a protein and if we orally take proteins your body thinks it's food and it breaks up proteins so you cannot really take these drugs o you have to bypass the GI track even though it's affecting and go right to the bloodstream

but we are working on a pill uh we'll have some data actually as early as next year uh for it's a gp1 only it's a single acting it's not going to be as good as tepati or zound it' be about as good as OIC we hope and this would be a once daily pill that'll be a fantastic um Innovation so um when you have drugs that are very very popular um you of to have people that make counterfeit or copycat drugs um we see them on television all the time advertise that way what about uh

for this do you have to worry about counterfeit drugs coming in that are trying to say the same thing it's a terrible problem right now actually because I think consumers don't really know the dangers or the difference um today the FDA and the government is allowed this to sort of grow and of course a weight loss medication that's effective would be a popular thing for people to go around the healthcare system and seek treatment on their own but the data we have is that 80% of these um medicines are coming out of China from unapproved

and unregulated sources we recently with borders and Customs seized a big batch that was shipped in dog food um people um then reformulate them and sell them locally in Med spas and other outfits but you really don't know what's in that vial we buy them and test them we find bacteria plant material viruses fungus you do not want to be using but these counterfeit drugs are not like they're they're cheaper uh they're cheaper because they don't have the same ingredients I assume but how much more expensive are your drugs than the the counterfeit ones in

other words if somebody wants to use um your product Zep bound how much does it cost a month you can buy Zep bound direct from Lily for $3.99 for the starter dose $3.99 no no this is a valuable Innovation David uh 399 $399 a month all right which is about1 a week and I know that's a sacrifice for many but that's without insurance with insurance most people pay $25 a month so that's the importance of insurance that's why we buy insurance to Shield us from our health costs the online ones you know are as cheap

as $100 but these are companies that want all the benefits of being a drug company but bear none of the responsibilities but you um for example you have this under patent for how many years in other words our system is you you have a drug you have 20 years from invention yeah from invention so how many more years do you have before it goes generic be till mid 2030s yeah so another 10 11 years okay and is this the most popular drug that Eli Lily has ever had should be by the end of the year

yeah we'll break that record and go beyond probably yeah all right some people say that if you go on this drug you have side effects that are not not completely desirable is that true so yeah there's two things to all drugs that work have side effects and um sometimes UNT effects and we have to warn against both of those that's why we do controlled studies and measure them carefully many people have mild to moderate GI distress when they start that's why we titrate we start at a low dose we recommend a low dose and go

up slowly almost everybody stays on the drug and goes through that and by the third or fourth month really don't have any effects anymore of that at all there are a few people where we don't have data or we are cautious one is um women who could become pregnant uh neither of the medications have information about that and then there's a condition called pancreatitis which is sort of an inflamed pancreas we worry about that with these drugs so if you've had a history of that don't use them let's suppose you take the drug and say

I've lost weight I'm very happy with my body now I'm going to get off the drug some people say that there are it's very difficult to not regain the weight that's right and science tells us that there's a reason for that um some people do uh maintain the the weight reduction or stay in that range uh they have to change a lot about how they live burn more energy eat different foods so we can all try that I think we should all try that actually um but uh some people cannot and there's a recent paper

in nature that actually told us why which is that once you're um have become obese your fat cells learn that that's their new state and they defend that state and so they're actually wanting more energy and that sends signals to your brain and so forth so once we uh as adults gain weight and have that on for a while it's very very difficult to reset your thermostat if you would to reset that level so for now we do recommend if they can't people cannot maintain weight loss off the drug to go back on the drugs

and use them chronically so um we do put fluoride in the water now at least for the time being um uh what about putting this in the water and just uh solve all the problems well we couldn't we shouldn't put it in the water people should use it under the guidance of their doctors but we should have um broad coverage just like we think it would be crazy if we didn't have antihypertensive medications available to all adults in America or anti-diabetes medications obesity causes 236 adult diseases and we know it's a precursor for these things

why not try to prevent it we have a a stigma in our country and in many other countries that this is sort of some personal failing but many of us were here because our ancestors conserved energy very effectively that's how they survive famines and floods and so forth so we're predetermined to want to keep weight on by our genetic background and we in a world of plenty of abundance um we need to probably have some medical help sometimes so what about uh overthe counter Why Can't This just be an over-the-counter drug you can just go

