When David Ricks became CEO of Eli Lilly, he faced the usual pressures of making the right, albeit risky, bets on the next big pharmaceutical breakthrough. But he also faced a unique challenge—the Midwest-based company’s culture of “Lilly nice” that led to very little dissent and conflict among leadership. To Ricks, those habits inhibited productive discussion, and risked losing Lilly’s edge as an innovator known for developing new drug classes, as it had with human insulin and the antidepressant Prozac. So he’s pushed to increase not just speed but also communication with researchers and scientists outside of the company to ensure that Lilly stays on top of the next big thing.
It’s paid off, both for the company’s stockholders and for patients—its market capitalization is valued close to $900 billion and its treatments outperform rivals. Lilly developed the most effective Alzheimer’s treatment yet, which studies show is more effective than its competitor in reducing the cognitive decline associated with the disease, and was approved by the FDA in July 2024. And its diabetes and obesity treatments (marketed as Mounjaro and Zepbound), which patients inject once a week, also reduce blood sugar and weight, respectively, more effectively than the competition. The company just announced encouraging data in April on its first oral version of these drugs, which so far appears to reduce blood sugar and weight by similar amounts as the injectable version.
“If it’s going to be a great drug, let’s make sure it says Lilly on it,” Ricks says of his drug development philosophy. A pill would be cheaper to make and therefore less expensive for patients as well—another issue Ricks has confronted head on. He led the company into unprecedented territory when he slashed the price of insulin to $35 a month, which prompted others in the industry to do the same. He’s applied the same strategy to reduce costs to patients for its weight loss and diabetes drugs, turning the pharmaceutical giant into a pharmacy for the first time with Lilly Direct, which allows patients to order the drug directly from Lilly, and also access doctors who can prescribe the medication at a reduced cost for those paying out of pocket. “Why didn’t these things happen earlier?” he says. “I don’t know, but I think people feel constrained by norms, and we just pushed beyond them. Do what you do well, where you can, and push the boundary when that’s not enough.”