Global Access & Health

Management Approach

Throughout our nearly 150-year history, Lilly has worked to address some of the most pressing health challenges facing humanity, including infections, diabetes, depression, cancer and obesity. Today, more than 55 million people are estimated to use Lilly medicines.

However, our impact on health goes beyond the medicines we discover, develop and manufacture.

Through our global health efforts, Lilly is committed to addressing complex health challenges around the world. Our efforts include a focus on noncommunicable diseases (NCDs) and people living in historically marginalized communities in the U.S. and low- and middle-income countries (LMICs). We are committed to expanding equitable and affordable access to our breakthrough medicines so that they can transform more people’s lives.

We work across industry boundaries, providing catalytic support to leading health organizations at the global, regional and local levels. We thoughtfully collaborate with proven organizations that have the knowledge and capabilities to enhance the education, diagnosis, treatment and care of people living with NCDs.

To drive progress, we established Lilly 30x30, the company’s global health effort which aims to improve access to quality health care for 30 million people living in resource-limited settings annually by 2030.

Why NCDs?

The growing human toll of NCDs, including cancer and diabetes, is unacceptable and inequitable. According to the World Health Organization, NCDs are the leading cause of death worldwide, claiming the lives of 41 million people each year. That number is expected to rise to 52 million by 2030.

The vast majority of NCD deaths occur in LMICs, where infrastructure and resources can be limited. The COVID-19 pandemic, which had a disproportionate impact on people living with NCDs, further exacerbated health discrepancies for people in LMICs and highlighted an urgent need to act.

Lilly’s current portfolio of medicines and pipeline are focused on NCDs. Beyond our scientific innovations, we believe our deep knowledge and expertise can help close health care gaps and assist in addressing the growing burden of NCDs for people living in communities with limited resources.

Pricing Around the World

We sell medicines in approximately 105 countries around the world. Each country values medications and innovation differently and must balance competing demands for finite resources, including other health care products and services, as well as meeting social needs, such as education or infrastructure.

Pricing medicines to achieve the optimal balance between affordable patient access and sustained investment in innovative treatments is complex. How to price medicines is one of the most important decisions we make as a company. When pricing a medicine, we use a value-based approach, reflecting the value provided to patients, providers, payers, caregivers, health systems and society. The approach also considers competitive dynamics and other environmental factors. Drawing from this information, we evaluate country-specific conditions when pricing medicines on a market-by-market basis to help ensure patients around the world have affordable access to the innovative medicines we develop.

We support public policies to meet this same end. We explore new pricing and reimbursement models in different markets, and we advocate for policy changes that help increase access to medicines while protecting innovation and enabling development of new medicines. For example, we support value-based and outcomes-based reimbursement models that can deliver greater health and economic value to health systems.

As a global company, we are aware that patients in LMICs face economic circumstances that may limit their ability to pay for health services and medicines. In response, Lilly is deploying alternative business models (see Lilly 30x30 below) and innovative collaborations to help provide high-quality, affordable Lilly medicines in these markets. We also support efforts to decrease the final price of medicines to patients in these countries, such as minimizing out-of-pocket costs and limiting markups across the supply chain.

Intellectual property (IP) protections play a central role in driving innovations that result in better patient outcomes. Additionally, IP protections provide the necessary incentives to enable the global health ecosystem to operate. At Lilly, we use patent rights to protect meaningful innovation that enables sustainable investment in the high-risk and costly research and development required to discover, develop and deliver innovative medicines. At the same time, we respect that patents are limited in scope and duration, and we support robust generic and biosimilar competition when IP protections expire. Lilly is deeply committed to promoting both world-leading innovation and lower out-of-pocket costs for patients.

IP protections also played a central role in facilitating Lilly’s rapid COVID-19 therapeutics collaborations on both the development and manufacturing fronts. These protections will be critical to confronting future pandemic challenges. For example, voluntary licensing enables companies to move quickly in response to an emergency, working together to develop new medicines. These agreements allow for rapid technology transfer between companies without risking misuse of the partners’ technology platforms.

Sustaining robust, reliable, predictable and enforceable IP frameworks also promotes the pursuit of breakthroughs in areas of unmet need, such as Alzheimer’s disease and antimicrobial resistance. By allowing some certainty in an otherwise high-risk, high-investment endeavor like medicines development, IP protections embolden investor confidence to keep the engines of innovation operating at full speed.

