In 2024, Eli Lilly became the world’s most valuable pharmaceutical company by market capitalization, reaching roughly $750 billion. The catalyst was tirzepatide, sold as Mounjaro for diabetes and Zepbound for obesity,a dual GLP-1/GIP agonist that outperformed its rival semaglutide in clinical trials and turned a 148-year-old Indianapolis company into the centre of the most consequential competition in modern pharma.
Pharmaceutical history is punctuated by molecules that change the trajectory of a company. For Eli Lilly, that molecule is tirzepatide. Approved by the FDA in 2022 as Mounjaro for type 2 diabetes, and in 2023 as Zepbound for chronic weight management, tirzepatide is a dual GLP-1/GIP receptor agonist,a mechanism that activates two incretin pathways simultaneously rather than the single GLP-1 pathway targeted by Novo Nordisk’s semaglutide. The clinical data was unambiguous. In head-to-head trials, tirzepatide demonstrated greater HbA1c reduction and greater weight loss than semaglutide. Those results did not just advance a product. They restructured a company’s valuation.
In 2019, Eli Lilly reported revenue of $22,320 million. By the latest available reporting period, that figure had reached $45,043 million,a doubling driven substantially by the GLP-1 portfolio. The market responded accordingly. In 2024, Lilly overtook Novo Nordisk to become the most valuable pharmaceutical company on earth by market capitalisation, reaching approximately $750 billion. The speed of the ascent was remarkable. A company that had spent decades as a mid-tier large-cap pharma, respected but not dominant, vaulted past every competitor on the strength of a single molecular platform and the clinical programme built around it.
But tirzepatide did not emerge from nothing. Lilly’s internal research on incretin biology dates back decades. The company launched Trulicity (dulaglutide), a once-weekly GLP-1 agonist, in 2014, building the commercial infrastructure,endocrinologist relationships, diabetes sales teams, payer negotiations,that would later support Mounjaro at scale. Trulicity was not a transformative drug. It was the rehearsal for one.
Colonel Eli Lilly, a Union Army veteran and pharmaceutical chemist, founded Eli Lilly and Company in Indianapolis in 1876 with $1,400 in capital and three employees. The company’s earliest contribution to medical history was manufacturing gelatin-coated pills at a time when most medicines were sold as loose powders of unreliable potency. Standardisation was the original innovation. It remains the company’s organising principle.
In 1923, Lilly became the first company to mass-produce insulin, working with the University of Toronto researchers who had isolated the hormone. The insulin franchise established a pattern that would repeat across the company’s history: Lilly did not discover the fundamental science, but it industrialised the manufacturing process that brought a laboratory breakthrough to millions of patients. The same pattern held with penicillin during the Second World War, when Lilly was among the companies that scaled production from laboratory flasks to factory vats.
By 2019, the company had 33,625 employees operating across 120 countries, spending 25.1 per cent of revenue,roughly $5.6 billion,on research and development. In 2020, R&D spending rose to $6.1 billion as the pipeline intensified. That R&D intensity, sustained over years at rates above most peers, is what produced tirzepatide. It is also what produced Kisunla (donanemab), an anti-amyloid antibody for Alzheimer’s disease approved in 2024, and the oncology drug Verzenio (abemaciclib) for breast cancer. The company invests at a rate that would be irrational unless you believe the pipeline will produce transformative molecules. Mounjaro proved the thesis.
The rivalry between Eli Lilly and Novo Nordisk is, by any measure, the most important competitive contest in the pharmaceutical industry today. It is a race worth hundreds of billions of dollars in market capitalisation, and it turns on a question of receptor pharmacology: is one incretin pathway enough, or are two better?
Novo Nordisk built the GLP-1 category. Ozempic (semaglutide) for diabetes and Wegovy (semaglutide) for obesity established that GLP-1 receptor agonists could produce clinically meaningful weight loss in addition to glucose control. The Danish company moved first, built enormous demand, and created the cultural moment in which obesity medicine became front-page news. Novo had the head start.
Lilly had the molecule. Tirzepatide’s dual mechanism,activating both GLP-1 and GIP receptors,delivered superior efficacy in the SURMOUNT and SURPASS trial programmes. Patients on the highest dose of tirzepatide achieved average weight loss exceeding 20 per cent of body weight in clinical trials, a figure that moved obesity treatment from incremental improvement toward surgical-grade results without surgery. The progression within Lilly’s own portfolio tells the story of an escalation: Trulicity was a solid GLP-1 competitor; Mounjaro was a leap in efficacy; Zepbound took the same molecule into the obesity indication that Novo had opened. Each step raised the stakes.
Both companies are now investing billions in manufacturing capacity to meet demand that has outstripped supply. The constraint on the GLP-1 market in 2024 and 2025 was not demand or willingness to pay. It was the physical ability to produce injectable peptides at sufficient scale. The winner of this race will be determined not only in the clinic but in the factory.
Eli Lilly has filed 659 patent applications with the Indian Patent Office between 1995 and 2026, of which 81 have been granted. That grant rate,roughly 12 per cent,reflects the stringent standards of India’s patent regime, particularly Section 3(d) of the Indian Patents Act, which bars patents on new forms of known substances unless they demonstrate enhanced efficacy. For a company whose portfolio centres on incretin analogues and monoclonal antibodies, every granted patent represents a molecule that cleared a higher bar than most jurisdictions impose.
The filings span Lilly’s five therapeutic areas: endocrinology, immunology, oncology, neuroscience, and other specialties. The diabetes and obesity molecules are particularly significant in the Indian context. India has an estimated 101 million people living with diabetes and a rapidly growing prevalence of obesity,the very disease burden that tirzepatide was designed to address. The intellectual property that Lilly has secured in India covers the molecules most directly relevant to the country’s most pressing metabolic health challenges.
Eighty-one granted patents may not sound like a large number against 659 filings. But each granted patent in India represents a molecule or formulation that survived examination by one of the world’s most rigorous patent offices. The portfolio includes protection for compounds across Lilly’s key franchises: the GLP-1 and GIP agonist platform, Verzenio’s CDK4/6 inhibition mechanism, Taltz’s IL-17A antibody, and the anti-amyloid approach underlying Kisunla.
Sources: Eli Lilly and Company Annual Reports and 10-K filings (2019–2024). Indian Patent Office (patent filing data). OPPI member directory.