buy it like an aspirin or something yeah I think that the we'll try to work on that through time the oral uh pill we have is a great candidate for that because that's much easier to dispense in a in that kind of Pharmacy setting and uh we'll need to get more evidence that it's broadly safe here you don't have the doctor supervision piece so we would want to make sure particularly develop data in pregnant women and other settings to make sure that that could be safely done but we would have an interest in expanding access

for this medication and reducing the price so how many times a day do you get asked about this drug every um hour on the hour yeah many yeah dozens yeah and it's a pleasure to talk about it because it's such a breakthrough that can change our country but nobody really expected that to happen as you point out sometimes things happen unexpectedly so um let's talk about some other um things for a while let's talk about Eli Lily itself when was this company started yeah 1876 so started by a colonel Eli Lily who uh served in

the Civil War he was a pharmacist by training LED infantry and artillery company and was a prisoner of war in Alabama actually and he saw firsthand the atrocities of Medical Care in the Civil War you may know I know you're a student of history that more people died after injury than from their inj injury due to Medical Care and at the time this was an AR of snake oyle salesman um medicine wasn't very Advanced but what we thought of medicine often was back to the counterfeiting uh discussion you know made up things harmful ingredients so

he started a company with a pledge to say everything that's in this is on the label if if it's in there you know about it transparency um and that then evolved into a company that embraced the scientific method and began to really um adopt the methods that the modern industry has which is then taking natural products which is what most medicines were in 1876 and refining them into what we think of as a medicine now so think willow bark into aspirin or um pancreases of cows into insulin um that's what the company really is built

on he how long did he live after he started the company about 25 years um and then he handed the keys to his son JK Lily who handed the keys to his two sons also named Eli and JK that's a little odd um but for three generations it was a family-run business yeah and the family is not an owner now not well so the Legacy wealth of the family is our largest shareholder the Lilian endowment is now probably the biggest foundation in the United States with about 80 billion of assets on management right Y and

they have one asset essentially which is our okay and they're your biggest shareholder yeah so okay so when Eli Lily evolved over the years in the the 20th century what were its big products yeah so insulin really was the birth of the modern company and this was a obviously a terrible condition type 1 diabetes and a breakthrough and we were part of commercializing that around the world invented the manufactur facturing method and created that business that was followed by actually penicillin so during World War II Lily was commissioned as one of the manufacturers for antibiotics

for the Army and we from there then iterated for 40 years antibiotics including still some that are used today like vamin which is the the last line of defense for the worst infections and Prozac were famous for which has really brought modern Psychiatry into the fold uh and of course now m that found and what about um in the future you're work what are the human problems you're working on in the future Alzheimer's I assume is one of them absolutely yeah so we think about our company of course we use scientific methods to create medicines

to solve tough problems we're not really interested in Niche problems we think we're here because we're a big company to do hard problems that are scalable that's sort of where makes our business work but also has the most human impact so we select these diseases that are common and tough so you mentioned Alzheimer's nurd degenerative conditions are the most frightening conditions most people think about Parkinson's ALS Alzheimer's and the science we've been investing there for 30 years we just launched our first medicine so now we're getting Revenue after 30 years on that project um and

we're working on a prevention study for that same medicine which could really transform Alzheimer's we think other neurod degenerative conditions like Parkinson's alss Etc uh are becoming more tractable with science and you'll see us invest heavily in that area going forward pain chronic pain another area we're very interested in so let's talk about the company today uh how many employees do you have 44,000 and you're headquartered in Indianapolis yes correct and where do you manufacture your drugs are they mostly in us or mostly overseas mostly in the US although a large majority in Europe as

well so those are our two big bases for production and in the US we're building lots of plants right now mostly to support Zep bound and monjaro but um uh spreading our spreading our footprint so when did the the your stock went up as I said about 10 times I mean when did you all realized this is so transformative that you're going to become the most valuable pharmaceutical company in the world by a factor of four or five times you know it's as you know from running companies David it's hard to know exactly what the

scale of something is but I I will the story of T zepper Zep Mound for me is this um in 2016 I was named as the in coming CEO in that fall one of our scientists in um the diabetes group called me about some early results they were receiving from a Singaporean site we had that was doing a phase one study um with tepati the ingredient and Zep bound and we had to stop the study because people were losing too much weight to stay in it and at first this was seen as like an alarming

thing U but of course we began to process that as wait a minute this could be something very special so we sped to the next stage of development phase two where you try to show safety and efficacy in a bigger study and I remember um in a kind of a a moment I was showing my daughter around to colleges we were at Cal Berkeley standing outside the Lawrence um Hall of Science um and I got a phone call and the team just got off the plane got the results and showed that people were losing over

