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A company that hardly needs an introduction is Eli Lilly, but what has it been up to lately, and what’s its pipeline strategy? Over the past year, Lilly has mixed headline-grabbing science with targeted dealmaking: it secured full U.S. Food and Drug Administration (FDA) approval for its Alzheimer’s drug Kisunla (donanemab) in July 2024, marking a major step in neurodegeneration, and then pushed hard to scale its obesity and diabetes franchise built around Zepbound/Mounjaro as demand surged into 2025.
At the same time, Lilly has been buying optionality in adjacent pillars. It completed the purchase of Morphic to deepen its inflammatory bowel disease bet, moved to acquire Scorpion Therapeutics’ mutant-selective PI3Kα program in oncology, and closed the acquisition of Verve Therapeutics to add a “one-and-done” cardiovascular gene-editing play.
In this article, we take a look at the Eli Lilly playbook.
Table of contents
Eli Lilly’s pipeline in motion
The past year has seen Eli Lilly cycle through regulatory wins and strategic deals at a remarkable pace. Taken together, these moves sketch Eli Lilly’s intent on broadening its pipeline strategy beyond its incretin franchise while shoring up multiple growth pillars.
2023-2024: Laying the groundwork in radiopharma
Lilly’s ambitions in oncology have gone beyond antibodies and small molecules to embrace radiopharmaceuticals, an area gaining traction at the moment. The cornerstone was the acquisition of POINT Biopharma, completed in December 2023, which gave Lilly two prostate-specific membrane antigen (PSMA)-targeted assets for prostate cancer, PNT2002, in phase 3 with lutetium-177, and PNT2001, an actinium-225–based “alpha-emitter” version in earlier development. With POINT came not just clinical programs but a manufacturing campus in Indianapolis and supply-chain know-how, crucial in a field where isotope sourcing is a bottleneck.
But Lilly didn’t stop there. In May 2024, it struck a deal worth up to $1.1 billion with Aktis Oncology, tapping into the biotech’s “miniprotein” platform to generate novel tumor-targeting radiopharmaceuticals and companion diagnostics. Just two months later, in July 2024, Lilly paid $140 million upfront for rights to Radionetics’ portfolio, with an option to acquire the company outright for close to $1 billion. Radionetics specializes in small-molecule radiopharma directed at G protein-coupled receptors (GPCRs), one of the largest and most druggable protein families, opening new target space beyond the usual suspects like PSMA or fibroblast activation protein (FAP).
July 2024: Eli Lilly Alzheimer’s drug’s approval opens new doors
The FDA granted full approval to Kisunla (donanemab-azbt) for early Alzheimer’s disease. Unlike earlier experimental antibodies, Kisunla comes with a fixed monthly dosing schedule and the possibility to stop treatment once amyloid plaques are cleared, potentially reducing treatment burden. The approval gave Lilly a long-sought entry into neurodegeneration, though safety warnings around amyloid-related imaging abnormalities (ARIA) keep the spotlight on real-world outcomes.
July/August 2024: Doubling down on inflammatory bowel disease (IBD)
Only days later, Lilly announced the $3.2 billion acquisition of Morphic, a biotech developing oral integrin inhibitors for IBD. Its lead candidate, MORF-057, targets α4β7 integrin and is currently in phase 2 trials for ulcerative colitis and Crohn’s. An oral option could reshape adherence in a market dominated by injectable biologics. The deal, closed in August, neatly complements Lilly’s own Omvoh (mirikizumab), an IL-23p19 antibody. In January 2025, Omvoh itself secured a second FDA approval, extending from ulcerative colitis into Crohn’s disease, establishing Lilly as a serious contender in gastroenterology.
December 2024: Eli Lilly expands incretin pipeline indications
Underlining the strength of its incretin franchise, Lilly secured a landmark FDA approval for Zepbound in obstructive sleep apnea in adults with obesity. It was the first time any drug had been cleared for this indication, with clinical data showing significant reductions in apnea/hypopnea index driven largely by weight loss. The decision broadened Zepbound’s reach beyond diabetes and obesity and opened a new therapeutic category.
January 2025: Eli Lilly makes a pipeline bet in oncology
In parallel, Lilly pushed into precision oncology by agreeing to pay up to $2.5 billion for Scorpion Therapeutics’ mutant-selective PI3Kα inhibitor STX-478. The PI3K pathway is a validated cancer target but has been plagued by safety issues. Scorpion’s approach focuses on mutations such as H1047X to spare the wild-type enzyme and avoid off-target toxicities. For Lilly, the acquisition adds small-molecule depth to an oncology strategy that already includes biologics and radioligands.
