WEBVTT - Eli Lilly CEO Dave Ricks Talks Weight Loss Drugs Success 0:00:02.440 --> 0:00:07.640 Bloomberg Audio Studios, podcasts, radio news. All right, let's go 0:00:07.640 --> 0:00:11.280 over now to Washington, because David Rubinstein is just about 0:00:11.280 --> 0:00:15.080 to begin speaking with Eli Lilly's CEO, and this is 0:00:15.120 --> 0:00:17.959 taking place at the Economic Club of Washington. We're going 0:00:18.040 --> 0:00:21.120 to check in with them as a begin to speak. 0:00:21.280 --> 0:00:22.000 Let's listen in. 0:00:22.760 --> 0:00:25.760 Right, I don't know one's paid more than me, but yeah, 0:00:26.200 --> 0:00:28.200 well he shouldn't be paid more than you. But okay, 0:00:28.720 --> 0:00:33.000 so let's talk about these phenomenon that's changed the world 0:00:33.159 --> 0:00:37.040 to some extent. Which is the anti obesity drug. Now, 0:00:37.080 --> 0:00:40.440 to make sure everybody's on the same page links, what 0:00:40.600 --> 0:00:42.920 is the name of your anti obesit drug? 0:00:43.280 --> 0:00:48.080 Okay, so the name is zep bound. The active ingredients 0:00:48.080 --> 0:00:49.080 called their zeppatide. 0:00:50.200 --> 0:00:52.120 So, by the way, who comes up with these names? 0:00:52.120 --> 0:00:53.360 Where do you raise names? 0:00:53.640 --> 0:00:55.000 Not me, David, not me. 0:00:55.240 --> 0:00:58.279 No, it's it's more complicated than we want to talk 0:00:58.280 --> 0:01:00.880 about here. But we can't have names that are similar 0:01:00.960 --> 0:01:03.600 to each other because doctors make prescribing ers. We can't 0:01:03.600 --> 0:01:05.960 have names that make claims about what the drug does, 0:01:06.000 --> 0:01:08.559 and we can't have names that only work in English. 0:01:08.640 --> 0:01:10.559 So we end up with these strange sounding names. 0:01:10.760 --> 0:01:14.840 Ok So, as I understand that number of years ago 0:01:14.920 --> 0:01:17.800 you can tell us how many somebody was working on 0:01:17.840 --> 0:01:22.920 a diabetes related drug and that drug ultimately got. 0:01:22.720 --> 0:01:24.120 To be approved by the FDA. 0:01:24.760 --> 0:01:28.280 But somebody discovered that actually helps you reduce weight. When 0:01:28.400 --> 0:01:30.640 was that discovered and was that ever the intention when 0:01:30.640 --> 0:01:31.840 the drug was being developed? 0:01:32.200 --> 0:01:33.479 Yeah, pretty early on. 0:01:33.640 --> 0:01:36.360 So we launched the first GLP one medication in the 0:01:36.400 --> 0:01:37.440 world in two thousand and five. 0:01:37.480 --> 0:01:38.679 It was called extend the Tide. 0:01:39.040 --> 0:01:41.800 It was a twice daily injection and it was indicated 0:01:41.800 --> 0:01:45.360 for people with diabetes. Like a lot of things in medicine, 0:01:45.480 --> 0:01:47.960 there's like iterative steps of improvement that occurred. 0:01:47.960 --> 0:01:49.200 But that was the first effort. 0:01:49.480 --> 0:01:51.600 On the cover of our the next year, our annual 0:01:51.600 --> 0:01:53.400 report is a woman who was using the drug and 0:01:53.480 --> 0:01:55.880 she said, my diabetes is under control, and I noticed 0:01:55.880 --> 0:01:58.040 I'm losing a little weight. Actually two thousand and six, 0:01:58.360 --> 0:02:01.120 it's a cover of our anal report. But we had 0:02:01.120 --> 0:02:05.160 to improve the medicines to really make them effective for 0:02:05.200 --> 0:02:10.120 weight loss. One big improvement was to make them weekly. 0:02:10.360 --> 0:02:16.120 That's a convenience benefit, but even more important, the action 0:02:16.200 --> 0:02:19.160 of the medicine flatter, meaning more consistent through the day 0:02:19.200 --> 0:02:21.560 and night. When we had it twice a day, there 0:02:21.560 --> 0:02:24.520 were ups and downs, and one effect of GLP one 0:02:24.600 --> 0:02:28.600 medications is they cause nausea and other gi distress. That's 0:02:28.600 --> 0:02:31.119 a function of the up and down in your system. 