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Eli Lilly and Company

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FY2021 Annual Report · Eli Lilly and Company
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United States
Securities and Exchange Commission
Washington, D.C. 20549
Form 10-K 
Annual report pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934
for the fiscal year ended December 31, 2021

Commission file number 001-06351

ELI LILLY AND COMPANY 

(Exact name of Registrant as specified in its charter)

Indiana
(State or other jurisdiction of
incorporation or organization)

35-0470950

(I.R.S. Employer
Identification No.)

Lilly Corporate Center, Indianapolis, Indiana 46285
(Address and zip code of principal executive offices)

Registrant's telephone number, including area code (317) 276-2000 

Securities registered pursuant to Section 12(b) of the Exchange Act:

Title of Each Class

Common Stock (no par value)
1.000% Notes due 2022

7 1/8% Notes due 2025

1.625% Notes due 2026

2.125% Notes due 2030

0.625% Notes due 2031

0.500% Notes due 2033

6.77% Notes due 2036

1.625% Notes due 2043

1.700% Notes due 2049

1.125% Notes due 2051

1.375% Notes due 2061

Trading Symbol(s)

Name of Each Exchange On Which Registered

LLY

LLY22

LLY25

LLY26

LLY30

LLY31

LLY33

LLY36

LLY43

LLY49A

LLY51

LLY61

New York Stock Exchange

New York Stock Exchange

New York Stock Exchange

New York Stock Exchange

New York Stock Exchange

New York Stock Exchange

New York Stock Exchange

New York Stock Exchange

New York Stock Exchange

New York Stock Exchange

New York Stock Exchange

New York Stock Exchange

Securities registered pursuant to Section 12(g) of the Exchange Act: None

Indicate by check mark if the Registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☒ No  ☐

Indicate by check mark if the Registrant is not required to file reports pursuant to Section 13 or 15(d) of the Exchange Act. Yes  ☐ No  ☒

Indicate by check mark whether the Registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Exchange Act during the preceding 12 
months (or for such shorter period that the Registrant was required to file such reports) and (2) has been subject to such filing requirements for the past 90 
days. Yes ☒ No  ☐

Indicate by check mark whether the Registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of 
Regulation S-T (§ 232.405 of this chapter) during the preceding 12 months (or for such shorter period that the Registrant was required to submit such files). 
Yes ☒ No ☐

Indicate by check mark whether the Registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an 
emerging growth company. See the definitions of "large accelerated filer," "accelerated filer," "smaller reporting company," and "emerging growth company" in 
Rule 12b-2 of the Exchange Act.

Large accelerated filer ☒

Non-accelerated filer ☐

Accelerated filer

☐

Smaller reporting company ☐
Emerging growth company ☐

If an emerging growth company, indicate by check mark if the Registrant has elected not to use the extended transition period for complying with any new or 
revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
Indicate by check mark whether the Registrant has filed a report on and attestation to its management's assessment of the effectiveness of its internal control 
over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or issued 
its audit report. ☒
Indicate by check mark whether the Registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act): 
Yes  ☐ No ☒
Aggregate market value of the common equity held by non-affiliates computed by reference to the price at which the common equity was last sold as of the 
last business day of the Registrant's most recently completed second fiscal quarter: approximately $193,649,000,000.

Number of shares of common stock outstanding as of February 18, 2022: 952,347,126

Portions of the Registrant's Proxy Statement for the 2022 Annual Meeting of Shareholders have been incorporated by reference into Part III of this report.

 
  
 
Eli Lilly and Company

Form 10-K
For the Year Ended December 31, 2021 

Table of Contents

Part I

Item 1.

Business

Item 1A.

Risk Factors

Item 1B.

Unresolved Staff Comments

Item 2.

Item 3.

Item 4.

Part II

Item 5.

Item 6.

Item 7.

Properties

Legal Proceedings

Mine Safety Disclosures

Market for the Registrant's Common Equity, Related Stockholder Matters, and 
Issuer Purchases of Equity Securities

[Reserved]
Management's Discussion and Analysis of Results of Operations and Financial 
Condition

Item 7A.

Quantitative and Qualitative Disclosures About Market Risk

Item 8.
Item 9.

Financial Statements and Supplementary Data
Changes in and Disagreements with Accountants on Accounting and Financial 
Disclosure

Item 9A.

Controls and Procedures

Item 9B.

Other Information

Item 9C.

Disclosure Regarding Foreign Jurisdictions that Prevent Inspections

Part III

Item 10.

Directors, Executive Officers, and Corporate Governance

Item 11.
Item 12.

Executive Compensation
Security Ownership of Certain Beneficial Owners and Management and Related 
Stockholder Matters

Item 13.

Certain Relationships and Related Transactions, and Director Independence

Item 14.

Principal Accountant Fees and Services

Item 15.

Exhibits and Financial Statement Schedules

Item 16.

Form 10-K Summary

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2Forward-Looking Statements

This Annual Report on Form 10-K and our other publicly available documents include forward-looking 
statements within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities 
Exchange Act of 1934 (Exchange Act), and are subject to the safe harbor created thereby under the Private 
Securities Litigation Reform Act of 1995. In particular, information appearing under "Business," "Risk Factors," 
and "Management's Discussion and Analysis of Results of Operations and Financial Condition" includes 
forward-looking statements. Forward-looking statements include all statements that do not relate solely to 
historical or current facts, and generally can be identified by the use of words such as "may," "believe," "will," 
"expect," "project," "estimate," "intend," "anticipate," "plan," "continue," or similar expressions or future or 
conditional verbs. 

Forward-looking statements inherently involve many risks and uncertainties that could cause actual results to 
differ materially from those expressed in forward-looking statements. Where, in any forward-looking 
statement, we express an expectation or belief as to future results or events, it is based on management's 
current plans and expectations, expressed in good faith and believed to have a reasonable basis. However, 
we can give no assurance that any such expectation or belief will result or will be achieved or accomplished. 
Investors therefore should not place undue reliance on forward-looking statements. The following include 
some but not all of the factors that could cause actual results or events to differ materially from those 
anticipated:
•

the impact of the evolving COVID-19 pandemic or any future pandemic, epidemic, or similar public health 
threat and the global response thereto;

•

•

•

•

•

•

•

uncertainties related to our efforts to develop, manufacture, and distribute potential treatments for 
COVID-19;

the significant costs and uncertainties in the pharmaceutical research and development process, including 
with respect to the timing and process of obtaining regulatory approvals;

the impact and outcome of acquisitions and business development transactions and related integration 
costs;

the expiration of intellectual property protection for certain of our products and competition from generic 
and/or biosimilar products;

our ability to protect and enforce patents and other intellectual property;

changes in patent law or regulations related to data package exclusivity;

competitive developments affecting current products and our pipeline;

• market uptake of recently launched products;

•

•

•
•

•

•

•

•

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•

•

•

information technology system inadequacies, breaches, or operating failures;

unauthorized access, disclosure, misappropriation, or compromise of confidential information or other 
data stored in our information technology systems, networks, and facilities, or those of third parties with 
whom we share our data;

unexpected safety or efficacy concerns associated with our products;
litigation, investigations, or other similar proceedings involving past, current, or future products or 
commercial activities as we are largely self-insured;

issues with product supply and regulatory approvals stemming from manufacturing difficulties, disruptions, 
or shortages, including as a result of demand, labor shortages, third-party performance, or regulatory 
actions relating to our facilities;

reliance on third-party relationships and outsourcing arrangements;

regulatory changes or other developments;

regulatory actions regarding currently marketed products; 

continued pricing pressures and the impact of actions of governmental and private payers affecting 
pricing of, reimbursement for, and access to pharmaceuticals;

devaluations in foreign currency exchange rates, changes in interest rates, and inflation;

changes in tax law, tax rates, or events that differ from our assumptions related to tax positions; 

asset impairments and restructuring charges;

3•

•

•

the impact of global macroeconomic conditions, trade disruptions, global disputes, unrest, war, or other 
costs, uncertainties and risks related to engaging in business in foreign jurisdictions; 

changes in accounting and reporting standards promulgated by the Financial Accounting Standards 
Board and the Securities and Exchange Commission (SEC); and

regulatory compliance problems or government investigations.

Investors should also carefully read the factors described under Item 1A, "Risk Factors" in this Annual Report 
on Form 10-K for a description of certain risks that could, among other things, cause our actual results to 
differ from those expressed in forward-looking statements. Investors should understand that it is not possible 
to predict or identify all such factors and should not consider the risks described above and under Item 1A, 
"Risk Factors" to be a complete statement of all potential risks and uncertainties.

All forward-looking statements speak only as of the date of this Annual Report and are expressly qualified in 
their entirety by the risk factors and cautionary statements included in this Annual Report. Except as is 
required by law, we expressly disclaim any obligation to publicly release any revisions to forward-looking 
statements to reflect events after the date of this Annual Report.

4Part I
Item 1. Business

Eli Lilly and Company (referred to as the company, Lilly, we, or us) was incorporated in 1901 in Indiana to 
succeed to the drug manufacturing business founded in Indianapolis, Indiana, in 1876 by Colonel Eli Lilly. We 
discover, develop, manufacture, and market products in a single business segment—human pharmaceutical 
products.

Our purpose is to unite caring with discovery to create medicines that make life better for people around the 
world. Most of the products we sell today were discovered or developed by our own scientists, and our long-term 
success depends on our ability to continually discover or acquire, develop, and commercialize innovative new 
medicines.

We manufacture and distribute our products through facilities in the United States (U.S.), including Puerto Rico, 
and 7 other countries. Our products are sold in approximately 120 countries.

Products

Our products include:

Diabetes products, including:

•

•

•

•

•

•

Basaglar®, in collaboration with Boehringer Ingelheim, a long-acting human insulin analog for the 
treatment of diabetes.

Humalog®, Humalog Mix 75/25, Humalog U-100, Humalog U-200, Humalog Mix 50/50, insulin lispro, 
insulin lispro protamine, and insulin lispro mix 75/25, human insulin analogs for the treatment of 
diabetes. 

Humulin®, Humulin 70/30, Humulin N, Humulin R, and Humulin U-500, human insulins of recombinant 
DNA origin for the treatment of diabetes.

Jardiance®, in collaboration with Boehringer Ingelheim, for the treatment of type 2 diabetes; to reduce 
the risk of cardiovascular death in adult patients with type 2 diabetes and established cardiovascular 
disease; and to reduce the risk of cardiovascular death and hospitalizations for heart failure in adults with 
heart failure and reduced ejection fraction.

Trajenta®, in collaboration with Boehringer Ingelheim, for the treatment of type 2 diabetes.

Trulicity®, for the treatment of type 2 diabetes and to reduce the risk of major adverse cardiovascular 
events in adult patients with type 2 diabetes and established cardiovascular disease or multiple 
cardiovascular risk factors.

Oncology products, including:

•

•

•

Alimta®, for the first-line treatment, in combination with two other agents, of advanced non-small cell lung 
cancer (NSCLC) for patients with non-squamous cell histology and no epidermal growth factor receptor 
or anaplastic lymphoma kinase genomic tumor aberrations; for the first-line treatment, in combination 
with another agent, of advanced non-squamous NSCLC; for the second-line treatment of advanced non-
squamous NSCLC; as monotherapy for the maintenance treatment of advanced non-squamous NSCLC 
in patients whose disease has not progressed immediately following chemotherapy treatment; and in 
combination with another agent for the treatment of malignant pleural mesothelioma.

Cyramza®, for use as monotherapy or in combination with another agent as a second-line treatment of 
advanced or metastatic gastric cancer or gastro-esophageal junction adenocarcinoma; in combination 
with another agent as a second-line treatment of metastatic NSCLC; in combination with another agent 
as a second-line treatment of metastatic colorectal cancer; as a monotherapy as a second-line treatment 
of hepatocellular carcinoma; and in combination with another agent as a first-line treatment of adult 
patients with metastatic NSCLC with activating epidermal growth factor receptor mutations. 

Erbitux®, indicated both as monotherapy and in combination with another agent for the treatment of 
certain types of colorectal cancers; and as monotherapy, in combination with chemotherapy, or in 
combination with radiation therapy for the treatment of certain types of head and neck cancers.

5•

•

•

Retevmo®, for the treatment of metastatic NSCLC in adult patients; for the treatment of advanced 
metastatic medullary thyroid cancer who require systemic therapy in adult and pediatric patients; and for 
the treatment of advanced metastatic thyroid cancer in adult and pediatric patients who require systemic 
therapy and are radioactive iodin-refractory.

Tyvyt®, in collaboration with Innovent Biologics, Inc., for the treatment of relapsed or refractory classic 
Hodgkin's lymphoma and for the first-line treatment of non-squamous NSCLC in combination with Alimta 
and another agent in China.

Verzenio®, for use as monotherapy or in combination with endocrine therapy for the treatment of HR+, 
HER2- metastatic breast cancer and in combination with endocrine therapy for treatment of HR+, HER2-, 
node positive, early breast cancer at high risk of recurrence and a Ki-67 score at least 20%, as 
determined by a U.S. Food and Drug Administration (FDA) approved test.

Immunology products, including:

• Olumiant®, in collaboration with Incyte Corporation, for the treatment of adults with moderately-to-

severely active rheumatoid arthritis and for moderate to severe atopic dermatitis. 

•

•

Baricitinib was granted Emergency Use Authorization (EUA) in 2021 for the treatment of COVID-19 in 
hospitalized adults and pediatric patients 2 years of age or older requiring supplemental oxygen, non-
invasive or invasive mechanical ventilation, or extracorporeal membrane oxygenation.

Taltz®, for the treatment of adults and pediatric patients aged 6 years or older with moderate-to-severe 
plaque psoriasis, adults with active psoriatic arthritis, adults with ankylosing spondylitis, and adults with 
active non-radiographic axial spondyloarthritis.

Neuroscience products, including:

•

•

•

Cymbalta®, for the treatment of major depressive disorder, diabetic peripheral neuropathic pain, 
generalized anxiety disorder, fibromyalgia, and chronic musculoskeletal pain due to chronic low back 
pain or chronic pain due to osteoarthritis.

Emgality®, for migraine prevention and the treatment of episodic cluster headache in adults.

Zyprexa®, for the treatment of schizophrenia, acute mixed or manic episodes associated with bipolar I 
disorder, and bipolar maintenance.

Other therapies, including:

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•

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•

Bamlanivimab and etesevimab, administered together, for the treatment of mild-to-moderate COVID-19 
in adults and pediatric patients from birth to 12 years old with positive results of direct SARS-CoV-2 viral 
testing and who are at high risk for progression to severe COVID-19, including hospitalization or death 
(EUA granted in 2021). In January 2022, the FDA revised the EUA for bamlanivimab and etesevimab 
administered together to limit their use to only when the patient is likely to have been infected with or 
exposed to a variant that is susceptible to this combination treatment.

Bebtelovimab, for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients (12 years 
of age and older and weighing at least 40 kilograms) with positive results of direct SARS-CoV-2 viral 
testing, and who are at high risk for progression to severe COVID-19, including hospitalization or death, 
and for whom alternative COVID-19 treatment options approved or authorized by the FDA are not 
accessible or clinically appropriate (EUA granted in 2022).

Cialis®, for the treatment of erectile dysfunction and benign prostatic hyperplasia.

Forteo®, for the treatment of osteoporosis in postmenopausal women and men at high risk for fracture 
and for glucocorticoid-induced osteoporosis in men and postmenopausal women.

Marketing and Distribution

We sell most of our products worldwide. We adapt our marketing methods and product emphasis in various 
countries to meet local customer needs and comply with local regulations.

6U.S.

We promote our major products in the U.S. through sales representatives who engage with physicians and other 
health care professionals. We also educate healthcare providers about our products in various other ways, 
including promoting in online health care channels, distributing literature and samples of certain products to 
physicians, and exhibiting at medical meetings. In addition, we advertise certain products directly to consumers 
in the U.S., and we maintain websites and other media channels with information about our major products. We 
supplement our employee sales force with contract sales organizations to leverage our resources and reach 
additional patients in need.

We maintain special business groups to service wholesalers, pharmacy benefit managers, managed care 
organizations, group purchasing organizations, government and long-term care institutions, hospitals, and certain 
retail pharmacies. We enter into arrangements with these organizations providing for discounts or rebates on our 
products.

In the U.S., most of our products are distributed through wholesalers that serve pharmacies, physicians and 
other health care professionals, and hospitals. In 2021, 2020, and 2019, three wholesale distributors in the U.S.
—McKesson Corporation, AmerisourceBergen Corporation, and Cardinal Health, Inc.—each accounted for 
between 15 percent and 20 percent of our consolidated revenue. No other customer accounted for more than 
10 percent of our consolidated revenue in any of these years.

Outside the U.S.

Outside the U.S., we promote our products to healthcare providers primarily through sales representatives and 
other health care channels. While the products we market vary from country to country, diabetes products 
constitute the largest single group of our consolidated revenue. Distribution patterns for our products also vary 
from country to country. In most countries in which we operate, we maintain our own sales organizations, but in 
some smaller countries we market our products through third-party distributors, some of which we have engaged 
through distribution and promotion arrangements.

Marketing Collaborations

Certain of our products are marketed in arrangements with other pharmaceutical companies.  For example, we 
and Boehringer Ingelheim have a global agreement to develop and commercialize a portfolio of diabetes 
products, including Trajenta, Jentadueto®, Jardiance, Glyxambi®, Synjardy®, Trijardy® XR, and Basaglar. 

For additional information, see Item 8, "Financial Statements and Supplementary Data - Note 4, Collaborations 
and Other Arrangements."

Competition

Our products compete globally with many other pharmaceutical products in highly competitive markets. 

Important competitive factors include effectiveness, safety, and ease of use; formulary placement, price, and 
demonstrated cost-effectiveness; marketing effectiveness; and research and development of new products, 
processes, modalities, and uses. Most new products that we introduce must compete with other branded, 
biosimilar, or generic products already on the market or that are later developed by competitors. When 
competitors introduce new products or delivery systems with therapeutic or cost advantages, including by 
developing new modalities, our products become subject to decreased sales, progressive price reductions, or 
both. 

We believe our long-term competitive success depends on discovering and developing (either alone or in 
collaboration with others) or acquiring innovative, cost-effective products that provide improved outcomes for 
patients and deliver value to payers, and continuously improving the productivity of our operations in a highly 
competitive environment. There can be no assurance that our efforts will result in commercially successful 
products, and it is possible that our products will be, or will become, uncompetitive from time to time as a result 
of products developed by our competitors.

7Generic Pharmaceuticals

One of the biggest competitive challenges we face is from generic pharmaceuticals. In the U.S. and Europe, the 
regulatory approval process for pharmaceuticals (other than biological products (biologics)) exempts generics 
from costly and time-consuming clinical trials to demonstrate their safety and efficacy, allowing generic 
manufacturers to rely on the safety and efficacy of the innovator product. As a result, generic manufacturers 
generally invest far fewer resources than we do in research and development and can price their products 
significantly lower than our branded products. Accordingly, when a branded non-biologic pharmaceutical loses its 
market exclusivity, it normally faces intense price competition from generic forms of the product, which can cause 
us to lose a significant portion of the product's revenue in a very short period of time.

Further, public and private payers typically encourage the use of generics as alternatives to brand-name drugs in 
their healthcare programs. Laws in the U.S. generally allow, and in many cases require, pharmacists to substitute 
generic drugs that have been rated under government procedures to be essentially equivalent to a brand-name 
drug. Where substitution is mandatory, it must be made unless the prescribing physician expressly forbids it. In 
many countries outside the U.S., intellectual property protection is weak, and we must compete with generic or 
counterfeit versions of our products relatively shortly after launch. 

Biosimilars

A number of our products and potential new medicines in our clinical-stage pipeline are biologics. In the U.S., the 
FDA regulates biologics under the Federal Food, Drug and Cosmetic Act, the Public Health Service Act, and 
implementing regulations. Competition for Lilly's biologics may be affected by the approval of follow-on biologics, 
also known as biosimilars. A biosimilar is a subsequent version of an approved innovator biologic that, due to its 
analytical and clinical similarity to the innovator biologic, may be approved based on an abbreviated data 
package that relies in part on the full testing required of the innovator biologic. Approval by the FDA ultimately 
depends on many factors, including a showing that the biosimilar is "highly similar" to the original product and 
has no clinically meaningful differences from the original product in terms of safety, purity, and potency.

Globally, most governments have developed abbreviated regulatory pathways to approve biosimilars as follow-
ons to innovator-developed biologics, including the Biologics Price Competition and Innovation Act of 2009 (the 
BPCIA) in the U.S. A number of biosimilars have been licensed under the BPCIA and in Europe. The patent and 
regulatory exclusivity for the existing innovator biologic generally must expire in a given market before biosimilars 
may enter that market. However, in the U.S., the product exclusivity period under the BPCIA could be affected by 
recent government proposals and litigation. See "- Patents, Trademarks, and Other Intellectual Property Rights." 
In addition, the extent to which a biosimilar, once approved, will be substituted for the innovator biologic in a way 
that is similar to traditional generic substitution for non-biologic products is not yet entirely clear, and will depend 
on a number of regulatory and marketplace factors that are still developing. In the U.S., currently only a 
biosimilar product that is determined to be "interchangeable" by the FDA will be considered substitutable for the 
original biologic product without the intervention of the health care provider who prescribed the original biologic 
product. To prove that a biosimilar product is interchangeable, the applicant must demonstrate that the product 
can be expected to produce the same clinical results as the original biologic product in any given patient, and if 
the product is administered more than once in a patient, that safety risks and potential for diminished efficacy of 
alternating or switching between the use of the interchangeable biosimilar biologic product and the original 
biologic product is no greater than the risk of using the original biologic product without switching. The FDA has 
begun to issue "interchangeable" designations for biosimilar products.

Biosimilars may present both competitive challenges and opportunities. For example, a competitor company has 
developed a version of insulin lispro that competes with our product Humalog. On the other hand, in collaboration 
with Boehringer Ingelheim, we developed Basaglar, an insulin glargine product, which has the same amino acid 
sequence as a product currently marketed by a competitor and has launched as a follow-on biologic in the U.S., 
and as a biosimilar in Europe and Japan. However, in March 2020, the FDA began regulating all of our insulin 
products as "biologics" rather than "drugs." Based on FDA draft guidance, this change may lessen the amount of 
data required for competitor biosimilar products to enter the market, some of which could be designated as 
interchangeable and therefore substituted for our insulin products at U.S. pharmacies. For example, in June 
2020, the FDA approved a New Drug Application (NDA) for Semglee, a follow-on insulin glargine product that 
competes with Basaglar in the U.S., and, in July 2021, Semglee received additional FDA approval as a biosimilar 
that is interchangeable to its reference insulin glargine product. The FDA's interpretation of important aspects of 
the laws regulating biosimilars continues to evolve and, therefore, the impact of these laws on our business 
remains subject to substantial uncertainty.

8U.S. Private Sector Dynamics

In the U.S. private sector, consolidation and integration among healthcare providers significantly affects the 
competitive marketplace for pharmaceuticals. Health plans, managed care organizations, pharmacy benefit 
managers, wholesalers, and other supply chain stakeholders have been consolidating into fewer, larger entities, 
thus enhancing their purchasing strength and importance. Private third-party insurers, as well as governments, 
typically maintain formularies that specify coverage (the conditions under which drugs are included on a plan's 
formulary) and reimbursement (the associated out-of-pocket cost to the consumer) to control costs by negotiating 
discounted prices in exchange for formulary inclusion.

Formulary placement can lead to reduced usage of a drug for the relevant patient population due to coverage 
restrictions, such as prior authorizations and formulary exclusions, or due to reimbursement limitations that result 
in higher consumer out-of-pocket cost, such as non-preferred co-pay tiers, increased co-insurance levels, and 
higher deductibles. Consequently, pharmaceutical companies face increased pressure in pricing and usage 
negotiation, and compete fiercely for formulary placement, not only on the basis of product attributes such as 
efficacy, safety profile, or patient ease of use, but also by providing rebates. As payers and pharmaceutical 
companies continue to negotiate formulary placement and pricing, value-based agreements, where pricing is 
based on achievement (or not) of specified outcomes, are another tool that may become increasingly prevalent. 
Price is an increasingly important factor in formulary decisions, particularly in treatment areas in which the payer 
has taken the position that multiple branded products are therapeutically comparable. We expect these 
downward pricing pressures will continue to negatively affect our consolidated results of operations. In addition to 
formulary placement, changes in insurance designs continue to drive greater consumer cost-sharing through 
high deductible plans and higher co-insurance or co-pays. For additional information on pricing and 
reimbursement for our pharmaceutical products, see "- Regulations and Private Payer Actions Affecting 
Pharmaceutical Pricing, Reimbursement, and Access - U.S."

Patents, Trademarks, and Other Intellectual Property Rights

Overview

Intellectual property protection is critical to our ability to successfully commercialize our life sciences innovations 
and invest in the search for new medicines. We own, have applied for, or are licensed under, a large number of 
patents in the U.S. and many other countries relating to products, product uses, formulations, and manufacturing 
processes. In addition, as discussed below, for some products we have effective intellectual property protection 
in the form of data protection under pharmaceutical regulatory laws.

