禮來 (LLY) 2026 年第三季財報電話會議：營收成長 39%，上調財測

重點摘要

• 第三季營收年增 39%，主要由 Mounjaro、Zepbound 以及各治療領域與地區的成長所推動。Mounjaro 與 Zepbound 合計創造超過 160 億美元的營收，比 2025 年第三季增加了 60 億美元。
• Non-GAAP 績效營業利益率上升 5.9 個百分點至 54.2%。Non-GAAP 每股盈餘 (EPS) 為 7.48 美元，其中包括每股 4.57 美元的收購研發 (IPR&D) 費用。
• 禮來 (Eli Lilly) 將 2026 年營收財測調升至 910 億至 920 億美元，目前預計 Non-GAAP 績效營業利益率為 52% 至 52.5%，Non-GAAP EPS 為 35 至 36 美元。
• 聯邦醫療保險 (Medicare) GLP-1 Bridge 計畫自 7 月 1 日推出以來，已為禮來藥物開出超過 50 萬份處方調劑。在 Bridge 新患者中，每 10 人就有 7 人選擇禮來的減重藥物。
• 在 TRANSCEND T2D2 試驗中，Retatrutide 使糖化血色素 (A1c) 降低了 2.2%，並帶來 20% 至 21% 的體重減輕；相較之下，2 毫克的 semaglutide 使 A1c 降低 1.8%，體重減輕 9.4%。
• 管理層預計 2027 年腸促胰島素 (incretin) 的銷量將持續成長，但淨實現價格仍將是一項逆風。2026 年記錄的約 20 億美元一次性營收項目預計不會重現。

關鍵財務數據

第三季營收包含約 9 億美元先前確認的項目，包括里程碑付款以及返利與折扣估算值的變動。

業務與經營績效

腸促胰島素產品組合仍為主要成長動力

美國營收成長 34%，主要受 Zepbound 和 Mounjaro 銷量增加帶動。報告的美國價格下降 7%；若扣除返利與折扣估算值的有利調整，價格則下降 10%。

美國腸促胰島素總處方量成長 32%。肥胖症腸促胰島素處方量成長 82%，其中禮來產品佔總處方量約 6 成，佔注射型處方量 7 成以上。在 2 型糖尿病領域，腸促胰島素處方量成長 8%，而禮來保持了 60% 以上的市佔率。

據 IQVIA 統計，國際腸促胰島素銷量增長了 53%。禮來的市佔率較 2026 年第二季增加了近 4 個百分點，在美國以外市場達到約 58%。

Medicare GLP-1 Bridge 計畫正在擴大年長者的用藥管道。管理層表示，約 75% 的 Bridge 參與者選擇了注射療法，而目前的使用者中有 80% 是首次接受腸促胰島素治療或先前未曾使用過。

Foundayo 推廣持續擴大

繼早期在阿聯酋上市後，Foundayo 於本季度在英國、墨西哥和沙烏地阿拉伯上市。在美國，每 10 名開始使用減重藥物的患者中約有 4 名選擇 Foundayo，且 Foundayo 新增患者數量較上一季翻倍。

管理層預計美國監管機構將於 2026 年第四季對 Foundayo 用於 2 型糖尿病的申請採取行動。公司還預計 2027 年將在所有全球主要市場推廣，計畫在慢性體重管理和 2 型糖尿病領域進行 40 多個國際市場的上市。

成長擴展至肥胖領域之外

禮來在腫瘤學、免疫學和神經科學領域重點產品的營收較 2025 年第三季翻倍。

• 在美國異位性皮膚炎處方市佔率成長的支撐下，Ebglyss 的營收成長了 59%。
• Jaypirca 全球營收成長 59%。
• 截至第三季末，Inluriyo 在美國轉移性乳癌市場中，佔新處方量的 60% 以上以及總處方量的 40%。
• Kisunla 營收成長 175%，並在美國類澱粉蛋白標靶治療領域維持領導地位。
• p-tau217 血液檢測數量年增超過一倍，協助了阿茲海默症的診斷與治療獲取。

