Lilly’s Mounjaro has a mountain to climb

Questions about Mounjaro’s launch dominated Lilly’s quarterly earnings call, after US sales of the new diabetes drug came in at $97.3m – slightly better than the sellside’s consensus but disappointing investors, some of whom were expecting a number well into triple figures. Discounting and drug giveaways likely lie behind the discrepancy, and with a further $86m of Mounjaro stock bought by Lilly’s Japanese partner Mitsubishi Tanabe, concerns about demand can probably be put to bed. Supply is another matter, however, and an issue that tripped up Lilly's rival Novo; this morning's call Lilly executives said Mounjaro production capacity was on track to double by the end of 2023, though they admitted that short-term hold-ups could not be ruled out. Lilly is eying a Mounjaro obesity approval by the end of next year, so this capacity will remain in focus. The other hot topic for Lilly is Alzheimer’s disease, and updates today included a sneak preview of a donanemab versus Aduhelm study, which executives said had met two co-primary endpoints. The phase 3 programme of a follow-on asset, now called remternetug, has also begun; analysts reckon remternetug could quickly supplant donanemab thanks to more convenient subcutaneous dosing.

Hot topics: Lilly's updates and trials to watch 
Product Trial Comment
Mounjaro Surmount 12 Due to read out next year and complete obesity filing; company expects regulatory decision "as early as late next year"
  Surmount-MMO New outcome study started looking at reduction in morbidity and mortality in adults with obesity (15,000 patients)
Donanemab Trailblazer-Alz4 Head-to-head vs Aduhelm, toplined positive, to be presented at CTAD in November; in donanemab arm, radiographic Aria-E rate 21.1% and symptomatic Aria-E 2.8%
  Trailblazer-Alz2 On track to read out mid-2023
Remternetug Trailrunner-Alz1 First phase 3 started in early Alzheimer's, testing IV & SC formulations
Source: company communications &

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