0:02:31.440 --> 0:02:33.320 So when we made it weekly, it was flatter and 0:02:33.360 --> 0:02:36.760 we could dose higher to see more weight loss. So 0:02:36.800 --> 0:02:39.160 that was sort of an accidental breakthrough of trying to 0:02:39.160 --> 0:02:41.519 make a more convenient form. 0:02:41.600 --> 0:02:44.080 So now there's another company that is sort of in 0:02:44.120 --> 0:02:48.919 the same business, Novode nord Is Yes, which is in Denmark, 0:02:49.480 --> 0:02:52.960 and they have a similar product, and they have a 0:02:53.080 --> 0:02:56.160 product that does the same thing. One is for o 0:02:56.600 --> 0:03:00.320 antiobesity and one is for diabetes and correct is there 0:03:00.400 --> 0:03:03.600 really any difference between the two of your drugs In 0:03:03.680 --> 0:03:05.079 terms of the drugs, there are. 0:03:05.120 --> 0:03:07.840 There's no difference really between the name the drug that's 0:03:07.919 --> 0:03:10.640 named for diabetes versus name for Obesit for either company. 0:03:10.680 --> 0:03:12.800 We do that for insurance reasons. We could talk about. 0:03:13.240 --> 0:03:16.520 But trezepetide is the latest version. It has two modes 0:03:16.520 --> 0:03:19.280 of action. So and by the way, we're having a 0:03:19.280 --> 0:03:22.919 conversation about weight loss medications. Right after you just ate lunch, 0:03:23.760 --> 0:03:26.960 and I know that that may cost some anxiety, but 0:03:28.080 --> 0:03:31.399 right now because you just ate lunch, your GI track 0:03:31.560 --> 0:03:33.160 is communicating with the rest of your body. 0:03:33.200 --> 0:03:34.120 It's communicating with. 0:03:34.080 --> 0:03:37.440 Hormones or proteins and telling it that you've been fed 0:03:37.880 --> 0:03:40.720 and you need to absorb nutrients and other things that 0:03:40.800 --> 0:03:45.040 are essentible life because food is essential life. What we're 0:03:45.080 --> 0:03:47.960 doing is boosting some of those signals with these medications. 0:03:48.280 --> 0:03:51.680 They're boosting the signal that you're full, boosting the signal 0:03:51.680 --> 0:03:53.200 that you no longer want to eat more in boosting 0:03:53.240 --> 0:03:57.320 signals that you should absorb nutrients that you've consumed, and 0:03:57.360 --> 0:04:00.800 so ours does that with two different hormones, one called 0:04:00.840 --> 0:04:04.960 GLP one, another new one called gip ozepic or semaglue 0:04:05.000 --> 0:04:06.320 tide just uses GLP one. 0:04:06.720 --> 0:04:09.120 But what the drug does is what it tells your 0:04:09.160 --> 0:04:11.240 body you're full when you're maybe not as full as 0:04:11.280 --> 0:04:11.800 you used to be. 0:04:12.440 --> 0:04:17.640 Yeah, well, so it tells your body your full, and 0:04:18.000 --> 0:04:21.600 it does that to the brain sense of saiety. Probably 0:04:21.640 --> 0:04:26.080 we've learned over time our sense of fullness becomes conditional. 0:04:26.600 --> 0:04:30.800 So as people eat more habitually, that signal kicks in 0:04:30.880 --> 0:04:35.560 later and later, and that's a cause and consequence of obesity. 0:04:36.320 --> 0:04:39.080 It does other things too, It actually makes your stomach 0:04:39.560 --> 0:04:43.440 fuller because it slows gastric motility, so it slows down 0:04:43.480 --> 0:04:49.360 your nutrients, which seems counterintuitive, but when you eat in 0:04:49.640 --> 0:04:51.800 when we our ancestors were alive ten thousand years ago, 0:04:51.880 --> 0:04:53.680 meals were rare and you want to absorb all the 0:04:53.760 --> 0:04:56.400 nutrients out of it. So that signal said, absorb the nutrients. 0:04:56.520 --> 0:04:56.800 All right. 