CLAIM #37097 · Eli Lilly and Company (LLY) · 2025Q4 earnings call · Feb 4, 2026 · due Dec 31, 2026
“There is a bolus of patients that we have nowadays in the Lilly Direct business that we believe are also Medicare patients. So expect that bolus, I think, is between 10-20% will actually move into the Medicare space.”
Lucas Montarce · CFO
How to check this claim
Look at: Share of current Lilly Direct patients who are Medicare-eligible and move into the Medicare channel following access being granted
It came true if: Percentage of the identified Lilly Direct patient bolus transitioning to Medicare coverage falls between 10% and 20%
Where: Management commentary on future earnings calls (Lilly Direct / Medicare enrollment disclosures)
In context
“have some impact to get some of the other employers over the hurdle on coverage. So just wondering if you're starting to see that yet. Mike Czapar: Great. Thanks, Terence, for the question on guidance and kind of Medicare ramp in the back half of the year as well as if there's any commercial opt-in. We'll go to Lucas. Lucas Montarce: Yeah. Terence, thank you for the question. Maybe starting with Medicare. As highlighted in the call text, basically, we are expecting that access to be granted no later than July 1. And as I mentioned all along, this will take time to build over time. But we feel very, very positive about the opportunity to bring anti-obesity medications to patients in Medicare. As I mentioned, again, the co-pay of $50 for the patients would be a compelling value proposition. There is a bolus of patients that we have nowadays in the Lilly Direct business that we believe are also Medicare patients. So expect that bolus, I think, is between 10-20% will actually move into the Medicare space. I think that will happen relatively fast, and we will continue to build on top of that. So that's kind of the drivers to start to think about, again, the penetration, but we'll build over time. Think about, again, more about the size of the opportunity in Medicare, thinking about 2027 as well. The second part of your question was about the employer opt-in. Ilya is right next to me here as well to talk about it. But as I mentioned, of course, again, the practice on physicians prescribing this medicine will become more natural, more broader in the anti-obesity medications. And physicians will be, again, more broadly basically also thinking about prescribing this in commercial. How that will then impact the employer side, I think the message is clear. Right? Again, there is a clear recogniti”
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SEC filings for LLY ↗ · Claim quote is verbatim from the 2025Q4 earnings call.