區域表現同樣強勁。按固定匯率計算，歐洲營收成長 29%，其中包括來自 Jardiance 一筆 4.1 億美元的一次性里程碑付款。日本營收成長 26%，中國成長 62%，世界其他地區營收按固定匯率成長 87%。

研發管線與製造投資

FDA 批准了 tirzepatide 用於降低 2 型糖尿病成人的心血管風險，並批准了每週一次的基礎胰島素 efsitora alfa（品牌名為 Onswik）。禮來還獲得了涉及 pirtobrutinib 和 imlunestrant 的新批准。

在患有 2 型糖尿病和肥胖症的人群中，EloraTZP 在第 48 週時實現了 23.3% 的體重減輕，比 tirzepatide 多出 57%。最高劑量使 A1c 降低了 2.9%，但因不良事件引起的停藥率也更高。禮來計畫在第三期試驗中使用更緩慢的劑量遞增時程。

該公司收購了 AtaiBeckley 和 Merida Biosciences。此外，公司亦在德州休士頓開工建設一座價值 65 億美元的製造工廠，並在維吉尼亞州里奇蒙開工建設一座價值 50 億美元的工廠。

管理層財務預測

更新後的展望反映出 Medicare GLP-1 Bridge 計畫帶來的美國強勁需求，以及 Mounjaro 在美國以外市場的持續成長。在採中間值計算時，在計入第三季每股 4.57 美元的收購研發 (IPR&D) 費用之前，EPS 預估值增加了 4.07 美元。

展望 2027 年，管理層預計美國腸促胰島素銷量將維持成長、Bridge 管道帶來全年度效果，以及預期的 Foundayo 2 型糖尿病產品上市。在國際市場，公司預期 Mounjaro 將保持領導地位，且 Foundayo 的上市將支持進一步的市場擴展。

管理層亦預計淨實現價格壓力仍將持續，儘管銷量成長預計將足以完全抵銷此壓力。公司將於 1 月公佈第四季業績時提供正式的 2027 年財測。

風險與關注焦點

• 較低的實現價格部分抵銷了產品組合與製造效率為第三季毛利率帶來的效益。管理層預計價格因素在 2027 年仍將是一項逆風。
• 隨著用藥管道擴大，營收結構可能會轉向淨價較低的 Medicare、Medicaid（醫療補助）及自費管道。
• 2026 年約有 20 億美元的營收來自一次性項目，主要是里程碑付款以及返利和折扣估算值的變動，管理層預計這些項目不會再次出現。
• Bridge 計畫目前仍為試行階段。管理層對永久納入給付保持樂觀，但也指出該計畫將需要 CMS 進行分析，並可能需要立法或監管行動。
• EloraTZP 最高劑量組錄得較多因不良事件而停藥的情況，因此第三期試驗的耐受性與劑量遞增將是重要的監測重點。
• 管理層承認新市場動態存在不確定性，包括國際自費需求以及管道擴展的速度。

分析師問答亮點

管理層將自 2026 年初以來全年營收財測約 100 億美元的增長，主要歸因於 Bridge 採用率、美國腸促胰島素滲透率以及國際消費者需求皆優於預期。管理層表示腸促胰島素的滲透率仍然較低，在美國符合條件的患者中約為十分之一，在美國境外約為百分之二，因此管理層認為未來仍有數年的成長空間。

在治療持續性方面，禮來表示有保費給付的 Zepbound 患者追蹤情況接近先前在 Trulicity 看到的 16 至 18 個月，而自費患者的持續性則接近給付市場的水平。管理層預計口服療法的服藥順從性將低於每週一次的注射劑。

禮來預計 2027 年商業保險 GLP-1 的覆蓋範圍將保持大致穩定，主要的給付擴展可能來自 Medicare 和 Medicaid。由此產生的渠道結構變動可能會降低每份處方的平均淨營收。

除了心血管與代謝健康領域之外，管理層將腫瘤學、神經科學和免疫學視為潛在的長期成長支柱。禮來有 8 款腫瘤藥物或主要適應症正在進入或接近第三期試驗，並繼續透過收購和授權引進在各治療領域增加早期及臨床階段的資產。