20% body weight in a longer study that was in April of 18 um we disclosed those results later that year and you could probably argue a lot of the runup in Lily was just execution from that moment forward because we had a pretty big study with some great results um we didn't know it would be this much but we knew it was special but you decided when you were overseeing this that we should continue this we started building factories we we invested five to six billion dollars in a phase three program um yeah if I

had been moved our chip if I had been in your job I would have taken credit for all of this so um you do you take the credit for this are you're the person responsible for this happening or not I mean I of course as a CO you have a role in all this but I it would be way overstating the role if I took credit I you know first of all we're an old company and um have people have worked there for 30 years on this problem so the credit goes to the scientist to

begin with secondly we have a lot of incumbent capabilities like how do you take a protein like glp1 which in the Natural Body lasts only a few seconds and make it into a week-long injection so that's a pharmacology exercise that's difficult and we have people who can do that and we have people who can do the clinical trials and everything else um to see the opportunity and go for it we have people who make it every day 247 we run our factories so it's a giant team sport just like the legacy of our success on

my watch will go beyond my tenure I'm inheriting some of that for my predat so is there a s one scientist that somebody can point to as the person who was responsible for this revolution well so there's four scientists at Lily who invented this drug and we celebrate them by the way three are immigrants to this country that's an interesting conversation um and they live in Indianapolis and so it's sometimes pointed out that the most valuable biotech company in the world is based in Indiana and that's a surprising fact to people but people uh come

from all over the world that work at our site to create amazing medicines so the way the pharmaceutical industry works as I understand it is you look at lots of potential problems that need to be solved you work with Scientists to come up with the drug and so forth you test them what is the typical period of time between you you say we're going to solve a problem with finding a a drug and then you actually get somebody to the market how long does that typically take so your better case scenario would be 8 to

12 years um as I mentioned in Alzheimer's we actually spent 34 years before we launched a drug um so this is a long long cycle time 8 to 12 but how many uh drugs do you work on that just you say it's not going to work and you just move for for with other ones there it a 90% failure rate and 10% success rate so it's about 100 to one from idea to Market so for every hundred ideas you might get one product it's about 10 to one from starting clinical studies so you have about

90% failure rate from phase one forward so some people say that drug companies don't really produce that many drugs anymore they're more marketing organization that they go out and find smaller companies that are producing these drugs and then they buy them up is that where you get most of your new drugs from or do you do it development internally yourself we're maybe a bit of an exception we're about 2/3 internal um but even that um Sten you know what what is the development where so is it the Drug's origin or is it the studies and

the expertise at it along the way so we do buy small companies we also collaborate with them we take what they worked on and we carry it Forward is that external I don't think so I think we added a lot of value there too but we have a big scientific base Lily employs almost 4,000 phds just for reference Harvard employees like 2,000 so we have a huge scientific base to create new medicines it's a it's a big part of our our strategy and in the pharmaceutical world the image is not always so wonderful in with

the public um I'm sure you're aware of this that people say pharmaceutical companies uh drug companies they will call them are charge too much and so forth how do you respond to the idea that drug companies are charging too much and very often people in the United States say I'm going across the border to Canada get the same drug for a lower price yeah thank you for asking that you know obviously it's something we want to change and fix um because what we think we do is pretty valuable um first problem is for uh artifact

of history and how healthcare insurance evolved in this country um people are largely shielded from surgery costs and Hospital costs about 3% of those total costs our country are paid out of pocket by consumers but for medicines it's closer to 20% so people think think the medicines are a larger part of the health bill because they're exposed to more of that versus Services that's again a historic thing we we advocate for better insurance coverage lower out-of-pocket costs for medications uh the second thing is you know be foreign countries it is true our prices are lower

in those places um we would like to correct that as well I mean our idea is that um basically the cost of a medicine is the cost of the R&D to produce it more so than the manufacturing obviously manufacturing cost is similar everywhere and right now there is an imbalance in who covers that R&D cost we should we should seek to correct that but the answer isn't just lower us to Canada's pricing we wouldn't have a pharmaceutical industry if we did that they don't pay for any of the R&D cost we have to raise developed