The patent protection anticipated to be of most relevance to pharmaceuticals is provided by national patents 
claiming the active ingredient (the compound patent), particularly those in major markets such as the U.S., major 
European countries, and Japan. These patents may be issued based upon the filing of international patent 
applications, usually filed under the Patent Cooperation Treaty (PCT). Patent applications covering compounds 
are generally filed during the Discovery Phase of the drug discovery process, which is described in the 
"Research and Development" section below. In general, national patents in each relevant country are available 
for a period of 20 years from the filing date of the PCT application, which is often years prior to the launch of a 
commercial product. Further patent term adjustments and restorations may extend the original patent term:

•

•

Patent term adjustment is a statutory right available to all U.S. patent applicants to provide relief in the 
event that a patent grant is delayed during examination by the United States Patent and Trademark 
Office (USPTO).

Patent term restoration is a statutory right provided to U.S. patent holders that claim inventions subject to 
review by the FDA. To make up for a portion of the time invested in clinical trials and the FDA review 
process, a single patent for a pharmaceutical product may be eligible for patent term restoration. Patent 
term restoration is limited by a formula and cannot be calculated until product approval due to 
uncertainty about the duration of clinical trials and the time it takes the FDA to review an application. 
There is a five-year cap on any restoration, and no patent's expiration date may be extended beyond 14 
years from FDA approval. Some countries outside the U.S. similarly offer forms of patent term restoration 
for patents claiming inventions subject to a local review by a regulatory agency. For example, 
Supplementary Protection Certificates are available to extend the life of a European patent up to an 
additional five years (subject to a 15-year cap from European Medicines Agency (EMA) approval). Also, 
in Japan, South Korea, and Australia, patent terms can be extended up to five years, depending on the 
length of regulatory review and other factors.

9Loss of effective patent protection for pharmaceuticals, especially for non-biologic products, typically results in 
the loss of effective market exclusivity for the product, which often results in severe and rapid decline in revenues 
for the product. However, in some cases the innovator company may retain exclusivity despite approval of the 
generic, biosimilar, or other follow-on versions of a new medicine beyond the expiration of the compound patent 
through manufacturing trade secrets, later-expiring patents on manufacturing processes, methods of use or 
formulations, or data protection that may be available under pharmaceutical regulatory laws. Changes to the 
laws and regulations governing these protections could result in earlier loss of effective market exclusivity. The 
primary forms of data protection are as follows:

•

•

•

•

Regulatory authorities in major markets generally grant data package protection for a period of years 
following new drug approvals in recognition of the substantial investment required to complete clinical 
trials. Data package protection prohibits other manufacturers from submitting regulatory applications for 
marketing approval in reliance on the innovator company's regulatory submission data for the drug. The 
base period of data package protection depends on the country. For example, the period is generally five 
years in the U.S. (12 years for new biologics as described below), effectively 10 years in Europe, and 
eight years in Japan. The period begins on the date of product approval and runs concurrently with the 
patent term for any relevant patent.

Under the BPCIA, the FDA has the authority to approve biosimilars. A competitor seeking approval of a 
biosimilar must file an application to show its molecule is highly similar to an approved innovator biologic 
and include a certain amount of safety and efficacy data that the FDA will consider on a case-by-case 
basis. Under the data protection provisions of this law, the FDA cannot approve a biosimilar application 
until 12 years after initial marketing approval of the innovator biologic, subject to certain conditions. 

In the U.S., the FDA has the authority to grant additional data protection for approved drugs where the 
sponsor conducts specified testing in pediatric or adolescent populations within a specified time period. If 
granted, this "pediatric exclusivity" provides an additional six months of exclusivity, which is added to the 
term of data protection and, for products other than biologics, to the term of any relevant patents, to the 
extent these protections have not already expired. While the term of the pediatric exclusivity attaches to 
the term of any relevant patent, pediatric exclusivity is a regulatory exclusivity—i.e., a bar to generic or 
biosimilar approval, not a patent right.

Under the U.S. orphan drug law, a specific use of a drug or biologic can receive "orphan" designation if it 
is intended to treat a disease or condition affecting fewer than 200,000 people in the U.S., or affecting 
more than 200,000 people but not reasonably expected to recover its development and marketing costs 
through U.S. sales. Among other benefits, orphan designation entitles the particular use of the drug to 
seven years of market exclusivity, meaning that the FDA cannot (with limited exceptions) approve 
another marketing application for the same drug for the same indication until expiration of the seven-year 
period. Unlike pediatric exclusivity, the orphan exclusivity period is independent of and runs in parallel 
with any applicable patents.

Outside the major markets, the adequacy and effectiveness of intellectual property protection for 
pharmaceuticals varies widely, and in a number of these markets we are unable to patent our products or to 
enforce the patents we receive for our products. Under the Trade-Related Aspects of Intellectual Property 
Agreement (TRIPs) administered by the World Trade Organization, more than 140 countries have agreed to 
provide non-discriminatory protection for most pharmaceutical inventions and to assure that adequate and 
effective rights are available to patent owners. Certain developing countries limit protection for biopharmaceutical 
products under their interpretation of "flexibilities" allowed under the agreement. Thus, some types of patents, 
such as those on new uses of compounds or new forms of molecules, are not available in certain developing 
countries. Further, many developing countries, and some developed countries, do not provide effective data 
package protection even though it is specified in TRIPs. 

Our Intellectual Property Portfolio

We consider intellectual property protection for certain products, processes, uses, and formulations—particularly 
with respect to those products discussed below—to be important to our operations. In addition to the patents and 
data protection identified below, we may hold patents on manufacturing processes, formulations, devices, or 
uses that extend exclusivity beyond the dates shown below. For approved products, dates include, where 
applicable, pending or granted patent term extensions.

10The most relevant U.S. patent protection or data protection and associated expiry dates for our major or recently 
launched patent-protected marketed products are as follows:

•

•

•

•

•

Alimta is protected by pediatric exclusivity (2022). See Item 8, "Financial Statements and Supplementary 
Data - Note 16, Contingencies," for information regarding our settlement agreement with Eagle 
Pharmaceuticals, Inc. and its impact on our exclusivity for Alimta.

Baqsimi® is protected by data protection (2022).

Cyramza is protected by a compound patent and biologics data protection (2026).

Emgality is protected by a compound patent (2033) and biologics data protection (2030).

Jardiance, and the related combination product Glyxambi, is protected by a compound patent (2028). 

• Olumiant is protected by a compound patent (2032). 

•

•

•

•

•

Retevmo is protected by a compound patent (2037) and by data protection (2025).

Reyvow® is protected by a compound patent (2030).

Taltz is protected by a compound patent (2030) and by biologics data protection (2028).

Trulicity is protected by a compound patent (2027) and by biologics data protection (2026).

Verzenio is protected by a compound patent (2031) and by data protection (2022).

Outside the U.S., important patent protection or data protection includes: 

•

•

•

•

Baqsimi is protected by data protection in Japan (2026).

Cyramza is protected by a compound patent (2028) and by data protection (2024) in major European 
countries, and by a compound patent (2026) and by data protection (2023) in Japan.

Emgality is protected by a compound patent (2033) and by data protection (2028) in major European 
countries, and by a compound patent (2035) and by data protection (2029) in Japan.

Jardiance is protected by a compound patent in major European countries (2029) and Japan (2030).

• Olumiant is protected by a compound patent (2032) and by data protection (2027) in major European 

countries, and by a compound patent (2033) and by data protection (2025) in Japan.

•

•

•

•

•

Retevmo is protected by a compound patent (2037) and by data protection (2031) in major European 
countries, and by a compound patent (2038) and by data protection (2029) in Japan.

Reyvow is protected by a compound patent (2026) and by data protection (2032) in Japan.

Taltz is protected by a compound patent (2031) and data protection (2027) in major European countries 
and a compound patent (2030) and data protection (2024) in Japan.

Trulicity is protected by a compound patent (2029) and by data protection (2024) in major European 
countries and by a compound patent (2029) and by data protection (2023) in Japan.

Verzenio is protected by a compound patent (2033) and data protection (2028) in major European 
countries and by a compound patent (2034) and data protection (2026) in Japan.

The following product candidates are currently under regulatory review. Upon approval, we expect relevant 
compound patent and data protections to apply:

• We have commenced a rolling submission in the U.S. for donanemab for the treatment of Alzheimer's 

disease.

• We have commenced a rolling submission in the U.S. for pirtobrutinib (LOXO-305) for the treatment of 

mantle cell lymphoma.

•

•

Reyvow has been submitted for regulatory review in certain major European countries for the acute 
treatment of migraine.

Tirzepatide has been submitted for regulatory review in the U.S., in Japan, and in certain major 
European countries as an adjunct to diet and exercise to improve glycemic control in adults with type 2 
diabetes.

11Worldwide, we sell all of our major products under trademarks consisting of our product names, logos, and 
unique product appearances (e.g., the appearance of our Trulicity autoinjector) which we consider in the 
aggregate to be important to our operations. Trademark protection varies throughout the world, with protection 
continuing in some countries as long as the mark is used, and in other countries as long as it is registered. 
Registrations are normally for fixed but renewable terms. Trademark protection typically extends beyond the 
patent and data protection for a product. 

Patent Licenses and Collaborations

Most of our major products are not subject to significant license and collaboration agreements. For information 
on our license and collaboration agreements, see Item 8, "Financial Statements and Supplementary Data - Note 
4, Collaborations and Other Arrangements." 

Patent Challenges 

In the U.S., the Drug Price Competition and Patent Term Restoration Act of 1984, commonly known as the 
Hatch-Waxman Act, authorizes the FDA to approve generic versions of innovative pharmaceuticals (other than 
biologics, which are discussed below in more detail) when the generic manufacturer has not conducted safety 
and efficacy studies but files an Abbreviated New Drug Application (ANDA). In an ANDA, the generic 
manufacturer must demonstrate only "pharmaceutical equivalence" and "bioequivalence" between the generic 
version and the NDA-approved drug—not safety and efficacy. Establishing pharmaceutical equivalence and 
bioequivalence is generally straightforward and inexpensive for the generic company.

Absent a patent challenge, the FDA cannot approve an ANDA until after certain of the innovator's patents expire. 
However, after the innovator has marketed its product for four years, a generic manufacturer may file an ANDA 
alleging that one or more or all of the patents listed in the innovator's NDA are invalid or not infringed. This 
allegation is commonly known as a "Paragraph IV certification." If the innovator responds by filing suit against the 
generic manufacturer, the FDA is then prohibited from approving the generic company's application for a 30-
month period (which can be shortened or extended by the trial court judge hearing the patent challenge). If one 
or more of the NDA-listed patents are challenged, the first filer(s) of a Paragraph IV certification may be entitled 
to a 180-day period of market exclusivity over all other generic manufacturers.

Generic manufacturers use Paragraph IV certifications extensively to challenge patents on innovative 
pharmaceuticals. In addition, generic companies have shown willingness to launch "at risk," i.e., after receiving 
ANDA approval but before final resolution of their patent challenge.

Under the BPCIA, the FDA cannot approve an application for a biosimilar product until data protection expires, 
12 years after initial marketing approval of the innovator biologic, and an application may not be submitted until 
four years following the date the innovator biologic was first approved. However, the BPCIA does provide a 
mechanism for a competitor to challenge the validity of an innovator's patents as early as four years after initial 
marketing approval of the innovator biologic. 

The patent litigation scheme under the BPCIA, and the BPCIA itself, is complex and continues to be interpreted 
and implemented by the FDA as well as courts. Courts have held that biosimilar applicants are not required to 
engage in the BPCIA patent litigation scheme and patent holders retain the right to bring suit under normal patent 
law procedures if a biosimilar applicant attempts to commercialize a product prior to patent expiration. Further, in 
the U.S., the increased likelihood of generic and biosimilar challenges to innovators' intellectual property has 
increased the risk of loss of innovators' market exclusivity. See also "- Competition - Biosimilars." In addition, 
there is a procedure in U.S. patent law, known as inter partes review (IPR), which allows any member of the 
public to file a petition with the USPTO seeking the review of any issued U.S. patent for validity. IPRs are 
conducted before Administrative Patent Judges in the USPTO using a lower standard of proof than used in 
federal district court. In addition, the challenged patents are not accorded the presumption of validity as they are 
in federal district court. Generic drug companies and even some investment firms have engaged in the IPR 
process in attempts to invalidate our patents. The use of IPR proceedings after the institution of litigation 
pursuant to the BPCIA or Hatch-Waxman Act is currently a topic of debate among legislators. We expect 
additional changes to the Patent Trial and Appeal Board (PTAB), including potentially to the policy to 
discretionarily deny an otherwise meritorious petition for IPR in light of a concurrent district court proceeding. See 
"Risk Factors—Risks Related to Our Business—Our long-term success depends on intellectual property 
protection; if our intellectual property rights are invalidated, circumvented, or weakened, our business will be 
adversely affected."

12Outside the U.S., the legal doctrines and processes by which pharmaceutical patents can be challenged vary 
widely. In recent years, we have experienced an increase in patent challenges from generic manufacturers in 
many countries outside the U.S.

For more information on administrative challenges and litigation involving our intellectual property rights, see 
Item 8, "Financial Statements and Supplementary Data - Note 16, Contingencies." 

Government Regulation of Our Operations

Our operations are regulated extensively by numerous national, state, and local agencies. 

Regulation of Products 

The lengthy process of laboratory and clinical testing, data analysis, manufacturing development, and regulatory 
review necessary for governmental approvals of our products is extremely costly and can significantly delay 
product introductions and revenue generation. In addition, our operations are subject to complex federal, state, 
local, and foreign laws and regulations concerning relationships with healthcare providers and suppliers, the 
environment, occupational health and safety, data privacy, and other matters. Evolving regulatory priorities have 
intensified governmental scrutiny of our operations, including with respect to current Good Manufacturing 
Practices (cGMP), quality assurance, and similar regulations. Compliance with the laws and regulations affecting 
the manufacture and sale of current products and the discovery, development, and introduction of new products 
will continue to require substantial effort, expense, and capital investment.

Of particular importance to our business is regulation by the FDA in the U.S. Pursuant to laws and regulations 
that include the Federal Food, Drug, and Cosmetic Act, the FDA has jurisdiction over all of our products and 
devices in the U.S. and administers requirements covering the testing, safety, effectiveness, manufacturing, 
quality control, distribution, labeling, marketing, promotion, advertising, dissemination of information, and post-
marketing surveillance of those products.

Following approval, our products remain subject to regulation by various agencies in connection with labeling, 
import, export, storage, recordkeeping, advertising, promotion, and safety reporting. We conduct extensive post-
marketing surveillance of the safety of the products we sell. The FDA may withdraw approval if compliance with 
regulatory requirements and standards is not maintained or if problems occur after a product reaches the market. 
The FDA strictly regulates marketing, labeling, advertising, and promotion of products that are placed on the 
market. Pharmaceutical products may be promoted only for the approved indications and in accordance with the 
provisions of the approved label. The FDA and other agencies actively enforce the laws and regulations 
prohibiting the promotion of off-label uses. 

The FDA extensively regulates all aspects of manufacturing quality for pharmaceuticals under its cGMP 
regulations. Outside the U.S., our products and operations are subject to similar regulatory requirements, notably 
by the EMA in Europe, the Ministry of Health, Labor and Welfare in Japan, and the National Medical Products 
Administration in China. Specific regulatory requirements vary from country to country. Regulatory requirements 
and approval processes outside the U.S. may differ from those in the U.S. and may involve additional costs, 
uncertainties, and risks.

We make substantial investments of capital and operating expenses to implement comprehensive, company-
wide quality systems and controls in our manufacturing, product development, and process development 
operations in an effort to maintain sustained compliance with cGMP and similar regulations. However, in the 
event we fail to adhere to these requirements, we become subject to potential government investigations, 
regulatory and legal actions, product recalls and seizures, fines and penalties, interruption of production leading 
to product shortages, import bans or denials of import certifications, delays or denials in new product approvals, 
and reputational harm, any of which would adversely affect our business. Certain of our products are 
manufactured by third parties, and their failure to comply with these regulations could adversely affect us, 
including through failure to supply product to us or delays in new product approvals. Any determination by the 
FDA or other regulatory authorities of manufacturing or other deficiencies could adversely affect our business. 

We are also subject to a variety of federal, state, local, and foreign environmental, health and safety, and other 
laws and regulations that may affect our research, development or production efforts. 

13Emergency Use Authorizations

The Secretary of Health and Human Services may authorize unapproved medical products to be manufactured, 
marketed, and sold in the context of an actual or potential emergency that has been designated by the 
government. After an emergency has been announced, the Secretary of Health and Human Services may 
authorize EUAs for the use of specific products based on criteria established by statute, including that the 
product at issue may be effective in diagnosing, treating, or preventing serious or life-threatening diseases when 
there are no adequate, approved, and available alternatives. An EUA is subject to additional conditions and 
restrictions, such as the obligation to provide fact sheets for healthcare providers administering the product and 
those to whom it is administered, adverse event monitoring and reporting, and recordkeeping and reporting 
requirements by product manufacturers. The FDA may also establish additional discretionary conditions of 
authorization that the FDA deems necessary or appropriate to protect the public health, including conditions 
related to product distribution, product administration and data collection and analysis concerning the safety and 
effectiveness of the product. In issuing an EUA, the FDA considers the totality of available scientific evidence 
regarding quality, safety and efficacy, including the known and potential risks of such products and the adequacy 
and availability of approved alternatives, among other factors. An EUA is not a substitute for obtaining FDA 
approval, licensure, or clearance for use of a product. An EUA terminates when the emergency determination 
underlying the EUA terminates, and EUAs can be revoked under other circumstances, the timing of which may 
occur unexpectedly or be difficult to predict.

Outside the U.S., the emergency use of medical products is subject to regulatory processes and requirements 
that differ from those in the U.S.

The COVID-19 pandemic has been designated as a national emergency in the U.S. On the basis of such 
determination, the Secretary of Health and Human Services declared that circumstances exist justifying the 
authorization of emergency use of drugs and biologics during the COVID-19 pandemic. The FDA has granted 
EUAs for bamlanivimab and etesevimab administered together, baricitinib, and bebtelovimab, and similar actions 
have been taken by other regulators in certain jurisdictions outside the U.S. However, the FDA has revised, and 
may in the future revise, any EUA for our COVID-19 antibodies in response to the prevalence of variants against 
which our antibodies have varying degrees of efficacy. For example, in January 2022, the FDA revised the EUA 
for bamlanivimab and etesevimab administered together to limit their use to only when the patient is likely to 
have been infected with or exposed to a variant that is susceptible to this combination treatment.

Other Laws and Regulations

The marketing, promotional, and pricing practices of pharmaceutical manufacturers, as well as the manner in 
which manufacturers interact with purchasers, prescribers, and patients, are subject to various other U.S. federal 
and state laws, as well as analogous foreign laws and regulations, including the federal anti-kickback statute, the 
False Claims Act, and state laws governing kickbacks, false claims, unfair trade practices, and consumer 
protection. These laws are administered by, among others, the Department of Justice, the Office of Inspector 
General of the Department of Health and Human Services, the Federal Trade Commission, the Office of 
Personnel Management, and state attorneys general. Over the past several years, state, federal, and foreign 
governments, agencies, and other regulatory bodies have increased their oversight, enforcement activities, and 
coordination with respect to pharmaceutical companies, which has resulted in intensified scrutiny, corporate 
criminal sanctions, and substantial civil settlements in the pharmaceutical industry. 

In December 2020, the Office of Inspector General of the U.S. Department of Health and Human Services and 
the Centers for Medicare & Medicaid Services (CMS) issued final rules expanding and modifying existing, and 
adding new, regulatory "safe harbors" and exceptions, respectively, under the anti-kickback statute and the 
Ethics in Patient Referrals Act. We are currently evaluating the impact, if any, these regulatory amendments will 
have upon becoming effective on our consolidated results of operations, liquidity, and financial position, which is 
uncertain at this time. 

The U.S. Foreign Corrupt Practices Act of 1977 (FCPA) prohibits certain individuals and entities, including U.S. 
publicly traded companies, from promising, offering, or giving anything of value to foreign officials with the corrupt 
intent of influencing the foreign official for the purpose of helping the company obtain or retain business or gain 
any improper advantage. The FCPA also imposes specific recordkeeping and internal controls requirements on 
U.S. publicly traded companies. As noted above, outside the U.S., our business is heavily regulated and 
therefore involves significant interaction with foreign officials. Additionally, in many countries outside the U.S., 
healthcare providers who prescribe pharmaceuticals are employed by the government and purchasers of 
pharmaceuticals are government entities; therefore, our interactions with these prescribers and purchasers are 
subject to regulation under the FCPA. 

14In addition to the U.S. application and enforcement of the FCPA, the various jurisdictions in which we operate 
and supply our products have laws and regulations aimed at preventing and penalizing corrupt and 
anticompetitive behavior. In recent years, several jurisdictions have enhanced their laws and regulations in this 
area, increased their enforcement activities, and/or increased the level of cross-border coordination and 
information sharing.

We are and could in the future become subject to administrative and legal proceedings and actions, which could 
include claims for civil penalties (including treble damages under the False Claims Act), criminal sanctions, and 
administrative remedies, including exclusion from U.S. federal and other health care programs. It is possible that 
an adverse outcome in future actions could have a material adverse impact on our consolidated results of 
operations, liquidity, and financial position.

We are also subject to a variety of federal, state, local, and foreign environmental, health and safety, and other 
laws and regulations that may affect our research, development or production efforts. 

Regulations and Private Payer Actions Affecting Pharmaceutical Pricing, Reimbursement, and Access 

U.S.

There continues to be considerable public and government scrutiny of pharmaceutical pricing, and measures to 
address the perceived high cost of pharmaceuticals are being considered at various levels of state and federal 
government. In addition, U.S. government action to reduce federal spending on entitlement programs, including 
Medicare and Medicaid, may affect payment for our products or services associated with the provision of our 
products. Additionally, there has been heightened governmental scrutiny recently over the manner in which drug 
manufacturers set prices for their marketed products, which has resulted in several Congressional inquiries and 
proposed and enacted federal and state legislation designed to, among other things, bring more transparency to 
product pricing, review the relationship between pricing and manufacturer patient programs and reform 
government program reimbursement methodologies for drug products. Restrictive or unfavorable pricing, 
coverage, or reimbursement determinations for our medicines or product candidates by governments, regulatory 
agencies, or private payers could also adversely impact our business and financial results. For example, in 
January 2022, the CMS proposed a national coverage determination (NCD) decision memorandum stating that 
the proposed NCD would cover FDA approved monoclonal antibodies that target amyloid for the treatment of 
Alzheimer's disease for people with Medicare only if they are enrolled in qualifying clinical trials (the Alzheimer’s 
Monoclonal Antibody NCD). If finalized in its current form, the proposed Alzheimer’s Monoclonal Antibody NCD 
would result in reduced coverage for, and negatively impact, our product candidate donanemab, and may 
negatively impact our business and financial results. The regulatory priorities of the current U.S. presidential 
administration could further intensify these efforts, which could have a material adverse impact on our business.

In the U.S., we are required to provide rebates to the federal government and respective state governments on 
their purchases of our pharmaceuticals under various federal and state healthcare programs, including state 
Medicaid and Medicaid Managed Care programs (minimum of 23.1 percent plus adjustments for price increases 
over time) and discounts to private entities who treat patients in certain types of health care facilities intended to 
serve low-income and uninsured patients (known as 340B facilities). No rebates are required at this time in the 
Medicare Part B (physician and hospital outpatient) program where reimbursement is set on an "average sales 
price plus 4.3 percent" formula. Additionally, an annual fee is imposed on pharmaceutical manufacturers and 
importers that sell branded prescription drugs to specified government programs. Since 2019, the Bipartisan 
Budget Act has required manufacturers of brand-name drugs, biologics, and biosimilars to provide a discount of 
70 percent of the cost of branded prescription drugs for Medicare Part D participants who are in the "doughnut 
hole" (the coverage gap in Medicare prescription drug coverage).

Rebates are also negotiated in the private sector. We pay rebates to private payers that provide prescription drug 
benefits to seniors covered by Medicare and to private payers that provide prescription drug benefits to their 
customers. These rebates are affected by the introduction of competitive products and generics in the same 
class. Our approach to the rebates we offer to private payers that provide prescription drug benefits to seniors 
covered by Medicare may be impacted by the 2020 regulatory amendments to the anti-kickback statute's 
discount safe harbor, which have currently been stayed until at least January 1, 2026. Pending legislation could 
repeal the amendments to the discount safe harbor. Accordingly, their impact on our business is uncertain at this 
time.

15Outside the U.S.

Globally, public and private payers are increasingly restricting access to pharmaceuticals based on assessments 
of comparative effectiveness and value, including through the establishment of formal health technology 
assessment processes. In addition, third-party organizations, including professional associations, academic 
institutions, and non-profit entities associated with payers, are conducting and publishing comparative 
effectiveness and cost/benefit analyses on medicines, the impact of which are uncertain at this time. 

