Eli Lilly Announces Phase 3 Trial Results for Foundayo
Eli Lilly and Company announced topline results from the Phase 3 ACHIEVE-4 trial evaluating the efficacy and safety of Foundayo, compared to insulin glargine in adults with type 2 diabetes and obesity or overweight at increased cardiovascular risk. ACHIEVE-4, the largest and longest study of Foundayo in type 2 diabetes to date, enrolled more than 2,700 participants across 15 countries. In the trial, Foundayo met the primary endpoint by demonstrating a non-inferior risk of major adverse cardiovascular events, including cardiovascular death, heart attack, stroke or hospitalization for unstable and sudden chest pain, compared to insulin glargine. In addition, Foundayo showed superior improvements in A1C and body weight at 52 weeks vs. insulin glargine, which persisted through 104 weeks of therapy. While not controlled for multiplicity, the risk of all-cause death was significantly lower for Foundayo vs. insulin glargine. "Across seven Phase 3 studies enrolling more than 11,000 patients, Foundayo has demonstrated a consistent safety and efficacy profile," said Thomas Seck, M.D., senior vice president of product development, Lilly Cardiometabolic Health. "ACHIEVE-4 adds a new dimension to that evidence - cardiovascular safety and a lower observed risk of all-cause death in patients who carry elevated cardiovascular risk. Together with the simplicity of a once-daily pill that requires no food or water restrictions, we believe Foundayo could be an important new treatment option for people with type 2 diabetes." In the trial, the risk of cardiovascular death, heart attack, stroke, or hospitalization for unstable sudden chest pain was 16% lower for Foundayo vs. insulin glargine, meeting the prespecified criteria for demonstrating non-inferiority. The risk of all-cause death was 57% lower with Foundayo vs. insulin glargine. Foundayo also showed clinically meaningful improvements from baseline across several cardiovascular risk factors, including non-HDL cholesterol, systolic blood pressure, triglycerides, and hsCRP. The overall safety and tolerability profile of Foundayo in ACHIEVE-4 was generally consistent with previous trials and with the GLP-1 class. The most common adverse events for patients taking Foundayo were nausea, vomiting, diarrhea, decreased appetite, and constipation. During the 52-week minimum treatment period, 10.6% of patients taking Foundayo discontinued treatment due to adverse events. ACHIEVE-4 included a thorough analysis of potential drug-induced liver injury, and these analyses confirmed there was no hepatic safety signal, consistent with all prior studies in the ACHIEVE and ATTAIN programs. Lilly will submit Foundayo for the treatment of type 2 diabetes to the U.S. FDA by the end of the second quarter under the Commissioner's National Priority Review Voucher.
Trade with 70% Backtested Accuracy
Analyst Views on LLY
About LLY
About the author

- Significant Sales Growth: Eli Lilly's Mounjaro and Zepbound GLP-1 drugs saw sales increases of 99% and 175% in 2025, respectively, showcasing the company's strong performance in the rapidly growing weight-loss drug market and further solidifying its market leadership.
- Outstanding Stock Performance: Over the past decade, Eli Lilly's stock has surged more than 1,100%, significantly outperforming the S&P 500's 230% increase, reflecting strong investor confidence in its future growth, although its current P/E ratio of 39x remains above the industry average.
- Intensifying Competitive Risks: Despite Eli Lilly's leading position in the GLP-1 space, competitors like Novo Nordisk and Pfizer are actively launching new products, which could erode Eli Lilly's market share, especially as patents expire and generics emerge, potentially impacting revenues significantly.
- Strategic Acquisition Moves: To address future competition and risks, Eli Lilly is leveraging the windfall from its GLP-1 success to pursue strategic acquisitions, which may help diversify its product pipeline, but the uncertainty surrounding the success of these new drugs could affect the company's long-term growth potential.
- Significant Sales Growth: Eli Lilly's Mounjaro and Zepbound GLP-1 drugs saw sales increases of 99% and 175% in 2025, respectively, indicating the company's leading position in the rapidly growing weight-loss market, which has driven its stock price up over 1,100% in the past decade.
- Valuation Risks: Despite Eli Lilly's P/E ratio of 39x, significantly above the industry average of 23x and close to its five-year average of 56x, a recent sell-off has made it relatively cheaper; however, the high absolute valuation may still deter potential investors.