countries what they pay and we can lower the US I think that's a policy argument we'll hear about soon with the new Administration and uh you know we're happy to engage in but we need to do both at the same time okay so today um the pharmaceutical industry is most concerned about what in Washington you're in Washington I thre him for a meeting of the business Round Table among other things but um what are you most concerned about are you concerned about the new Administration coming into Power have you met with President elect Trump talk

about your issues have you met with members of Congress talk about your issues what are your big issues you care about in Washington we have General issues for American Business Like tax reform which is a big topic going to be for next year and the regulatory situation which I think has evolved for us in our industry in a negative way in the last four years um so those are Hot Topics at a general um sense Healthcare is always a topic and so then our role in it and Medicine affordability um is a key area one

you know but I think my experience having done this for eight years is um there's often more common ground than you'd think just reading the newspapers I think everyone would like um the US have a strong biofarma industry that invents amazing medicines like zound and makes them here like Lily does but at the same time we want our things to be cheap and accessible to all okay that that's hard to solve for all those things but we can make progress like one example is we were known um for the insulin pricing challenges we had and

Insulin was overpriced in the US according to the critics and we were able to bring that price down Why by compressing basically the middlemen and what they get and then working with Medicare to cap the cost of insulin which we supported at $35 a month I think there are solutions and by engaging we can find them and we're happy to do that with the new Administration or the the current one met have you met with anybody in the new Administration yet yeah I think it was reported last week we had a dinner down in Florida

yeah how was that like did they serve up fattening food or they don't do that with you probably shouldn't say too much about it but um it was all you could imagine and and a little bit more yeah let's talk about uh your own background where where were you born yeah I was born in Bloomington Indiana so whoer by birth but uh my dad was a grad student at IU at the time and we quickly left and moved to California my mom was from California um and I grew up in the Bay Area and Then

followed in their footsteps and went to Purdue University back in Indiana so I'm sort of like a like a bad Penny keep returning to that state um so at the keny center this weekend we honored The Grateful Dead you don't look like you're some a person who's A Grateful Dead type person from so we were you were in the Bay Area but you didn't get caught up in the Grateful Dead right I was a little younger than that that era um and I left yeah maybe in time to escape that all right so you went

back to college where your father had gone to school yeah and my mother yeah okay Purdue yeah and what did you study there so I started uh studying business and Engineering ended up with a degree in industrial management which combines those two and then went to work for IBM in in New York um which uh I joined it was the stock wasn't an all-time high when I left it was an alltime low they had a tough time in the early 90s well you fixed that turned it around yeah maybe yeah yeah so all right so

went to join uh Eli Lily in what year so I left IBM to follow my girlfriend who's now my wife who was going to medical school at Indiana University so again back to Indiana um and I needed something to do there so I decided to enroll in their MBA program and I got an MBA uh of course medicine's a four-year degree MBA is 2 so I still needed something to do in Indiana so I joined Lily okay and what when you joined what did you what was your position at the beginning yeah I was uh

in the department that looked at m&a transactions and um in the finance and business development group and a great introduction to the did you ever say I'm going to be the CEO someday or something like that not then um I I actually really was thinking I'll be here for 2 years years and then we'll be off to Chicago or San Francisco and do something different um but I fell in love with the company I mean it's a it's a amazing place it's a very humanistic culture PE but yet very rigorous and scientific so it's demanding

smart people but people are nice to each other it's a Midwest and I fell in love with the mission which is what could be better than making medicine for people and I had an experience actually a few years in which if I could share I worked on a medicine to collaborate and bring into the company for diabetes and right as I was leaving that job U my mother was diagnosed with diabetes and she was put on that medicine and so you know the sort of the point of what we do just became super Salient for

me and I said this is not a bad way to spend my time and I said to my wife let's stay here in Indiana and she said really and um and we ended up staying yeah raised our realized that you were on a track to be the CEO was it 5 years before later um well so I um worked in that job and then I had some jobs running markets I I ran our Canadian business and I went to China for two and a half years and ran our Chinese business and I was suddenly called