In most international markets, we operate in an environment of government-mandated cost-containment 
programs, which may include price controls, international reference pricing (to other countries' prices), discounts 
and rebates, therapeutic reference pricing (to other, often generic, pharmaceutical choices), restrictions on 
physician prescription levels, and mandatory generic substitution. We may experience additional pricing 
pressures resulting from the financial strain of the COVID-19 pandemic on government-funded healthcare 
systems around the world.

We cannot predict the extent to which our business may be affected by these or other potential future legislative, 
regulatory, or payer developments. However, in general we expect to see continued focus on regulating pricing 
resulting in additional state, federal, and international legislative and regulatory developments that could have 
further negative effects on pricing and reimbursement for our products.

See Item 7, "Management's Discussion and Analysis - Results of Operations - Executive Overview - Other 
Matters - Trends Affecting Pharmaceutical Pricing, Reimbursement, and Access" for additional information 
regarding recent legislative, administrative, and other pricing initiatives and their impact on our results.

Research and Development

Our commitment to research and development dates back more than 140 years. We invest heavily in research 
and development because we believe it is critical to our long-term competitiveness. At the end of 2021, we 
employed approximately 8,100 people in pharmaceutical research and development activities, including a 
substantial number of physicians, scientists holding graduate or postgraduate degrees, and highly skilled 
technical personnel. 

Our internal pharmaceutical research focuses primarily on the areas of diabetes, immunology, neuroscience, and 
oncology. During the past two years, we have also focused on researching and developing potential treatments 
for COVID-19. In addition to discovering and developing new medicines, we seek to expand the value of existing 
products through new uses, formulations, and therapeutic approaches that provide additional value to patients.

To supplement our internal efforts, we collaborate with others, including academic institutions and research-
based pharmaceutical and biotechnology companies. We use the services of physicians, hospitals, medical 
schools, and other research organizations worldwide to conduct clinical trials to establish the safety and 
effectiveness of our medicines. We also invest in external research and technologies that we believe 
complement and strengthen our own efforts. These investments can take many forms, including, among others, 
licensing arrangements, co-development agreements, co-promotion arrangements, joint ventures, acquisitions, 
and equity investments.

Pharmaceutical development is time-consuming, expensive, and risky. Very few of the candidates discovered by 
researchers ultimately become approved medicines. The process from discovery to regulatory approval can take 
over a decade. Candidates can fail at any stage of the process, and even late-stage candidates sometimes fail to 
receive regulatory approval or achieve commercial success. The following describes in more detail the research 
and development process for pharmaceutical products:

Phases of New Drug Development

• Discovery Phase

In the discovery phase, scientists identify, design, and synthesize promising candidates by analyzing their 
effect on biological targets thought to play a role in disease. Targets are often unproven and only candidates 
that have the desired effect on the target and meet other design criteria move to the next phase of 
development, which includes the initiation of studies in animals to support regulatory and safety 
requirements for clinical research in humans. The discovery phase can take years and the probability of any 
one candidate becoming a medicine is extremely low.

16•

Early Development Phase

Early development includes initial testing for safety and efficacy and early analyses of manufacturing 
requirements. Safety testing is initially performed in laboratory tests and animals, as necessary. In general, 
the first human tests (often referred to as Phase I) are conducted in small groups of subjects to assess 
safety and evaluate the potential dosing range. Subsequently, larger populations of patients are studied 
(Phase II) to identify initial signs of efficacy while continuing to assess safety. In parallel, scientists work to 
identify safe, effective, and economical manufacturing processes. Long-term animal studies continue to test 
for potential safety issues. Of the candidates that enter the early development phase, approximately 10 
percent move to the late development phase. The early development phase varies but can take several 
years to complete.

•

Late Development Phase

Late phase development projects (typically Phase III) have met initial safety requirements and shown initial 
evidence of efficacy in earlier studies. As a result, these candidates generally have a higher likelihood of 
success and trials include larger patient populations to demonstrate safety and efficacy in the disease. 
These studies are designed to demonstrate the benefit and risk of the potential new medicine and may be 
compared to competitive therapies, placebo, or both. Phase III studies are generally conducted globally and 
are designed to support regulatory filings for marketing approval. The duration of Phase III testing varies by 
disease and may take two to four years.

•

Submission Phase

Once a potential new medicine is submitted to regulatory agencies, the time to final marketing approval can 
vary from several months to several years, depending on the disease state, the strength and complexity of 
available data, the degree of unmet need, and the time required for the regulatory agency(ies) to evaluate 
the submission, which can depend on prioritization by regulators and other factors. There is no guarantee 
that a potential medicine will receive marketing approval, or that decisions on marketing approvals or 
indications will be consistent across geographic areas.

We believe our investments in research, both internally and in collaboration with others, have resulted in a robust 
pipeline of potential new medicines and new treatment indications in all stages of development. We currently 
have approximately 45 new medicine candidates in clinical development or under regulatory review, and a larger 
number of projects in the discovery phase. See Item 7, "Management's Discussion and Analysis - Results of 
Operations - Executive Overview - Late-Stage Pipeline," for more information on certain of our product 
candidates.

Raw Materials and Product Supply

Most of the principal materials we use in our manufacturing operations are available from more than one source. 
However, we obtain certain raw or intermediate materials primarily from only one source. We generally seek to 
maintain sufficient inventory to supply the market until an alternative source of supply could be implemented, in 
the event one of these suppliers was unable to provide the materials or product. However, various developments 
from time to time lead to interruption or shortages in supply until we establish new sources or, in some cases, 
implement alternative processes.

The majority of our revenue comes from products produced in our own facilities. Our principal active ingredient 
manufacturing occurs at sites we own in the U.S., including Puerto Rico, and Ireland. Finishing operations, 
including formulation, filling, assembling, delivery device manufacturing, and packaging, take place at a number 
of sites throughout the world. We utilize third parties for certain active ingredient manufacturing and finishing 
operations.

We manage our supply chain (including our own facilities, contracted arrangements, and inventory) in a way that 
is intended to allow us to meet substantially all expected product demand while maintaining flexibility to 
reallocate manufacturing capacity to improve efficiency and respond to changes in supply and demand. To 
maintain a stable supply of our products, we use a variety of techniques including comprehensive quality 
systems, inventory management, and back-up sites.

17However, pharmaceutical production processes are complex, highly regulated, and vary widely from product to 
product. Shifting or adding manufacturing capacity can be a very lengthy process requiring significant capital 
expenditures, process modifications, and regulatory approvals. Accordingly, developments such as unplanned 
plant shutdowns, manufacturing or quality assurance difficulties at one of our facilities or contracted facilities, 
failure or refusal of a supplier or contract manufacturer to supply contracted quantities, increases in demand on a 
supplier, or difficulties in predicting or variability in demand for our products, from time to time lead to interruption 
or higher costs in the supply of certain products or product shortages. Further, global transportation and logistics 
challenges, as well as tight labor markets, have caused, and in the future may cause, delays in, and/or increase 
costs related to, distribution of our medicines, the construction or acquisition of manufacturing capacity, 
procurement activity, and supplier or contract manufacturer arrangements. For more information on the additional 
risks we face in connection with any difficulties, disruptions, and shortages in the manufacturing, distribution, and 
sale of our products, see "Risk Factors - Risks Related to Our Business - Manufacturing and supply chain 
difficulties, disruptions, or shortages could lead to product supply problems."

In addition, the strain on global transportation, logistics, and labor markets caused by the COVID-19 pandemic 
and an increase in overall demand in our industry for certain materials have had, and may continue to have, a 
number of impacts on our business, including increased costs to provide a consistent supply of our medicines 
where they are needed and disruptions in the supply of our medicines. For more information, see Item 1A, "Risk 
Factors - Risks Related to Our Business - The COVID-19 pandemic has adversely impacted and may continue to 
adversely impact our business and operations. We are currently unable to predict the full extent to which the 
COVID-19 pandemic or any future pandemic, epidemic, or similar public health threat will adversely impact our 
business and operations in the future." and Item 7, "Management's Discussion and Analysis - Results of 
Operations - Executive Overview - COVID-19 Pandemic."

Quality Assurance

Our success depends in great measure on customer confidence in the quality of our products and in the integrity 
of the data that support their safety and effectiveness. Product quality arises from a total commitment to quality in 
all parts of our operations, including research and development, purchasing, facilities planning, manufacturing, 
distribution, and dissemination of information about our medicines. 

Quality of production processes involves strict control of ingredients, equipment, facilities, manufacturing 
methods, packaging materials, and labeling. We perform tests at various stages of production processes and on 
the final product in an effort to ensure that the product meets all applicable regulatory requirements and our 
internal standards. These tests may involve chemical and physical chemical analyses, microbiological testing, 
testing in animals, or a combination thereof. Additional assurance of quality is provided by quality assurance 
groups that audit and monitor all aspects of quality related to pharmaceutical manufacturing procedures and 
systems in company operations and at third-party suppliers.

Executive Officers of the Company

The following table sets forth certain information regarding our current executive officers.

The term of office for each executive officer expires on the date of the annual meeting of the board of directors, 
to be held on May 2, 2022 in connection with the company's annual meeting of shareholders, or on the date his 
or her successor is chosen and qualified. No director or executive officer has a "family relationship" with any 
other director or executive officer of the company, as that term is defined for purposes of this disclosure 
requirement. There is no understanding between any executive officer or director and any other person pursuant 
to which the executive officer was selected.

18Name

Age

Titles and Business Experience

David A. Ricks

Anat Ashkenazi 

Stephen F. Fry

Anat Hakim

54

49

56

52

Edgardo Hernandez

47

Patrik Jonsson

55

Chair, President, and Chief Executive Officer (CEO) (since 2017). Previously, Mr. Ricks held various 
leadership roles with Lilly, including senior vice president and president, Lilly Bio-Medicines. Mr. Ricks has 
25 years of service with Lilly.

Senior Vice President and Chief Financial Officer (since 2021). Previously, Ms. Ashkenazi held various 
leadership roles with Lilly, including senior vice president, controller and chief financial officer, Lilly 
Research Laboratories, and vice president, finance and chief financial officer, Lilly Diabetes and Lilly 
global manufacturing and quality. Ms. Ashkenazi has 20 years of service with Lilly. 

Senior Vice President, Human Resources and Diversity (since 2011). Previously, Mr. Fry held various 
leadership roles with Lilly, including vice president, human resources. Mr. Fry has 34 years of service with 
Lilly.

Senior Vice President, General Counsel and Secretary (since 2020). Prior to joining Lilly, Ms. Hakim was 
senior vice president, general counsel and secretary of WellCare Health Plans, Inc. (WellCare) from 2016 
to 2018, and executive vice president, general counsel and secretary of WellCare from 2018 to 2020. Prior 
to joining WellCare, she served as divisional vice president and associate general counsel of intellectual 
property litigation at Abbott Laboratories from 2010 to 2013 and divisional vice president and associate 
general counsel of litigation from 2013 to 2016. Ms. Hakim has two years of service with Lilly.

Senior Vice President and President, Manufacturing Operations (since 2021). Previously, Mr. Hernandez 
held various leadership roles with Lilly, including senior vice president, global parenteral drug product, 
delivery devices and regional manufacturing, and vice president, Fegersheim operations. Mr. Hernandez 
has 17 years of service with Lilly.

Senior Vice President and President, Lilly Immunology, Lilly USA, and Chief Customer Officer (since 
2021). Previously, Mr. Jonsson held various leadership roles with Lilly, including senior vice president and 
president, Lilly USA, and chief customer officer, senior vice president and president, Lilly Bio-Medicines 
and president and general manager, Lilly Japan. Mr. Jonsson has 31 years of service with Lilly.

Michael B. Mason 

55

Senior Vice President and President, Lilly Diabetes (since 2020). Previously, Mr. Mason held various 
leadership roles with Lilly, including senior vice president, connected care and insulins and vice president 
of U.S. Diabetes. Mr. Mason has 32 years of service with Lilly.

Johna L. Norton

Leigh Ann Pusey

Diogo Rau

Daniel M. 
Skovronsky, M.D., 
Ph.D.

55

59

47

48

Senior Vice President, Global Quality (since 2017). Previously, Ms. Norton held various leadership roles 
with Lilly, including vice president, global quality assurance API manufacturing and product research and 
development. Ms. Norton has 31 years of service with Lilly.

Senior Vice President, Corporate Affairs and Communications (since 2017). Prior to joining Lilly, Ms. 
Pusey was president and chief executive officer of the American Insurance Association from 2009 to 2017. 
Ms. Pusey has four years of service with Lilly.

Senior Vice President and Chief Information and Digital Officer (since 2021). Prior to joining Lilly, Mr. Rau 
was senior director of information systems and technology for retail and online stores of Apple Inc. from 
2011 to 2021. Prior to his tenure at Apple, he served as a partner at McKinsey & Company.

Senior Vice President, Chief Scientific and Medical Officer, and President, Lilly Research Laboratories 
(since 2021). Previously, Dr. Skovronsky held various leadership roles with Lilly, including senior vice 
president, chief scientific officer, and president, Lilly Research Laboratories, and senior vice president, 
clinical and product development. Dr. Skovronsky has 11 years of service with Lilly.

Jacob Van Naarden

37

Alonzo Weems

51

Anne E. White

Ilya Yuffa

53

47

Senior Vice President, CEO Loxo Oncology at Lilly, and President, Lilly Oncology (since 2021). Previously, 
Mr. Van Naarden served as Chief Executive Officer-Loxo Oncology at Lilly, and Chief Operating Officer-
Loxo Oncology at Lilly. Mr. Van Naarden joined Lilly in 2019 when the company acquired Loxo Oncology, 
Inc., where he was the chief operating officer. In previous roles, Mr. Van Naarden worked in various 
biotechnology investing, operating, and advisory capacities, including positions with HealthCor 
Management, Aisling Capital, and Goldman Sachs. Mr. Van Naarden has three years of service with Lilly.

Senior Vice President, Enterprise Risk Management, and Chief Ethics and Compliance Officer (since 
2021). Previously, Mr. Weems held various leadership roles with Lilly, including vice president and deputy 
general counsel for corporate legal functions, general counsel for Lilly USA, and general counsel for 
biomedicines and diabetes. Mr. Weems has 24 years of service with Lilly.

Senior Vice President and President, Lilly Neuroscience (since 2021). Previously, Ms. White held various 
leadership roles with Lilly, including senior vice president and president, Lilly Oncology, vice president of 
Portfolio Management, Chorus, and Next Generation Research and Development. Ms. White has 26 years 
of service with Lilly.

Senior Vice President and President, Lilly International (since 2021). Previously, Mr. Yuffa held various 
leadership roles with Lilly, including senior vice president and president, Lilly Bio-Medicines, vice president 
of U.S. Diabetes, general manager of Italy Hub, and vice president, global ethics and compliance officer 
since 2014. Mr. Yuffa has 25 years of service with Lilly.

19Human Capital Management

Our core values—integrity, excellence, and respect for people—shape our approach to attracting, retaining, 
engaging, and developing a highly skilled and ethical workforce, which is critical to executing our strategy. We 
believe the strength of our workforce significantly contributes to our financial performance and enables us to 
make life better for people around the world. For instance, most of the products we sell today were discovered or 
developed by our own scientists, and our long-term success depends on our ability to continually discover or 
acquire, develop, and commercialize innovative new medicines. We believe that fostering a positive culture that 
values the contributions of our talented colleagues helps drive our success.

We are committed to creating a safe, supportive, ethical, and rewarding work environment through strategic 
focus on our human capital management process, fairness and nondiscrimination in our employment practices, 
robust training and development opportunities, and competitive pay and benefits. We believe our dedication to 
promoting diversity, equity, and inclusion (DEI) within our company reflects our values and is a key driver of 
business success and growth. 

We regularly conduct anonymous employee surveys to seek feedback from our workforce on a variety of topics. 
These results are reviewed and analyzed by our leaders in order to implement changes to our policies and 
benefits designed to improve our employees' well-being. As a result of our efforts, we believe that we have a 
highly performing, cohesive workforce and that our employee relations are good.

At the end of 2021, we employed approximately 35,000 people, including approximately 19,600 employees 
outside the U.S. Our employees include approximately 8,100 people engaged in research and development 
activities.

Strategy and Oversight

In order to build diverse and inclusive teams, our CEO and executive committee set expectations for inclusive 
leadership and hold leaders accountable for achieving results. Because dedication to human capital 
management is also a core component of our corporate governance, our board of directors regularly engages 
with management and facilitates a system of reporting designed to monitor human capital management initiatives 
and progress as part of the overarching framework that guides how we attract, retain, engage, and develop a 
workforce that aligns with our values and mission. 

Diversity, Equity, and Inclusion

We are committed to fairness and nondiscrimination in our employment practices, and we deeply value diverse 
backgrounds, skills, and global perspectives. To fulfill our purpose, we believe we must look at challenges from 
multiple viewpoints and understand the diverse experiences of the patients who depend on us. 

We believe that fostering DEI begins with understanding. For example, our Employee Journeys research has 
yielded important insights about the experiences of women, Black/African American, Latinx, Asian, and LGBTQ+ 
employees at Lilly. The results of this research are reviewed by our senior leadership, and we deploy actions and 
activities in response to these insights to improve our workplace and corporate culture.

In 2020, as part of our DEI and community initiatives, Lilly and the Lilly Foundation launched the Racial Justice 
Commitment and pledged $25 million and 25,000 volunteer hours over five years to help decrease the burden of 
racial injustice and its effects on communities of color. The Racial Justice Commitment aims to drive change 
across five areas: internal people development, health equity, social impact, diversity partners, and family 
sustaining jobs, through the use of financial and people resources. In 2021, we made progress in these efforts, 
including through the development of two apprenticeship programs at Lilly for individuals without college 
degrees.

Since 2017, we have committed to increasing the number of women, Black/African American, Latinx, and Asian 
populations in leadership roles, and we actively monitor our progress. From the end of 2017 through the end of 
2021, we increased the percentage of women in management globally from 41 percent to 48 percent. For 
minority group members (MGM) in the U.S. over the same period, we increased management representation 
from 16 percent to 24 percent. Across all levels of our workforce, from the end of 2017 through the end of 2021, 
we have seen increased representation for MGMs in the U.S. and women globally. Our focus on DEI is also 
evident at our executive committee and board of directors. Five of 15 current members (approximately 33 
percent) of our executive committee (which includes our CEO) are women and two are MGM. In addition, as of 
the filing of this report, the company's 13-member board of directors includes four women and six members who 
are MGMs.

20Our efforts in DEI and workplace benefits have garnered numerous recognitions, including, in 2021, Top 50 
Companies for Diversity by DiversityInc., America's Best Employers for Diversity by Forbes, America's Most 
JUST Companies and Forbes JUST 100 by Forbes and JUST Capital, Perfect Score on the Human Rights 
Campaign Foundation Corporate Equality Index, World's Most Ethical Companies by Ethisphere, Leading 
Disability Employer by the National Organization on Disability, Top Employers by Science Magazine, and 100 
Best Companies, Top Companies for Executive Women, Best Companies for Dads, and Best Companies for 
Multicultural Women by Working Mother Magazine.

Employee Development

We believe talent begins with the hiring process. We therefore require hiring managers to consider a diverse pool 
of candidates and we strive to provide a diverse panel of interviewers for open positions. We believe that hiring in 
this way helps ensure that people from all backgrounds have equal opportunity to advance their careers.

We offer training to enable our employees to perform their duties in our highly regulated industry. We also strive 
to cultivate a culture that promotes ongoing learning by encouraging employees to seek further education and 
growth experiences, helping them build rewarding careers. We have introduced online programming to facilitate 
access to our learning and development offerings. Many training courses are designed to improve accessibility 
for people with disabilities and other unique needs. Across Lilly, we are working to design learning experiences to 
be more inclusive and effective. In addition, we have implemented tools and resources and improved our talent 
programs and processes to provide broad access to information and transparency regarding career development 
and advancement at Lilly.

In early 2022, we launched Discover, a 12-month new employee onboarding program with multiple touchpoints 
designed to foster integration into the Lilly culture, to accelerate learning in their new roles and to create 
connections to further a sense of belonging at Lilly. Discover was shaped in part by external benchmarking, 
feedback from employees, and learnings from onboarding remotely during the COVID-19 pandemic.

Employee resource groups (ERGs) are another important component of developing talent at Lilly. We currently 
have 11 ERGs representing groups including women, MGMs, LGBTQ+ individuals, veterans, and people with 
disabilities. ERGs offer our diverse workforce opportunities to build relationships, engage with senior leaders, 
advance our caring community, and offer unique insights and perspectives to improve our business. 

We have continued our efforts to create an inclusive workplace with the goal of ensuring that all employees feel 
safe to speak up and share their ideas at work. Our Make it Safe to Thrive education and awareness program is 
designed to help employees and leaders understand how individual psychological safety can be created and 
enhanced and includes live and online training and a monthly video series.

Lilly is committed to fostering a culture of diversity and respect in the workplace—an environment free of 
discrimination, harassment, or retaliation of any kind. In 2022, as part of our annual review of The Red Book 
(Lilly's comprehensive code of business conduct applicable to our board and all employees worldwide) and 
related policies and procedures, we revised the Global Conduct in the Workplace procedure to continue to help 
ensure that we maintain a respectful, safe, inclusive, and professional workplace.

Employee Health and Safety

We strive to foster a healthy, vibrant work environment, which includes keeping our employees safe. We seek to 
create a companywide culture where best-in-class safety practices are consistently followed. To do this, we 
assess and continuously attempt to improve our companywide safety performance to promote the well-being of 
employees and to help safeguard communities where we operate. As the COVID-19 pandemic has evolved, we 
have taken various measures to protect and support the health and safety of our employees globally, including 
instituting travel restrictions and work-from-home arrangements, offering onsite testing and vaccination options 
where possible, and instituting safety precautions such as masking, social distancing, and enhanced cleaning 
practices. To support employee well-being in the U.S., we also enhanced local benefits related to health care, 
childcare, and time off. We believe this holistic approach and dedication to safety helps us be our best as we 
deliver on our company purpose to improve lives around the world.

21Information Available on Our Website

Our company website is www.lilly.com. None of the information accessible on or through our website is 
incorporated into this Annual Report on Form 10-K. We make available through the website, free of charge, our 
company filings with the SEC as soon as reasonably practicable after we electronically file them with, or furnish 
them to, the SEC. These include our Annual Reports on Form 10-K, Quarterly Reports on Form 10-Q, Current 
Reports on Form 8-K, proxy statements, registration statements, and any amendments to those documents. The 
link to our SEC filings is investor.lilly.com/financial-information/sec-filings.

Paper copies of the company's Annual Report on Form 10-K and Quarterly Reports on Form 10-Q that are filed 
with the SEC are available without charge upon written request to:

ELI LILLY AND COMPANY
c/o General Counsel and Secretary
Lilly Corporate Center
Indianapolis, Indiana 46285

In addition, the Governance portion of our website includes our corporate governance guidelines, board of 
directors and committee information (including committee charters), and our articles of incorporation and bylaws. 
The link to our corporate governance information is lilly.com/leadership/governance.

22Item 1A. Risk Factors

In addition to the other information contained in this Annual Report on Form 10-K, the following risk factors 
should be considered carefully in evaluating our company. It is possible that our business, financial condition, 
liquidity, cash flows, or results of operations could be materially adversely affected by any of these risks. 
Certain of these risks could also adversely affect the company's reputation. Additional risks and uncertainties 
not presently known to us or that we currently believe to be immaterial could also adversely affect our 
business and reputation.

Risks Related to Our Business

•

The COVID-19 pandemic has adversely impacted and may continue to adversely impact our 
business and operations. We are currently unable to predict the full extent to which the COVID-19 
pandemic or any future pandemic, epidemic, or similar public health threat will adversely impact 
our business and operations in the future.

The COVID-19 pandemic continues to burden healthcare systems worldwide. The focus of resources on 
COVID-19, widespread protective measures implemented to control the spread of COVID-19, and the 
resulting strain on global transportation, manufacturing, and labor markets have negatively impacted 
development, manufacturing, supply, distribution, and sales of our medicines.

Although in-person interactions with healthcare professionals have largely resumed, we continue to see a 
lack of "normal" access and fewer in-person interactions by patients and our employees with healthcare 
professionals. As the COVID-19 pandemic continues to develop, we may decide to halt such in-person 
interactions in the future and, in those cases, expect to resume such interactions as it is safe to do so and 
in compliance with applicable guidance and requirements.

The strain on global transportation, logistics, and labor markets caused by the COVID-19 pandemic and 
an increase in overall demand in our industry for certain materials resulting in changed buying patterns 
and constrained supply have had, and may continue to have, a number of impacts on our business, 
including increased costs to provide a consistent supply of our medicines where they are needed and 
disruptions and shortages in the supply of our medicines. These factors may negatively affect our results 
of operations.

