Pharmaceutical Executive Daily: Eli Lilly Reports Positive Results from Two Phase III Trials

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In today's Pharmaceutical Executive Daily, Eli Lilly's Retatrutide delivers up to 22.6% weight loss in two new Phase III trials, a clinical trial expert discusses why the U.S. is losing trial volume to Australia and China, and a pharmacy benefits executive weighs in on why short-term cost thinking is complicating GLP-1 coverage decisions.

Eli Lilly has reported positive topline results from the Triumph-2 and Triumph-3 Phase III trials of Retatrutide, an investigational once-weekly triple hormone receptor agonist targeting GIP, GLP-1, and glucagon receptors. In Triumph-2, adults with type 2 diabetes and obesity lost up to 20.8% of their body weight at the highest dose after 80 weeks, along with meaningful reductions in A1C. In Triumph-3, adults with severe obesity and cardiovascular disease lost up to 22.6% of body weight, along with improvements in triglycerides, blood pressure, and inflammatory markers, though cardiovascular event data did not reach statistical significance. With five positive Phase III trials now complete, Lilly plans to submit a biologics license application to FDA in the first quarter of 2027.

Dr. Richard Graham, chairman and co-founder of TruTechnologies, told Pharmaceutical Executive that the U.S. is losing clinical trial volume to Australia for early Phase I work and to China for later-stage trials, where state-coordinated coordination among sites, sponsors, and CROs has sharply cut trial timelines. He said FDA's new Project Trialblazer initiative, aimed at accelerating early-stage trial starts, doesn't address the later-phase competition from China. Graham argued that the U.S. system involves too many stakeholders, including patients, sponsors, sites, CROs, investors, payers, and regulators, pulling in different directions, and that fixing isolated pieces of the process won't be enough to close the gap.

Finally, Susan Thomas, chief commercial officer at LucyRx, notes how plan sponsors evaluating GLP-1 coverage often focus on immediate cost impact rather than the longer-term cardiometabolic benefits, such as reduced heart attacks and strokes, that take longer to materialize in claims data. She says that shorter-term thinking has turned GLP-1 coverage into a budget line item rather than a long-term population health strategy. Her comments follow CVS Health's decision earlier this year to restore coverage of Zepbound and add Lilly's oral GLP-1 Foundayo after previously dropping Zepbound amid pricing negotiations with Novo Nordisk.

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