July 2025: Eli Lilly refines Alzheimer’s pipeline positioning
One year after approval, the FDA cleared an updated label for Kisunla, incorporating new clinical data from the TRAILBLAZER-ALZ 2 trial. The changes included a titration schedule adjustment, designed to reduce side-effect risk and improve practical use. For Lilly, label evolution is critical to winning over clinicians and payers in a market where Alzheimer’s antibodies still face skepticism.
June/July 2025: A long-horizon cardiovascular gamble
In June, Lilly unveiled the $1.3 billion acquisition of Verve Therapeutics, closing the deal a month later. Verve is pioneering in vivo CRISPR therapies to edit genes involved in cholesterol metabolism, with a lead program targeting PCSK9. The idea is to achieve a one-time, durable low-density lipoprotein cholesterol (LDL-C) reduction, an alternative to chronic dosing with statins or PCSK9 antibodies.
September 2025: Scaling to meet demand and presenting positive data
Beyond pipeline bets and progression, Lilly has also invested heavily in its own infrastructure. In September, it announced a $5 billion manufacturing facility in Virginia, one of several U.S. expansions aimed at securing supply for Mounjaro and Zepbound and future advanced therapies. With demand for obesity drugs far outstripping supply, manufacturing capacity has become as strategically important as pipeline innovation.
Earlier in the year, in April, Lilly also reported data for orforglipron, its once-daily oral GLP-1 receptor agonist. In phase 3 trials, the drug produced around 12% weight loss over 72 weeks in people with obesity and showed superiority to oral semaglutide on both weight and A1C reduction in type 2 diabetes. While less potent on weight loss than injectable incretins, orforglipron could extend the franchise to patients who prefer pills over injections, provided Eli Lilly can scale manufacturing to meet demand.
Reading the playbook: Eli Lilly’s positioning
What emerges from this string of milestones is that Eli Lilly has learned to use its incretin windfall as both shield and sword in its strategy. The GLP-1 franchise, with Mounjaro and Zepbound at its core, is not just a revenue machine but the foundation of Lilly’s strategic flexibility. The approval of Zepbound in obstructive sleep apnea at the end of 2024 underlined just how far the market for incretins can stretch, while pivotal trial data for the oral GLP-1 candidate orforglipron in 2025 showed Lilly’s intent to reach patients who might never consider injections.
At the same time, the company has poured billions into new manufacturing facilities in Virginia and Texas to secure capacity and margins, signaling that production scale has become as strategic as clinical innovation in this space. The contrast with Novo Nordisk is notable. Novo has largely concentrated its firepower on expanding the incretin franchise, through new formulations, combination approaches, and scaling production, whereas Lilly is already channeling its GLP-1 cash flows into a broader set of bets, from Alzheimer’s and IBD to radiopharma and gene editing.
The entry into Alzheimer’s disease with Kisunla is a different kind of play in Eli Lilly’s strategy. It is less about revenue in the near term and more about credibility and scientific ambition. Approval brought prestige and a foothold in neurodegeneration, but also the burden of proving that uptake can be sustained in the real world despite safety warnings and payer scrutiny. The label update in mid-2025 was a reminder that Eli Lilly is still refining dosing and titration to help convince prescribers and insurers, but the franchise’s durability remains uncertain.
Oncology tells another story again. Instead of competing head-on in crowded antibody markets, Lilly has built an oncology stack that mixes radiopharmaceuticals and targeted small molecules. Lilly’s acquisition of POINT Biopharma provided a late-stage PSMA pipeline and hard-to-replicate manufacturing capabilities, while follow-on deals with Aktis and Radionetics added discovery platforms in miniproteins and GPCR-targeted ligands. The investment in actinium-225 supply shows an awareness that isotope access is as important as pipeline breadth. Alongside these radiopharma moves, the Scorpion deal brought in a mutant-selective PI3Kα inhibitor, a risky but potentially rewarding shot in a class where competitors have stumbled. The pattern is clear: Lilly is looking for modalities that peers cannot easily copy at scale.
Finally, the Verve acquisition placed a long-dated option in cardiovascular disease on the table. A one-time in vivo CRISPR therapy that permanently lowers LDL cholesterol would be a radical departure from chronic dosing models. It is a high-risk bet, with delivery, durability, and outcomes all still unproven, but strategically it balances a portfolio otherwise anchored in chronic metabolic treatments.
Taken together, Lilly’s playbook looks consistent: exploit the GLP-1 to the fullest, use the cash to buy and build differentiated platforms in oncology and beyond, and place one or two audacious bets that could redefine the company’s long-term mix. The risks of Eli Lilly’s strategy are obvious – manufacturing timelines, Alzheimer’s uptake, radiopharma execution – but so is the ambition.
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