We also face risks and uncertainties related to our COVID-19 therapies, including heightened regulatory 
scrutiny of our manufacturing practices, quality assurance, and similar regulations, restrictions on 
administration that limit widespread and timely access to our therapies, and risks related to handling, 
return, and/or refund of product after delivery by us. In addition, expedited authorization processes have 
allowed restricted distribution of products with less than typical safety and efficacy data, and additional 
data that become available may call into question the safety or effectiveness of our COVID-19 therapies. 
The availability of superior or competitive therapies, including therapies that can be administered more 
easily, or preventative measures such as vaccines, coupled with the unpredictable nature of pandemics, 
have and could further negatively impact or eliminate demand for our COVID-19 therapies. We also 
expect that additional revenue from the sale of bamlanivimab and etesevimab after the first quarter of 
2022 will be limited. Mutations or the spread of other variants of the coronavirus have in some cases 
impacted the effectiveness of our COVID-19 therapies, and may further render our therapies more or less 
effective or ineffective. Furthermore, the FDA has revised, and may in the future revise, any EUA for our 
COVID-19 therapies in response to the prevalence of variants against which our therapies have varying 
degrees of efficacy. These and other risks related to COVID-19 could affect other aspects of our business 
or intensify other risks inherent in our business, including potentially resulting in delays or denials in the 
approval or launch of other products or indications.

It remains difficult to reasonably assess or predict the full extent of the ongoing impact of the COVID-19 
pandemic on us. The degree to which the COVID-19 pandemic continues to affect us will depend on 
developments that are highly uncertain and beyond our knowledge or control, including, but not limited to, 
the duration and severity of the pandemic, the actions taken to reduce its transmission, including 
widespread availability and efficacy of vaccines, the introduction and spread of new variants of the 
coronavirus that may be resistant to currently approved vaccines, the continuation of existing or 
implementation of new government restrictions and the speed with which, and extent to which, more 
stable economic and operating conditions resume. Should the COVID-19 pandemic, or any future 
pandemic, epidemic, or similar public health threat, and any associated supply chain disruption, labor 

23market impact, recession, or depression continue for a prolonged period, these risks could be 
exacerbated, causing further impact on our business and operations in the future.

•

Pharmaceutical research and development is very costly and highly uncertain; we may not 
succeed in developing, licensing, or acquiring commercially successful products sufficient in 
number or value to replace revenues of products that have lost or will soon lose intellectual 
property protection or are displaced by competing products or therapies. 

There are many difficulties and uncertainties inherent in pharmaceutical research and development, the 
introduction of new products, and business development activities to enhance our product pipeline. 

There is a high rate of failure inherent in new drug discovery and development. To bring a drug from the 
discovery phase to market can take over a decade and often costs in excess of $2 billion. Failure can 
occur at any point in the process, including in later stages after substantial investment. As a result, most 
funds invested in research programs will not generate financial returns. New product candidates that 
appear promising in development may fail to reach the market or may have only limited commercial 
success because of efficacy or safety concerns, inability to obtain or maintain necessary regulatory 
approvals or payer reimbursement or coverage, limited scope of approved uses, label changes, changes 
in the relevant treatment standards or the availability of new or better competitive products, difficulty or 
excessive costs to manufacture, or infringement of the patents or intellectual property rights of others. 
Regulatory agencies establish high hurdles for the efficacy and safety of new products and indications. 
Delays and uncertainties in drug approval processes can result in delays in product launches and lost 
market opportunity. In addition, it can be very difficult to predict revenue growth rates of new products and 
indications.

We cannot state with certainty when or whether our products now under development will be approved or 
launched; whether, if initially granted, such approval will be maintained; whether we will be able to 
develop, license, or otherwise acquire additional product candidates or products; or whether our products, 
once launched, will be commercially successful. 

We must maintain a continuous flow of successful new products and successful new indications or brand 
extensions for existing products, both through our internal efforts and our business development activities, 
sufficient both to cover our substantial research and development costs and to replace revenues that are 
lost as profitable products lose intellectual property exclusivity or are displaced by competing products or 
therapies. Failure to do so in the short-term or long-term would have a material adverse effect on our 
business, results of operations, cash flows, and financial position.

We engage in various forms of business development activities to enhance our product pipeline, including 
licensing arrangements, co-development agreements, co-promotion arrangements, joint ventures, 
acquisitions, and equity investments. There are substantial risks associated with identifying successful 
business development targets and consummating related transactions. Increased focus on business 
combinations in our industry, including by the Federal Trade Commission, and heightened competition for 
attractive targets has and could continue to delay, jeopardize or increase the costs of our business 
development activities. In addition, failures or difficulties in integrating or retaining new personnel or the 
operations of the businesses, products, or assets we acquire (including related technology, commercial 
operations, compliance programs, manufacturing, distribution, and general business operations and 
procedures) may affect our ability to realize the expected benefits of business development transactions 
and may result in our incurrence of substantial asset impairment or restructuring charges. We also may 
fail to generate the expected revenue and pipeline enhancement from business development activities 
due to developments outside our control, including unsuccessful clinical trials, issues related to the 
quality, integrity, or broad applicability of data, regulatory impediments, and commercialization challenges. 
Accordingly, business development transactions may not be completed in a timely manner (if at all), may 
not result in successful commercialization of any product, and may give rise to legal proceedings or 
regulatory scrutiny.

See Item 1, "Business - Research and Development - Phases of New Drug Development" and Item 7, 
"Management's Discussion and Analysis - Results of Operations - Executive Overview - Late-Stage 
Pipeline," for more details about our current product pipeline. 

24• We depend on products with intellectual property protection for most of our revenues, cash flows, 
and earnings; we have lost or soon will lose effective intellectual property protection for a number 
of our products, which has resulted and is likely to continue to result in rapid and severe declines 
in revenues.

A number of our products, including Alimta and Forteo, have recently lost, or soon will lose, significant 
patent protection and/or data protection in the U.S. as well as in key jurisdictions outside the U.S. We 
have faced, and remain exposed to, generic competition following the loss of such intellectual property 
protection. In particular, we expect that the entry of generic competition for Alimta in the U.S. following the 
loss of patent exclusivity will cause a rapid and severe decline in revenue for the product and have a 
material adverse effect on our consolidated results of operations and cash flows.

Certain other significant products no longer have effective exclusivity through patent protection or data 
protection. For non-biologic products, loss of exclusivity (whether by expiration of legal rights or by 
termination thereof as a consequence of litigation) typically results in the entry of one or more generic 
competitors, leading to a rapid and severe decline in revenues, especially in the U.S. For biologics (such 
as Humalog, Humulin, Erbitux, Cyramza, Trulicity, Taltz, and Emgality), loss of exclusivity may or may not 
result in the near-term entry of competitor versions (i.e., biosimilars) due to many factors, including 
development timelines, manufacturing challenges, and/or uncertainties regarding the regulatory pathways 
for approval of the competitor versions. Generic pharmaceutical companies could also introduce a generic 
product before resolution of any related patent litigation.

There is no assurance that the patents we are seeking will be granted or that the patents we hold will be 
found valid and enforceable if challenged. Moreover, patents relating to particular products, uses, 
formulations, or processes do not preclude other manufacturers from employing alternative processes or 
marketing alternative products or formulations that compete with our patented products. In addition, 
competitors or other third parties may assert claims that our activities infringe patents or other intellectual 
property rights held by them, or allege a third-party right of ownership in our existing intellectual property. 
See Item 7, "Management's Discussion and Analysis - Results of Operations - Executive Overview - 
Other Matters - Patent Matters," and Item 1, "Business - Patents, Trademarks, and Other Intellectual 
Property Rights," for more details. 

• Our long-term success depends on intellectual property protection; if our intellectual property 
rights are invalidated, circumvented, or weakened, our business will be adversely affected. 

Our long-term success depends on our ability to continually discover or acquire, develop, and 
commercialize innovative new medicines. Without strong intellectual property protection, we would be 
unable to generate the returns necessary to support our significant investments in research and 
development, as well as the other expenditures required to bring new drugs to the market. Intellectual 
property protection varies throughout the world and is subject to change over time, depending on local 
laws and regulations. Changes to such laws and regulations could reduce protections for our innovative 
products. In the U.S., in addition to the process for challenging patents set forth in the BPCIA, which 
applies to biologic products, the Hatch-Waxman Act provides generic companies substantial incentives to 
seek to invalidate our patents covering pharmaceutical products. As a result, we expect that our U.S. 
patents on major pharmaceutical products, including biologics, will continue to be routinely challenged in 
litigation and may not be upheld. In addition, a separate IPR process currently allows competitors to seek 
invalidation of patents at the USPTO without the protections of the BPCIA or Hatch-Waxman Act. The use 
of IPR proceedings after the institution of litigation pursuant to the BPCIA or Hatch-Waxman Act is 
currently a topic of debate among legislators and the future ability of our competitors to use IPR 
proceedings as an alternative to Hatch-Waxman Act or BPCIA litigation procedures to challenge our 
patents remains uncertain. However, if our patents are challenged through this expedited review process, 
even if we prevail in demonstrating the validity of our patent, our win provides limited precedential value at 
the PTAB and no precedential value in federal district court, meaning the same patent can be challenged 
by other competitors. We face many generic manufacturer challenges to our patents outside the U.S. as 
well. The entry of generic competitors typically results in rapid and severe declines in revenues. In 
addition, competitors or other third parties may claim that our activities infringe patents or other 
intellectual property rights held by them. If successful, such claims could result in our being unable to 
market a product in a particular territory or being required to pay significant damages for past infringement 
or royalties on future sales. In addition, intellectual property protection in certain jurisdictions outside the 
U.S. is weak and we face additional risks to our intellectual property rights, including competition with 
generic or counterfeit versions of our products relatively shortly after launch. See Item 1, "Business - 

25Patents, Trademarks, and Other Intellectual Property Rights," and Item 8, "Financial Statements and 
Supplementary Data - Note 16: Contingencies," for more details.

• We and our products face intense competition from multinational pharmaceutical companies, 
biotechnology companies, and lower-cost generic and biosimilar manufacturers, and such 
competition could have a material adverse effect on our business.

We compete with a large number of multinational pharmaceutical companies, biotechnology companies, 
and generic pharmaceutical companies and, in many cases, our products compete against the leading 
products of one or more of our competitors. To compete successfully, we must continue to deliver to the 
market innovative, cost-effective products that meet important medical needs. Our product revenues can 
be adversely affected by the introduction by competitors of branded products that are perceived as 
superior by the marketplace, by generic or biosimilar versions of our branded products, and by generic or 
biosimilar versions of other products in the same therapeutic class as our branded products. Our 
revenues can also be adversely affected by treatment innovations that eliminate or minimize the need for 
treatment with our drugs.

Regulation of generic and biosimilar products varies around the world and such regulation is complex and 
subject to ongoing interpretation and implementation by regulatory agencies and courts. Particularly for 
biosimilars, recent health authority guidelines and legislative proposals could make it less burdensome for 
competitor products to enter the market and further incentivize uptake of biosimilars. In the U.S., the FDA 
has begun issuing "interchangeability" designations for biosimilar products, which could – subject to state 
law requirements – enable pharmacies to substitute biosimilars for innovator biological products. Given 
the importance of biologic products to our clinical-stage pipeline, such regulation could have a material 
adverse effect on our business. See Item 1, "Business - Competition" and "Business - Research and 
Development," for more details.

In addition, we rely on our ability to attract, engage, and retain highly qualified and skilled personnel in 
order to compete effectively. To continue to commercialize our products, and advance the research, 
development, and commercialization of additional modalities and product candidates, we may need to 
expand our workforce, including in the areas of manufacturing, clinical trials management, regulatory 
affairs, and sales and marketing, both in and outside the U.S. We continue to face intense competition for 
qualified individuals from numerous multinational pharmaceutical companies, biotechnology companies, 
academic and other research institutions, as well as employers near our manufacturing and other 
facilities, which has and may continue to increase our labor costs. Our ability to attract and retain talent in 
our increasingly competitive environment may be further complicated by evolving employment trends 
arising from the COVID-19 pandemic, including vaccination mandates, increased preferences for remote, 
alternative, or flexible work arrangements, and other factors. Our failure to compete effectively for talent 
could negatively affect sales of our current and any future approved products, and could result in material 
financial, legal, commercial, or reputational harm to our business.

•

Failure, inadequacy, breach of, or unauthorized access to, our IT systems or those of our third-
party service providers, unauthorized access to our confidential information, or violations of data 
protection laws, could each result in material harm to our business and reputation.

A great deal of confidential information owned by us or our business partners or other third parties is 
stored in our information systems, networks, and facilities or those of third parties. This includes valuable 
trade secrets and intellectual property, clinical trial information, corporate strategic plans, marketing plans, 
customer information, and personally identifiable information, such as employee and patient information 
(collectively, confidential information). We also rely, to a large extent, on the efficient and uninterrupted 
operation of complex information technology systems, infrastructure, and hardware (together, IT 
systems), some of which are within our control and some of which are within the control of third parties, to 
accumulate, process, store, and transmit large amounts of confidential information and other data. We are 
subject to a variety of continuously evolving and developing laws and regulations around the world related 
to privacy, data protection, and data security. Maintaining the security, confidentiality, integrity and 
availability of our IT systems and confidential information is vital to our business. Our failure, or the failure 
of our third party service providers, to protect and maintain the security, confidentiality, integrity, and 
availability of our (or their) IT systems and our confidential information and other data could significantly 
harm our reputation as well as result in significant costs, including those related to fines, litigation, and 
obligations to comply with applicable data breach laws.

26IT systems are vulnerable to system inadequacies, operating failures, service interruptions or failures, 
security breaches, malicious intrusions, or cyber-attacks from a variety of sources. Cyber-attacks are 
growing in their frequency, sophistication, and intensity, and are becoming increasingly difficult to detect, 
mitigate, or prevent. Cyber-attacks come in many forms, including the deployment of harmful malware, 
exploitation of vulnerabilities (including those of third-party software or systems), denial-of-service attacks, 
the use of social engineering, and other means to compromise the confidentiality, integrity and availability 
of our IT systems, confidential information, and other data. Breaches resulting in the compromise, 
disruption, degradation, manipulation, loss, theft, destruction, or unauthorized disclosure or use of 
confidential information, or the unauthorized access to, disruption of, or interference with our IT systems, 
products and services, can occur in a variety of ways, including but not limited to, negligent or wrongful 
conduct by employees or others with permitted access to our systems and information, or wrongful 
conduct by hackers, competitors, certain governments or nation-states, or other current or former 
company personnel. Our third-party partners, including third-party providers of data hosting or cloud 
services, as well as suppliers, distributors, alliances, and other third parties with whom we may share 
data, face similar risks, which could affect us directly or indirectly. The healthcare industry has been and 
continues to be a target for cyber-attacks, and the number of threats has only increased over time. 
Numerous federal agencies that monitor and regulate internet and cyber-crime have issued guidance, 
alerts and directives warning of software vulnerabilities that require immediate patching, malicious actors 
targeting healthcare related systems and nation-state sponsored hacking designed to steal valuable 
information.

The failure, inadequacy, or breach of our IT systems or business processes, the compromise, disruption, 
degradation, manipulation, loss, theft, destruction, or unauthorized access to, disclosure or use of, 
confidential information, or the unauthorized access to, disruption of, or interference with our products and 
services that rely on IT systems or business processes, could impair our ability to secure and maintain 
intellectual property rights; result in a product manufacturing interruption or failure, or in the interruption or 
failure of products or services that rely on IT systems or business processes; damage our operations, 
customer relationships, or reputation; result in unfavorable clinical trial results by virtue of incorrect or 
unreliable data; and/or cause us to lose trade secrets or other competitive advantages. Unauthorized 
disclosure of personally identifiable information could expose us to significant sanctions for violations of 
data privacy laws and regulations around the world and could damage public trust in our company. In 
addition, IT system security in jurisdictions outside the U.S. is weaker and may result in additional costs, 
uncertainties, and risks. 

To date, system inadequacies, operating failures, unauthorized access, service interruptions or failures, 
security breaches, malicious intrusions, cyber-attacks, and the compromise, disruption, degradation, 
manipulation, loss, theft, destruction, or unauthorized disclosure or use of confidential information have 
not had a material impact on our consolidated results of operations. We maintain cyber liability insurance; 
however, this insurance may not be sufficient to cover the financial, legal, business, or reputational losses 
that may result from an interruption or breach of our IT systems. We continue to implement measures in 
an effort to protect, detect, respond to, and minimize or prevent these risks and to enhance the resiliency 
of our IT systems; however, these measures may not be successful and we may fail to detect or 
remediate security breaches, malicious intrusions, cyber-attacks, or other compromises of our systems. 
Any of these events could result in material financial, legal, commercial, or reputational harm to our 
business.

•

Significant economic downturns or international trade and other global disruptions or disputes 
could adversely affect our business and operating results. 

While pharmaceuticals have generally been less sensitive to overall economic cycles, prolonged 
economic slowdowns could lead to decreased utilization of our products, affecting our sales volume. 
Declining tax revenues attributable to economic downturns increase the pressure on governments to 
reduce health care spending, leading to increasing government efforts to control drug prices and 
utilization. Additionally, some customers, including governments or other entities reliant upon government 
funding, may be unable to pay for our products in a timely manner. Also, if our customers, suppliers, or 
collaboration partners experience financial difficulties, we could experience slower customer collections, 
greater bad debt expense, and performance defaults by suppliers or collaboration partners. Similarly, in 
the event of a significant economic downturn, we could have difficulty accessing credit markets.

27Significant portions of our business are conducted in Europe, including the United Kingdom, in Asia, 
including China, and in other international geographies. Trade and other global disputes and interruptions 
in international relationships, including related to tariffs, trade protection measures, import or export 
licensing requirements, the imposition of trade sanctions or similar restrictions by the U.S. or other 
governments, unrest or war, as well as pandemic diseases, such as COVID-19, affect our ability to do 
business. For example, tensions between the U.S. and China have led to a series of tariffs and sanctions 
being imposed by the U.S. on imports from China mainland, as well as other business restrictions. These 
and similar events could adversely affect us, or our business partners or customers. 

•

Pharmaceutical products can develop unexpected safety or efficacy concerns, which could have a 
material adverse effect on our revenues, income, and reputation. 

Pharmaceutical products receive regulatory approval based on data obtained in controlled clinical trials of 
limited duration. After approval, the products are used for longer periods of time by much larger numbers 
of patients. Accordingly, we and others (including regulatory agencies and private payers) collect 
extensive information on the efficacy and safety of our marketed products by continuously monitoring the 
use of our products in the marketplace. In addition, we or others may conduct post-marketing clinical 
studies on efficacy and safety of our marketed products. New safety or efficacy data from both market 
surveillance and post-marketing clinical studies may result in product label changes or other measures 
that could reduce the product's market acceptance and result in declining sales. Serious safety or efficacy 
issues that arise after product approval have, and could in the future, result in voluntary or mandatory 
product recalls or withdrawals from the market. Safety issues have, and could in the future, result in costly 
product liability claims. See also " - The COVID-19 pandemic has adversely impacted and may continue 
to adversely impact our business and operations. We are currently unable to predict the full extent to 
which the COVID-19 pandemic or any future pandemic, epidemic, or similar public health threat will 
adversely impact our business and operations in the future."

• We face litigation and investigations related to our products, how we price our products, and how 
we commercialize our products; we could face large numbers of claims in the future, which could 
adversely affect our business, and we are self-insured for such matters. 

We are subject to a substantial number of product liability claims involving various current and historical 
products, litigation and investigations related to how we commercialize and/or how we price our products, 
including relating to our 340B drug pricing program, as well as contractual disputes. See Item 8, 
"Financial Statements and Supplementary Data - Note 16, Contingencies" for more information on our 
current product liability litigation, as well as pricing litigation, investigations, and inquiries. Because of the 
nature of pharmaceutical products, we are and could in the future become subject to large numbers of 
product liability claims for our previous, current, or future products, or to further litigation or investigations, 
including related to pricing or other commercial practices. Such matters could affect our results of 
operations or require us to recognize substantial charges to resolve and, if involving marketed products, 
could adversely affect sales of the product. Due to a very restrictive market for liability insurance, we are 
self-insured for litigation liability losses for all our currently marketed products, as well as for litigation or 
investigations related to our pricing practices or other similar matters. 

• Manufacturing and supply chain difficulties, disruptions, or shortages could lead to product 

supply problems. 

Pharmaceutical manufacturing is complex and highly regulated. Manufacturing or quality assurance 
difficulties at our facilities or contracted facilities, the failure or refusal of a supplier or contract 
manufacturer to supply contracted quantities, or increases in demand on a supplier could result in delays 
and disruptions in the manufacturing, distribution, and sale of our products and/or product shortages, 
leading to lost revenue. Further, global transportation and logistics challenges, as well as tight labor 
markets, have caused, and in the future may cause, delays in, and/or increase costs related to, 
distribution of our medicines, the construction or other acquisition of manufacturing capacity, procurement 
activity, and supplier or contract manufacturer arrangements. Such difficulties, disruptions, or challenges 
could result from quality, oversight, or regulatory compliance problems; natural disasters or pandemic 
disease; equipment, mechanical, data, or information technology system vulnerabilities, such as system 
inadequacies, inadequate controls or procedures, operating failures, service interruptions or failures, 
security breaches, malicious intrusions, or cyber-attacks from a variety of sources; labor shortages; 
contractual disputes with our suppliers and contract manufacturers; or inability to obtain single-source or 
other raw or intermediate materials. In addition, difficulties in predicting or variability in demand for our 

28products and indications and the very long lead times necessary for the expansion and regulatory 
qualification of pharmaceutical manufacturing capacity from time to time result in difficulty meeting 
demand for, or disruptions, shortages, and higher costs in the supply of, our products. See Item 1, 
"Business - Raw Materials and Product Supply," for more details.

•

Reliance on third-party relationships and outsourcing arrangements could adversely affect our 
business. 

We rely on third parties, including suppliers, distributors, alliances, and collaborations with other 
pharmaceutical and biotechnology companies, and third-party service providers, for selected aspects of 
product and clinical development, manufacturing, commercialization, hosting of, and support for, 
information technology systems, product distribution, and certain financial transactional processes. As 
examples, we outsource the day-to-day management and oversight of some of our clinical trials to 
contract research organizations and the distribution of our products through logistics 
providers. Outsourcing these functions involves the risk that the third parties may not perform to our 
standards or legal requirements; may not produce reliable results; may not perform in a timely manner; 
may not maintain the confidentiality, integrity, and availability of confidential and proprietary information 
relating to us, our clinical trial subjects, or patients; may experience disruption or fail to perform due to 
information technology system vulnerabilities, breaches, cyber-attacks, or inadequate controls or 
procedures; may be unable to satisfy their commitments to us in which case we may not be able to 
achieve acceptable alternative sourcing; or may fail to perform at all. The foregoing risks may be 
heightened in jurisdictions outside the U.S., where we may face additional costs, uncertainties, and risks. 
Failure of these third parties to meet their contractual, regulatory, confidentiality, privacy, security, or other 
obligations to us, our clinical trial subjects, and our patients could have a material adverse effect on our 
business. 

Risks Related to Government Regulation

• Our business is subject to increasing government price controls and other public and private 
restrictions on pricing, reimbursement, and access for our drugs, which could have a material 
adverse effect on our reputation or business. 

Public and private payers continue to take aggressive steps to control their expenditures for 
pharmaceuticals by placing restrictions on pricing and reimbursement for, and patient access to, our 
medicines. These pressures could continue to negatively affect our future revenues and net income. 
Governments and private payers worldwide have intensified their scrutiny of, and actions intended to 
address, pricing, reimbursement, and access to pharmaceutical products. Additional policies, regulations, 
legislation, or enforcement, including as a result of the regulatory priorities of the current U.S. presidential 
administration and other regulatory authorities worldwide, could adversely impact our business and 
revenue. For example, pending legislation in the U.S. could result in government negotiation of the price 
of some of our medicines, including insulin. Furthermore, restrictive or unfavorable pricing, coverage, or 
reimbursement determinations for our medicines or product candidates by governments, regulatory 
agencies, or private payers, such as the recently proposed Alzheimer’s Monoclonal Antibody NCD, may 
adversely impact our business and financial results. However, we cannot predict the likelihood, nature, or 
extent of current and future health care reform efforts. We also may continue to experience potential 
additional pricing pressures resulting from the financial strain of the COVID-19 pandemic on government-
funded healthcare systems around the world.

For more details, see Item 1, "Business - Regulations and Private Payer Actions Affecting Pharmaceutical 
Pricing, Reimbursement, and Access," Item 7, "Management's Discussion and Analysis - Results of 
Operations - Executive Overview - Other Matters - Trends Affecting Pharmaceutical Pricing, 
Reimbursement, and Access," and Item 8, "Financial Statements and Supplementary Data - Note 16: 
Contingencies."

•

Changes in foreign currency rates, interest rate risks, or inflation could materially affect our 
results of operations.