法說會逐字稿全文

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完整財報電話會議逐字稿

管理層陳述

Operator

Ladies and gentlemen, thank you for standing by, and welcome to the Eli Lilly Third Quarter 2026 Earnings Conference Call. [Operator Instructions]

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

Mike Czapar

Good morning. Thank you for joining us for Eli Lilly and Company's Q3 2026 Earnings Call. I'm Mike Czapar, Senior Vice President of Investor Relations. Joining me on today's call are Dave Ricks, Lilly's Chair and CEO; Lucas Montarce, Chief Financial Officer; Dr. Dan Skovronsky, Chief Scientific 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.

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. 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.

Now I'll turn the call over to Dave.

David Ricks

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. 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. We continued the global rollout of Foundayo, launching in the U.K., 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 U.S. approval of our new weekly insulin and new indications for Inluriyo, Jaypirca and Mounjaro As part of Medicare GLP-1 bridge program, we expanded access to obesity medicines in the U.S. approximately 20 million seniors. Since the July 1 launch, more than 0.5 million people have filled a prescription for a Lilly medicine through this program. We've heard positive feedback from patients and physicians about the initial implementation.

Within the GLP-1 Bridge program, the Lilly portfolio is performing well. Among new Bridge patients, 7 out of 10, starting on 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. A recently published paper from the University of Southern California Schaeffer Center for Health Policy & 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.

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 2 new manufacturing facilities a $6.5 billion facility in Houston, Texas, and a $5 billion facility in Richmond, Virginia. We distributed $1.5 billion of dividends in the third quarter and executed $400 million in share repurchases.

We launched a 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. Lastly, we announced Patrick Johnson, 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 Patrick for his many contributions over a successful 36-year career at Lilly.

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

Lucas Montarce

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 a strong momentum across therapeutic areas and geographies. Gross margin as a percentage of revenue increased 80 basis points to 84.4%. A 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.

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. 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.

On Slide 8, we quantify the effect of price, rate and volume on revenue growth. U.S. revenue increased 34% in Q3 primarily driven by volume growth from Zepbound and Mounjaro, partially offset by a 7% decline in price. U.S. price benefited from a favorable adjustment to estimates from rebates and discounts. Excluding this adjustment, U.S. 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 onetime milestone payment related to Jardiance. No additional Jardiance milestone payment remains under our agreement with Boehringer Ingelheim.

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 uptick of Mounjaro. Mounjaro is the first medicine in China to exceed $1 billion of revenue during its first full year. 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.

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 U.S., Ebglyss continued to gain share of new prescriptions in the specialty dermatology market and is the fastest growing medicine in atopic dermatitis. Oncology, Jaypirca had another strong quarter as worldwide revenue increased 59% compared to Q3 2025. In the U.S., Jaypirca was the fastest-growing BTK inhibitor as measured by total prescriptions. Inluriyo continued its impressive uptick in the metastatic breast cancer oats market, exiting Q3 with more than 60% share of new U.S. prescriptions and 40% of U.S. total prescriptions. In neuroscience, Kisunla revenue grew 175% compared to Q3 2025. Kisunla maintained its leadership position in U.S. amyloid-targeting therapies.

Diagnostic testing momentum continues to build, and the number of p-tau217 blood test more than doubled compared to Q3 2025, translating to more people being diagnosed with Alzheimer's disease and accessing treatment. Finally, in Cardiometabolic Health, Mounjaro and Zepbound combined for more than $16 billion of revenue, contributing $6 billion of growth compared to Q3 2025.

As seen on Slide 10, total prescriptions in the U.S., incretins market grew 32% compared to Q3 2025. Overall GLP-1s and the Medicare GLP-1 Bridge program are expanding the number of people taking incretin therapy. In the U.S., total increasing 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. In the U.S., 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 U.S., Lilly's portfolio again performed well.

