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$27 billion on American plants — right before a 100% tariff hit foreign drugs.

Eli Lilly saw the pharma tariff coming and built at home. $19.8 billion last quarter, up 56%. The company where policy and profit converge.

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Yesterday we covered the 100% tariff on imported medicine. Today we cover the company that saw it coming. Eli Lilly is the most valuable pharmaceutical company in the world, worth about $1 trillion. It reports Q2 earnings this morning. And it has spent the last two years doing exactly what the new tariff regime rewards: building factories in America.

Lilly was founded in Indianapolis in 1876 by a Civil War veteran, Colonel Eli Lilly. A hundred fifty years later, it’s still headquartered there — and it just committed $27 billion to build four new U.S. plants. That’s the largest domestic manufacturing investment in the company’s history. When we covered the Section 232 pharma investigation in May, Lilly was already ahead of the policy.

Start with the business. In Q1 2026, Lilly posted $19.8 billion in revenue — up 56% year over year. Adjusted EPS of $8.55 beat estimates by more than $1.50. U.S. revenue rose 43% to $12.1 billion. The company raised full-year guidance to $82–$85 billion and lifted its profit outlook.

The engine is the GLP-1 franchise. Mounjaro, for type 2 diabetes, and Zepbound, for weight loss — the same molecule, tirzepatide, sold under two names. Together they generated $12.8 billion in a single quarter, about 65% of total revenue. Mounjaro alone grew 125% year over year.

The new growth lever is Foundayo — orforglipron — Lilly’s once-daily oral obesity pill, approved and launched this spring. It’s the first GLP-1 pill you can take any time of day without food or water restrictions. If injectables built the trillion-dollar company, the pill is the bet on the next trillion. Today’s Q2 report gives Foundayo its first full quarter on the books.

Here’s where the manufacturing story meets the market story. Yesterday’s Section 232 tariff hits foreign-made patented drugs with a 100% rate. Companies that build domestically pay 20% — or 0% with pricing concessions. Lilly’s $27 billion U.S. buildout means a growing share of its production is tariff-advantaged while foreign-dependent rivals scramble.

This is the reshoring thesis working in real time. A company invested in American factories before the policy landed. Now the policy rewards exactly that behavior. Whether by foresight or luck, Lilly turned a looming tariff into a competitive moat. It’s the clearest example of policy and profit converging that we’ve covered.

The bull case is dominance plus optionality. Lilly leads the fastest-growing drug market in history — obesity and diabetes — with the strongest injectable franchise and now an oral pill. The $27 billion domestic buildout makes it tariff-advantaged. And the pipeline runs deep, with retatrutide and other candidates behind Foundayo. This is a growth story rare for a company its size.

The bear case is concentration and price. Two-thirds of revenue comes from two drugs that are really one molecule. Novo Nordisk is a fierce competitor and launched its own obesity pill first. Realized prices are falling — down 7% in the U.S., 25% abroad — as access expands and rebates grow. And at more than 30 times forward earnings, the stock prices in years of flawless execution.

Here’s the through-line for this newsletter. We started with a tariff threat against pharma. We covered the small towns landing billion-dollar plants. We covered the 100% tariff that landed last week. Lilly is where all of it converges: a 150-year-old American company, headquartered in Indianapolis, betting $27 billion that the future of medicine is made here. Today’s earnings will show whether the market agrees. Watch the print — and watch the guidance.

This issue is for informational purposes only and does not constitute financial advice. Always do your own research before you invest.

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