As a global company, we face foreign currency risk exposure from fluctuating currency exchange rates, 
interest rate risk from our exposure to floating and variable interest rates, and inflation risk from existing 
and expected rates of inflation in the U.S. and other jurisdictions. While we seek to manage a portion of 
these exposures through hedging and other risk management techniques, significant fluctuations in 
currency rates, interest rates, and inflation can have a material impact, either positive or negative, on our 

29results of operations. Further, in the event of an extreme devaluation of local currency, the price of our 
products could become unsustainable in the relevant market. In addition, the discontinuation, 
modification, or other reform of the London Interbank Offered Rate (LIBOR), or the replacement of LIBOR 
with a different reference rate, could increase our interest expense, decrease our cash flows, and/or 
require us to amend certain of our existing agreements. See Item 7, "Management's Discussion and 
Analysis - Financial Condition and Liquidity" and Item 8, "Financial Statements and Supplementary Data - 
Note 1: Summary of Significant Accounting Policies and Implementation of New Financial Accounting 
Standard" for more details.

•

Changes in tax laws or exposure to additional tax liabilities could increase our income taxes and 
decrease our net income. 

We are subject to income taxes in the U.S. and numerous foreign jurisdictions, and in the course of our 
business, we make judgments about the expected tax treatment of various transactions and events. 
Changes in tax laws, regulations, administrative practices, principles, and interpretations, as well as 
events that differ from our expectations, have affected and may adversely affect our effective tax rates, 
cash flows, and/or and results of operations. For example, in December 2017, the U.S. enacted tax 
reform legislation significantly revising U.S. tax laws, and a number of other countries are also actively 
considering or enacting tax changes. Significant uncertainty currently exists regarding proposed tax 
policies of the current U.S. presidential administration and Congress, including modifications to certain 
aspects of the 2017 tax law. In addition, tax authorities in the U.S. and other jurisdictions in which we do 
business routinely examine our tax returns and are intensifying their scrutiny and examinations of profit 
allocations among jurisdictions, which could unfavorably impact our results of operations. Further, actions 
taken with respect to tax-related matters by associations such as the Organisation for Economic 
Cooperation and Development and the European Commission could influence tax laws in countries in 
which we operate. Modifications to key elements of the current U.S. or international tax framework could 
have a significant impact on our effective tax rate, results of operations, and cash flows. See Item 7, 
"Management's Discussion and Analysis - Results of Operations - Executive Overview - Other Matters - 
Tax Matters" and Item 8, "Financial Statements and Supplementary Data - Note 14: Income Taxes," for 
more details.

•

Regulatory compliance problems could be damaging to the company. 

The marketing, promotional, and pricing practices of pharmaceutical manufacturers, as well as the 
manner in which manufacturers interact with purchasers, prescribers, and patients, are subject to 
extensive regulation. Many companies, including us, have been subject to claims related to these 
practices asserted by federal, state, and foreign governmental authorities, private payers, and consumers. 
These claims have resulted in substantial expense and other significant consequences to us. We are and 
could in the future become subject to such investigations, the outcomes of which could include criminal 
charges and fines, penalties, or other monetary or non-monetary remedies, including exclusion from U.S. 
federal and other health care programs. Such investigations have intensified and may continue to 
intensify as a result of the regulatory priorities of the current U.S. presidential administration and other 
regulatory authorities worldwide. In addition, regulatory issues concerning compliance with cGMP, quality 
assurance, and similar regulations (and comparable foreign regulations) for our products can lead to 
regulatory and legal actions, product recalls and seizures, fines and penalties, interruption of production 
leading to product shortages, import bans or denials of import certifications, delays or denials in the 
approvals of new products or supplemental approvals of current products pending resolution of the 
issues, and reputational harm, any of which would adversely affect our business. Regulatory compliance 
and processes in jurisdictions outside the U.S. may also be less predictable and result in additional costs, 
uncertainties, and risks. See Item 1, "Business - Government Regulation of Our Operations," for more 
details. 

30Item 1B. Unresolved Staff Comments

None.

Item 2. Properties

Our principal domestic and international executive offices are located in Indianapolis. At December 31, 2021, 
we owned 9 production and distribution sites in the United States (U.S.), including Puerto Rico. Together with 
the corporate administrative offices, these facilities contain an aggregate of approximately 8.1 million square 
feet of floor area dedicated to production, distribution, and administration. Major production sites include 
Indianapolis, Indiana; Carolina, Puerto Rico; and Branchburg, New Jersey.

We own production and distribution sites in 7 countries outside the U.S., containing an aggregate of 
approximately 4.7 million square feet of floor area. Major production sites include facilities in Ireland, France, 
Spain, Italy, and China.

In the U.S., our research and development facilities contain an aggregate of approximately 4.4 million square 
feet of floor area, primarily consisting of owned facilities located in Indianapolis and smaller leased sites 
primarily in San Diego, California; San Francisco, California; and New York, New York. Outside the U.S., we 
own a small research and development facility in Spain and lease a small site in Singapore.

We believe that none of our properties is subject to any encumbrance, easement, or other restriction that 
would detract materially from its value or impair its use in the operation of the business. The buildings we own 
are of varying ages and in good condition.

Item 3. Legal Proceedings

We are a party to various currently pending legal actions, government investigations, and environmental 
proceedings. Information pertaining to legal proceedings is described in Item 8, "Financial Statements and 
Supplementary Data - Note 16: Contingencies," and incorporated by reference herein. 

Item 4. Mine Safety Disclosures

Not applicable.

31Part II
Item 5. Market for the Registrant's Common Equity, 

Related Stockholder Matters, and Issuer 
Purchases of Equity Securities

Information relating to the principal market for our common stock and related stockholder matters is described 
in Item 7, "Management's Discussion and Analysis of Results of Operations and Financial Condition" and Item 
12, "Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters." 
This information is incorporated herein by reference.

As of February 18, 2022, there were approximately 20,641 holders of record of our common stock based on 
information provided by EQ Shareowner Services, our transfer agent. Our common stock is listed under the 
ticker symbol LLY on the New York Stock Exchange (NYSE). 

The following table summarizes the activity related to repurchases of our equity securities during the fourth 
quarter ended December 31, 2021:

Total Number of
Shares Purchased
(in thousands)

Average Price Paid
per Share

Total Number of Shares
Purchased as Part of
Publicly Announced
Plans or Programs
(in thousands)

Period
October 2021   . . . . . .  
November 2021       . . .
December 2021       . . .
Total        . . . . . . . . . . . . .

2,398  $ 
—   
546   
2,944   

254.70   

— 

254.70   
254.70   

Approximate Dollar Value
of Shares that May Yet Be
Purchased Under the
Plans or Programs
(dollars in millions)
4,889.1 
4,889.1 
4,750.0 

2,398  $ 
—   
546   

2,944 

During the three months ended December 31, 2021, we repurchased the remaining $500.0 million of shares 
available under the $8.00 billion share repurchase program authorized in June 2018 and $250.0 million of 
shares available under the $5.00 billion share repurchase program authorized in May 2021. 

32 
 
 
 
PERFORMANCE GRAPH

The following graph compares the return on Lilly stock with that of the Standard & Poor's (S&P) 500 Stock 
Index and our peer group for the years 2017 through 2021. The graph assumes that, on the last business day 
of 2016, a person invested $100 each in Lilly stock, the S&P 500 Stock Index, and the peer group's collective 
common stock. The graph measures total shareholder return, which takes into account both stock price and 
dividends. It assumes that dividends paid by a company are immediately reinvested in that company's stock. 

Value of $100 Invested on Last Business Day of 2016 Comparison of Five-Year Cumulative Total 
Shareholder Return Among Lilly, S&P 500 Stock Index, and Peer Group(1)

Dec-16
Dec-17
Dec-18
Dec-19
Dec-20
Dec-21

Lilly
$  100.00 
  117.83 
  165.50 
  192.23 
  251.93 
  418.40 

Peer Group
$  100.00 
  117.86 
  123.85 
  146.23 
  149.47 
  179.16 

S&P 500
$  100.00 
  121.83 
  116.49 
  153.17 
  181.35 
  233.41 

(1)  We constructed the peer group as the industry index for this graph. It is comprised of the following companies in the pharmaceutical and 
biotechnology industries: AbbVie Inc.; Amgen Inc.; AstraZeneca PLC; Biogen Inc.; Bristol-Myers Squibb Company; Gilead Sciences Inc.; 
GlaxoSmithKline plc; Johnson & Johnson; Merck & Co., Inc.; Novartis AG.; Novo Nordisk A/S; Pfizer Inc.; Roche Holding AG; Sanofi S.A.; 
and Takeda Pharmaceutical Company Limited. The peer group used for performance benchmarking aligns with the peer group used for 
executive compensation purposes for 2021 other than our peer group for performance benchmarking excludes Allergan plc, Celgene 
Corporation, and Shire plc as they were acquired in 2020, 2019 and 2019, respectively.

LillyPeer GroupS&P 500Dec-16Dec-17Dec-18Dec-19Dec-20Dec-21$50$100$150$200$250$300$350$400$45033Item 6. [Reserved]

Item 7. Management's Discussion and Analysis of 

Results of Operations and Financial Condition

RESULTS OF OPERATIONS
(Tables present dollars in millions, except per-share data)

General

Management's discussion and analysis of results of operations and financial condition is intended to assist the 
reader in understanding and assessing significant changes and trends related to the results of operations and 
financial position of our consolidated company. This discussion and analysis should be read in conjunction 
with Item 8, "Financial Statements and Supplementary Data." Certain statements in this Item 7 constitute 
forward-looking statements. Various risks and uncertainties, including those discussed in "Forward-Looking 
Statements" and Item 1A, "Risk Factors," may cause our actual results, financial position, and cash generated 
from operations to differ materially from these forward-looking statements.

Executive Overview

This section provides an overview of our financial results, recent product and late-stage pipeline 
developments, and other matters affecting our company and the pharmaceutical industry. Earnings per share 
(EPS) data are presented on a diluted basis.

COVID-19 Pandemic

In response to the COVID-19 pandemic, we have focused on maintaining a supply of our medicines; reducing 
the strain on the medical system; developing treatments for COVID-19; protecting the health, safety, and well-
being of our employees; supporting our communities; and ensuring affordability of and access to our 
medicines, particularly insulin. As part of our response to the COVID-19 pandemic, and at the request of the 
United States (U.S.) and international governments, we invested in large-scale manufacturing of COVID-19 
antibodies at risk, in order to ensure rapid access to patients around the world. 

The U.S. Food and Drug Administration (FDA) granted Emergency Use Authorizations (EUA) for 
bamlanivimab and etesevimab administered together for higher-risk patients who have been recently 
diagnosed with mild-to-moderate COVID-19 and for baricitinib for treatment with or without remdesivir in 
hospitalized COVID-19 patients. In the third quarter of 2021, the FDA expanded the EUA for bamlanivimab 
and etesevimab administered together to include post-exposure prophylaxis in certain individuals for the 
prevention of SARS-CoV-2 infection. We expect that additional revenue from the sale of bamlanivimab and 
etesevimab after the first quarter of 2022 will be limited. In February 2022, the FDA granted an EUA for 
bebtelovimab for certain high-risk patients who have been recently diagnosed with mild-to-moderate 
COVID-19. We have agreed with the U.S. government to supply up to 600,000 doses of bebtelovimab no later 
than March 31, 2022 for at least $720 million with an option of 500,000 additional doses no later than July 31, 
2022. The FDA has revised, and may in the future revise, any EUA for our COVID-19 therapies in response to 
the prevalence of variants against which our therapies have varying degrees of efficacy. 

The COVID-19 pandemic has, and may continue to, adversely impact our business and operations. The focus 
of resources on COVID-19, widespread protective measures implemented to control the spread of COVID-19, 
and the resulting strain on global transportation, manufacturing, and labor markets have negatively impacted 
development, manufacturing, supply, distribution, and sales of our medicines. In addition to decreases in new 
prescriptions, changes in payer segment mix, and the increased use of patient affordability programs in the 
U.S., we have experienced, and may continue to experience if the COVID-19 pandemic undergoes resurgent 
or more severe waves, decreased demand as a result of lack of "normal" access and fewer in-person 
interactions by patients and our employees with healthcare professionals. 

34We also face risks and uncertainties related to our COVID-19 therapies, including heightened regulatory 
scrutiny of our manufacturing practices, quality assurance, and similar regulations, restrictions on 
administration that limit widespread and timely access to our therapies, and risks related to handling, return, 
and/or refund of product after delivery by us. The availability of superior or competitive therapies, including 
therapies that can be administered more easily, or preventative measures such as vaccines, coupled with the 
unpredictable nature of pandemics, have and could further negatively impact or eliminate demand for our 
COVID-19 therapies. Mutations or the spread of other variants of the coronavirus have in some cases 
impacted the effectiveness of our COVID-19 therapies, and may further render our therapies more or less 
effective or ineffective. 

The strain on global transportation, logistics, and labor markets caused by the COVID-19 pandemic and an 
increase in overall demand in our industry for certain materials resulting in changed buying patterns and 
constrained supply have had, and may continue to have, a number of impacts on our business, including 
increased costs to provide a consistent supply of our medicines where they are needed and potential 
disruptions in the supply of our medications. These factors may negatively affect our results of operations.

It remains difficult to reasonably assess or predict the full extent of the ongoing impact of the COVID-19 
pandemic on us. The degree to which the COVID-19 pandemic continues to affect us will depend on 
developments that are highly uncertain and beyond our knowledge or control. We are currently unable to 
predict the full extent to which the COVID-19 pandemic or any future pandemic, epidemic or similar public 
health threat will adversely impact our business and operations in the future.

See Item 1A, "Risk Factors" for additional information on risk factors that could impact our business and 
operations.

Financial Results

The following table summarizes our key operating results:

Year Ended December 31

2021

Revenue         . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  28,318.4 
Gross margin     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
21,005.6 
Gross margin as a percent of revenue      . . . . . . . . . . . . . . . . . .
Operating expenses   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  13,457.5 
Acquired in-process research and development      . . . . . . . . .  
874.9 
316.1 
Asset impairment, restructuring, and other special charges      
Other—net, (income) expense      . . . . . . . . . . . . . . . . . . . . . . . .  
201.6 
Income before income taxes     . . . . . . . . . . . . . . . . . . . . . . . . . .
6,155.5 
Income taxes   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
573.8 
Net income     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5,581.7 
EPS      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6.12 

 74.2 %

$ 

$ 

2020
24,539.8 
19,056.5 

 77.7 %

12,206.9 
660.4 
131.2 
(1,171.9) 
7,229.9 
1,036.2 
6,193.7 
6.79 

Percent 
Change
15
10

10
32
NM
NM
(15)
(45)
(10)
(10)

NM - not meaningful

Revenue increased in 2021 driven by increased volume and, to a lesser extent, the favorable impact of 
foreign exchange rates, partially offset by lower realized prices. Operating expenses, defined as the sum of 
research and development and marketing, selling, and administrative expenses, increased in 2021, driven 
primarily by higher development expenses for late-stage assets. The decreases in net income and EPS in 
2021 were driven primarily by reduction in other-net, (income) expense and higher operating expenses, 
partially offset by higher gross margin. 

35 
 
 
 
 
 
 
 
 
 
 
 
The following highlighted items affect comparisons of our 2021 and 2020 financial results:

2021

Cost of Sales (See Note 6 to the consolidated financial statements)

• We recognized a net inventory impairment charge related to our COVID-19 antibodies of 

$339.7 million. As part of our response to the COVID-19 pandemic, and at the request of the U.S. and 
international governments, we invested in large-scale manufacturing of COVID-19 antibodies at risk, 
in order to ensure rapid access to patients around the world. As the COVID-19 pandemic evolved 
during 2021, we incurred a net inventory impairment charge primarily due to the combination of 
changes to current and forecasted demand from U.S. and international governments, including 
changes to our agreement with the U.S. government, and near-term expiry dates of COVID-19 
antibodies.

Acquired In-Process Research and Development (IPR&D) (Note 3 to the consolidated financial 
statements)

• We recognized acquired IPR&D charges of $874.9 million related to business development 

transactions. 

Asset Impairment, Restructuring, and Other Special Charges (Note 5 to the consolidated financial 
statements)

• We recognized charges of $316.1 million primarily related to an impairment of a contract-based 

intangible asset from our acquisition of Loxo Oncology, Inc. (Loxo), an intangible asset impairment 
resulting from the sale of the rights to Qbrexza®, as well as acquisition and integration costs 
associated with the acquisition of Prevail Therapeutics Inc. (Prevail). 

Other-Net, (Income) Expense (Note 18 to the consolidated financial statements)

• We recognized a debt extinguishment loss of $405.2 million related to the repurchase of debt. 

• We recognized $176.9 million of net investment gains on equity securities. 

 2020 

Acquired IPR&D (Note 3 to the consolidated financial statements)

• We recognized acquired IPR&D charges of $660.4 million related to business development 

transactions. 

Asset Impairment, Restructuring, and Other Special Charges (Note 5 to the consolidated financial 
statements)

• We recognized charges of $131.2 million primarily related to severance costs incurred as a result of 

actions taken worldwide to reduce our cost structure.

Other-Net, (Income) Expense (Note 18 to the consolidated financial statements)

• We recognized $1.44 billion of net investment gains on equity securities. 

36Late-Stage Pipeline

Our long-term success depends on our ability to continually discover or acquire, develop, and commercialize 
innovative new medicines. We currently have approximately 45 new medicine candidates in clinical 
development or under regulatory review, and a larger number of projects in the discovery phase.

The following certain new molecular entities (NMEs) are currently in Phase II or Phase III clinical trials or have 
been submitted for regulatory review in the U.S., Europe, or Japan. The following table reflects the status of 
certain NMEs, including certain other developments since our Quarterly Report on Form 10-Q for the quarter 
ended September 30, 2021.

Compound
COVID-19 Antibodies

Indication

Bebtelovimab (LY-
CoV1404)

COVID-19

Diabetes

Status 

Developments

Emergency 
Use 
Authorization 

The FDA granted EUA for certain high-risk 
patients recently diagnosed with mild-to-
moderate COVID-19 in February 2022.

Type 2 diabetes

Submitted

Submitted in the U.S. using a priority review 
voucher and in Europe and Japan in 2021. 

Tirzepatide 

Basal Insulin-Fc

GGG Tri-Agonist

GLP-1R NPA

Immunology

Heart failure with 
preserved ejection 
fraction

Obesity
Nonalcoholic 
steatohepatitis 
Type 1 and 2 
diabetes
Obesity

Type 2 diabetes

Obesity

Type 2 diabetes

Phase III

Phase III trials are ongoing.

Phase II

Phase II trial is ongoing. 

Phase II

Phase II trials are ongoing.

Phase II

Phase II trials are ongoing. 

Phase II

Phase II trials are ongoing.

Lebrikizumab(1)

Atopic dermatitis

Phase III

Mirikizumab

CXCR1/2 Ligands 
Monoclonal Antibody

IL-2 Conjugate

Crohn's Disease

Ulcerative colitis

Hidradenitis 
suppurativa
Systemic lupus 
erythematosus
Ulcerative colitis

Granted FDA Fast Track designation(2). 
Announced in 2021 that Phase III trials met 
primary and all key secondary endpoints. 
Phase III trials are ongoing.

Phase III trials are ongoing. 
Announced in 2021 that Phase III trials met 
primary and all key secondary endpoints. 

Phase III

Phase II

Phase II trial is ongoing.

Phase II

Phase II trials are ongoing.

PD-1 MAB Agonist

Rheumatoid arthritis Phase II

Phase II trial is ongoing.

37Indication

Status 

Developments

Early Alzheimer's 
disease

Submission 
initiated 

Granted FDA Breakthrough Therapy 
designation(3). Initiated a rolling submission in 
the U.S. for accelerated approval in 2021. 
Phase III trials are ongoing.

Preclinical 
Alzheimer's disease
Preclinical 
Alzheimer's disease

Phase III

Phase III trial is ongoing.

Phase III

Phase III trial is ongoing. 

Chronic pain

Phase II

Phase II trials are ongoing. 

Compound
Neuroscience

Donanemab

Solanezumab

Epiregulin/TGFα 
MAB
GBA1 Gene Therapy 
(PR001)
GRN Gene Therapy 
(PR006)

Parkinson's disease  Phase II

Frontotemporal 
dementia

Phase II

O-glc-NAcase

Alzheimer's disease Phase II

PACAP38 Antibody Chronic pain

SSTR4 Agonist

Chronic pain

TRPA1 Antagonist

Pain

Phase II

Phase II

Phase II

Acquired in the Prevail acquisition in 2021. 
Granted FDA Fast Track designation(2). Phase 
II trials are ongoing. 

Phase II trial initiated in the fourth quarter of 
2021.
Phase II trial is ongoing.

Phase II trials are ongoing.

Phase II trials are ongoing.

Oncology

Selpercatinib 
(Retevmo®)

Lung cancer

Thyroid cancer

Approved(4)

Phase III trials are ongoing. 

Sintilimab injection(5) Lung cancer 

Submitted 

In February 2022, the Oncologic Drugs 
Advisory Committee recommended that the 
FDA require additional clinical trials prior to a 
final regulatory decision.

Initiated a rolling submission in the U.S. for 
accelerated approval in the fourth quarter of 
2021. Phase II and Phase III trials are 
ongoing.

Pirtobrutinib 
(LOXO-305)

Imlunestrant

Mantle cell 
lymphoma

Submission 
initiated

Chronic lymphocytic 
leukemia
B-cell malignancies

ER+HER2- 
metastatic breast 
cancer

Phase III

Phase III trials are ongoing.

Phase II

Phase II trial is ongoing.

Phase III

Phase III trial is ongoing.

(1) In collaboration with Almirall, S.A. in Europe. 
(2) Fast Track designation is designed to expedite the development and review of new therapies to treat serious conditions and address 

unmet medical needs.

(3) Breakthrough Therapy designation is designed to expedite the development and review of potential medicines that are intended to treat 
a serious condition where preliminary clinical evidence indicates that the treatment may demonstrate substantial improvement over 
available therapy on a clinically significant endpoint. 

(4) Continued approval may be contingent on verification and description of clinical benefit in confirmatory Phase III trials.
(5) In collaboration with Innovent Biologics, Inc.

38Our pipeline also contains several new indication line extension (NILEX) products. The following certain 
NILEX products for use in the indication described are currently in Phase II or Phase III clinical trials or have 
been submitted for regulatory review in the U.S., Europe, or Japan. The following table reflects the status of 
certain NILEX products, including certain other developments since our Quarterly Report on Form 10-Q for 
the quarter ended September 30, 2021:

Compound
Diabetes

Empagliflozin 
(Jardiance®)(1)

Immunology

Baricitinib 
(Olumiant®)

Oncology

Abemaciclib 
(Verzenio®)

Indication

Status

Developments

Heart failure with 
preserved ejection 
fraction

Submitted 

Chronic kidney 
disease

Phase III

Granted FDA Breakthrough Therapy 
designation(2) and FDA Fast Track 
designation(3). Submitted in the U.S. and 
Europe in 2021 and in Japan in January 2022. 
The FDA granted priority review for adults with 
heart failure independent of left ventricular 
ejection fraction.
Granted FDA Fast Track designation(3). Phase 
III trials are ongoing. 

COVID-19

Emergency 
Use 
Authorization(4) 

Submitted in the U.S. and the FDA granted 
priority review in January 2022.

Alopecia areata

Submitted

Systemic lupus 
erythematosus

Discontinued

Granted FDA Breakthrough Therapy 
designation(2). Submitted in U.S., Europe and 
Japan in 2021.

Announced in January 2022 that, based on 
top-line efficacy results from Phase III trials,  
we discontinued development.

HR+, HER2- 
Adjuvant breast 
cancer 

Approved 

Approved in the U.S. and Japan in the fourth 
quarter of 2021. 

Prostate cancer

Phase III

Phase III trial is ongoing.

HR+, HER2+ 
Adjuvant breast 
cancer

Discontinued

Announced in January 2022 that we will 
discontinue the Phase III trial in response to 
the changing treatment landscape and global 
enrollment challenges.

(1) In collaboration with Boehringer Ingelheim. 
(2) Breakthrough Therapy designation is designed to expedite the development and review of potential medicines that are intended to treat 
a serious condition where preliminary clinical evidence indicates that the treatment may demonstrate substantial improvement over 
available therapy on a clinically significant endpoint. 

(3) Fast Track designation is designed to expedite the development and review of new therapies to treat serious conditions and address 

unmet medical needs.

(4) The FDA granted EUA for treatment with or without remdesivir in hospitalized COVID-19 patients.

There are many difficulties and uncertainties inherent in pharmaceutical research and development and the 
introduction of new products, as well as a high rate of failure inherent in new drug discovery and 
development. To bring a drug from the discovery phase to market can take over a decade and often costs in 
excess of $2 billion. Failure can occur at any point in the process, including in later stages after substantial 
investment. As a result, most funds invested in research programs will not generate financial returns. New 
product candidates that appear promising in development may fail to reach the market or may have only 
limited commercial success because of efficacy or safety concerns, inability to obtain or maintain necessary 
regulatory approvals or payer reimbursement or coverage, limited scope of approved uses, label changes, 
changes in the relevant treatment standards or the availability of new or better competitive products, difficulty 
or excessive costs to manufacture, or infringement of the patents or intellectual property rights of others. 
Regulatory agencies establish high hurdles for the efficacy and safety of new products and indications. Delays 
and uncertainties in drug approval processes can result in delays in product launches and lost market 
opportunity. In addition, it can be very difficult to predict revenue growth rates of new products and indications. 

