Eli Lilly ran the fastest-accrued Alzheimer's study in history by going direct-to-patient. This model, using televisits and centralized diagnostics, is highly effective for preventative medicines where motivated patients can be recruited online.
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The direct-to-consumer channel exploded for Eli Lilly with Zepbound. The drug was a perfect fit because the diagnosis is simple, efficacy is easily measured by the patient, and it allows motivated self-pay customers to bypass insurance friction.
The pharmaceutical industry is often misunderstood because it communicates through faceless corporate entities. It could learn from tech's "go direct" strategy, where leaders tell compelling stories. Highlighting the scientists and patient journeys behind breakthroughs could dramatically improve public perception and appreciation.
General Catalyst's CEO highlights a core flaw in healthcare: insurance providers don't reimburse for longevity or preventative care because customers frequently switch plans, preventing insurers from capturing long-term ROI. The first company to solve this misalignment and make longevity "financeable" will unlock a massive market.
While AI holds long-term promise for molecule discovery, its most significant near-term impact in biotech is operational. The key benefits today are faster clinical trial recruitment and more efficient regulatory submissions. The revolutionary science of AI-driven drug design is still in its earliest stages.
A significant number of Eli Lilly's compelling inventions came from unsanctioned projects. The company intentionally provides budget flexibility and avoids micromanagement at its R&D sites, allowing scientists to pursue their curiosity.
To commercialize curative 'one-and-done' genetic medicines, Eli Lilly is considering a subscription-like model. The procedure could be free upfront, with patients or insurers paying an ongoing fee only as long as it works.
Chronic disease patients face a cascade of interconnected problems: pre-authorizations, pharmacy stockouts, and incomprehensible insurance rules. AI's potential lies in acting as an intelligent agent to navigate this complex, fragmented system on behalf of the patient, reducing waste and improving outcomes.
The median $40,000 cost per trial enrollee is high because pharma companies essentially run a parallel, premium healthcare system for participants. They pay for all care and level it up globally to standardize the experiment.
To avoid the pitfalls of scale in R&D, Eli Lilly operates small, focused labs of 300-400 people. These 'internal biotechs' have mission focus and autonomy, while leveraging the parent company's scale for clinical trials and distribution.
A key part of Eli Lilly's R&D strategy is tackling large-scale health problems that currently have no treatments and therefore represent a 'zero-dollar market.' This blue-ocean strategy contrasts with competitors who focus on areas with established payment pathways.