Slide 11 shows aggregate trends in international incretins, which have increased by 53% since the same period last year as measured by IQVIA across sales. Lilly strengthened its leadership position outside the U.S., gaining nearly 4 percentage points of share compared to Q2 2026 to reach approximately 58%. Slide 12 provides an update on the Foundayo launch. In the U.S., total prescriptions and the share of new patients continue to rise. Approximately 4 in 10 patients starting an overall obesity medicine chose 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 U.S. and expect regulatory action in Q4. Outside the U.S., Foundayo has launched in 4 countries and is under regulatory review in more than 4 additional countries. We continue to expect a global rollout in all major markets in 2027.

On Slide 13, we provide an update on year-to-date capital allocation. Moving to Slide 14 is our updated 2026 financial guidance. Based on a 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 U.S. driven by rapid uptake of Medicare GLP-1 Bridge program and outside of the U.S. from strong Mounjaro performance. 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 range before updates to the Q3 acquired IPR&D charges of $4.57 per share.

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. Beginning with the U.S. 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 U.S., we expect Monjaro's leadership position to continue. We expect to launch Foundayo which will drive additional market growth. Consistent with prior years, we expect net realized price to be a headwind more than offset by volume growth. It is also worth noting that the 2026 revenue benefited from approximately $2 billion of onetime items primarily related to milestones payments and changes in estimates for rebates and discounts that we don't expect to record.

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

Daniel Skovronsky

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 III readout from our GIP GLP-1 glucagon triple agonist, retatrutide. Just yesterday, we shared top line results from TRANSCEND T2D2, 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 of semaglutide. These data demonstrate retatrutide can provide even more glycemic control than an approved diabetes medicine, provide 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.

Moving to another Lilly triple agonist. At last month's European Association for the Study of Diabetes meeting, we presented Phase II data for EloraTZP. EloraTZP is a combination of our selective amylin receptor agonist, or lintide in our GIP/GLP-1 dual agonist, tirzepatide. As shown on Slide 16, EloraTZP delivered weight loss of 23.3% at 48 weeks with 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.

In addition, the highest dose combination of EloraTZP delivered A1c reduction of 2.9% at 48 weeks. And more than 3 out of 4 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 III 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 3 physiologic hormones at once.

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 III, of course, we will use a slower optimized dose escalation schedule, which we anticipate will improve tolerability. Note that monotherapy of eloralintide showed excellent tolerability, with discontinuations due to adverse events lower than placebo. We look forward to beginning the Phase III trials of co-formulated EloraTZP imminently.

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 noninferiority versus insulin glargine, reaffirming its cardiovascular safety profile. An additional prespecified 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. These data complement the 6 previously presented Phase III trials for orforglipron that support the potential of orforglipron as a foundational daily oral treatment for people with obesity and people with type 2 diabetes.

Also in cardiometabolic health this quarter, in the U.S., we received 2 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.

Moving to oncology. The FDA approved pirtobrutinib for certain patients with previously untreated CLL or SLL based on the brewing CLL 313 Phase III trial. Pirtobrutinib reduced the risk of disease progression or death by 80% compared to bendamustine plus rituximab. This approval underscores pertibrutinib's versatility across the CLL continuum of care. It cannot 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 set.

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 2 central drivers of ER-positive breast cancer with an evidence-based treatment approach, established tolerability profile and no new monitoring requirements. We look forward to the results from EMBER-4 ongoing Phase III trial of imlunestrant in high-risk early breast cancer.

Elsewhere in oncology, we initiated a Phase III trial with our PI3 kinase alpha inhibitor, tersolisib in combination with the CDK4/6 inhibitor in endocrine therapy in advanced breast cancer. Tersolisib is a mutant-selective PI3-kinase alpha inhibitor intended to target the PI3 kinase mutations in breast cancer, while sparing normal PI3 kinase and healthy tissue. 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 8 new oncology medicines or major new indications that are in Phase III trials or will start Phase III shortly.

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.

Moving to immunology. We shared positive Phase III results for lebrikizumab in people with moderate to severe atopic dermatitis of the handset 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 potential label update. We also shared 52-week results from Phase IIIb 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.

