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We release our guide for twenty twenty six. Twenty five percent is the midpoint of the growth that we expect to see in twenty twenty six is industry leading growth, and that's a continuation of the momentum that we see as well in twenty twenty five. By the way, thinking about the Q four that we also release, the revenue that we deliver in the fourth quarter, we deliver forty three percent growth, so it's a continuation of that strong
momentum getting into twenty twenty six. What is driving that is the similar drivers, the key growth products that we have. Of course, the Increding is getting all the attention, but we have a breadth of our portfolio across all over therapeutic areas that will continue to drive that growth into twenty twenty six. Thinking about the drivers that you mentioned, we talk about the Increding portfolio both in the US
and or US. You see that the market in the fourth quarter on the antiobesity space grew eighty five percent, and we actually outpaced that growth in the fourth quarter, and very strong growth as well in type two diabetes seventeen percent. So we continue to drive that growth into twenty twenty six. You mentioned as well the introduction of
our four ripon. Very excited. We submitted for regulatory approval in the fourth quarter and we expect to have regulatory reaction as early as Q two, so we expect to see as well our oral pill coming into the market,
a very exciting opportunity to expand the market. In addition to that, we are expanding through access as well with the agreement that we have with signing with the administration in Medicare that we expect not later than July, will provide access to Medicare patients more than forty million patients that could benefit to have access to antiobesity medications as well. So very exciting time, very exciting opportunity ahead of us.
So, Lucas, there's a lot to dig into there, and you mentioned, of course the breath of your portfolio, but investors really really care about the pill at this moment, so I have to ask a little bit more about that. You mentioned that potential two Q launch. Is there a possibility that this outlook that you gave this morning gets upgraded as we start to see some of the uptake there.
Yeah, it's early days at this time, we just put the guide out there. We have a very thorough process, and we feel good about the guy that we have in place for twenty twenty six is still very compelling. By the way, twenty five percent there is no single pharmat company growing at this space, So we feel about good. We can see throughout the year if we see that
continue to trend in the positive direction. But at this time, given all the variables that we have, we feel good about the guy that we have in place.
And so let's talk about the timeline a little bit more here. You and I spoke a few weeks ago at the JP Morgan Healthcare Conference. You said that you're on track for that second quarter approval. You reiterated that timeline today, of course, pending FDA approval. Let's talk a little bit about the f There's been some challenges there. There's been some turnover. Do you see that potentially impacting the timeline and all.
At this time, we are engaging with the fdaight and we feel good about the progress. And so the time that I cover in JP Morgan that you alluded is still consistent with our expectation that we expect to see regulator reaction as early as Q two.
All right, well, we're almost in the second quarter, so we'll keep looking for updates there. I want to talk about pricing as well, because you take a look at this headline, you see global pricing declines in the low to mid teens. This caught my eye because of course Novo Nordis came out with that early release yesterday and then they said on their earnings call this morning that
they're facing unprecedented pricing pressure this year. So talk us through that, what that means for Eli Lilly and how you plan to make that up.
Yeah, well, actually the guy twenty five percent is encompassing as well. The price step was set down that we have in twenty twenty six, so that's included in our guide for twenty twenty six. Already. When you think about the variables, they are all actually out there. We talk about the agreement with the administration, those prices are public. We talk about direct to patients that we adjust the price by fifty dollars across all our presentations. That's actually
already implemented in the marketplaces of last December. And then we have the Medicare access that again we have a price of two forty five. That's also public price public information out there as well, So those variables are out there. There is no news from my perspective in terms of the pricing dynamics. Is still going to be a price
erosion versus last year. That's included in our guide. Very strong volume growth that we expect to see that will more than upset that to get to that twenty five percent that we have in our guide.
Well, the dynamic is really interesting between pricing and volume. Another line and you're earnings release that caught my eye was that you take a look at US revenue increased forty three percent. That was driven by a fifty percent increase in volume, but it was partially offset by that
seven percent decrease due to those lower realized prices. So is the hope that you know, you think about some of the things in the pipeline, the pill being one of them, is the hope that that's going to help expand the market and thus expand volume as you see that price erosion.
Yeah, that's very important. As you mentioned again, when you think about the volume growth and the volume opportunity. In particular, studying with both obesity and tie two diabetes, we have a large opportunity. Both segments are really large, in particular anti bysidium medications. You're talking about more than one hundred million patients in the US that we can serve, and then globally there is another nine hundred million patients that
we can serve as well. Nowadays we are serving low single digits, so the penetration is low, so there is a big opportunity to continue to drive that growth. The fourth quarter, I mentioned that the market in the US grew eighty five five percent, so there is a very big runway to continue to drive growth into the future. That that's reflected on our volume growth expectation for twenty twenty six.
And you touched on this a little bit, Lucas, but I do want to talk a little bit more about MFN pricing there what would impact would you expect that to have on your way laws sales this year?
So the impact is included in that guy that I talk about again, the load to meetings in price erosion that that's reflected in that price is in that price a guy that we have for the year, and the prices, as I mentioned, are public the two forty five for the government segment and the public prices that we have in direct to patients, including the adjustment that we did for fifty dollars. So all these public prices, we have
been very disciplined on our pricing strategy. You can look at the results quarter on quarter that we maintained that discipline throughout twenty twenty five, and my covenment is to maintain that price discipline getting into twenty twenty six as well.
All right, fair enough, and I do I should bring up Medicare access as well, because expanding Medicare access that is certainly top of mind for investors. And I'd love to hear from your perspective, how do you see that wider access impacting the market? And again when it comes to the pill, would you expect that to be available to Medicare patients at launch.
That's a great point of course, again not only to repartite again set Bound, but also or Fotillipon will be available in the Medicare segment once that access is provided, so both molecules will have access to Medicare patients and the patients will pay actually fifty dollars will be the copy that the patients will be paying for both medicines, So great opportunity to drive access. I mentioned forty million patients.
As always, penetrations will built over time, so studying off July, hopefully we will see that penetration growing over time, so that will build not only in twenty twenty six, but also getting into twenty twenty seven as well.
And Lucas, before I let you go, one thing that has changed since you and I spoke a couple of weeks ago back in January is that your ZEP bound QuickPen and actually one approval last month. As I understand it, that product is tied to your deal that you have with the Trump administration. So talk us through the role out here. Do you plan to make QuickPen available to all patients or would it only be an option for those Medicare patients.
Yeah, it's great news. By the way, I'm glad that you brought it up because you asked me about the quick pen approval. And again it has been three weeks and now we have the quick pen approval and we're planning to bring it to the market within the next thirty days, so that will bring another option. Of course, again we will are discussing about the channel segments you mentioned, Medicare being one of them, but also we will bring it in direct to patients so that we would have
more broad access. Is another opportunity, another option for patients that will have the opportunity to get to the QuickPen device. By the way, the quickpent device is one that we have available in many countries Gloali with a great acceptance as well.
All right, Lucas, thank you so much. I know it's a busy morning, so really appreciate you taking the time for us.