0:04:56.800 --> 0:04:59.120 I don't want to confuse people, but there are four 0:04:59.279 --> 0:05:01.920 different names that people should know for these drugs. Now 0:05:01.960 --> 0:05:05.120 you have an anti BCD drug which is called what 0:05:05.400 --> 0:05:07.680 zep bound bound, and then you have a diabetes drug 0:05:07.720 --> 0:05:08.120 which is. 0:05:08.040 --> 0:05:10.839 Called Manjaro, same medicine, different. 0:05:10.600 --> 0:05:11.520 Name, different names. 0:05:11.760 --> 0:05:15.120 And then Novo Nordis Nordisk has two drugs. 0:05:15.320 --> 0:05:18.680 Their names are Ozempic and we go vy All. 0:05:18.760 --> 0:05:21.440 Both are semiglue tide, same medicine, two different names. 0:05:21.600 --> 0:05:24.920 But the confusing thing is Ozempic is like it's like 0:05:24.960 --> 0:05:27.600 a generic name. People say, I'm on ozempic. Ozempic is 0:05:27.640 --> 0:05:31.160 not the anti obesity drug, it's the diabetes ibtes drug. 0:05:31.240 --> 0:05:33.960 So why is it? Why don't people get the right names? 0:05:36.040 --> 0:05:39.960 Should we blame the media? I don't know. It was 0:05:40.000 --> 0:05:40.920 the first. 0:05:42.440 --> 0:05:46.360 Drug that began to be used off label for obesity, 0:05:47.800 --> 0:05:50.680 and again it was a flat once a week, and 0:05:50.680 --> 0:05:53.440 people discovered if I just give take more than prescribed, 0:05:53.680 --> 0:05:56.080 I can lose more weight. And then Novo did a 0:05:56.120 --> 0:05:59.720 study credit to them that showed clinically that people lose 0:05:59.760 --> 0:06:00.880 clin meaningful. 0:06:00.640 --> 0:06:02.480 Weight on their medicine. 0:06:02.520 --> 0:06:04.600 You lose you know, thirteen to fifteen percent of your 0:06:04.600 --> 0:06:07.560 body weight. On ours, you lose you know, twenty to 0:06:07.600 --> 0:06:08.440 twenty six percent. 0:06:08.520 --> 0:06:10.440 Well, let me go through that again, because there was 0:06:10.440 --> 0:06:12.400 a study. It was just came out a couple of 0:06:12.520 --> 0:06:15.520 days ago. I think that said one on one comparing 0:06:15.600 --> 0:06:21.360 the two. Your drug anti obese drug loses weight more 0:06:21.480 --> 0:06:23.919 rapidly for people than the other product. 0:06:23.960 --> 0:06:25.720 Is that rapidly? And more so? 0:06:26.000 --> 0:06:29.320 Forty seven percent more so After a year and a half, roughly, 0:06:29.680 --> 0:06:31.680 people on our drug loss seventeen more. 0:06:31.600 --> 0:06:33.200 Pounds then on we go. 0:06:33.240 --> 0:06:35.720 I know people need to lose so much weight in 0:06:35.760 --> 0:06:38.400 this country. Our country has as I got it right, 0:06:38.520 --> 0:06:41.400 seventy five percent of the people are overweight and forty 0:06:41.400 --> 0:06:44.240 two percent are obese. When did that happen when we 0:06:44.279 --> 0:06:46.920 went to no fat fruit? Or when did all of 0:06:46.960 --> 0:06:48.600 a sudden we become so obese? 0:06:49.240 --> 0:06:52.240 Yeah, if you look at the epidemiology charts. It really 0:06:52.440 --> 0:06:56.279 seems to have started in the sixties growth in overweight 0:06:56.320 --> 0:07:00.400 and obesit in the country, and really excel righted in 0:07:00.400 --> 0:07:01.480 the eighties and nineties. 0:07:01.920 --> 0:07:04.719 So what are the reasons? 0:07:04.960 --> 0:07:09.279 How we live certainly is one of them, and energy 0:07:09.279 --> 0:07:11.960 expenditure has to be part of the story. What we eat, though, 0:07:12.400 --> 0:07:15.960 is probably a more important reason, not just the quantity 0:07:16.000 --> 0:07:20.160 which has risen modestly through that period of time, but 0:07:20.240 --> 0:07:23.040 actually what's in our food has changed, and I think 0:07:23.080 --> 0:07:25.160 that's also attributed to this. 0:07:25.320 --> 0:07:26.640 All right, So back to the drug. 0:07:27.200 --> 0:07:30.440 When you realized it could lose weight, did you get 0:07:30.440 --> 0:07:32.960 the FDA to say, yes, it can be prescribed for 0:07:33.080 --> 0:07:35.680 losing weight or it's still you can't get that prescribed 0:07:35.680 --> 0:07:35.920 for you. 0:07:36.240 --> 0:07:36.400 No. 0:07:36.400 --> 0:07:36.480 No. 0:07:36.800 --> 0:07:39.560 As of last year, we zetbound launched It's for weight 0:07:39.600 --> 0:07:41.840 loss for people who have high body weight. 