Eli Lilly Eyes Obesity Access Expansion With Zepbound, Foundayo and Pipeline Bets

Key Points

• Access expansion is Lilly’s primary obesity-growth opportunity: Commercial insurance coverage remains around 50%, while the Medicare Bridge program could reach an estimated 20 million eligible people. Lilly says the program has already enrolled nearly 600,000 users, with many being new patients.
• Foundayo is gaining traction as an oral obesity treatment: More than 36,000 people had tried the medicine by the second quarter, and it captured over 30% of new starts in the oral GLP-1 category. Lilly is expanding advertising, physician support and international launches.
• Lilly is building a broad obesity pipeline beyond Zepbound: Retatrutide is being positioned for both high-efficacy and better-tolerated treatment needs, while eloralintide is being studied alone and with tirzepatide. The company is also pursuing less-frequent dosing and maintenance strategies to improve adherence.

Eli Lilly and Company NYSE: LLY is pursuing a broad obesity portfolio designed to address different patient needs across treatment initiation, maintenance, efficacy, tolerability and dosing convenience, according to Ilya Yuffa, the company’s executive vice president and president of Lilly USA and Global Customer Capabilities.

Speaking at a Morgan Stanley event hosted by U.S. BioPharma Analyst Terence Flynn, Yuffa said obesity treatment utilization remains in the single digits among people who could potentially benefit from medication. He said Lilly views its tirzepatide-based medicines, including Zepbound, as foundational to its strategy while developing and launching additional options such as the oral medicine Foundayo, retatrutide and eloralintide.

Coverage and Medicare Bridge Program

Yuffa said commercial insurance coverage for obesity medicines has remained “relatively stagnant” at roughly 50%. While some employers have removed coverage and others are considering adding it, he said he does not anticipate a substantial change in either direction heading into 2027.

He identified the Medicare Bridge program as the largest potential driver of access expansion. Lilly has also seen some states begin to add Medicaid coverage, while its Employer Connect initiative and more than 20 third-party providers are holding discussions with employers about benefit designs, cost-sharing flexibility and related support services.

“We will have a number of employers opt in or maintain coverage through this program” for 2027, Yuffa said, noting that employers generally make benefit decisions before October for the following year.

On the economics of treatment, Yuffa cited a Lilly study involving people age 55 and older using Zepbound. He said the study found direct medical-cost savings beginning as early as six months, reaching more than $600 per person per month after 12 months. According to Yuffa, those savings more than offset the cost of the medicine in the study population.

Yuffa said the Bridge program has experienced only minor initial logistical issues and has otherwise operated well. The program uses standardized eligibility criteria across Medicare, unlike the varying prior-authorization requirements seen in commercial plans, he said. He added that Dr. Oz had cited nearly 600,000 people using Bridge to access medicines.

Lilly estimates that around 20 million people could be eligible based on the program’s criteria. Yuffa said 60% to 70% of participants so far have been new patients, and that the $50 standard out-of-pocket cost for eligible Medicare participants has contributed to a preference for injectable treatments and Zepbound.

Foundayo Launch Progress

Yuffa said Lilly has increased consumer advertising for Foundayo, including a recently launched advertisement featuring Martha Stewart, as it works to build brand awareness. The company had increased the number of people trying the medicine to more than 36,000 as of its second-quarter results, he said, and that number continues to rise.

Lilly is also seeking to improve physician experience with the medicine through samples, expanded access and coverage, and peer-to-peer programs. Yuffa said Foundayo had reached more than 30% share of new starts in the oral GLP-1 category, describing the result as a marked improvement over the prior two months.

While he declined to provide a timeline for Foundayo to achieve a leading share position, Yuffa said Lilly is focused on expanding treatment access and reaching patients who could benefit.

Outside the U.S., Lilly has launched Foundayo in the United Arab Emirates and the United Kingdom and said early results indicate that the product has expanded the market by bringing new patients into treatment. The company has also received approvals in Saudi Arabia and Mexico and has submitted the medicine in more than 40 markets. Yuffa said Lilly plans to launch following approvals, with supply and commercial teams prepared.

He said approximately 75% of the obesity market outside the U.S. is self-pay. Lilly has also received approval for obesity reimbursement in France, he said.

Pipeline Positioning

Yuffa said Lilly sees retatrutide as potentially serving patients at both ends of the obesity-treatment spectrum. He pointed to phase 2 results suggesting bariatric-like efficacy at higher doses for some patients, while lower doses showed tirzepatide-like efficacy with one dose-escalation step and favorable tolerability.

For eloralintide, Yuffa cited phase 2 results showing up to 20% efficacy in monotherapy and said lower doses produced placebo-like tolerability with 13% efficacy. Lilly is also studying eloralintide in combination with tirzepatide, with the goal of determining whether it can increase efficacy without compromising tolerability.

The company is also exploring less-frequent dosing approaches and maintenance strategies. Yuffa said Lilly’s focus is not solely on a long-acting product but on addressing consumer and physician needs related to adherence, tolerability and maintaining weight-loss goals.

Alzheimer’s Disease Market

In Alzheimer’s disease, Yuffa said Lilly feels positive about its profile, including once-monthly dosing and a treatment approach intended to continue until patients reach a plaque-removal threshold. He said Lilly currently holds leading share but emphasized that improving diagnosis and treatment infrastructure is more important than share competition.

Yuffa highlighted blood-based biomarkers as an important innovation that could help shorten what he described as a difficult and lengthy process of diagnosing and treating Alzheimer’s disease. Lilly has doubled the number of people being treated, he said, but added that substantial work remains to improve access for patients.

About Eli Lilly and Company (NYSE:LLY)

Eli Lilly and Company is a global pharmaceutical company that discovers, develops, manufactures and markets medicines for a range of medical conditions. Its portfolio includes treatments for diabetes and obesity, oncology, immunology, neuroscience, cardiovascular disease and other areas of significant unmet medical need.

The company's products include Mounjaro and Trulicity for diabetes, Zepbound for chronic weight management, and insulin products such as Humalog. Lilly also markets Verzenio for certain breast cancers and Kisunla for the treatment of early symptomatic Alzheimer's disease.

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