Earlier this month, we closed the acquisition of Merida Biosciences, which is developing MER511, a precision immunology therapy in Phase I for Graves' disease and thyroid eye disease. This drug was designed to selectively degrade the disease-causing auto antibodies 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.

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.

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

David Ricks

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 2 new manufacturing facilities in the U.S. to support our future growth. 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.

We've developed differentiated capabilities in R&D, manufacturing and commercial operations. where we're engaging directly with patients through platforms like Lilly Direct, changing the way people access health care. Given the depth of our anchorage 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 the decades to come. And with 3/4 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 deliver diversified and durable growth for Lilly and our shareholders. Q3 was another strong quarter and another step toward our long-term goals.

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

Mike Czapar

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.

Operator

[Operator Instructions] Our first question today is coming from Chris Schott with JPMorgan.

分析師問答

Christopher Schott

Congrats on the progress. I guess a bigger picture one. You've raised guidance on the top line by roughly $10 billion year-to-date. I guess you reflect on what's happening here. Just talk a little bit about what the biggest surprises have been as we think about U.S. versus OUS cash pay versus commercial, et cetera? 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 kind of longer addressable TAM for the company?

Mike Czapar

Great. Thanks, Chris, for the question. To talk a bit about guidance and our outlook for incretins in the future, we'll go to Lucas.

Lucas Montarce

Yes, Chris, thank you for your question. 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 to talk about the launch of Foundayo in Q2. We talk about starting the Medicare Bridge program. And then, of course, we talk about the variable of the growth of U.S. in particular, on the incretin out-of-pocket business and the runway of that growth.

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.

Going back to your second part of the question about the runway of that is at pulling forward or not. If 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. If you look at the U.S. and we're talking about 1 out of 10 patients that we are reaching nowadays. And in U.S., we are talking about 2 patients out of 100 patients. So it's actually a really low base, though the number seems really big, $16 billion this quarter of increasing business. The runway of opportunity of growth is still for many years to come from my perspective.

And on top of that, we continue to fund 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.

Operator

Our next question is coming from Geoff Meacham with Citi.

Geoffrey Meacham

I want to ask about what data you have on tirzepatide persistency in 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.

Mike Czapar

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

Ilya Yuffa

Geoff, thanks for the question. What we've seen in persistency and actually before we even launched Zepbound, we've had success with Trulicity in the past, and that was kind of the standard of what is possible for chronic medicine for adherence, which ended up coming around 16 to 18 months of adherence. 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. So the persistency actually for iconic medication and is doing extraordinarily well.

Now expectations for oral, it's still early. But as typical chronic medications as long as 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. One additional data point, I think, will be important as we look at even the success of Bridge early days in Bridge having a low 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.

Operator

Our next question is coming from Seamus Fernandez with Guggenheim.

Seamus Fernandez

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. 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.

Mike Czapar

Great. Thanks, Seamus. Always welcome Neuroscience questions. So we'll go to Carole talk about prospects for Kisunla and maybe kind of the neuroscience space more broadly?

Carole Ho

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. 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.

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. 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.

Operator

Our next question is coming from Evan Seigerman with BMO Capital Markets.

Evan Seigerman

Bigger picture one here. So clearly, the incretin franchise has become an enormous earnings driver, but it 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 multibillion-dollar growth pillar? And does recent BD activitie suggests that neuroscience and immunology are emerging as higher strategic priorities?

Mike Czapar

Great. Thanks, Evan, for the question about the next big opportunity after incretin. So we'll go to Dan to talk a bit about some of the pipeline opportunities he's excited about.

Daniel Skovronsky

Thanks, Evan. I would say that we're excited about all 3 of our other therapeutic areas, which are immunology, neuroscience and oncology and the BD activity reflects not just our strategic intent to grow those areas. But the intersection of that strategic attempt with assets that are actually out there and are attractive to us.

Oncology is probably the space where we've made the most progress, and we highlighted 8 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 up the way we see them too.

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 the space. And you could 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.

