Citi: Medicare Coverage Changes Everything, Eli Lilly's Oral GLP-1 Drug Sales to Triple Market Forecast Next Year

Deep News
2025/11/13

Citi has raised Eli Lilly's (LLY) price target to $1,500. Analysts suggest that as Medicare opens the door to obesity treatment in the U.S., the launch and market penetration of Lilly's new oral GLP-1 drug, Orforglipron, will experience a "violent" surge far exceeding market expectations.

According to sources, Citi stated in a November 12 report that after roadshow discussions with Eli Lilly CEO Dave Ricks, they have grown "increasingly optimistic" about the prospects of Orforglipron. The drug is expected to bring "significant optionality value" to Lilly's stock. With anticipated approval in Q1 2026 and broad Medicare coverage expected by spring, analysts believe the commercialization timeline has been accelerated.

Citi revised its 2026 sales forecast for Orforglipron from $500 million to $1.8 billion, starkly contrasting the market consensus of around $470 million. Long-term projections suggest peak sales could exceed $40 billion.

**Medicare Shift Triggers Domino Effect** Citi emphasized that as Medicare officially changes its stance to include obesity coverage, Orforglipron is undergoing a landmark transformation. Analysts believe commercial and private insurers will likely follow the government’s lead, unlocking massive market potential for GLP-1 drugs. Factors such as ICER reports highlighting GLP-1 drugs' cost-effectiveness over lifestyle interventions alone and political alignment with government policies suggest "significantly improved access is imminent."

Moreover, government payers outside the U.S. are closely monitoring this shift and may incorporate it into 2026/2027 budget planning.

**Faster Early-Stage Adoption** Citi attributes Orforglipron’s explosive potential to a perfect combination of "volume" and "price." Expanded Medicare coverage will directly bring a large patient pool, while lower pricing will significantly reduce barriers to access. Both factors are proven to enhance patient adherence and persistence, driving faster initial sales growth compared to predecessors like tirzepatide.

While maintaining peak sales projections exceeding $40 billion post-2030, Citi raised its 2030 sales forecast from $11.2 billion to $18.2 billion (versus a market consensus of $12.1 billion). Sensitivity analysis shows that even under the worst-case scenario ($149 monthly pricing, 0.1% penetration), first-year sales could reach $590 million, easily surpassing expectations. This accelerated uptake could significantly boost Lilly’s near-term cash flow—an underappreciated catalyst.

Additionally, Lilly’s injectable products Zepbound and Mounjaro will benefit from expanded market access, with 2030 sales forecasts raised to $26.2 billion and $38.1 billion, respectively.

**Key Opinion Leaders (KOLs) Bullish** Investor focus has shifted from "whether Orforglipron will commercialize" to "how large its commercialization will be." Citi cited strong endorsements from KOLs, including Dr. Louis Philipson of the University of Chicago Kovler Diabetes Center, who called its Phase 3 ACHIEVE-1 data "spectacular" and supported its use as a first-line treatment for type 2 diabetes. Harvard’s Dr. Vanita Aroda echoed similar "first-line use" views.

The most striking endorsement came from Brigham and Women’s Hospital’s Dr. Mehmet Burak, who highlighted Orforglipron’s weight-loss efficacy, tolerability, dosing flexibility, no food-effect limitations, and broad applicability for obesity complications—potentially making it "the best-selling drug on Earth." These expert opinions lend high credibility to its commercial prospects.

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