39We manage research and development spending across our portfolio of potential new medicines. A delay in, 
or termination of, any one project will not necessarily cause a significant change in our total research and 
development spending. Due to the risks and uncertainties involved in the research and development process, 
we cannot reliably estimate the nature, timing, and costs of the efforts necessary to complete the 
development of our research and development projects, nor can we reliably estimate the future potential 
revenue that will be generated from any successful research and development project. Each project 
represents only a portion of the overall pipeline, and none is individually material to our consolidated research 
and development expense. While we do accumulate certain research and development costs on a project 
level for internal reporting purposes, we must make significant cost estimations and allocations, some of 
which rely on data that are neither reproducible nor validated through accepted control mechanisms. 
Therefore, we do not have sufficiently reliable data to report on total research and development costs by 
project, by preclinical versus clinical spend, or by therapeutic category. 

Other Matters

Patent Matters

We depend on patents or other forms of intellectual property protection for most of our revenue, cash flows, 
and earnings. 

In 2021, our vitamin regimen patents for Alimta® expired worldwide. Following the loss of patent exclusivity in 
major European countries and Japan, we faced, and remain exposed to, generic competition which has 
eroded revenue and is likely to continue to rapidly and severely erode revenue from current levels. In the 
U.S., we expect pediatric data exclusivity to provide us with protection through May 2022. However, we and 
Eagle Pharmaceuticals, Inc. (Eagle) reached an agreement in December 2019 to settle all pending U.S. 
patent litigation, allowing Eagle a limited initial entry into the market with its product starting February 2022 
(up to an approximate three-week supply) and subsequent unlimited entry starting April 2022. We expect that 
the entry of generic competition in the U.S. following the loss of exclusivity will cause a rapid and severe 
decline in revenue and will have a material adverse effect on our consolidated results of operations and cash 
flows. See Note 16 to the consolidated financial statements for a more detailed account of the legal 
proceedings currently pending regarding, among others, our Alimta patents.

Our compound patent for Humalog® (insulin lispro) has expired in major markets. Global regulators have 
different legal pathways to approve similar versions of insulin lispro. A competitor has similar version of insulin 
lispro in the U.S. and in certain European markets. While it is difficult to estimate the severity of the impact of 
insulin lispro products entering the market, we do not expect and have not experienced a rapid and severe 
decline in revenue; however, we expect additional pricing pressure and some loss of market share that may 
continue over time.

Our formulation and use patents for Forteo® have expired in major markets. We expect further decline in 
revenue as a result of the entry of generic and biosimilar competition due to the loss of patent exclusivity in 
major markets. 

Our regulatory data and patent exclusivity for Cymbalta® expired in Japan. Beginning in mid-2021, we have 
faced, and remain exposed to, generic competition which has eroded revenue and is likely to continue to 
rapidly and severely erode revenue from current levels.

Foreign Currency Exchange Rates

As a global company, we face foreign currency risk exposure from fluctuating currency exchange rates, 
primarily the U.S. dollar against the euro, Japanese yen, and Chinese yuan. While we seek to manage a 
portion of these exposures through hedging and other risk management techniques, significant fluctuations in 
currency rates can have a material impact, either positive or negative, on operating expenses. While there is 
uncertainty in the future movements in foreign exchange rates, fluctuations in these rates could adversely 
impact our future consolidated results of operations and cash flows.

40Trends Affecting Pharmaceutical Pricing, Reimbursement, and Access

Global concern over access to and affordability of pharmaceutical products continues to drive regulatory and 
legislative debate, as well as worldwide cost containment efforts by governmental authorities. Such measures 
may include the use of mandated discounts, price reporting requirements, mandated reference prices, 
restrictive formularies, changes to available intellectual property protections, as well as other efforts. In 
addition, consolidation of private payors in the U.S. has significantly impacted the market for pharmaceuticals 
by increasing payor leverage in negotiating manufacturer price concessions and pharmacy reimbursement 
rates. Furthermore, restrictive or unfavorable pricing, coverage, or reimbursement determinations for our 
medicines or product candidates by governments, regulatory agencies, or private payers, such as the recently 
proposed Alzheimer’s Monoclonal Antibody national coverage determination, may adversely impact our 
business and financial results. We expect that these actions may intensify and could particularly affect certain 
products, such as insulin, as governments manage and emerge from the COVID-19 pandemic, which could 
adversely affect our business. In addition, we are engaged in litigation and investigations related to our 340B 
program that, if resolved adversely to us, could negatively impact our business and consolidated results of 
operations. It is not currently possible to predict the overall potential adverse impact to us or the general 
pharmaceutical industry of continued cost containment efforts worldwide. 

In addition, evolving regulatory priorities have intensified governmental scrutiny of our operations and our 
industry, including with respect to current Good Manufacturing Practices, quality assurance, and similar 
regulations, and increased focus on business combinations in our industry. Any regulatory issues concerning 
these matters could lead to regulatory and legal actions, product recalls and seizures, fines and penalties, 
interruption of production leading to product shortages, import bans or denials of import certifications, delays 
or denials in the approvals of new products or supplemental approvals of current products pending resolution 
of the issues, impediments to the completion of business combinations, and reputational harm, any of which 
would adversely affect our business.

See Item 1, "Business - Regulations and Private Payer Actions Affecting Pharmaceutical Pricing, 
Reimbursement, and Access" and Note 16 to the consolidated financial statements for additional information.

Tax Matters

We are subject to income taxes and various other taxes in the U.S. and in many foreign jurisdictions; 
therefore, changes in both domestic and international tax laws or regulations have affected and may affect our 
effective tax rate, results of operations, and cash flows. In 2017, the U.S. enacted the Tax Cuts and Jobs Act 
(the 2017 Tax Act), which contains a provision that requires capitalization and amortization of research and 
development expenses for tax purposes starting in 2022. Previously, these expenses could be deducted in 
the year incurred. While this provision of the 2017 Tax Act is expected to have an immaterial impact on our 
consolidated results of operations, if it is not deferred or repealed by Congress, we expect that the 
implementation of this provision will increase our cash payments of income taxes by up to $1.50 billion in 
2022 and subsequently decrease our cash payments of income taxes moderately over the five-year 
amortization period.

The U.S. and countries around the world are actively considering and enacting tax law changes. Tax 
proposals introduced by Congress and the U.S. presidential administration contain significant changes, 
including increases to the tax rates at which both domestic and foreign income of U.S. companies would be 
taxed. In addition, tax authorities in the U.S. and other jurisdictions in which we do business routinely examine 
our tax returns and are intensifying their scrutiny and examinations of profit allocations among jurisdictions, 
which could adversely impact our future consolidated results of operations and cash flows. Further, actions 
taken with respect to tax-related matters by associations such as the Organisation for Economic Co-operation 
and Development and the European Commission could influence tax laws in countries in which we operate.

41Acquisitions

We opportunistically invest in external research and technologies that we believe complement and strengthen 
our own efforts. These investments can take many forms, including acquisitions, collaborations, investments, 
and licensing arrangements. We view our business development activity as a way to enhance our pipeline 
and strengthen our business. 

In January 2021, we acquired all shares of Prevail for a purchase price that included $22.50 per share in cash 
(or an aggregate of $747.4 million, net of cash acquired) plus one non-tradable contingent value right (CVR) 
per share. The CVR entitles Prevail stockholders up to an additional $4.00 per share in cash (or an aggregate 
of approximately $160 million) payable, subject to certain terms and conditions, upon the first regulatory 
approval of a Prevail product in one of the following countries: U.S., Japan, United Kingdom, Germany, 
France, Italy, or Spain. Under the terms of the agreement, we acquired potentially disease-modifying AAV9-
based gene therapies for patients with neurodegenerative diseases. The acquisition establishes a new 
modality for drug discovery and development, extending our research efforts through the creation of a gene 
therapy program that is being anchored by Prevail's portfolio of assets. 

In February 2020, we acquired all shares of Dermira, Inc. for a purchase price of $849.3 million, net of cash 
acquired. Under the terms of the agreement, we acquired lebrikizumab, a novel, investigational, monoclonal 
antibody being evaluated for the treatment of moderate-to-severe atopic dermatitis. Lebrikizumab was 
granted Fast Track designation from the FDA. We also acquired Qbrexza cloth, a medicated cloth for the 
topical treatment of primary axillary hyperhidrosis (uncontrolled excessive underarm sweating). In 2021, we 
sold the rights to Qbrexza. See Note 5 to the consolidated financial statements for additional information 
regarding the sale of the rights to Qbrexza. 

In February 2019, we acquired all shares of Loxo for a purchase price of $6.92 billion, net of cash acquired. 
Under the terms of the agreement, we acquired a pipeline of investigational medicines, including 
selpercatinib, an oral RET inhibitor, and LOXO-305 (pirtobrutinib), an oral BTK inhibitor. In the second quarter 
of 2020, the FDA approved selpercatinib (Retevmo) under its Accelerated Approval regulations and continued 
approval may be contingent upon verification and description of clinical benefit in confirmatory trials.

See Note 3 to the consolidated financial statements for additional information regarding our recent 
acquisitions.

42Operating Results—2021 

Revenue

The following table summarizes our revenue activity by region:

U.S.      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Outside U.S.    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Revenue      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Year Ended
December 31,

2021
16,811.0  $ 
11,507.4 
28,318.4  $ 

2020
14,229.3 
10,310.5 
24,539.8 

Percent Change
18
12
15

The following are components of the change in revenue compared with the prior year:

Volume     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Price     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Foreign exchange rates    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Percent change    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2021 vs. 2020

U.S.

 19 %
 (1) %
 — %
 18 %

Outside U.S. Consolidated
 16 %
 (2) %
 1 %
 15 %

 13 %
 (4) %
 3 %
 12 %

Numbers may not add due to rounding.
In the U.S the increase in volume in 2021 was primarily driven by COVID-19 antibodies, Trulicity®, and Taltz®.

Outside the U.S. the increase in volume in 2021 was primarily driven by Trulicity, Olumiant, COVID-19 
antibodies, Verzenio, and Taltz. The decrease in realized prices outside the U.S. was primarily driven by the 
price impact of the updated National Reimbursement Drug List formulary for certain products, largely Tyvyt®, 
in China.

43 
 
The following table summarizes our revenue activity in 2021 compared with 2020:

Year Ended
December 31,

2021

2020

U.S.

Total

Total

Outside U.S.

Product
Trulicity     . . . . . . . . . . . . . . . . . . . . . . . . . . . $  4,914.4  $  1,557.6  $  6,471.9  $  5,068.1 
Humalog(1)       . . . . . . . . . . . . . . . . . . . . . . . .
2,625.9 
1,320.7 
COVID-19 antibodies(2)
1,978.0 
871.2 
    . . . . . . . . . . . . . . . . .  
Taltz       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
1,788.5 
1,542.4 
Alimta      . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2,329.9 
1,233.9 
Jardiance(3)
     . . . . . . . . . . . . . . . . . . . . . . . .  
1,153.8 
807.3 
Verzenio     . . . . . . . . . . . . . . . . . . . . . . . . . .  
834.9 
912.7 
Humulin®
     . . . . . . . . . . . . . . . . . . . . . . . . . .  
1,259.6 
832.9 
Olumiant(4)        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
638.9 
324.1 
Cyramza®
    . . . . . . . . . . . . . . . . . . . . . . . . .  
1,032.6 
358.1 
Basaglar®
        . . . . . . . . . . . . . . . . . . . . . . . . .  
1,124.4 
588.3 
Forteo      . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
1,046.3 
441.6 
Cialis®
       . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
607.1 
10.6 
Cymbalta     . . . . . . . . . . . . . . . . . . . . . . . . .
767.7 
38.7 
Emgality®      . . . . . . . . . . . . . . . . . . . . . . . . .
362.9 
434.5 
Erbitux®
536.4 
481.8 
Zyprexa®
406.5 
39.6 
Tyvyt      . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
308.7 
— 
Trajenta®(5)    . . . . . . . . . . . . . . . . . . . . . . . .  
358.5 
82.1 
Other products  . . . . . . . . . . . . . . . . . . . . .  
1,340.1 
547.1 
Revenue      . . . . . . . . . . . . . . . . . . . . . . . . $  16,811.0  $  11,507.4  $  28,318.4  $  24,539.8 

2,453.0 
2,239.3 
2,212.8 
2,061.4 
1,490.8 
1,349.9 
1,222.6 
1,115.1 
1,033.0 
892.5 
801.9 
718.4 
581.5 
577.2 
548.3 
430.3 
418.1 
372.5 
1,327.9 

1,132.3 
261.4 
670.4 
827.5 
683.5 
515.0 
389.6 
791.0 
674.8 
304.2 
360.3 
707.9 
542.8 
142.7 
66.4 
390.7 
418.1 
290.4 
780.8 

     . . . . . . . . . . . . . . . . . . . . . . . . . . .  
     . . . . . . . . . . . . . . . . . . . . . . . . . .  

Percent 
Change
28
(7)
NM
24
(12)
29
48
(3)
75
—
(21)
(23)
18
(24)
59
2
6
35
4
(1)
15

Numbers may not add due to rounding.
NM - Not meaningful
(1) Humalog revenue includes insulin lispro.
(2) COVID-19 antibodies include sales for bamlanivimab administered alone as well as sales for bamlanivimab and etesevimab 

administered together and were made pursuant to EUAs or similar regulatory authorizations.

(3) Jardiance revenue includes Glyxambi®, Synjardy®, and Trijardy® XR.
(4) Olumiant revenue includes sales for baricitinib, for treatment in hospitalized COVID-19 patients, that were made pursuant to EUA or 

similar regulatory authorizations.

(5) Trajenta revenue includes Jentadueto®.

Revenue of Trulicity, a treatment for type 2 diabetes and to reduce the risk of major adverse cardiovascular 
events in adult patients with type 2 diabetes and established cardiovascular disease or multiple 
cardiovascular risk factors, increased 28 percent in the U.S., driven by increased demand. Revenue outside 
the U.S. increased 26 percent, driven by increased volume and, to a lesser extent, the favorable impact of 
foreign exchange rates, partially offset by lower realized prices.

Revenue of Humalog, an injectable human insulin analog for the treatment of diabetes, decreased 11 percent 
in the U.S., primarily driven by lower realized prices. Humalog's lower realized prices in the U.S. in 2021 were 
driven by higher contracted rebates and discounts and increased utilization in more highly-rebated 
government segments, partially offset by lower utilization in the 340B segment. Revenue outside the U.S. 
decreased 1 percent, driven by decreased volume and, to a lesser extent, lower realized prices, largely offset 
by the favorable impact of foreign exchange rates. Included in the revenue of Humalog in the U.S. are our 
own insulin lispro authorized generics. While it is difficult to estimate the severity of the impact of similar 
insulin lispro products entering the market, we do not expect and have not experienced a rapid and severe 
decline in revenue. However, due to the impact of competition and due to pricing pressure in the U.S. and 
some international markets, we expect some price decline and loss of market share to continue over time.

44 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Revenue of COVID-19 antibodies, treatments for mild to moderate COVID-19 for higher-risk patients and for 
post-exposure prophylaxis in certain individuals for the prevention of SARS-CoV-2 infection, was $1.98 billion 
in the U.S. during the year ended December 31, 2021. Revenue outside the U.S. was $261.4 million during 
the year ended December 31, 2021. The availability of superior or competitive therapies, including therapies 
that can be administered more easily, or preventative measures, such as vaccines, coupled with the 
unpredictable nature of pandemics, have and could further negatively impact or eliminate demand for these 
COVID-19 antibodies. The FDA has revised, and may in the future revise, any EUA for our COVID-19 
antibodies in response to the prevalence of variants against which our antibodies have varying degrees of 
efficacy. We expect that additional revenue from the sale of bamlanivimab and etesevimab after the first 
quarter of 2022 will be limited.

Revenue of Taltz, a treatment for moderate-to-severe plaque psoriasis, active psoriatic arthritis, ankylosing 
spondylitis, and active non-radiographic axial spondyloarthritis, increased 20 percent in the U.S., driven by 
increased demand, partially offset by lower realized prices due to increased rebates to gain commercial 
access. Revenue outside the U.S. increased 34 percent, primarily driven by increased volume. 

Revenue of Alimta, a treatment for various cancers, decreased 2 percent in the U.S., driven by decreased 
volume, partially offset by higher realized prices. Revenue outside the U.S. decreased 22 percent, primarily 
driven by decreased volume due to the entry of generic competition in certain markets and, to a lesser extent, 
lower realized prices, partially offset by the favorable impact of foreign exchange rates. Following the loss of 
exclusivity in major European countries and Japan in June 2021, we faced, and remain exposed to, generic 
competition which has eroded revenue and is likely to continue to rapidly and severely erode revenue from 
current levels. In the U.S., we expect the limited entry of generic competition starting February 2022 and 
subsequent unlimited entry starting April 2022. We expect that the entry of generic competition following the 
loss of exclusivity in the U.S. will cause a rapid and severe decline in revenue. See "Executive Overview - 
Other Matters- Patent Matters" for additional information. 

Revenue of Jardiance, a treatment for type 2 diabetes, to reduce the risk of cardiovascular death in adult 
patients with type 2 diabetes and established cardiovascular disease, and to reduce the risk of cardiovascular 
death and hospitalization for heart failure in adults with heart failure and reduced ejection fraction, increased 
30 percent in the U.S., primarily driven by increased demand. Revenue outside the U.S. increased 28 
percent, primarily driven by increased volume. See Note 4 to the consolidated financial statements for 
information regarding our collaboration with Boehringer Ingelheim involving Jardiance.

Revenue of Verzenio, a treatment for HR+, HER2- metastatic breast cancer and high risk early breast cancer, 
increased 35 percent in the U.S., driven by increased demand. Revenue outside the U.S. increased 75 
percent, driven by increased volume.

Revenue of Humulin, an injectable human insulin for the treatment of diabetes, decreased 4 percent in the 
U.S., driven by decreased demand and, to a lesser extent, lower realized prices. Revenue outside the U.S. 
decreased 1 percent, driven by decreased volume, largely offset by higher realized prices and the favorable 
impact of foreign exchange rates.

Revenue of Olumiant, a treatment for adults with moderately-to-severely active rheumatoid arthritis, moderate 
to severe atopic dermatitis, and of baricitinib, a treatment, with or without remdesivir, of hospitalized patients 
with COVID-19, increased $260.3 million in the U.S., driven by increased volume and, to a lesser extent, 
higher realized prices. Revenue outside the U.S. increased 38 percent, driven by increased volume and, to a 
lesser extent, the favorable impact of foreign exchange rates, partially offset by lower realized prices. 
Increased volume worldwide was partially driven by utilization of Olumiant for the treatment of hospitalized 
patients with COVID-19.

Revenue of Cyramza, a treatment for various cancers, decreased 6 percent in the U.S., driven by decreased 
demand, partially offset by higher realized prices. Revenue outside the U.S. increased 4 percent, driven by 
increased volume, partially offset by lower realized prices. 

45Gross Margin, Costs, and Expenses

Gross margin as a percent of revenue was 74.2 percent in 2021, a decrease of 3.5 percentage points 
compared with 2020, driven by higher sales of COVID-19 antibodies. 

Research and development expenses increased 15 percent to $7.03 billion in 2021, primarily driven by higher 
development expenses for late-stage assets.

Marketing, selling, and administrative expenses increased 5 percent to $6.43 billion in 2021, primarily due to 
increased marketing costs to continue to drive growth for certain products, investment in preparation for new 
launches, and lower marketing activities in 2020 as a result of pandemic-related spending reductions.

We recognized acquired IPR&D charges of $874.9 million and $660.4 million in 2021 and 2020, respectively, 
related to business development transactions. See Note 3 to the consolidated financial statements for 
additional information.

We recognized asset impairment, restructuring, and other special charges of $316.1 million in 2021. The 
charges were primarily related to an impairment of a contract-based intangible asset from our acquisition of 
Loxo, an intangible asset impairment resulting from the sale of the rights to Qbrexza, as well as acquisition 
and integration costs associated with the acquisition of Prevail. In 2020, we recognized $131.2 million of asset 
impairment, restructuring, and other special charges primarily related to severance costs incurred as a result 
of actions taken worldwide to reduce our cost structure. 

Other—net, (income) expense was expense of $201.6 million in 2021 compared to income of $1.17 billion in 
2020, primarily driven by lower net investment gains on equity securities and a debt extinguishment loss of 
$405.2 million related to the repurchase of debt.

Our effective tax rate was 9.3 percent in 2021, compared with an effective tax rate of 14.3 percent in 2020, 
primarily driven by the tax impacts of acquired IPR&D charges, lower net investment gains on equity 
securities, as well as a net discrete tax benefit. 

Operating Results—2020 

For a discussion of our results of operations pertaining to 2020 and 2019 see Item 7, "Management's 
Discussion and Analysis of Results of Operations and Financial Condition" in our Annual Report on Form 10-K 
for the year ended December 31, 2020.

46FINANCIAL CONDITION AND LIQUIDITY

We believe our available cash and cash equivalents, together with our ability to generate operating cash flow and 
our access to short-term and long-term borrowings, are sufficient to fund our existing and planned capital 
requirements, which include: 

•

•

•

•

•

working capital requirements, including related to employee payroll, clinical trials, manufacturing 
materials, and taxes;

capital expenditures;

share repurchases and dividends;

repayment of outstanding short-term and long-term borrowings; 

contributions to our defined benefit pension and retiree health benefit plans;

• milestone and royalty payments; and

•

potential business development activities, including acquisitions, collaborations, investments, and 
licensing arrangements.

Our management continuously evaluates our liquidity and capital resources, including our access to external 
capital, to ensure we can adequately and efficiently finance our capital requirements. As of December 31, 2021, 
our material cash requirements primarily related to purchases of goods and services to produce our products and 
conduct our operations, capital equipment expenditures, dividends, repayment of outstanding borrowings, 
milestone and royalty payments, the remaining obligations for the one-time repatriation transition tax (also known 
as the 'Toll Tax') from the 2017 Tax Act, leases, unfunded commitments to invest in venture capital funds, and 
retirement benefits (see Notes 11, 4, 14, 10, 7, and 15 to the consolidated financial statements). We anticipate 
our cash requirements related to ordinary course purchases of goods and services and capital equipment 
expenditures will be consistent with our past levels relative to revenues. 

Beginning in 2022, the 2017 Tax Act contains a provision that requires us to capitalize and amortize research and 
development expenses for tax purposes, whereas previously we could fully deduct these expenses in the year 
incurred. While this provision of the 2017 Tax Act is expected to have an immaterial impact on our consolidated 
results of operations, if it is not deferred or repealed by Congress, we expect that the implementation of this 
provision will increase our cash payments of income taxes by up to $1.50 billion in 2022 and subsequently 
decrease our cash payments of income taxes moderately over the five-year amortization period. See "Results of 
Operations - Executive Overview - Other Matters -Tax Matters" for additional information. 

We plan to invest more than $1 billion over several years in a new facility in Concord, North Carolina to 
manufacture parenteral (injectable) products and devices. We plan to invest more than 400 million euros over 
several years in a new facility in Limerick, Ireland to expand our manufacturing network for biologic active 
ingredients.

Cash and cash equivalents increased to $3.82 billion as of December 31, 2021, compared with $3.66 billion at 
December 31, 2020. Net cash provided by operating activities was $7.26 billion in 2021, compared with 
$6.50 billion in 2020. Refer to the consolidated statements of cash flows for additional information on the 
significant sources and uses of cash for the years ended December 31, 2021 and 2020. 

In addition to our cash and cash equivalents, we held total investments of $3.30 billion and $2.99 billion as of 
December 31, 2021 and 2020, respectively. See Note 7 to the consolidated financial statements for additional 
information.

In January 2021, we acquired all shares of Prevail for a purchase price that included $22.50 per share in cash (or 
an aggregate of $747.4 million, net of cash acquired) plus one non-tradable CVR per share. The CVR entitles 
Prevail stockholders up to an additional $4.00 per share in cash (or an aggregate of approximately $160 million) 
payable, subject to certain terms and conditions. This acquisition was funded primarily through cash on hand. 
See Note 3 to the consolidated financial statements for additional information. 

47As of December 31, 2021, total debt was $16.88 billion, an increase of $289.4 million compared with 
$16.60 billion at December 31, 2020. In September 2021, we issued euro-denominated notes consisting of 
€500.0 million of 1.125 percent fixed-rate notes due in September 2051 and €700.0 million of 1.375 percent 
fixed-rate notes due in September 2061, with interest to be paid annually, and British pound-denominated notes 
consisting of £250.0 million of 1.625 percent fixed-rate notes due in September 2043, with interest to be paid 
annually. We paid $1.91 billion of the net cash proceeds from the offering to purchase and redeem certain higher 
interest rate U.S. dollar-denominated notes with an aggregate principal amount of $1.50 billion. We used the 
remaining net proceeds from the offering to prefund certain 2022 debt maturities and for general corporate 
purposes. In addition, in September 2021, we issued euro-denominated notes consisting of €600.0 million of 
0.50 percent fixed-rate notes due in September 2033, with interest to be paid annually. The net proceeds from 
the offering will be used to fund, in whole or in part, eligible projects designed to advance one or more of our 
environmental, social, and governance objectives. See Note 11 to the consolidated financial statements for 
additional information. 