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.

Operator

Our next question is coming from Kerry Holford with Berenberg.

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 the majority of Medicare demand is injectable. I wonder has that surprised you with regard to your products in that space. And also could you talk to what proportion of patients in that Medicare channel for the Bridge program specifically and naive versus existing patients transferring from other channels?

Mike Czapar

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

Ilya Yuffa

Yes. Thanks for the question. For Bridge 1, it's 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 of 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.

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 in 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.

In terms of expanding number of people actually being treated after the first bolus of people coming into Medicare. We're seeing now 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. 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 a potential of saving significant amount for Medicare overall.

Operator

Our next question is coming from Asad Haider with Goldman Sachs.

Asad Haider

Maybe just back to Foundayo, thanks for the comments earlier, and I know that it'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 U.S. as well as internationally in the context of both competitive dynamics versus oral Wegovy and then your own internal expectations. And then on the titration schedule for Foundayo, the 2 lower doses still represent about 75% to 80% of TRxs in recent weeks. So where do you see that going at steady state?

Mike Czapar

Great. Thanks, Asad. I think we'll start maybe with international and go to Patrick to talk a bit about some of the U.S. launches and then Ilya maybe a couple of nuggets on the U.S. as well.

Patrik Jonsson

Well, thank you very much. We have now launched in 4 markets outside the U.S. We started with the UAE very late in Q2. In the second half of Q3, we launched in U.K., Saudi and Mexico I would say that so far, the launch is very much in line with our expectations. A lot of similarities with the learnings from the U.S. in terms of the orals are truly expanding the market and we see a huge amount of patients actually being new to incretins.

In Middle East, I think we have the political situation to take into account that we are the market leader in UAE competition from Wegovy. In Saudi, we have launched in both type 2 and chronic rate management, and we have a good uptick U.K., 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.

Mexico, week 6, 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 the work that has been done in the U.S. as well. 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 in 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 reimbursed and will take some time.

Ilya Yuffa

Yes. In the U.S., we've made significant progress since last quarter. You've seen over 0.5 million TRx in the quarter, but the fundamentals in some of the communicators that we've been talking about as part of our initial launch have been moving in a really positive direction. Consumer awareness and interest has improved with our investment in campaign with Martha Stewart, you're seeing Also, a 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 shared market.

So our NBRx share 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 within -- from Q2 to Q3, we're taking 45% of that growth with Foundayo. 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 our maintenance services. We have multiple maintenance doses. So that 25% of people are at one of our maintenance doses. That's actually higher than what you see on Wegovy pill. And so we're encouraged by that. Of course, that's something continue to monitor, but the experience overall that we're seeing both from provider and consumer has been positive.

David Ricks

I would just add, we're under review for type 2 diabetes. We see that as an extraordinary opportunity for Foundayo as well. Remembering today in the U.S., 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 sort of another leg to the stool here for the Foundayo performance.

Operator

Our next question is coming from Steve Scala with TD Cowen.

Steve Scala

This is a follow-up to Chris' 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? A key for investors, I think, is to determine when the surprise factor runs its course. So any color would be appreciated.

Mike Czapar

Great. Thanks, Steve, for the good direct question. We'll go to Lucas to maybe provide a little extra color on guidance. And David, if you want to add anything, feel free to all.

Lucas Montarce

Yes, Steve, thank you for the question. 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, of course, again, now with yesterday newspaper, you think about that, again, we are performing very much better than again, what we had initially guided to. But if you look at the runway of that growth across the U.S., I know U.S. has been all the events we were public about again the unknowns associated with that, starting with the Bridge program, when the rich program will start the uptick of that as well. the progression of all U.S. markets, both in share and also penetration. And those all played out better than what we anticipated.

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 as public as possible about how we see the projections and now we provided some perspective into 2027 as well. So I think in my -- from my perspective, we continue to drive, again, a very total process every single quarter and be public about again did variables that could affect positively or negatively as well our guidance projections.

