Why People Are Losing Faith in Healthcare

What It Covers

Scott Galloway interviews Eli Lilly CEO David Ricks on the company's first-ever trillion-dollar healthcare valuation, GLP-1 drug technology's expanding applications beyond weight loss, the broken U.S. healthcare pricing system, Lilly's competitive advantages in pharma R&D, and why AI remains overhyped in drug discovery.

Key Questions Answered

• •GLP-1 pricing trajectory: Lilly's Zepbound dropped 60% in price since launch, now available at $399/month through Lilly Direct, bypassing pharmacy benefit managers. The oral version Foundeo starts at $159/month. Medicare seniors gain access at $50/month starting July 1, opening the market to 70 million additional patients.
• •GLP-1 applications beyond obesity: Clinical trials show GLP-1 drugs reduce chronic inflammation, with Lilly's triple-acting retatrutide demonstrating the strongest pharmacological pain reduction ever recorded for knee arthritis. Trials also confirm reduced alcohol consumption, with a phase-three study targeting alcohol use disorder underway under the drug name brinapatide.
• •Pharma competitive advantage through speed: Lilly cut R&D cycle time by five years — from 11 years to roughly six — while competitors stayed flat. Since U.S. patents last 20 years, this creates significantly more protected market time per drug. Lilly identifies target markets before they become obvious, committing to obesity research in 2018 when no competitors were investing.
• •AI in drug discovery — realistic timeline: Current LLMs excel at synthesizing existing knowledge but fail at drug discovery because humans have mapped only 10–20% of human biology. Lilly has automated roughly 20 of approximately 1,000 preclinical steps using AI. Meaningful acceleration requires building biological datasets that don't yet exist, making a realistic impact timeline 5–10 years out.
• •Obesity as fiscal policy: Obesity-related healthcare costs total approximately $1.4 trillion annually — roughly equal to the entire proposed U.S. defense budget. With 70% of Americans overweight or obese versus Japan's 4% obesity rate, the U.S. spends $13,050 per person on healthcare versus Japan's $5,500, suggesting obesity reduction is a prerequisite for meaningful deficit reduction.