Eli Lilly and Company (Lilly) has reclaimed the top spot on the 2025 Pharmaceutical Innovation Index, marking its return to number one after previously holding the position in 2021. This achievement follows a notable improvement from its rankings in recent years, reflecting the company’s exceptional ability to innovate and deliver transformative therapies across multiple high-impact therapeutic areas.

A key driver behind Lilly’s return to the top is the approval of Zepbound (tirzepatide) as the first and only prescription treatment for moderate-to-severe obstructive sleep apnea (OSA) in adults with obesity. The approval came after SURMOUNT-OSA Phase 3 data demonstrated that tirzepatide reduced apnea and hypopnea events by over 25 events per hour at 52 weeks, compared with about five events with placebo (P<0.001). By activating GIP and GLP-1 receptors, tirzepatide suppresses appetite and promotes weight loss—mechanisms that directly support OSA improvement.

Lilly also made significant strides in Alzheimer’s disease, with the approval of Kisunla (donanemab). Approved in the US, Japan, Great Britain, and China, Kisunla is Lilly’s first amyloid plaque-targeting therapy, demonstrating significant potential in mild cognitive impairment and mild dementia. Despite facing a negative opinion from NICE in the UK due to cost concerns, Kisunla has found success in other major markets.

Lilly has expanded its immunology portfolio with the approval of Ebglyss (lebrikizumab) for moderate-to-severe atopic dermatitis and the acquisition of Morphic Therapeutic. The acquisition strengthens Lilly’s pipeline in inflammatory bowel disease with the addition of oral integrin therapies like MORF-057, and aligns with the company’s broader strategy to address unmet needs across autoimmune diseases.

The LillyDirect platform reflects Lilly’s commitment to improving patient access and affordability by streamlining therapy delivery and reducing insulin costs. Furthermore, the phased rollout of Mounjaro (tirzepatide) for obesity in the UK—endorsed by NICE but initially limited to a defined patient group—underscores the company’s focus on navigating healthcare system constraints to ensure innovative treatments reach those most in need.

With its continued focus on breakthrough treatments, strategic acquisitions, and patient-centered access, Lilly has demonstrated its leadership in pharmaceutical innovation, earning its spot at the top of the Innovation Index.