Eli Lilly: cross-border access for the specialty portfolio

Quick orientation

Eli Lilly and Company is a US-headquartered pharmaceutical company based in Indianapolis, Indiana. Lilly's specialty footprint has expanded sharply over the past five years across cardiometabolic disease (Mounjaro and Zepbound for type 2 diabetes and obesity), Alzheimer's disease (Kisunla, the second FDA-approved disease-modifying anti-amyloid therapy), oncology (Verzenio in HR-positive HER2-negative breast cancer; Jaypirca for relapsed CLL and MCL; Retevmo for RET-altered tumors), immunology (Taltz, Olumiant, Ebglyss in atopic dermatitis), and migraine (Emgality, Reyvow).

For cross-border named-patient programs, the GLP-1 and GIP-GLP-1 obesity and diabetes franchise (Mounjaro, Zepbound) generates the highest current volume of inquiries, followed by the Alzheimer's franchise (Kisunla) and the oncology franchise.

Portfolio in cross-border NPP scope

Mounjaro and Zepbound (tirzepatide)

Dual GIP and GLP-1 receptor agonist. Mounjaro is approved for type 2 diabetes; Zepbound is approved for chronic weight management and for moderate-to-severe obstructive sleep apnea in adults with obesity. US WAC at the standard maintenance doses runs above $1,000 per month. Cross-border requests are heavy from patients in MENA and India who cannot obtain reliable local supply, who want the specific dose strength not stocked locally, or who want the FDA-labeled Zepbound obesity indication where only the Mounjaro diabetes indication is locally registered.

Kisunla (donanemab)

Anti-amyloid monoclonal antibody approved for early symptomatic Alzheimer's disease (MCI due to AD and mild AD dementia) with confirmed amyloid pathology. Cross-border requests come from patients in the Gulf and India where amyloid PET or CSF biomarker confirmation has been completed but the anti-amyloid pathway is not yet locally registered. Reserve Meds coordinates Kisunla with attention to the required MRI monitoring schedule for ARIA.

Jaypirca (pirtobrutinib)

Non-covalent BTK inhibitor approved for relapsed or refractory MCL after a prior BTK inhibitor, and for CLL or SLL after a BTK inhibitor and a BCL-2 inhibitor. International requests come from MCL and CLL patients in MENA and India who have failed ibrutinib or acalabrutinib.

Verzenio (abemaciclib)

CDK4/6 inhibitor approved for HR-positive HER2-negative early breast cancer at high risk of recurrence (adjuvant) and for advanced or metastatic breast cancer. International requests cluster around the adjuvant indication where the locally registered CDK4/6 panel may exclude Verzenio.

Retevmo (selpercatinib)

RET kinase inhibitor approved for RET-fusion-positive NSCLC, RET-mutant medullary thyroid cancer, and RET-fusion-positive thyroid cancer and other solid tumors. Cross-border requests come from patients with RET-altered tumors in MENA and India where local availability is limited.

Taltz (ixekizumab)

IL-17A inhibitor approved for plaque psoriasis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axSpA, and pediatric plaque psoriasis. International requests cluster around pediatric psoriasis weight-band dosing and the newer axial spondyloarthritis indications.

Olumiant (baricitinib) and Ebglyss (lebrikizumab)

Olumiant is a JAK1/2 inhibitor approved for rheumatoid arthritis, severe alopecia areata, and COVID-19. Ebglyss is an IL-13 inhibitor approved for moderate to severe atopic dermatitis. International requests for Olumiant come heavily from severe alopecia areata patients. Ebglyss requests come from AD patients who have failed dupilumab.

Emgality (galcanezumab) and Reyvow (lasmiditan)

Anti-CGRP monoclonal antibody (Emgality) for migraine prevention and episodic cluster headache; selective 5-HT1F agonist (Reyvow) for acute migraine treatment. International requests cluster around chronic migraine patients in the Gulf and India.

Trulicity (dulaglutide)

Once-weekly GLP-1 receptor agonist for type 2 diabetes. Cross-border requests come predominantly when Mounjaro supply is locally constrained.

Why patients route Lilly products through cross-border NPP

Three patterns dominate. First, the GLP-1 supply situation: global demand for Mounjaro and Zepbound exceeds production capacity, and local stock-outs in MENA and India have driven patients to route through US-sourced supply chains. Second, Kisunla is too new globally for most non-US labels; the Alzheimer's anti-amyloid pathway is largely a US-only access route in mid-2026. Third, the Lilly Cares Foundation and Lilly Savings Card are restricted to US residents. International patients route as cash-pay.

Manufacturer engagement posture

Reserve Meds coordinates Lilly-manufactured US product through DSCSA-compliant specialty wholesaler channels. We are not an authorized Lilly distributor. All Reserve Meds orders are cash-pay at firm-quote pricing.

For Lilly market access teams: Reserve Meds maintains structured demand visibility across the cardiometabolic, Alzheimer's, oncology, and immunology franchises. If your group is sizing pre-registration demand in MENA and India, we are open to a structured conversation under NDA.

Common cross-border destinations for the Lilly portfolio

The GLP-1 franchise concentrates in the UAE, Saudi Arabia, India, and Egypt. Kisunla is heaviest in the Gulf where private neurology imaging access is strongest. The oncology franchise (Verzenio, Jaypirca, Retevmo) tracks oncology specialist concentration in Saudi Arabia, India, UAE, and Egypt. The dermatology and rheumatology franchise spans the Gulf and India.

What Reserve Meds provides

For every Lilly product order, Reserve Meds coordinates DSCSA chain-of-custody documentation; cold-chain validated logistics where required; country regulatory pathway expertise covering named-patient import approval, customs clearance, and any required physician declaration; and a single patient-facing coordinator. We do not replace the patient's treating physician. A US-licensed pharmacist reviews every prescription before dispensing.

Next step for patients

Patients or caregivers who have a treating physician's prescription for a Lilly product and want a firm quote can start a request below.

Start a request for a Lilly product

Next step for Lilly teams

If you are on the Lilly access, medical affairs, or international market access team and want to discuss coordinated named-patient program demand from MENA and India, reach us at [email protected]. We will share aggregated demand views under NDA.

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