back from China by the CEO who was a new CEO and he said you need to come run our us business and I said yeah I'm happy to do that at some point but I'm we were really in the middle of a growth phase there we weren't done with the agenda I had set out and he had agreed to I said 'j don't you want me to finish the job he said you need to come back and I think that was the point where I was sort of being cultivated for big something bigger yeah so

did you beat South some other person to get the job or no I mean it's we've mostly hired people from within the company there were other candidates I'm sure when my predecessor retired and the board considered me and I was lucky enough to get it okay so um you now have three children yeah for a while I've had three children yeah yes they're they're young adults now okay all right but uh are any of them interested in uh weight reduction programs or things like that or not really well so my son is he's an AI

consultant so not so much my daughter is actually uh getting Masters in cell biology and interested in med school so she's thinking about medicine and medical science um and we talk a lot about the weight loss drugs and my youngest son is a geology student at Purdue so we'll see what he does and so what do you do for relaxation to stay in shape you you're not on one of these uh drugs I think because you look very fit and exercise a lot yeah I'm not but I would never hesitate to be on one if

I needed it um but the best medicine is prevention and so you know paying attention to exercise is something I've always cared about it's a way I I reduce stress too um so I led running and now I don't run anymore but I do other things um I like hiking I love um Backcountry skiing in the outdoors play golf um being outside is where I find both Fitness and peace but then you know also I think it's important to to watch what you eat I think par I've turned 57 years ago and um we we

really needed to change what we eat that's what my wife and I decided so we did and it's I think been helpful to keep same body weight what do you eat things we recognize as food yeah um so basically things that aren haven't been through factories and um are you know you recognize that a farmer might grow you've had an astounding success at Eli Lily suppose a president of United States said you should be the Secretary of HHS or something like that what would you say I'm busy right now uh I I've never actually thought

about that I saw that on your question list you you served in the government maybe I could get some advice no I don't think you need advice for me because we we didn't do too well but U but uh all right so you're happy with and you're you're so young there's a lot to do you know the company as you pointed out um graciously is really doing well but um you know we really have a strong desire to do even more and we're just at the beginning of this weight loss story you know right now

there's six or seven million Americans who are taking these medicines there are 110 million with obesity and we need to build more plants and develop more data get in better insurance coverage and then there's the whole world to cover it's projected in 5 years there'll be a billion people on the planet who have obesity and it's going to become a much bigger problem in the developing world than it ever has been in America um partly because the rate of growth uh of obesity in India and China is much faster than we experienced and um populations

that are non-caucasians particularly um South Asians appear to be much more susceptible to chronic disease at lower weights so we have a lot of work to do to to make the biggest impact we can yeah the greatest obesity in the world is actually in those countries on South Pacific like number one the I think is americ right so today uh where do you want to take your company now you can't find any drug that's going to be more successful than one you have is this you're just going to keep promoting this drug is that your

biggest thing or there's no other drug you can I can imagine it would be anything comparable to this well we can imagine that and so we're trying to uh first of all within the Obesity metabolic Health space I think there's two things I'm very excited about one is we have tepati mararo zound on the market we have 11 other pipeline projects aimed at the same problem but in different ways so we have a triple acting uh medicine that's in phase three for those that have even higher body weight or more severe health problems with the

oral project nine others beyond that uh we think this this is going to be a very large segment with many different types of medicines for different conditions and different situations people might find themselves in we're going to exploit that fully the second thing is we've talked a lot about like cardiovascular health diabetes these conditions that ones think about with being overweight but these medicines uh we think and we've aim to prove can be useful for other things we don't think about connected to weight uh he these are often called anti-ed donics so they're reducing that

desire cycle so next year you'll see Lily start large studies in alcohol abuse and nicotine use even in drug abuse um we'll also begin studies in anti-inflammatory conditions because you don't think of that with weight but actually there is a quite a strong signal in anti-inflammatory and then beyond that David we need to make important medicines for the Long Haul old company we plan to be here another 150 years plus and I mentioned my excitement about brain health I think that's really the next Frontier to make a big difference so have you ever thought about

eating a lot gaining weight and then going to one of your drugs so you can actually experience it because you don't use it because you don't you're so thin I'd like to I'd like to avoid that but it might happen and I wouldn't hesitate use them yesterday you announced a $15 billion stock buback yeah um many people criticize stock BuyBacks they say you should use your money to invest in your products and so forth how do you respond to that yeah I don't understand that argument really a stock buyback is a way to essentially You