As of December 31, 2021, we had a total of $5.26 billion of unused committed bank credit facilities, $5.00 billion 
of which is available to support our commercial paper program. See Note 11 to the consolidated financial 
statements for additional information. We believe that amounts accessible through existing commercial paper 
markets should be adequate to fund any short-term borrowing needs.

For the 136th consecutive year, we distributed dividends to our shareholders. Dividends of $3.40 per share and 
$2.96 per share were paid in 2021 and 2020, respectively. In the fourth quarter of 2021, effective for the dividend 
to be paid in the first quarter of 2022, the quarterly dividend was increased to $0.98 per share, resulting in an 
indicated annual rate for 2022 of $3.92 per share.

Capital expenditures of $1.31 billion during 2021, compared to $1.39 billion in 2020.

In 2021, we repurchased $1.00 billion of shares, which completed our $8.00 billion share repurchase program 
authorized in June 2018. Additionally, our board authorized a $5.00 billion share repurchase program in May 
2021. In 2021, we repurchased $250.0 million of shares under the $5.00 billion share repurchase program. As of 
December 31, 2021, we had $4.75 billion remaining under the $5.00 billion share repurchase program. See Note 
13 to the consolidated financial statements for additional information.

See "Results of Operations - Executive Overview - Other Matters - Patent Matters" for information regarding 
recent and upcoming losses of patent protection.

Both domestically and abroad, we continue to monitor the potential impacts of the economic environment; the 
creditworthiness of our wholesalers and other customers, including foreign government-backed agencies and 
suppliers; the uncertain impact of health care legislation; and various international government funding levels.

In the normal course of business, our operations are exposed to fluctuations in interest rates, currency values, 
and fair values of equity securities. These fluctuations can vary the costs of financing, investing, and operating. 
We seek to address a portion of these risks through a controlled program of risk management that includes the 
use of derivative financial instruments. The objective of this risk management program is to limit the impact on 
earnings of fluctuations in interest and currency exchange rates. All derivative activities are for purposes other 
than trading.

Our primary interest rate risk exposure results from changes in short-term U.S. dollar interest rates. In an effort to 
manage interest rate exposures, we strive to achieve an acceptable balance between fixed and floating rate debt 
positions and may enter into interest rate derivatives to help maintain that balance. As of December 31, 2021, 
substantially all of our total long-term debt carries interest at a fixed rate. We have converted approximately 13 
percent of our long-term fixed-rate notes to floating rates through the use of interest rate swaps. Based on our 
overall interest rate exposure at December 31, 2021 and 2020, including derivatives and other interest rate risk-
sensitive instruments, a hypothetical 10 percent change in interest rates applied to the fair value of the 
instruments as of December 31, 2021 and 2020, respectively, would not have a material impact on earnings, 
cash flows, or fair values of interest rate risk-sensitive instruments over a one-year period.

48Our foreign currency risk exposure results from fluctuating currency exchange rates, primarily the U.S. dollar 
against the euro, Japanese yen, and Chinese yuan. We face foreign currency exchange exposures when we 
enter into transactions arising from subsidiary trade and loan payables and receivables denominated in foreign 
currencies. We also face currency exposure that arises from translating the results of our global operations to the 
U.S. dollar at exchange rates that have fluctuated from the beginning of the period. We may enter into foreign 
currency forward or option derivative contracts to reduce the effect of fluctuating currency exchange rates 
(primarily the euro, the Japanese yen, and Chinese yuan). Our corporate risk-management policy outlines the 
minimum and maximum hedge coverage of such exposures. Gains and losses on these derivative contracts 
offset, in part, the impact of currency fluctuations on the existing assets and liabilities. We periodically analyze 
the fair values of the outstanding foreign currency derivative contracts to determine their sensitivity to changes in 
foreign exchange rates. A hypothetical 10 percent change in exchange rates (primarily against the U.S. dollar) 
applied to the fair values of our outstanding foreign currency derivative contracts as of December 31, 2021 and 
2020, would not have a material impact on earnings, cash flows, or financial position over a one-year period. 
This sensitivity analysis does not consider the impact that hypothetical changes in exchange rates would have on 
the underlying foreign currency denominated transactions.

Our fair value risk exposure relates primarily to our public equity investments and to equity investments that do 
not have readily determinable fair values. As of December 31, 2021 and 2020, our carrying values of these 
investments were $1.83 billion and $2.04 billion, respectively. A hypothetical 20 percent change in fair value of 
the equity instruments would have impacted other-net, (income) expense by $365.6 million and $407.6 million as 
of December 31, 2021 and 2020, respectively. 

We have no off-balance sheet arrangements that have a material current effect or that are reasonably likely to 
have a material future effect on our financial condition, changes in financial condition, revenues or expenses, 
results of operations, liquidity, capital expenditures, or capital resources. We acquire and collaborate on potential 
products still in development and enter into research and development arrangements with third parties that often 
require milestone and royalty payments to the third party contingent upon the occurrence of certain future events 
linked to the success of the asset in development. Milestone payments may be required contingent upon the 
successful achievement of an important point in the development life cycle of the pharmaceutical product (e.g., 
approval for marketing by the appropriate regulatory agency or upon the achievement of certain sales levels). If 
required by the arrangement, we may make royalty payments based upon a percentage of the sales of the 
product in the event that regulatory approval for marketing is obtained. 

Individually, these arrangements are generally not material in any one annual reporting period. However, if 
milestones for multiple products covered by these arrangements were reached in the same reporting period, the 
aggregate expense or aggregate milestone payments made could be material to our results of operations or 
cash flows, respectively, in that period. See Note 4 to the consolidated financial statements for additional 
information. These arrangements often give us the discretion to unilaterally terminate development of the 
product, which would allow us to avoid making the contingent payments; however, we are unlikely to cease 
development if the compound successfully achieves milestone objectives. We also note that, from a business 
perspective, we view these payments as positive because they signify that the product is successfully moving 
through development and is now generating or is more likely to generate cash flows from sales of products.

49APPLICATION OF CRITICAL ACCOUNTING ESTIMATES

In preparing our financial statements in accordance with accounting principles generally accepted in the U.S., 
we must often make estimates and assumptions that affect the reported amounts of assets, liabilities, 
revenues, expenses, and related disclosures. Some of those judgments can be subjective and complex, and 
consequently actual results could differ from those estimates. For any given individual estimate or assumption 
we make, it is possible that other people applying reasonable judgment to the same facts and circumstances 
could develop different estimates. We believe that, given current facts and circumstances, it is unlikely that 
applying any such other reasonable judgment would cause a material adverse effect on our consolidated 
results of operations, financial position, or liquidity for the periods presented in this report. Our most critical 
accounting estimates have been discussed with our audit committee and are described below.

Revenue Recognition and Sales Return, Rebate, and Discount Accruals

We recognize revenue primarily from two different types of contracts, product sales to customers (net product 
revenue) and collaborations and other arrangements. For product sales to customers, provisions for returns, 
rebates and discounts are established in the same period the related product sales are recognized. To 
determine the appropriate transaction price for our product sales at the time we recognize a sale to a direct 
customer, we estimate any rebates or discounts that ultimately will be due to the direct customer and other 
customers in the distribution chain under the terms of our contracts. Significant judgments are required in 
making these estimates. The largest of our sales rebate and discount amounts are rebates associated with 
sales covered by managed care, Medicare, Medicaid, chargeback, and patient assistance programs in the 
U.S. In determining the appropriate accrual amount, we consider our historical rebate payments for these 
programs by product as a percentage of our historical sales as well as any significant changes in sales trends 
(e.g., patent expiries and product launches), an evaluation of the current contracts for these programs, the 
percentage of our products that are sold via these programs, and our product pricing.

Refer to Note 2 to the consolidated financial statements for further information on revenue recognition and 
sales return, rebate, and discount accruals.

Revenue recognized from collaborations and other arrangements will include our share of profits from the 
collaboration, as well as royalties, upfront and milestone payments we receive under these types of contracts.

Financial Statement Impact

We believe that our accruals for sales returns, rebates, and discounts are reasonable and appropriate based 
on current facts and circumstances. Our rebate and discount liabilities are included in sales rebates and 
discounts on our consolidated balance sheet. Our sales return liability is included in other current liabilities 
and other noncurrent liabilities on our consolidated balance sheet. As of December 31, 2021, a 5 percent 
change in our consolidated sales return, rebate, and discount liability would have led to an approximate $366 
million effect on our income before income taxes. 

The portion of our consolidated sales return, rebate, and discount liability resulting from sales of our products 
in the U.S. was approximately 90 percent as of December 31, 2021 and 2020.

The following represents a roll-forward of our most significant U.S. sales return, rebate, and discount liability 
balances, including managed care, Medicare, Medicaid, chargeback, and patient assistance programs:

(Dollars in millions)
Sales return, rebate, and discount liabilities, beginning of year    . . . . . . . . . . . . . . . . . . $  5,400.0  $  4,635.5 
Reduction of net sales(1) 
  18,668.4 
Cash payments    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   (19,344.7)    (17,903.9) 
Sales return, rebate, and discount liabilities, end of year   . . . . . . . . . . . . . . . . . . . . . . . . $  6,161.6  $  5,400.0 
(1) Adjustments of the estimates for these returns, rebates, and discounts to actual results were less than 1 percent of consolidated 

      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   20,106.3 

2020

2021

revenue for each of the years presented.

50Litigation Liabilities and Other Contingencies

Background and Uncertainties

Litigation liabilities and other contingencies are, by their nature, uncertain and based upon complex 
judgments and probabilities. The factors we consider in developing our litigation liability reserves and other 
contingent liability amounts include the merits and jurisdiction of the litigation, the nature and the number of 
other similar current and past matters, the nature of the product and the current assessment of the science 
subject to the litigation, as applicable, and the likelihood of settlement and current state of settlement 
discussions, if any. In addition, we accrue for certain liability claims incurred, but not filed, to the extent we can 
formulate a reasonable estimate of their costs based primarily on historical claims experience and data 
regarding product usage. We accrue legal defense costs expected to be incurred in connection with 
significant liability contingencies when both probable and reasonably estimable.

We also consider the insurance coverage we have to diminish the exposure for periods covered by insurance. 
In assessing our insurance coverage, we consider the policy coverage limits and exclusions, the potential for 
denial of coverage by the insurance company, the financial condition of the insurers, and the possibility of and 
length of time for collection. Due to a very restrictive market for litigation liability insurance, we are self-insured 
for litigation liability losses for all our currently marketed products. In addition to insurance coverage, we 
consider any third-party indemnification to which we are entitled or under which we are obligated. With 
respect to our third-party indemnification rights, these considerations include the nature of the indemnification, 
the financial condition of the indemnifying party, and the possibility of and length of time for collection.

The litigation accruals and environmental liabilities and the related estimated insurance recoverables have 
been reflected on a gross basis as liabilities and assets, respectively, on our consolidated balance sheets.

Acquisitions

Background and Uncertainties

To determine whether acquisitions or licensing transactions should be accounted for as a business 
combination or as an asset acquisition, we make certain judgments, which include assessing whether the 
acquired set of activities and assets would meet the definition of a business under the relevant accounting 
rules. 

If the acquired set of activities and assets meets the definition of a business, assets acquired and liabilities 
assumed are required to be recorded at their respective fair values as of the acquisition date. The excess of 
the purchase price over the fair value of the acquired net assets, where applicable, is recorded as goodwill. If 
the acquired set of activities and assets does not meet the definition of a business, the transaction is recorded 
as an acquisition of assets and, therefore, any acquired IPR&D that does not have an alternative future use is 
charged to expense at the acquisition date, and goodwill is not recorded. See Note 3 to the consolidated 
financial statements for additional information. 

The judgments made in determining estimated fair values assigned to assets acquired and liabilities assumed 
in a business combination, as well as estimated asset lives, can materially affect our consolidated results of 
operations. The fair values of intangible assets, including acquired IPR&D, are determined using information 
available near the acquisition date based on estimates and assumptions that are deemed reasonable by 
management. Significant estimates and assumptions include, but are not limited to, probability of technical 
success, revenue growth and discount rate. Depending on the facts and circumstances, we may deem it 
necessary to engage an independent valuation expert to assist in valuing significant assets and liabilities. 

The fair values of identifiable intangible assets are primarily determined using an "income method," as 
described in Note 8 to the consolidated financial statements.

The fair value of any contingent consideration liability that results from a business combination is primarily 
determined using a discounted cash flow analysis, as described in Note 7 to the consolidated financial 
statements. Estimating the fair value of contingent consideration requires the use of significant estimates and 
judgments, including, but not limited to, probability of technical success and the discount rate.

Financial Statement Impact

As of December 31, 2021, a 5 percent change in the contingent consideration liability would result in a 
change in income before income taxes of $3.5 million.

51Impairment of Indefinite-Lived and Long-Lived Assets

Background and Uncertainties

We review the carrying value of long-lived assets (both intangible and tangible) for potential impairment on a 
periodic basis and whenever events or changes in circumstances indicate the carrying value of an asset (or 
asset group) may not be recoverable. We identify impairment by comparing the projected undiscounted cash 
flows to be generated by the asset (or asset group) to its carrying value. If an impairment is identified, a loss is 
recorded equal to the excess of the asset's net book value over its fair value, and the cost basis is adjusted.

Goodwill and indefinite-lived intangible assets are reviewed for impairment at least annually, or more 
frequently if impairment indicators are present, by first assessing qualitative factors to determine whether it is 
more likely than not that the fair value of the intangible asset is less than its carrying amount. If we conclude it 
is more likely than not that the fair value is less than the carrying amount, a quantitative test that compares 
the fair value of the intangible asset to its carrying value is performed to determine the amount of any 
impairment.

Several methods may be used to determine the estimated fair value of acquired IPR&D, all of which require 
multiple assumptions. We utilize the "income method," as described in Note 8 to the consolidated financial 
statements.

For acquired IPR&D assets, the risk of failure has been factored into the fair value measure and there can be 
no certainty that these assets ultimately will yield a successful product, as discussed previously in "Results of 
Operations - Executive Overview - Late-Stage Pipeline." The nature of the pharmaceutical business is high-
risk and requires that we invest in a large number of projects to maintain a successful portfolio of approved 
products. As such, it is likely that some acquired IPR&D assets will become impaired in the future.

Estimates of future cash flows, based on what we believe to be reasonable and supportable assumptions and 
projections, require management's judgment. Actual results could vary materially from these estimates.

Retirement Benefits Assumptions

Background and Uncertainties

Defined benefit pension plan and retiree health benefit plan costs include assumptions for the discount rate, 
expected return on plan assets, and retirement age. These assumptions have a significant effect on the 
amounts reported. In addition to the analysis below, see Note 15 to the consolidated financial statements for 
additional information regarding our retirement benefits.

Annually, we evaluate the discount rate and the expected return on plan assets in our defined benefit pension 
and retiree health benefit plans. We use an actuarially determined, plan-specific yield curve of high quality, 
fixed income debt instruments to determine the discount rates. In evaluating the expected return on plan 
assets, we consider many factors, with a primary analysis of current and projected market conditions, asset 
returns and asset allocations (approximately 75 percent of which are growth investments), and the views of 
leading financial advisers and economists. We may also review our historical assumptions compared with 
actual results, as well as the discount rates and expected return on plan assets of other companies, where 
applicable. In evaluating our expected retirement age assumption, we consider the retirement ages of our 
past employees eligible for pension and medical benefits together with our expectations of future retirement 
ages.

Annually, we determine the fair value of the plan assets in our defined benefit pension and retiree health 
benefit plans. Approximately 38 percent of our plan assets are in hedge funds and private equity-like 
investment funds (collectively, alternative assets). We value these alternative investments using significant 
unobservable inputs or using the net asset value reported by the counterparty, adjusted as necessary. Inputs 
include underlying net asset values, discounted cash flows valuations, comparable market valuations, and 
adjustments for currency, credit, liquidity and other risks.

52Financial Statement Impact

If the 2021 discount rate for the U.S. defined benefit pension and retiree health benefit plans (U.S. plans) 
were to change by a quarter percentage point, income before income taxes would change by $21.6 million. If 
the 2021 expected return on plan assets for U.S. plans were to change by a quarter percentage point, income 
before income taxes would change by $31.5 million. If our assumption regarding the 2021 expected age of 
future retirees for U.S. plans were adjusted by one year, our income before income taxes would be affected 
by $51.1 million. The U.S. plans, including Puerto Rico, represent approximately 80 percent of each of the 
total projected benefit obligation and total plan assets at December 31, 2021.

Adjustments to the fair value of plan assets are not recognized in pension and retiree health benefit expense 
in the year that the adjustments occur. Such changes are deferred, along with other actuarial gains and 
losses, and are amortized into expense over the expected remaining service life of employees.

Income Taxes

Background and Uncertainties

We prepare and file tax returns based upon our interpretation of tax laws and regulations, and we record 
estimates based upon these interpretations. Our tax returns are routinely subject to examination by taxing 
authorities, which could result in future tax, interest, and penalty assessments. Inherent uncertainties exist in 
estimates of many tax positions due to changes in tax law resulting from legislation and regulation as 
concluded through the various jurisdictions' tax court systems. We recognize the tax benefit from an uncertain 
tax position only if it is more likely than not that the tax position will be sustained upon examination by the 
taxing authorities, based on the technical merits of the position. The tax benefits recognized in the financial 
statements from such a position are measured based on the largest benefit that has a greater than 50 percent 
likelihood of being realized upon ultimate resolution. The amount of unrecognized tax benefits is adjusted for 
changes in facts and circumstances. For example, adjustments could result from changes to existing tax law, 
the issuance of regulations by taxing authorities, new information obtained during a tax examination, or 
resolution of a tax examination. We believe our estimates for uncertain tax positions are appropriate and 
sufficient to pay assessments that may result from examinations of our tax returns. We recognize both 
accrued interest and penalties related to unrecognized tax benefits in income tax expense.

We have recorded valuation allowances against certain of our deferred tax assets, primarily those that have 
been generated from net operating losses, tax credits, and other tax carryforwards and carrybacks in certain 
taxing jurisdictions. In evaluating whether we would more likely than not recover these deferred tax assets, we 
have not assumed future taxable income in the jurisdictions associated with these carryforwards where 
history does not support such an assumption. Implementation of tax planning strategies to recover these 
deferred tax assets or to generate future taxable income in these jurisdictions could lead to the reversal of all 
or a portion of these valuation allowances and a reduction of income tax expense.

Financial Statement Impact

As of December 31, 2021, a 5 percent change in the amount of uncertain tax positions and the valuation 
allowance would result in a change in net income of $84.9 million and $43.8 million, respectively.

LEGAL AND REGULATORY MATTERS 

Information relating to certain legal proceedings can be found in Note 16 to the consolidated financial 
statements and is incorporated here by reference.

53Item 7A. Quantitative and Qualitative Disclosures About 

Market Risk

You can find quantitative and qualitative disclosures about market risk (e.g., interest rate risk) at Item 7, 
"Management's Discussion and Analysis - Financial Condition and Liquidity." That information is incorporated 
by reference herein.

54Item 8. Financial Statements and Supplementary Data
Consolidated Statements of Operations

ELI LILLY AND COMPANY AND SUBSIDIARIES
(Dollars in millions and shares in thousands, 
except per-share data)
Year Ended December 31
Revenue (Note 2)       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  28,318.4  $  24,539.8  $  22,319.5 
Costs, expenses, and other:

2019

2020

2021

Cost of sales       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Research and development       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Marketing, selling, and administrative   . . . . . . . . . . . . . . . . . . . . . . .
Acquired in-process research and development (Note 3)       . . . . . .
Asset impairment, restructuring, and other special charges 
(Note 5)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other—net, (income) expense (Note 18)     . . . . . . . . . . . . . . . . . . . .

Income before income taxes        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income taxes (Note 14)        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net income from continuing operations   . . . . . . . . . . . . . . . . . . . . . . .
Net income from discontinued operations (Note 19)    . . . . . . . . . . . .
Net income        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

7,312.8 
7,025.9 
6,431.6 

874.9 

5,483.3 
6,085.7 
6,121.2 

660.4 

4,721.2 
5,595.0 
6,213.8 

239.6 

316.1 
201.6 
22,162.9 
6,155.5 
573.8 
5,581.7 
— 
5,581.7  $ 

131.2 
(1,171.9)   
17,309.9 
7,229.9 
1,036.2 
6,193.7 
— 
6,193.7  $ 

575.6 
(291.6) 
17,053.6 
5,265.9 
628.0 
4,637.9 
3,680.5 
8,318.4 

Earnings per share:    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Earnings from continuing operations - basic        . . . . . . . . . . . . . . . . . $ 
Earnings from discontinued operations - basic      . . . . . . . . . . . . . . .
Earnings per share - basic   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

Earnings from continuing operations - diluted        . . . . . . . . . . . . . . . . $ 
Earnings from discontinued operations - diluted       . . . . . . . . . . . . . .
Earnings per share - diluted      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

6.15  $ 
— 
6.15  $ 

6.12  $ 
— 
6.12  $ 

6.82  $ 
— 
6.82  $ 

6.79  $ 
— 
6.79  $ 

4.98 
3.95 
8.93 

4.96 
3.93 
8.89 

Shares used in calculation of earnings per share:    . . . . . . . . . . . . . .
Basic         . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Diluted    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

906,963 
911,681 

907,634 
912,505 

931,059 
935,684 

See notes to consolidated financial statements.

55 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Consolidated Statements of Comprehensive Income (Loss)

ELI LILLY AND COMPANY AND SUBSIDIARIES
(Dollars in millions)
Net income       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  5,581.7  $  6,193.7  $  8,318.4 
Other comprehensive income (loss) from continuing operations:

Year Ended December 31

2019

2020

2021

122.1 
14.2 

(89.9) 
34.4 

13.5 
(15.9)   

Change in foreign currency translation gains (losses)     . . . . . . . . . . . .
Change in net unrealized gains (losses) on securities      . . . . . . . . . . . .
Change in defined benefit pension and retiree health benefit plans 
(Note 15)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Change in effective portion of cash flow hedges   . . . . . . . . . . . . . . . . .
Other comprehensive income (loss) from continuing operations 
before income taxes      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Benefit (provision) for income taxes related to other 
comprehensive income (loss) from continuing operations   . . . . . . . . .
Other comprehensive income (loss) from continuing operations, net 
of tax (Note 17)    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other comprehensive income from discontinued operations, net of 
tax (Note 17)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
56.8 
Other comprehensive income (loss), net of tax (Note 17)     . . . . . . . . . . .
(783.4) 
Comprehensive income    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  7,735.0  $  6,220.9  $  7,535.0 

(157.1)   
(152.9)   

2,699.4 
151.6 

— 
2,153.3 

(970.0) 
34.3 

— 
27.2 

(695.3)   

(173.7)   

2,848.6 

2,153.3 

(840.2) 

(991.2) 

151.0 

200.9 

27.2 

See notes to consolidated financial statements.

56 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Consolidated Balance Sheets

ELI LILLY AND COMPANY AND SUBSIDIARIES
(Dollars in millions, shares in thousands)
Assets
Current Assets

December 31

2021

2020

Cash and cash equivalents (Note 7)       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
3,657.1 
Short-term investments (Note 7)       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
24.2 
Accounts receivable, net of allowances of $22.5 (2021) and $25.9 (2020)      . . .
5,875.3 
Other receivables     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1,053.7 
Inventories (Note 6)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3,980.3 
Prepaid expenses and other      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2,871.5 
Total current assets    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17,462.1 
Investments (Note 7)       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2,966.8 
Goodwill (Note 8)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3,766.5 
Other intangibles, net (Note 8)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7,450.0 
Deferred tax assets (Note 14)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2,830.4 
Property and equipment, net (Note 9)       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8,681.9 
Other noncurrent assets    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3,475.4 
Total assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  48,806.0  $  46,633.1 
Liabilities and Equity
Current Liabilities

3,818.5  $ 
90.1 
6,672.8 
1,454.4 
3,886.0 
2,530.6 
18,452.4 
3,212.6 
3,892.0 
7,691.9 
2,489.3 
8,985.1 
4,082.7 

Short-term borrowings and current maturities of long-term debt (Note 11)       . . . . $ 
Accounts payable      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Employee compensation     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sales rebates and discounts   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dividends payable       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Income taxes payable (Note 14)      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other current liabilities       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total current liabilities    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other Liabilities

Long-term debt (Note 11)        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Accrued retirement benefits (Note 15)       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Long-term income taxes payable (Note 14)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred tax liabilities (Note 14)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other noncurrent liabilities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total other liabilities     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Commitments and Contingencies (Note 16)
Eli Lilly and Company Shareholders' Equity (Notes 12 and 13)

1,538.3  $ 
1,670.6 
958.1 
6,845.8 
885.5 
126.9 
3,027.5 
15,052.7 

8.7 
1,606.7 
997.2 
5,853.0 
770.6 
495.1 
2,750.3 
12,481.6 

15,346.4 
1,954.1 
3,920.0 
1,733.7 
1,644.3 
24,598.5 

16,586.6 
4,094.5 
3,837.8 
2,099.9 
1,707.5 
28,326.3 

Common stock—no par value
   Authorized shares: 3,200,000
   Issued shares: 954,116 (2021) and 957,077 (2020)      . . . . . . . . . . . . . . . . . . . . .
598.2 
Additional paid-in capital     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6,778.5 
Retained earnings    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7,830.2 
Employee benefit trust      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(3,013.2) 
Accumulated other comprehensive loss (Note 17)      . . . . . . . . . . . . . . . . . . . . . . . .
(6,496.4) 
Cost of common stock in treasury      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(55.7) 
Total Eli Lilly and Company shareholders' equity     . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5,641.6 
Noncontrolling interests     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
183.6 
Total equity    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5,825.2 
Total liabilities and equity     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  48,806.0  $  46,633.1 

596.3 
6,833.4 
8,958.5 
(3,013.2)   
(4,343.1)   
(52.7)   

8,979.2 
175.6 
9,154.8 

See notes to consolidated financial statements.