David Ricks

Yes, Steve. I appreciate the question. You followed the company a long time. Our goal is to give us accurate projections we can. But of course, there's a symmetry with missing on the downside. That's like everyone's impulse. But let's remember, like we're in the middle of the largest new category expansion in the history of the pharmaceutical industry. And Billy is 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.

And the JPMorgan Conference at the beginning of the year, I said there's like 2 big variables this year. If I knew the ante, 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. 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 our 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.

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 I appreciate the question, but that's sort of how I've seen it in the last 3 years. And we're beating on the up, that's better than missing on the down. And I think that's good news, mostly not because of the earnings speeds, but because we're actually executing against a really scaled opportunity and performing well.

Operator

Our next question is coming from Terence Flynn with Morgan Stanley.

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 3 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 the probably the only hole you have in your incretin pipeline.

Mike Czapar

Thanks, Terence. We'll actually go to Ken to talk about the long-acting approach. And if there's anything to share beyond what's been public.

Kenneth Custer

Thanks for the question, Terence. As we discussed previously, we do see an opportunity for longer-acting acreage, particularly in a category that's big with such a consumer emphasis, we're taking the same approach we usually do and we see an important square on the board that we want to fill, which is baking off several competing platforms to switch provides the best product possible.

This is a space where we think the molecule properties are really going to matter. And so that's why we haven't signal anything yet, but it is true we have multiple efforts in the clinic. 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 III.

Operator

Our next question is coming from Trung Huynh with RBC.

Trung Huynh

So as you look to '27, what are you seeing in terms of opt- in terms of GLP-1 coverage amongst the larger employers in the U.S. And with those dynamics in mind and Bridge continuing to ramp, could your U.S. 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?

Mike Czapar

Thanks, Trung. I will go to Ilya to talk about 2027 early opt-in trends and maybe the broader access environment as well as we look into the next year?

Ilya Yuffa

Yes. Overall, obviously, there's been noise around a number of employers opting out of coverage at the same time. We're having positive discussions to connect and other channels on improving access there as well. Our expectation is that overall access on the commercial side will maintain relatively stable through 2027. Obviously, we continue to have conversions to improve on that. The main access improvements overall for '27 were more likely be predominantly growth of Medicare and Medicaid as opportunities for expanded coverage.

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

Operator

Our next question is coming from Akash Tewari with Jefferies.

Akash Tewari

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

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 U.S. so far?

Mike Czapar

Thanks, Akash. Sounds like questions for Patrick. So talk a bit about pricing expectations kind of on the cadence from here, thinking about net price U.S. versus ex U.S.? And anything about the emergence of a middle income cash pay market.

Patrik Jonsson

Yes. Thank you very much. We have taken a very disciplined approach to pricing OUS. And I think we have seen that both providers, consumers and payers are willing to pay for a differentiated product. And we have seen that even after the launch of generics in India, Brazil and Canada, we are holding our shares and continue to grow, and that's a discipline that we will continue to apply. In terms of the out-of-pocket willingness, we actually see quite a big willingness to pay out of pocket for U.S. as well.

Of course, when markets are getting further penetrated and like the U.K., where we launched more than 2 years ago and where we have a penetration very much along the lines of the U.S., we see a lower growth as we expected. I think overall, taking into account where we are, penetration-wise, low single digit long term, we see a tremendous opportunity, OUS 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 9 European markets covered, but we will continue those efforts and continue to take a disciplined approach in terms of pricing.

David Ricks

Maybe just a comment on the ex U.S. versus U.S. I mean our goal because of the consumer nature of this is to a much tighter band of pricing on OBC medicines than maybe you've seen historically in other medicine categories.

Operator

Our next question is coming from Umer Raffat with Evercore.

Umer Raffat

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? And perhaps more importantly, if you could put the effect size comparisons versus lidERA knowing that the treatment setting for you is a little more real world with meaningful post CDK4 penetration?

Mike Czapar

Thank you, Umer. We'll go to Jake to talk a bit about EMBER-4.