0:07:42.280 --> 0:07:45.920 And do insurance companies reimburse people for the cost of 0:07:45.960 --> 0:07:46.640 these drugs? 0:07:46.840 --> 0:07:52.640 Some do, more should so as of today, the federal 0:07:52.640 --> 0:07:56.000 government actually has a prohibition on reimbursing any of these drugs, 0:07:57.080 --> 0:07:59.720 which is a problem I think, although the Biden administration 0:07:59.880 --> 0:08:03.280 just advanced rulemaking to change that. That's good news and 0:08:03.320 --> 0:08:06.920 we hope the next administration will continue that process. Seventeen 0:08:06.960 --> 0:08:10.240 states in their Medicaid program have decided to step outside 0:08:10.240 --> 0:08:13.400 of that federal rule and reimburse them anyway. So California 0:08:13.600 --> 0:08:17.440 just started, for instance, Massachusetts, other states and then about 0:08:17.480 --> 0:08:22.200 sixty percent of employers have some form of reimbursement. 0:08:22.520 --> 0:08:25.960 So if losing weight makes you healthier, why would people 0:08:25.960 --> 0:08:29.800 who care about insurance reimbursement medicare and not insist on 0:08:30.480 --> 0:08:32.240 paying for this because it would make you healthier and 0:08:32.280 --> 0:08:34.480 therefore you don't have other diseases you have that they 0:08:34.480 --> 0:08:35.360 have to reimburse you for. 0:08:35.600 --> 0:08:37.320 I think in four or five years, we'll look back 0:08:37.320 --> 0:08:40.320 and say, yeah, that's what should have happened, and it's 0:08:40.320 --> 0:08:43.040 silly that we don't pay for what is already known 0:08:43.120 --> 0:08:45.839 to be a primary contributor to poor health, which is 0:08:45.880 --> 0:08:46.720 excess body weight. 0:08:47.120 --> 0:08:50.360 But you do, people have different motives and incentives. 0:08:50.640 --> 0:08:54.280 As you know, we re enroll in commercial assurance every year. 0:08:54.440 --> 0:08:57.160 So unfortunately, I don't think insurance companies have your best 0:08:57.160 --> 0:09:01.720 interest at heart. Maybe that's tough to say, but they 0:09:01.840 --> 0:09:03.800 really think about it in one year increments and the 0:09:03.800 --> 0:09:06.280 benefits surely will play out over a longer period of time. 0:09:06.559 --> 0:09:09.200 Maybe your employer has a stronger interest in your long 0:09:09.280 --> 0:09:12.240 term health. That's probably why many have stepped forward. 0:09:12.320 --> 0:09:13.040 And then evidence. 0:09:13.080 --> 0:09:15.400 Our job is to make the evidence produce the evidence 0:09:15.440 --> 0:09:18.400 that we're not just having people lose weight, but losing 0:09:18.440 --> 0:09:21.240 weight with our medicine causes improved health. And we have 0:09:21.280 --> 0:09:23.599 many studies out this year that are demonstrating that. 0:09:23.800 --> 0:09:26.920 So to take this medicine, you have to inject yourself, correct. 0:09:26.880 --> 0:09:28.720 Us, Yeah, well why not just go to a pill? 0:09:29.679 --> 0:09:32.920 A great idea. Yeah, we're working on that. 0:09:34.320 --> 0:09:37.560 The injection you have to inject because it's a protein 0:09:37.679 --> 0:09:41.959 and if we orally take proteins, your body thinks it's 0:09:41.960 --> 0:09:44.600 food and it breaks up proteins, so you cannot really 0:09:44.600 --> 0:09:46.640 take these drugs or eily. You have to bypass the 0:09:46.640 --> 0:09:49.760 GI track even though it's affecting, and go right to 0:09:49.800 --> 0:09:52.880 the bloodstream. But we are working on a pill. We'll 0:09:52.880 --> 0:09:56.040 have some data actually as early as next year. It's 0:09:56.040 --> 0:09:58.000 a GLP one only it's a single acting It's not 0:09:58.040 --> 0:09:59.599 going to be as good as yours appetiteer as that 0:09:59.679 --> 0:10:02.520 found be about as good as oozempic, we hope, and 0:10:02.559 --> 0:10:03.960 this would be a once daily pill. 0:10:04.000 --> 0:10:06.240 That'll be a fantastic innovation. 