LLY · 10-Q · 2026Q1 · Full report

Pricing and Reimbursement Pressure

ELI LILLY & Co · 2026-04-30 · Importance 58 · Surprise 42 · In source text

Lilly identifies global concerns around access and affordability driving governmental cost containment efforts, including mandated discounts, price reporting, reference pricing, restrictive formularies, and changes to IP protections. Management warns reforms, political initiatives, uneven economic growth, inflation/deflation, trade disputes, and government budget priorities are expected to add continued pressure on cost, pricing, reimbursement, and access for its products. Lilly notes that private payers and PBMs in the U.S. also significantly impact access through negotiation of rebates and reimbursement rates and that unfavorable coverage or reimbursement determinations have and may continue to adversely impact the business. The company highlights ongoing litigation and investigations (e.g., 340B, insulin access, pricing) that could further affect results.

Key facts

• We finalized voluntary agreements with the U.S. government in the first quarter of 2026 in which we agreed to lower Medicaid and certain other drug prices for U.S. patients and to launch new medicines with a more balanced pricing approach across developed nations. source
• Private payers and pharmacy benefit managers in the U.S. continue to significantly impact the market for pharmaceuticals through negotiation of access, manufacturer price or rebate concessions and pharmacy reimbursement rates. source

Impact estimates