Dave Ricks, CEO of Eli Lilly | The All-In Interview

Lilly is betting that tirzepatide can become far more than an obesity drug. Ricks said Lilly has 105 studies underway across other chronic diseases, while a three-year study in overweight adults with prediabetes produced 94% fewer new diabetes diagnoses.

The biggest constraint on GLP-1 growth is increasingly manufacturing, not demand. Lilly has approvals in more than 40 countries where it has not launched because it cannot supply enough injectable drug, making its phase-three oral GLP-1 orforglipron potentially crucial for mass-market scale.

For most patients, today’s obesity drugs remain long-term treatments rather than temporary cures. Ricks said weight typically returns after stopping therapy, although Lilly is researching mechanisms that might reset the body’s defended weight and studying easier maintenance approaches after initial weight loss.

Insurance coverage remains the main barrier between GLP-1 demand and widespread use. Ricks estimated only about half of employer plans cover obesity drugs; Lilly Direct now combines telehealth with mail fulfillment, while discounted Zepbound options cited in the interview ranged from roughly $399 to $600 monthly.

Lilly’s economics depend on reinvesting unusually large profits into unusually large scientific bets. Ricks said the company would spend more than $11 billion on R&D that year and expects mature net GLP-1 pricing around $3,000–$4,000 annually, despite much higher headline prices.

Lilly is building its future through many small external bets rather than a few giant acquisitions. Ricks said its venture arm makes hundreds of investments and Lilly bought roughly 24 companies for about $3 billion in one year, aiming to buy promising science before major de-risking events sharply increase valuations.

Ricks has made development speed a measurable competitive advantage. Lilly cut its average first-human-dose-to-FDA timeline from about 11 years to 6.1, while work that once took 120 days between receiving trial data and submitting to the FDA can now routinely be completed within two weeks.

Ricks does not expect AI to replace experimental drug development anytime soon. Lilly works with OpenAI, Microsoft, Amazon, Google and others, but he sees near-term value mainly in optimizing specific steps and killing low-probability ideas early, with wet-lab and clinical feedback remaining essential.