0:10:06.320 --> 0:10:09.160 So when you have drugs that are very very popular 0:10:09.880 --> 0:10:13.400 that you often have people that make counterfeit or copycat drugs. 0:10:13.920 --> 0:10:16.880 We see them on television all the time advertise, right, 0:10:17.320 --> 0:10:19.440 what about for this do you have to worry about 0:10:19.480 --> 0:10:21.800 counterfeit drugs coming in that are trying to say the 0:10:21.800 --> 0:10:22.199 same thing. 0:10:22.320 --> 0:10:24.880 It's a terrible problem right now, actually, because I think 0:10:24.920 --> 0:10:26.480 consumers don't really know. 0:10:26.600 --> 0:10:27.920 The dangers or the difference. 0:10:29.040 --> 0:10:32.720 Today, the FDA and the government has allowed this to 0:10:32.880 --> 0:10:36.320 sort of grow. And of course a weight loss medication 0:10:36.360 --> 0:10:38.520 that's effective would be a popular thing for people to 0:10:38.880 --> 0:10:41.320 go around the healthier system and seek treatment on their own. 0:10:41.960 --> 0:10:43.960 But the data we have is that eighty percent of 0:10:44.000 --> 0:10:47.400 these medicines are coming out of China from unapproved and 0:10:47.480 --> 0:10:52.600 unregulated sources. We recently with Borders and Customs seized a 0:10:52.760 --> 0:10:57.640 big batch that was shipped in dog food. People then 0:10:57.720 --> 0:11:01.800 reformulate them and sell them locally in meds and other outfits. 0:11:01.840 --> 0:11:04.080 But you really don't know what's in that bile. We 0:11:04.120 --> 0:11:08.000 buy them and test them, we find bacteria, plant material, viruses, fungus. 0:11:08.600 --> 0:11:09.600 You do not want to be using. 0:11:09.880 --> 0:11:13.320 See, But these counterfeit drugs are not like they're cheaper. 0:11:13.840 --> 0:11:16.480 They're cheaper because they don't have the same ingredients I assume. 0:11:16.760 --> 0:11:19.839 But how much more expensive are your drugs than the 0:11:20.360 --> 0:11:22.520 counterfeit ones? In other words, if somebody wants to use 0:11:23.600 --> 0:11:27.720 your product, zep bound, how much does it cost a month? 0:11:27.840 --> 0:11:30.000 You can buy zet bound direct from Lily for three 0:11:30.120 --> 0:11:31.840 ninety nine for the starter dose. 0:11:31.640 --> 0:11:33.240 Eight dollars and ninety nine cents. 0:11:33.280 --> 0:11:36.760 No, this is a valuable innovation, David. 0:11:37.120 --> 0:11:40.080 Three hundred ninety nine, three dred and ninety. 0:11:39.920 --> 0:11:42.440 Nine dollars a month, all right, which is about one 0:11:42.480 --> 0:11:44.400 hundred dollars a week. And I know that's a sacrifice 0:11:44.400 --> 0:11:48.600 for many, but that's without insurance. With insurance, most people 0:11:48.640 --> 0:11:51.959 pay twenty five dollars a month. So that's the importance 0:11:51.960 --> 0:11:54.040 of insurance. That's why we buy insurance to shield us 0:11:54.080 --> 0:11:56.760 from our health costs. The online ones, you know, are 0:11:56.760 --> 0:11:59.800 as cheap as one hundred dollars. But these are companies 0:11:59.840 --> 0:12:01.920 that want all the benefits of being a drug company 0:12:01.920 --> 0:12:03.359 but bear none of the responsibilities. 0:12:03.400 --> 0:12:07.280 But you, for example, you have this underpatent for how 0:12:07.320 --> 0:12:09.760 many years? In other words, our system is you have 0:12:09.800 --> 0:12:13.120 a drug, you have twenty years from invention. Yeah, from events. 0:12:13.120 --> 0:12:14.800 So how many more years do you have before it 0:12:14.800 --> 0:12:15.439 goes generic? 