by buying your own shares you give the people who already own your shares the opportunity to sell at a higher price and get a return on their investment I don't know why that's bad but um I would also point out in our current situation we're spending almost more than anyone in the world on R&D already um we'll spend 11 A5 billion dollars this year on research and development by the way the country of Germany spends about 8 and a half billion on all of its uh medical R&D that's their NIH equivalent so we're at the

nation state scale on R&D um we're we have announced Investments of $23 billion in new capital in the United States for factories we can't go faster there's no more vendors to build plants faster than we're building right now um so returning some of the rewards that uh investors deserve for taking risk on the company seems like a reasonable thing to do so you're meet members of Congress when you're in town I assume how do you find that experience uplifting or um that wasn't the word I was going to use um yeah look at an individual

level we love our congressmen and I think at an individual level they seem quite smart and rational people collectively they don't seem to be able to act uh very rationally um but we're going to try to convince them to do so I think there's a lot we can do you know it's a complicated world right now for Global businesses like ours there's a lot we could do that would make a pretty big difference and it seems relatively easy to us so um we'll work with them to do that now I assume you're very popular in

Indiana because your company's very popular and you're a very nice person or so forth have you ever thought of running for office yourself again I have not considered public service at this point I'm busy doing what I'm interested in but and we've been lucky in Indiana we have a um you know it's a right leaning state but we've a very common sense leadership we've enjoyed good relationship there so um that hasn't come up no one's tried to recruit me um yet okay so um let me ask you finally finally on the the drug that everybody's

talking about um is it difficult to get a a doctor to prescribe that or if you go into a doctor and you say you want it doctor automatically gives it to you or you have to examine you and say you're a little overweight they'll have to examine you but it's a both and right now our Market studies are when people ask for either our drug or or no V about eight out of 10 times they get it um it's a very consumer-driven thing and most doctors aren't resistant to it when we launch Z bound you

know we just started advertising that's an unusual thing usually you go out of the gates you try to raise awareness but there was so much online buzz and virality to this we didn't really have to um half the doctors writing the medicine in the United States right now our medicine we've never spoken to so usually we have like salesmen who go out Sal people talk to them free samples you don't have to give free samples we haven't done any free samples and and half of them we haven't even spoken to yet we we need to

speak to them to educate them on risk and benefits but um they're just spontaneously writing because consumers are asking them for it it's a unique medicine yeah so has there ever been a drug anywhere in the United States that's as popular as this particular drug is uh sweeping the world and the and the country is anything like this and we've seen before I don't think so I think U both ours and and our competitors drugs will easily be the largest selling drugs in the US next year and um for a good reason I'd say that

they uh obviously people when they begin taking them almost immediately feel better and they want to stay on them we do lots of clinical trials and often people uh we randomize to Placebo so they don't know they're on the drug or not and the people on the drug often drop out of the study at a higher rate because you feel about the same when you're on most chronic medications um maybe have some side effects but you don't notice your health improving on these you notice your health improving immediately people have a scale in their bathroom

they step on it every day they love losing weight Physicians like it because the Baseline of Medical Care is diet and exercise so when people aren't successful it's frustrating here they can feel successful because people who are chronically overweight or even quite obese um can lose a lot of weight I had a letter uh this weekend I got from a lady who um lived in Kansas she's 45 years old she weighed 420 lbs and she sent me the letter because yesterday she weighed 188 and she's been on our drug for two years and um she

was unsure if she was going to live to be 50 and now she's sure she is so this is a imagine that at the nation scale we could change uh the trajectory of Health here in the country with with our invention well in that particular example for examp somebody goes from 400 plus pounds down they their body organs must have been weakened by having that large weight for a long time so even if they lose the weight they're still not going to be as healthy as if they had never been obese right well we don't

know that actually I think the the body's proven to be pretty resilient obviously she'll need to keep the weight off she'll need to exercise and eat well um and take good care of her health but um this particular person for instance had diabetes and no longer has clinical diabetes it's not detectable so actually her health is improving as she's losing the weight already well it's a great American success story and uh I congratulate you on pulling this off and uh I hope you'll continue to find other drugs that are going to be as successful as

this and I could you know could use a couple of them myself Alzheimer's or whatever else I might need in the future but um uh thank you very much for being here and thanks for the great thanks David appreciate it