- Patent Expiration Risks: With limited patent protection for Mounjaro and Zepbound, the emergence of generics could drastically reduce Eli Lilly's revenues from these GLP-1 drugs, posing a significant threat to its current dominance in the weight-loss category.
- Intensifying Competition: Eli Lilly faces fierce competition in the GLP-1 space from companies like Novo Nordisk and Pfizer, which are also developing similar drugs, potentially impacting Eli Lilly's market share and necessitating close monitoring of its ability to maintain its competitive edge.
- Significant Sales Growth: Eli Lilly's GLP-1 drugs, Mounjaro and Zepbound, experienced sales increases of 99% and 175% respectively in 2025, indicating the company's strong position in the rapidly growing weight-loss market, despite fierce competition.
- Outstanding Stock Performance: Over the past decade, Eli Lilly's stock has surged more than 1,100%, significantly outperforming the S&P 500's 230% increase, reflecting strong investor confidence in its future growth, yet potential risks must be acknowledged.
- Intensifying Competition Risks: With competitors like Novo Nordisk and Pfizer launching new drugs, Eli Lilly's dominance in the GLP-1 market may be threatened, particularly as patents expire and generics could significantly reduce its revenues.
- Acquisition Strategy Adjustment: Eli Lilly is leveraging the profits from its GLP-1 success to acquire companies in other areas, which may present new growth opportunities, but there is also the risk that the new drugs may not meet expectations, necessitating careful evaluation by investors.
- Eli Lilly's Market Performance: Eli Lilly reported a 45% sales increase in 2025, exceeding $65 billion, with net income nearing $21 billion, demonstrating its strong profitability in the GLP-1 drug market and solidifying its leadership in the healthcare sector.
- New Drug Approval Boosts Growth: The recent FDA approval of Eli Lilly's weight-loss drug Foundayo is expected to generate significant revenue, further enhancing its competitive edge in the rapidly growing healthcare market.
- Viking Therapeutics' Potential: Viking Therapeutics, with a market cap of only $4 billion, presents higher risk but shows promise with its GLP-1 drug VK2735 performing well in clinical trials; approval could attract large healthcare companies for acquisition, significantly increasing its market value.
- Balancing Risk and Reward: While Eli Lilly's stock is relatively safe, its price-to-earnings ratio exceeds 40, potentially limiting upside; in contrast, Viking Therapeutics could trigger a bidding war post-approval of VK2735, offering higher return potential.
- Market Leadership: Eli Lilly's latest launch in the weight loss sector further solidifies its leadership position in this niche, expected to drive revenue growth in light of the escalating global obesity crisis.
- Innovative Drug Launch: The newly approved oral GLP-1 treatment Foundayo, while less effective than Zepbound, is anticipated to attract more cash-paying patients due to its needle-free administration and lower price, potentially achieving sales of $1 billion to $2 billion in the next five years.
- Significant Market Potential: The success of Foundayo is likely to complement Zepbound, with projections suggesting substantial market share growth by 2030, enhancing Eli Lilly's overall performance amid competition from other biotech firms.
- Ongoing Innovation Capability: Eli Lilly's GLP-1 portfolio is regarded as one of its most significant breakthroughs in history, with plans to introduce the triple agonist retatrutide targeting other weight loss niches, showcasing the company's strong potential for innovation and market expansion.
- Market Opportunity: Eli Lilly's new drug Foundayo is projected to generate sales of $1 billion to $2 billion in its first year, and while it may not be as effective as Zepbound, its lower cost as an oral GLP-1 option could attract more patients, driving growth in the weight-loss market.
- Product Innovation: The launch of Foundayo not only provides a needle-free treatment option for cash-paying patients but also reduces storage requirements, thereby improving adherence among patients who are apprehensive about injections, further solidifying Eli Lilly's leadership in the weight-loss medication space.
- Long-Term Strategy: Eli Lilly's ongoing innovation in the GLP-1 sector, particularly the complementarity with Zepbound, suggests significant sales growth potential in the coming years, with projections indicating that tirzepatide could reach the highest sales peak in pharmaceutical history by 2030.
- Financial Performance: Eli Lilly has experienced rapid revenue and earnings growth in recent years, outpacing its peers, and its dividends have increased by 239% over the past decade, highlighting its attractiveness and stability as a long-term investment.