0:12:15.559 --> 0:12:18.839 Until mid twenty thirties? Yeah, so another ten eleven years. 0:12:19.000 --> 0:12:22.160 Okay, And is this the most popular drug that Eli 0:12:22.200 --> 0:12:23.120 Lilly has ever had? 0:12:23.559 --> 0:12:25.840 Should be by the end of the year, Yeah, break 0:12:25.840 --> 0:12:28.079 that record and go beyond probably right. 0:12:28.120 --> 0:12:30.360 Some people say that if you go on this drug, 0:12:30.480 --> 0:12:34.040 you have side effects that are not completely desirable. 0:12:34.320 --> 0:12:35.160 Is that true? 0:12:35.400 --> 0:12:38.640 So yeah, there's two things to all drugs that work 0:12:38.720 --> 0:12:41.920 have side effects and sometimes on tour effects, and we 0:12:42.000 --> 0:12:44.240 have to warn against both of those. That's why we 0:12:44.280 --> 0:12:47.400 do controlled studies and measure them carefully. Many people have 0:12:47.960 --> 0:12:51.120 mild to moderate GI distress when they start, that's why 0:12:51.120 --> 0:12:53.160 we ty trade. We started a low dose, We recommend 0:12:53.320 --> 0:12:56.760 a low dose and go up slowly. Almost everybody stays 0:12:56.880 --> 0:12:59.360 on the drug and goes through that and by the 0:12:59.440 --> 0:13:02.400 third or fourth really don't have any effects any more 0:13:02.440 --> 0:13:04.840 of that at all. There are a few people where 0:13:04.840 --> 0:13:07.800 we don't have data or we are cautious. One is 0:13:08.520 --> 0:13:12.160 women who could become pregnant. Neither of the medications have 0:13:12.559 --> 0:13:15.679 information about that. And then there's a condition called pancreatitis, 0:13:15.720 --> 0:13:18.120 which is sort of an inflamed pancreas. We worry about 0:13:18.120 --> 0:13:19.840 that with these drugs. So if you've had a history that, 0:13:19.920 --> 0:13:20.440 don't use them. 0:13:20.679 --> 0:13:23.040 Let's suppose you take the drug and say, I've lost weight, 0:13:23.400 --> 0:13:24.760 I'm very happy with my body. 0:13:24.800 --> 0:13:26.120 Now I'm going to get off the drug. 0:13:26.400 --> 0:13:29.400 Some people say that there are it's very difficult to 0:13:29.440 --> 0:13:30.400 not regain the weight. 0:13:31.000 --> 0:13:33.480 That's right, and science tells us that there's a reason 0:13:33.520 --> 0:13:39.120 for that. Some people do maintain the weight reduction or 0:13:39.280 --> 0:13:42.120 stay in that range, they have to change a lot 0:13:42.160 --> 0:13:45.240 about how they live, burn more energy, eat different foods. 0:13:45.440 --> 0:13:47.199 So we can all try that. I think we should 0:13:47.200 --> 0:13:51.280 all try that, actually, but some people cannot. And there's 0:13:51.280 --> 0:13:55.080 a recent paper in Nature that actually told us why, 0:13:55.160 --> 0:13:59.160 which is that once have become obese, your fat sales 0:13:59.240 --> 0:14:02.520 learned that that's their new state, and they defend that state, 0:14:03.360 --> 0:14:07.240 and so they're actually wanting more energy and that sends 0:14:07.240 --> 0:14:09.600 signals to your brain and so forth. So once we 0:14:10.160 --> 0:14:12.920 as adults gain weight and have that on for a while, 0:14:13.200 --> 0:14:16.319 it's very very difficult to reset your thermostat if you 0:14:16.320 --> 0:14:19.840 would to reset that level. So for now we do 0:14:19.880 --> 0:14:23.240 recommend if they can't. People cannot maintain weight loss off 0:14:23.280 --> 0:14:25.560 the drug to go back on the drugs and use 0:14:25.600 --> 0:14:26.200 them chronically. 0:14:26.280 --> 0:14:29.200 So we do put fluoride in the water now, or 0:14:29.200 --> 0:14:32.520 at least for the time being. What about putting this 0:14:32.600 --> 0:14:36.040 in the water and just solve all the problems, Well. 0:14:35.880 --> 0:14:37.480 We couldn't. We shouldn't put it in the water. 