Jacob Van Naarden

Thanks, Umer. 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 opportunity is in the adjuvant setting with the EMBER-4 study. We've not talked about interim analysis on these studies on the study. We've been very consistent that we expect the study to read out in 2027 next year. So we're sticking with that. That is what we expect.

I think you're raising a good point at 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 there's didn't.

So a bunch of differences. I think 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 to start to read out and see what it shows us. but excited to get to that point.

Operator

Our next question is coming from Carter Gould with Cantor.

Carter Gould

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

Mike Czapar

Thanks, Carter. We'll go to Dave to talk a bit about our discussions with administration.

David Ricks

Yes. Well, I think we're pretty optimistic about expansion, I think, for 3 reasons, Carter. One is the early uptake is strong, and I think you see both demand and appropriate on-label use of the medications. The industry did a fantastic job implementing the PA criteria in a way that was not kind of 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.

And I think we highlighted today the independent study from USC that estimates not just breakeven, but like massive cost savings for Medicare due to this program the CMS will -- because it's being done as a pilot program, we'll do their own analysis. But I think all signals now point to a pretty successful cost effectiveness which could yield either a legislative or a regulatory shift in the coverage permanently. 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 '28 calendar year. And we'll certainly work with the administration and all our partners who supply party coverage to good access across our portfolio and continue the success of the program so far.

Mike Czapar

Thanks, Dave. We'll try to squeeze in 2 more if we could, please.

Operator

Our next question is coming from Michael Yee with UBS Securities.

Michael Yee

Maybe just a long-term portfolio question around city 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 at about what the portfolio would look like and how consumers would choose between these different products given various competition and price declines.

Mike Czapar

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

Kenneth Custer

Thanks, Mike, for the question. Maybe let's start with the size of the problem we're confronting here is 10 million or so people living in the U.S. with obesity or overweight and internationally. That number has a 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. each of the molecules in our growing portfolio, they have unique features and probably each of them can fill multiple roles.

We talked about how Foundayo was 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 sort of a cornerstone with a growing body of evidence to support it, including Surround MMO very soon. 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 at the 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. Beyond that, we have our selective amylin portfolio, which opens up a new pharmacological access that can offer incretin like weight lowering with really more placebo like GI tolerability.

And then last but not least, the LR TGP, we see this as sort of the most physiological approach yet to weight loss that could also again play a lot of roles and 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. We probably can't a priority 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 a really a platform with a consistent appearance 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.

Mike Czapar

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

Operator

Our final question is coming from Courtney Breen with Bernstein.

Courtney Breen

I know we've spoken a little bit about the pipeline, but I used 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. Obviously, there's been a rapid pace for the first part of this year. Can you just help us understand when 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 are kind of ensuring that you're keeping the bar high as you continue to take on enrolling this pipeline kind of beyond what we see in Phase II right now.

Mike Czapar

Thanks, Courtney. 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.

Jacob Van Naarden

Yes. Thanks for the question. It's funny, you mentioned risk reward. Risk is really our friend here. Risk allows us to actually create value. And 1 of the ways we can deploy that for the reasons we can because we don't need revenue tomorrow. 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 2 ahead, which allows us to take more risk in a calculated way.

And some of that is very early to deal making, which oftentimes are not really even press release by us. So some of them you don't maybe know as much about. 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 derisking for us to feel confident that there's a real medicine or maybe more than 1 medicine there. And we can point to a handful of deals even on the year this year that fit that paradigm.

So I think you'll see more both of those categories from us across all the therapeutic areas. We're not solving for any 1 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. 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.

Mike Czapar

We'll go to Dave for a couple of closing comments.

David Ricks

Okay. Excellent. Thanks for joining us for today's call. Obviously, a strong quarter for the company. I want to take a moment though to promote an upcoming event, which is our December Investor Day. This will really be an R&D and pipeline focused today. 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. I also want to take a minute just to again congratulate Patrick 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 6 or 7. So thank you, Patrick, for everything.

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.

Operator

Thank you. This does conclude our conference for today. This conference will be made available for replay beginning at 1:00 p.m. 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. Thank you for your participation, and you may now disconnect your lines.