IP protections also improve patient access by expanding the innovation base and reliably driving entry of biosimilars and generics. Because of the limited duration of IP protections, expiration of those protections allows for shifts to generic and biosimilar medicines. These products create financial savings for patients and create budgetary headroom for health systems to expand access to newer medicines. Lilly supports healthy markets for generics and biosimilars, including removal of regulatory, pricing, reimbursement and access barriers when IP protections expire. In addition, Lilly continues to engage in approaches to IP in Least Developed Countries that take into account their unique challenges. These may include voluntary licensing, non-assert policies or selective approaches to filing, in addition to supporting capacity-building initiatives which can foster a dynamic local innovation ecosystem.

In 2021, Lilly joined the IP PACT (IP Principles for Advancing Cures and Therapies), a multi-company initiative affirming the biopharmaceutical industry’s commitment to innovation and keeping patients at the center of our work. The IP PACT includes ten principles guiding the way our industry uses IP, including to facilitate collaboration and partnerships, to act responsibly in patent proceedings and to support vibrant generic and biosimilar markets. The principles are intended to balance the needs of patients, society and our business — to further health care innovation and help patients live longer, healthier lives.

Lilly 30x30

Through investments in people, medicines and health systems, we strive to improve access to quality health care for 30 million people living in resource-limited settings annually by 2030. We call this global effort Lilly 30x30. To achieve our goal, we are leveraging company resources and collaborating with leading health organizations to increase access to Lilly medicines and address complex global health challenges. We work to enhance health across three areas of impact:

Pipeline – discovering medicines, repurposing internal assets and supporting external pipelines
Programs – strengthening and creating new programs that help improve access to Lilly medicines
Philanthropy (and other initiatives) – supporting efforts that strengthen health systems, increase access to medicines and improve care.

In each of these areas, we are working to develop high-impact, scalable and sustainable solutions for people living in communities with limited resources, including by investing in and leveraging local and regional capabilities.

Governance of Lilly 30x30

To embed accountability throughout the company, Lilly 30x30 is governed by a steering committee of 13 senior executives, including six Executive Committee members and the head of Social Impact. Reporting to the CEO, this committee oversees management of key priorities and operational milestones to measure our progress and help ensure Lilly 30x30 is strategically aligned with our business and core purpose of making life better for people around the world.

As a medicine company, our greatest contribution to global health is the discovery and development of innovative medicines.

In 2023, we continued to engage external organizations with the goal of developing innovative solutions for diseases disproportionately affecting people living in resource-limited settings. Lilly committed $50 million to venture capital firms that specialize in near- and long-term health care solutions for patients in LMICs. This allocation includes a commitment to LeapFrog Emerging Consumer Fund IV. LeapFrog is an impact growth equity fund investing in South and Southeast Asian and African businesses that, among other priorities, provide innovative health care solutions to low-income consumers by offering relevant and affordable products to promote wellness and help prevent and manage chronic diseases.

Lilly continues to be a top-tier investor in the Antimicrobial Resistance (AMR) Action Fund, with $100 million committed over the life of the fund. The AMR Action Fund was launched in 2020 by more than 20 leading biopharmaceutical companies, including Lilly. Joining forces with global charitable organizations and development banks, the AMR Action Fund aims to accelerate antibiotic development with the goal of delivering two to four new antibiotics by 2030. To date, the fund has made investments in seven U.S. and European biotech organizations with pipelines targeting a range of infections.

In 2023, through Lilly 30x30, we launched a new process to systematically evaluate internal assets to identify product development and access planning strategies for LMICs with the goal of accelerating our reach and scale. We will continue to explore potential opportunities and business development models that further support the development of our Lilly 30x30 pipeline, including venture impact investing.

Through Lilly 30x30, we are strengthening our existing programs and developing new approaches to improve access to Lilly products and services for people living in resource-limited settings. These efforts include exploring alternative business models and expanding access strategies and patient support programs.

Patient Support Programs
Lilly offers a variety of affordability solutions through patient support programs and copay assistance across the major products of our portfolio, including medicines for diabetes, migraine, immunology and cancer. We offer these programs across the globe.

Our patient support programs fall into three categories:

supporting patients through reimbursement and product access issues

answering questions related to living with disease and managing health

providing information on Lilly medicines and training on Lilly devices.

Alternative Access Programs
Lilly offers alternative access programs in addition to standard pricing, reimbursement and access models. These programs facilitate appropriate patient access to Lilly medicines by addressing specific challenges faced by institutional payers, patients or channel partners.

We are also advancing manufacturing and public-private partnership-based solutions to expand access to our products in the countries where Lilly currently has no or limited presence.