0:14:37.600 --> 0:14:40.120 People should use it under the guidance of their doctors. 0:14:40.480 --> 0:14:45.760 But we should have broad coverage, just like we think 0:14:46.040 --> 0:14:49.720 it would be crazy if we didn't have antihypertensive medications 0:14:50.000 --> 0:14:51.640 available to all adults in America. 0:14:51.480 --> 0:14:52.920 Or anti diabetes medications. 0:14:53.360 --> 0:14:57.720 Obesity causes two hundred and thirty six adult diseases, and 0:14:58.320 --> 0:15:00.400 we know it's a precursor for these things. Why not 0:15:00.480 --> 0:15:03.600 try to prevent it. We have a stigma in our 0:15:03.640 --> 0:15:05.480 country and in many other countries that this is sort 0:15:05.480 --> 0:15:09.520 of some personal failing. But many of us we're here 0:15:09.600 --> 0:15:12.680 because our ancestors can served energy very effectively. That's how 0:15:12.720 --> 0:15:15.680 they survive famines and floods and so forth. So we're 0:15:15.720 --> 0:15:18.800 pre determined to want to keep weight on by our 0:15:18.840 --> 0:15:22.760 genetic background, and we in a world of plenty of abundance, 0:15:23.600 --> 0:15:26.640 we need to probably have some medical help sometimes. 0:15:26.280 --> 0:15:28.760 So what about over the counter. Why can't this just 0:15:28.800 --> 0:15:30.320 be an over the counter drug. You're going just go 0:15:30.320 --> 0:15:31.640 buy it like an AskMen or something. 0:15:31.720 --> 0:15:34.280 Yeah. I think we'll try to work on that through time. 0:15:34.320 --> 0:15:36.680 The oral pill we have is a great candada for that, 0:15:36.720 --> 0:15:39.600 because that's much easier to dispense in that kind of 0:15:39.600 --> 0:15:43.240 pharmacy setting, and we'll need to get more evidence that 0:15:43.480 --> 0:15:46.720 it's broadly safe. Here you don't have the doctors supervision piece, 0:15:47.040 --> 0:15:49.400 so we would want to make sure, particularly develop data 0:15:49.440 --> 0:15:51.760 and pregnant women in other settings to make sure that 0:15:51.760 --> 0:15:53.280 that could be safely done. But we would have an 0:15:53.280 --> 0:15:56.760 interest in expanding access for this medication and reducing the price. 0:15:56.960 --> 0:15:58.760 So how many times a day do you going to 0:15:58.800 --> 0:16:01.480 ask about this drug today? 0:16:01.520 --> 0:16:02.120 Hour on the hour? 0:16:02.480 --> 0:16:05.520 Yeah? Many, yeah, dozens. Yeah. 0:16:05.920 --> 0:16:07.480 And it's a pleasure to talk about it because it's 0:16:07.480 --> 0:16:08.160 such a breakthrough. 0:16:08.320 --> 0:16:09.400 It can change our country. 0:16:09.440 --> 0:16:12.080 But nobody really expected that to happen. As you point out, 0:16:12.080 --> 0:16:15.760 sometimes things happen unexpectedly. So let's talk about some other 0:16:17.080 --> 0:16:19.960 things for a while. Let's talk about Eli Lilly itself. 0:16:20.520 --> 0:16:21.960 When was this company started? 0:16:22.680 --> 0:16:26.240 Yeah, eighteen seventy six, so started by a Colonel Eli 0:16:26.240 --> 0:16:28.440 Lilly who served in the Civil War. He was a 0:16:28.440 --> 0:16:33.760 pharmacist by training, led infantry and artillery company and was 0:16:33.800 --> 0:16:36.680 a prisoner of war in Alabama actually, and he saw 0:16:36.760 --> 0:16:38.760 firsthand the atrocities of. 0:16:38.720 --> 0:16:39.880 Medical care in the Civil War. 0:16:39.920 --> 0:16:42.120 You may know, you know, your student of history, that 0:16:42.240 --> 0:16:46.120 more people died after injury than from their injury due 0:16:46.120 --> 0:16:48.760 to medical care. And at the time this was an 0:16:48.800 --> 0:16:52.360 air of snake oil salesman. Medicine wasn't very advanced, but 0:16:52.440 --> 0:16:55.600 what we thought of medicine often was back to the 0:16:55.640 --> 0:17:00.280 counterfeiting discussion, you know, made up things, harmful ingredients. So 0:17:00.320 --> 0:17:02.520 he started a company with a pledge to say everything 0:17:02.560 --> 0:17:03.960 that's in this is on the label. 