In late 2022, Lilly announced a collaboration with EVA Pharma to enhance sustainable access to affordable human and analog insulin in Africa, with the goal of reaching at least 1 million people living with diabetes in LMICs by 2030. Lilly will be supplying active pharmaceutical ingredient (API) for insulin at a significantly reduced price and will provide technology transfer to enable EVA Pharma to manufacture and supply insulin to many LMICs, most of which are in Africa. EVA Pharma expects the first registration of its human and analog insulin products in Egypt in 2024, followed by registration and distribution in other African countries.

Similarly, in 2023, Lilly announced a collaboration with International Agencies (Bangladesh) Ltd. (IABL) through which Lilly will supply its API for human insulin at a reduced price. The collaboration aims to increase patient access and improve affordability for high-quality insulin for nearly one million people living with diabetes in Bangladesh by 2030. IABL will formulate, fill and finish human insulin vials and cartridges under its own trademark and brand name by 2025, exclusively for the Bangladesh market.

Also in 2023, Lilly entered into a distribution and promotion agreement with Aspen Pharmacare to sell, promote and distribute Lilly’s pharmaceutical portfolio in South Africa and the rest of Sub-Saharan Africa. The effort seeks to expand access to Lilly’s innovative portfolio of medicines and to reach more patients in the region.

Through strategic contributions and engagements Lilly supports global health organizations in their work to strengthen local health care systems and improve access to quality health care. Our focus lies in championing innovative, sustainable and scalable solutions to help address pressing global health concerns, especially for diabetes and cancer care. We seek to facilitate cross-industry action to develop and test models of care to reach as many people as possible.

Through our support, we prioritize the World Health Organization’s six building blocks of health system strengthening. These fundamental components — leadership and governance, health financing, health workforce, service delivery, information and research, and medical products and technologies – form the backbone of a robust health care system. By concentrating on these priorities, we aim to:

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enhance capabilities of the health care workforce and systems

improve service delivery mechanisms, training of health care providers and digital information systems

help bring quality health care closer to the patient, including by leveraging community health workers.

This strategic approach enables us to help address health access challenges, fostering resilience and sustainability in the pursuit of our 30x30 goals. Data and lessons learned through the various initiatives supported by Lilly are shared to help inform public policy and advocate for scale-up and replication of proven, cost-effective solutions.

AMPATH – Academic Model Providing Access to Healthcare

NCD – Noncommunicable Disease

Additional support for charitable efforts to close gaps associated with health access in resource limited settings in the U.S. and LMICs are provided by the Lilly Foundation, a separate tax-exempt organization that provides strategic and philanthropic support to other qualifying tax-exempt organizations consistent with Lilly’s general philanthropic objectives.

See more details about the work and the organizations Lilly supports.

Multi-Stakeholder Collaborations to Advance the U.N. Sustainable Development Goals

We are members of several multi-stakeholder collaborations focused on tackling global health challenges, including:

Access to Oncology Medicines Coalition (ATOM) – A global initiative to improve access to essential cancer medicines and increase the capacity to use these medicines appropriately in low-middle-income countries.
Coalition for Access to NCD Medicines & Products – A global, multisectoral coalition dedicated to increasing access to medicines and health products for NCDs to reduce the impact of diseases such as diabetes, hypertension and cardiovascular disease.
NCD Alliance – A global thought leader on policy and practice related to NCDs.
Partnership for Quality Medical Donations (PQMD) – A global collaboration that brings together global medical-product companies and humanitarian organizations to promote sustainable access to quality health care in underserved communities during times of crisis.

Product Contributions

In 2023, Lilly and its affiliates provided more than $4.3 billion in medicines to charitable organizations that offer free Lilly medicines to qualifying patients around the world.** This includes product contributions used by third parties for patient assistance programs and humanitarian efforts and support of Life for a Child and AMPATH, noted above.

As part of these efforts, Lilly donates medications to the Lilly Cares Foundation, a separate nonprofit organization. The Lilly Cares' Patient Assistance Program provides qualifying patients in the U.S. with financial need prescribed Lilly medications at no cost. In 2023, Lilly Cares helped more than 197,000 people obtain prescribed medications across the therapeutic areas of diabetes, immunology, neuroscience, cancer, pain, endocrinology, cardiovascular and bone, muscle and joint. Over the past 20 years, Lilly Cares has helped more than 1 million patients with financial need receive medicines donated by Lilly.

**Products valued at wholesale acquisition cost.

Global Health Highlights

1 Includes value of medicines provided by Lilly and its affiliates to charitable organizations that offer free Lilly medicines to qualifying patients. Product contributions valued at wholesale acquisition cost.

2 Includes financial commitments from Lilly and $17.8 million from the Eli Lilly and Company Foundation, a separate nonprofit organization, commonly referred to as the Lilly Foundation.