0:17:05.160 --> 0:17:07.680 If it's in there, you know about it. 0:17:07.760 --> 0:17:12.680 Transparency, and that then evolved into a company that embraced 0:17:12.680 --> 0:17:17.119 the scientific method and began to really adopt the methods 0:17:17.160 --> 0:17:20.199 that the modern industry has, which is then taking natural products, 0:17:20.200 --> 0:17:22.280 which is what most medicines were in eighteen seventy six, 0:17:22.600 --> 0:17:25.240 and refining them into what we think of as medicine now. 0:17:25.280 --> 0:17:29.760 So thank Willow bark into aspirin or pancreases of cows 0:17:29.800 --> 0:17:30.440 into insulin. 0:17:31.400 --> 0:17:33.080 That's what the company really was built on. 0:17:33.840 --> 0:17:36.360 How long did he live after he started the company. 0:17:36.000 --> 0:17:38.600 About twenty five years and he handed the keys to 0:17:38.640 --> 0:17:41.679 his son JK. Lilly, who handed the keys to his 0:17:41.800 --> 0:17:44.919 two sons, also named Eli and JK. That's a little odd, 0:17:45.880 --> 0:17:48.679 but for three generations it was a family run business. 0:17:48.840 --> 0:17:52.679 Yeah, and the family is not an owner now not well. 0:17:52.600 --> 0:17:55.640 So the legacy wealth of the family is our largest shareholder, 0:17:55.680 --> 0:17:56.560 the Lily Endowment. 0:17:56.640 --> 0:17:59.000 So that only endowment is now probably the biggest foundation 0:17:59.040 --> 0:18:03.000 in the United States. Eighty billion dollars of assets Onner Management, right, yep. 0:18:03.080 --> 0:18:05.840 And they have one asset essentially, which is okay. 0:18:05.560 --> 0:18:08.520 And they're your biggest shareholder. Yeah, so okay. 0:18:08.640 --> 0:18:12.080 So when Eli Lilly evolved over the years in the 0:18:12.080 --> 0:18:14.280 twentieth century, what were its big products? 0:18:14.400 --> 0:18:17.280 Yeah, so insulin really was the birth of the modern company. 0:18:17.640 --> 0:18:20.400 And this was obviously a terrible condition, type one diabetes 0:18:20.440 --> 0:18:23.159 and a breakthrough, and we were part of commercializing that 0:18:23.280 --> 0:18:26.600 around the world, invented the manufacturing method and created that 0:18:26.640 --> 0:18:30.480 business that was followed by actually penicillin. So during World 0:18:30.520 --> 0:18:32.800 War Two, Lily was commissioned as one of the manufacturers 0:18:32.800 --> 0:18:36.320 for antibiotics for the army and we from there then 0:18:36.400 --> 0:18:41.479 iterated for forty years antibiotics, including still some that are 0:18:41.560 --> 0:18:44.800 used today like bankamasin which is the last line of 0:18:44.800 --> 0:18:47.000 defense for the worst infections. 0:18:47.119 --> 0:18:48.840 And Prozac we're famous for. 0:18:48.720 --> 0:18:52.520 Which really brought modern psychiatry into the fold. And of 0:18:52.520 --> 0:18:54.240 course now Manjarro and zep. 0:18:54.200 --> 0:18:57.879 Bound And what about the future your work? What are 0:18:57.920 --> 0:19:01.360 the human problems you're working on on the future. Alzheimer's, 0:19:01.359 --> 0:19:02.280 I assume is one of them. 0:19:02.320 --> 0:19:04.840 Absolutely, Yeah, So we think about our company. Of course, 0:19:04.880 --> 0:19:08.879 we use scientific methods to create medicines to solve tough problems. 0:19:09.160 --> 0:19:12.160 We're not really interested in niche problems. We think we're 0:19:12.160 --> 0:19:14.679 here because we're a big company to do hard problems 0:19:14.720 --> 0:19:17.439 that are scalable. That's sort of where it makes our 0:19:17.480 --> 0:19:19.439 business work, but also is the most human impact. So 0:19:19.800 --> 0:19:22.879 we select these diseases that are common and tough. So 0:19:23.000 --> 0:19:26.800