57 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Consolidated Statements of Shareholders' Equity 

ELI LILLY AND COMPANY 
AND SUBSIDIARIES
(Dollars in millions, shares in 
thousands)

Common Stock

Shares

Amount

Additional
Paid-in
Capital

Retained
Earnings

Employee 
Benefit 
Trust

Accumulated 
Other 
Comprehensive 
Loss

Common Stock in 
Treasury

Shares

Amount

Noncontrolling 
Interest

Balance at January 1, 2019

 1,057,639  $ 

661.0  $  6,583.6  $ 11,395.9  $  (3,013.2)  $ 

(5,729.2) 

604  $ 

(69.4)  $ 

1,080.4 

Equity of Eli Lilly and Company Shareholders

Net income

Other comprehensive 
income (loss), net of tax

Cash dividends declared 
per share: $2.68

Retirement of treasury 
shares

Purchase of treasury shares

Issuance of stock under 
employee stock plans, net

Stock-based compensation

Acquisition of common 
stock in exchange offer

Deconsolidation of Elanco

Other

Balance at December 31, 
2019

Net income 

Other comprehensive 
income, net of tax

Cash dividends declared 
per share: $3.07

Retirement of treasury 
shares

Purchase of treasury shares

Issuance of stock under 
employee stock plans, net

Stock-based compensation

Other

Balance at December 31, 
2020

Net income

Other comprehensive 
income, net of tax

Cash dividends declared 
per share: $3.53

Retirement of treasury 
shares

Purchase of treasury shares

Issuance of stock under 
employee stock plans, net

Stock-based compensation

Other

Balance at December 31, 
2021

  8,318.4 

(2,430.5) 

(794.4) 

37.7 

11.0 

  (102,640) 

(64.1) 

  (12,363.4) 

3,057 

1.9 

(210.7) 

312.4 

 (102,640) 

  12,427.5 

  37,639 

(4,400.0) 

(74) 

8.6 

  65,001 

(8,027.5) 

  958,056 

598.8 

  6,685.3 

  4,920.4 

(3,013.2) 

(6,523.6) 

530 

(60.8) 

  6,193.7 

(2,786.2) 

27.2 

(3,627) 

(2.3) 

(497.7) 

2,648 

1.7 

(212.7) 

308.1 

(2.2) 

(3,627) 

500.0 

3,627 

(500.0) 

(43) 

5.1 

  957,077 

598.2 

  6,778.5 

  7,830.2 

(3,013.2) 

(6,496.4) 

487 

(55.7) 

  5,581.7 

(3,201.7) 

2,153.3 

(5,412) 

(3.4) 

(1,246.6) 

2,451 

1.5 

(287.9) 

342.8 

(5.1) 

(5,412) 

  1,250.0 

5,412 

(1,250.0) 

(24) 

3.0 

(1,028.9) 

(8.0) 

92.2 

126.6 

(35.2) 

183.6 

3.4 

(11.4) 

  954,116  $ 

596.3  $  6,833.4  $  8,958.5  $  (3,013.2)  $ 

(4,343.1) 

463  $ 

(52.7)  $ 

175.6 

See notes to consolidated financial statements.

58 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Consolidated Statements of Cash Flows

ELI LILLY AND COMPANY AND SUBSIDIARIES
(Dollars in millions)
Cash Flows from Operating Activities
Net income      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  5,581.7  $  6,193.7  $  8,318.4 

Year Ended December 31

2019

2020

2021

Adjustments to Reconcile Net Income to Cash Flows from 
Operating Activities:

Gain related to disposition of Elanco (Note 19)      . . . . . . . . . . . . . . . .
Gain on sale of antibiotic business in China (Note 3)   . . . . . . . . . . .
Depreciation and amortization       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Debt extinguishment loss (Note 11)     . . . . . . . . . . . . . . . . . . . . . . . . .
Change in deferred income taxes    . . . . . . . . . . . . . . . . . . . . . . . . . . .
Stock-based compensation expense    . . . . . . . . . . . . . . . . . . . . . . . .
Net investment gains      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Acquired in-process research and development (Note 3)     . . . . . . .
Other non-cash operating activities, net     . . . . . . . . . . . . . . . . . . . . . .
Other changes in operating assets and liabilities, net of 
acquisitions and divestitures:

Receivables—(increase) decrease     . . . . . . . . . . . . . . . . . . . . . . . . .
Inventories—(increase) decrease    . . . . . . . . . . . . . . . . . . . . . . . . . .
Other assets—(increase) decrease    . . . . . . . . . . . . . . . . . . . . . . . .
Income taxes payable—increase (decrease)    . . . . . . . . . . . . . . . .
Accounts payable and other liabilities—increase (decrease)     . . .
Net Cash Provided by Operating Activities   . . . . . . . . . . . . . . . . . . . .
Cash Flows from Investing Activities

Purchases of property and equipment     . . . . . . . . . . . . . . . . . . . . . . .
Proceeds from sales and maturities of short-term investments     . .
Purchases of short-term investments     . . . . . . . . . . . . . . . . . . . . . . . .
Proceeds from sales of noncurrent investments     . . . . . . . . . . . . . . .
Purchases of noncurrent investments . . . . . . . . . . . . . . . . . . . . . . . .
Purchases of in-process research and development    . . . . . . . . . . .
Cash paid for acquisitions, net of cash acquired (Note 3)     . . . . . . .
Cash distributed to Elanco upon disposition      . . . . . . . . . . . . . . . . . .
Cash received for sale of antibiotic business in China     . . . . . . . . . .
Other investing activities, net     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net Cash Used for Investing Activities         . . . . . . . . . . . . . . . . . . . . . . . .
Cash Flows from Financing Activities

— 
— 
1,547.6 
405.2 
(802.3)   
342.8 
(178.0)   
874.9 
511.4 

— 
— 
1,323.9 
— 
(134.5)   
308.1 
(1,438.5)   
660.4 
333.9 

(3,680.5) 
(309.8) 
1,232.6 
252.5 
62.4 
312.4 
(403.1) 
239.6 
499.3 

(1,278.3)   
(235.9)   
1,515.4 
(359.7)   
(664.1)   
7,260.7 

(1,350.2)   
(533.4)   
(457.1)   
322.0 
1,271.3 
6,499.6 

(127.2) 
(258.7) 
(602.3) 
(221.3) 
(477.7) 
4,836.6 

(1,309.8)   
47.4 
(83.5)   
800.0 
(929.9)   
(563.4)   
(747.4)   
— 
— 
24.3 
(2,762.3)   

(1,387.9)   
129.7 
(11.4)   
757.1 
(358.7)   
(641.2)   
(849.3)   
— 
— 
102.8 
(2,258.9)   

(1,033.9) 
136.6 
(42.7) 
609.8 
(247.5) 
(319.6) 
(6,917.7) 
(374.0) 
354.8 
(248.7) 
(8,082.9) 

(3,086.8)   
(4.0)   

Dividends paid       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net change in short-term borrowings      . . . . . . . . . . . . . . . . . . . . . . . .
Proceeds from issuance of long-term debt        . . . . . . . . . . . . . . . . . . .
Repayments of long-term debt    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Purchases of common stock        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other financing activities, net     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net Cash Used for Financing Activities     . . . . . . . . . . . . . . . . . . . . . . .
Effect of exchange rate changes on cash and cash equivalents     . . . . .
Net increase (decrease) in cash and cash equivalents   . . . . . . . . . . . . .
Cash and cash equivalents at beginning of year (2019 includes 
$677.5 of discontinued operations)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7,998.2 
Cash and Cash Equivalents at End of Year     . . . . . . . . . . . . . . . . . . . . $  3,818.5  $  3,657.1  $  2,337.5 

(2,687.1)   
(1,494.2)   
2,062.3 
(276.5)   
(500.0)   
(241.6)   
(3,137.1)   
216.0 
1,319.6 

2,410.8 
(1,905.4)   
(1,250.0)   
(295.9)   
(4,131.3)   
(205.7)   
161.4 

(2,409.8) 
995.4 
6,556.4 
(2,866.4) 
(4,400.0) 
(200.1) 
(2,324.5) 
(89.9) 
(5,660.7) 

3,657.1 

2,337.5 

See notes to consolidated financial statements.

59 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Notes to Consolidated Financial Statements
ELI LILLY AND COMPANY AND SUBSIDIARIES
(Tables present dollars in millions, except per-share data)

Note 1: Summary of Significant Accounting Policies and Implementation of New Financial Accounting 
Standard

Basis of Presentation

The accompanying consolidated financial statements include Eli Lilly and Company and all subsidiaries and 
have been prepared in accordance with accounting principles generally accepted in the United States 
(GAAP). We consider majority voting interests, as well as effective economic or other control over an entity 
when deciding whether or not to consolidate an entity. We generally do not have control by means other than 
voting interests. Where our ownership of consolidated subsidiaries is less than 100 percent, the 
noncontrolling shareholders' interests are reflected as a separate component of equity. All intercompany 
balances and transactions have been eliminated.

The preparation of financial statements in conformity with GAAP requires management to make estimates 
and assumptions that affect the reported amounts of assets, liabilities, revenues, expenses, and related 
disclosures at the date of the financial statements and during the reporting period. Actual results could differ 
from those estimates. We issued our financial statements by filing with the Securities and Exchange 
Commission (SEC) and have evaluated subsequent events up to the time of the filing of this Annual Report on 
Form 10-K.

Certain reclassifications have been made to prior periods in the consolidated financial statements and 
accompanying notes to conform with the current presentation.

All per-share amounts, unless otherwise noted in the footnotes, are presented on a diluted basis.

On March 11, 2019, we completed the disposition of our remaining 80.2 percent ownership of Elanco Animal 
Health Incorporated (Elanco) common stock through a tax-free exchange offer. As a result, Elanco has been 
presented as discontinued operations in our consolidated financial statements for all periods presented.

We operate as a single operating segment engaged in the discovery, development, manufacturing, marketing, 
and sales of pharmaceutical products worldwide. A global research and development organization and a 
supply chain organization are responsible for the discovery, development, manufacturing, and supply of our 
products. Regional commercial organizations market, distribute, and sell the products. The business is also 
supported by global corporate staff functions. Our determination that we operate as a single segment is 
consistent with the financial information regularly reviewed by the chief operating decision maker for purposes 
of evaluating performance, allocating resources, setting incentive compensation targets, and planning and 
forecasting for future periods.

Research and Development Expenses and Acquired In-Process Research and Development (IPR&D)

Research and development expenses include the following:

•

Research and development costs, which are expensed as incurred.

• Milestone payment obligations incurred prior to regulatory approval of the product, which are accrued 

when the event requiring payment of the milestone occurs.

Acquired IPR&D expense includes the initial costs of externally developed IPR&D projects, acquired directly 
in a transaction other than a business combination, that do not have an alternative future use.

Earnings Per Share (EPS)

We calculate basic EPS based on the weighted-average number of common shares outstanding plus the 
effect of incremental shares from potential participating securities. We calculate diluted EPS based on the 
weighted-average number of common shares outstanding plus the effect of incremental shares from our 
stock-based compensation programs. 

60Foreign Currency Translation

Operations in our subsidiaries outside the United States (U.S.) are recorded in the functional currency of each 
subsidiary which is determined by a review of the environment where each subsidiary primarily generates and 
expends cash. The results of operations for our subsidiaries outside the U.S. are translated from functional 
currencies into U.S. dollars using the weighted average currency rate for the period. Assets and liabilities are 
translated using the period end exchange rates. The U.S. dollar effects that arise from translating the net 
assets of these subsidiaries are recorded in other comprehensive income (loss).

Advertising Expenses

Costs associated with advertising are expensed as incurred and are included in marketing, selling, and 
administrative expenses. Advertising expenses, comprised primarily of television, radio, print media, and 
Internet advertising, totaled approximately $1.2 billion, $1.1 billion, and $1.1 billion in 2021, 2020, and 2019, 
respectively, which was less than 5 percent of revenue each year.

Other Significant Accounting Policies

Our other significant accounting policies are described in the remaining appropriate notes to the consolidated 
financial statements.

Implementation of New Financial Accounting Standard

Accounting Standards Update 2021-01, Reference Rate Reform, provides for temporary optional expedients 
and exceptions in applying current GAAP to contracts, hedging relationships, and other transactions affected 
by the transition from the use of the London Interbank Offered Rate (LIBOR) to an alternative reference rate. 
The standard can be adopted immediately and is applicable to contracts entered into before January 1, 2023. 
We do not expect the transition from the use of LIBOR to an alternative reference rate to have a material 
impact to our consolidated statements of operations or balance sheets at the initial transition. 

Note 2: Revenue

The following table summarizes our revenue recognized in our consolidated statements of operations:

Net product revenue      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Collaboration and other revenue(1)
Revenue     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

       . . . . . . . . . . . . . . . . . . . .  

25,957.9  $ 

22,694.8  $ 

2,360.5 

1,845.0 

28,318.4  $ 

24,539.8  $ 

20,377.3 
1,942.2 
22,319.5 

(1) Collaboration and other revenue associated with prior period transfers of intellectual property was $175.0 million, $135.6 million, and 

$301.5 million during the years ended December 31, 2021, 2020, and 2019, respectively.

2021

2020

2019

We recognize revenue primarily from two different types of contracts, product sales to customers (net product 
revenue) and collaborations and other arrangements. Revenue recognized from collaborations and other 
arrangements will include our share of profits from the collaboration, as well as royalties, upfront and 
milestone payments we receive under these types of contracts. See Note 4 for additional information related 
to our collaborations and other arrangements. Collaboration and other revenue disclosed above includes the 
revenue from the Jardiance® and Trajenta® families of products resulting from our collaboration with 
Boehringer Ingelheim discussed in Note 4. Substantially all of the remainder of collaboration and other 
revenue is related to contracts accounted for as contracts with customers.

61 
 
Net Product Revenue

Revenue from sales of products is recognized at the point where the customer obtains control of the goods 
and we satisfy our performance obligation, which generally is at the time we ship the product to the customer. 
Payment terms differ by jurisdiction and customer, but payment terms in most of our major jurisdictions 
typically range from 30 to 70 days from date of shipment. Revenue for our product sales has not been 
adjusted for the effects of a financing component as we expect, at contract inception, that the period between 
when we transfer control of the product and when we receive payment will be one year or less. Any 
exceptions are either not material or we collect interest for payments made after the due date. Provisions for 
rebates, discounts, and returns are established in the same period the related sales are recognized. We 
generally ship product shortly after orders are received; therefore, we generally only have a few days of 
orders received but not yet shipped at the end of any reporting period. Shipping and handling activities are 
considered to be fulfillment activities and are not considered to be a separate performance obligation. We 
exclude from the measurement of the transaction price all taxes assessed by a governmental authority that 
are imposed on our sales of product and collected from a customer.

Most of our products are sold to wholesalers that serve pharmacies, physicians and other health care 
professionals, and hospitals. For the years ended December 31, 2021, 2020, and 2019, our three largest 
wholesalers each accounted for between 15 percent and 20 percent of consolidated revenue. Further, they 
each accounted for between 18 percent and 28 percent of accounts receivable as of December 31, 2021 and 
2020. 

Significant judgments must be made in determining the transaction price for our sales of products related to 
anticipated rebates, discounts and returns. The following describe the most significant of these judgments:

Sales Rebates and Discounts - Background and Uncertainties

• We initially invoice our customers at contractual list prices. Contracts with direct and indirect 

customers may provide for various rebates and discounts that may differ in each contract. As a 
consequence, to determine the appropriate transaction price for our product sales at the time we 
recognize a sale to a direct customer, we must estimate any rebates or discounts that ultimately will 
be due to the direct customer and other customers in the distribution chain under the terms of our 
contracts. Significant judgments are required in making these estimates.

•

•

The rebate and discount amounts are recorded as a deduction to arrive at our net product revenue. 
Sales rebates and discounts that require the use of judgment in the establishment of the accrual 
include managed care, Medicare, Medicaid, chargebacks, long-term care, hospital, patient assistance 
programs, and various other programs. We estimate these accruals using an expected value 
approach.

The largest of our sales rebate and discount amounts are rebates associated with sales covered by 
managed care, Medicare, Medicaid, chargeback, and patient assistance programs in the U.S. In 
determining the appropriate accrual amount, we consider our historical rebate payments for these 
programs by product as a percentage of our historical sales as well as any significant changes in 
sales trends (e.g., patent expiries and product launches), an evaluation of the current contracts for 
these programs, the percentage of our products that are sold via these programs, and our product 
pricing. Although we accrue a liability for rebates related to these programs at the time we record the 
sale, the rebate related to that sale is typically paid up to six months later. Because of this time lag, in 
any particular period our rebate adjustments may incorporate revisions of accruals for several 
periods.

• Most of our rebates outside the U.S. are contractual or legislatively mandated and are estimated and 

recognized in the same period as the related sales. In some large European countries, government 
rebates are based on the anticipated budget for pharmaceutical payments in the country. An estimate 
of these rebates, updated as governmental authorities revise budgeted deficits, is recognized in the 
same period as the related sale.

62Sales Returns - Background and Uncertainties

• When product sales occur, to determine the appropriate transaction price for our sales, we estimate a 
reserve for future product returns related to those sales using an expected value approach. This 
estimate is based on several factors, including: historical return rates, expiration date by product (on 
average, approximately 24 months after the initial sale of a product to our customer), and estimated 
levels of inventory in the wholesale and retail channels, as well as any other specifically-identified 
anticipated returns due to known factors such as the loss of patent exclusivity, product recalls and 
discontinuances, or a changing competitive environment. We maintain a returns policy that allows 
most U.S. customers to return product for dating issues within a specified period prior to and 
subsequent to the product's expiration date. Following the loss of exclusivity for a patent-dependent 
product, we expect to experience an elevated level of product returns as product inventory remaining 
in the wholesale and retail channels expires. Adjustments to the returns reserve have been and may 
in the future be required based on revised estimates to our assumptions. We record the return 
amounts as a deduction to arrive at our net product revenue. Once the product is returned, it is 
destroyed; we do not record a right of return asset. Our returns policies outside the U.S. are generally 
more restrictive than in the U.S. as returns are not allowed for reasons other than failure to meet 
product specifications in many countries. Our reserve for future product returns for product sales 
outside the U.S. is not material.

•

•

As a part of our process to estimate a reserve for product returns, we regularly review the supply 
levels of our significant products at the major wholesalers in the U.S. and in major markets outside 
the U.S., primarily by reviewing periodic inventory reports supplied by our major wholesalers and 
available prescription volume information for our products, or alternative approaches. We attempt to 
maintain U.S. wholesaler inventory levels at an average of approximately one month or less on a 
consistent basis across our product portfolio. Causes of unusual wholesaler buying patterns include 
actual or anticipated product-supply issues, weather patterns, anticipated changes in the 
transportation network, redundant holiday stocking, and changes in wholesaler business operations. 
In the U.S., the current structure of our arrangements provides us with data on inventory levels at our 
wholesalers; however, our data on inventory levels in the retail channel is more limited. Wholesaler 
stocking and destocking activity historically has not caused any material changes in the rate of actual 
product returns.

Actual U.S. product returns have been less than 2 percent of our U.S. revenue during each of the 
past three years and have not fluctuated significantly as a percentage of revenue, although 
fluctuations are more likely in periods following loss of patent exclusivity for major products in the U.S. 
market. 

Adjustments to Revenue

We record adjustments to revenue as a result of changes in estimates, for the judgments described above, for 
our most significant U.S. sales returns, rebates and discounts liability balances. Such adjustments for 
products shipped in previous periods resulted in approximately 2 percent or less increase to U.S revenue 
during each of the years ended December 31, 2021, 2020, and 2019.

Collaboration and Other Arrangements

We recognize several types of revenue from our collaborations and other arrangements, which we discuss in 
general terms immediately below and more specifically in Note 4 for each of our material collaborations and 
other arrangements. Our collaborations and other arrangements are not contracts with customers but are 
evaluated to determine whether any aspects of the arrangements are contracts with customers. 

•

•

•

Revenue related to products we sell pursuant to these arrangements is included in net product 
revenue, while other sources of revenue (e.g., royalties and profit sharing from our partner) are 
included in collaboration and other revenue.

Initial fees and developmental milestones we receive in collaborative and other similar arrangements 
from the partnering of our compounds under development are generally deferred and amortized into 
income through the expected product approval date. 

Profit-sharing due from our collaboration partners, which is based upon gross margins reported to us 
by our partners, is recognized as collaboration and other revenue as earned.

63•

•

•

Royalty revenue from licensees and certain of our collaboration partners, which is based on sales to 
third-parties of licensed products and technology, is recorded when the third-party sale occurs and the 
performance obligation to which some or all of the royalty has been allocated has been satisfied (or 
partially satisfied). This royalty revenue is included in collaboration and other revenue.

For arrangements involving multiple goods or services (e.g., research and development, marketing 
and selling, manufacturing, and distribution), each required good or service is evaluated to determine 
whether it is distinct. If a good or service does not qualify as distinct, it is combined with the other non-
distinct goods or services within the arrangement and these combined goods or services are treated 
as a single performance obligation for accounting purposes. The arrangement's transaction price is 
then allocated to each performance obligation based on the relative standalone selling price of each 
performance obligation. For arrangements that involve variable consideration where we have sold 
intellectual property, we recognize revenue based on estimates of the amount of consideration we 
believe we will be entitled to receive from the other party, subject to a constraint. These estimates are 
adjusted to reflect the actual amounts to be collected when those facts and circumstances become 
known.

Significant judgments must be made in determining the transaction price for our sales of intellectual 
property. Because of the risk that products in development will not receive regulatory approval, we 
generally do not recognize any contingent payments that would be due to us upon or after regulatory 
approval. 

Contract Liabilities

Our contract liabilities result from arrangements where we have received payment in advance of performance 
under the contract and do not include sales returns, rebates, and discounts. Changes in contract liabilities are 
generally due to either receipt of additional advance payments or our performance under the contract. 

The following table summarizes contract liability balances:

2021

2020

Contract liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

262.6  $ 

276.8 

The contract liabilities balances disclosed above as of December 31, 2021 and 2020 were primarily related to 
the remaining license period of symbolic intellectual property and obligations to perform research and 
development activities or supply product for a defined period of time.

During the years ended December 31, 2021, 2020, and 2019, revenue recognized from contract liabilities as 
of the beginning of the respective year was not material. Revenue expected to be recognized in the future 
from contract liabilities as the related performance obligations are satisfied is not expected to be material in 
any one year.

64 
Disaggregation of Revenue 

The following table summarizes revenue by product:

Revenue—to unaffiliated customers:

Diabetes:

2021

U.S.

2020

2019

2021

2020

2019

Outside U.S.

      . . . . . . . . . . . . . $  4,914.4  $  3,835.9  $  3,155.2  $  1,557.6  $  1,232.2  $ 

Trulicity®
Humalog® (1)
Jardiance (2)      . . . . . . . . . .
Humulin®
Basaglar®
Trajenta (3)       . . . . . . . . . . .
Other Diabetes      . . . . . . .
Total Diabetes        . . . . . . . . .

     . . . . . . . . . .   1,320.7 
807.3 
832.9 
588.3 
82.1 
173.6 
  8,719.3 

  . . . . . . . . . . . . .  
     . . . . . . . . . . . .  

  1,485.6 
620.8 
866.4 
842.3 
95.6 
162.5 
  7,909.1 

  1,669.7 
565.9 
879.7 
876.2 
224.8 
158.0 
  7,529.5 

  1,132.3 
683.5 
389.6 
304.2 
290.4 
111.2 
  4,468.8 

  1,140.3 
533.0 
393.2 
282.1 
263.0 
81.5 
  3,925.3 

972.7 
  1,151.0 
378.3 
410.4 
236.3 
365.8 
88.1 
  3,602.6 

Oncology:

Alimta®      . . . . . . . . . . . . . .
Verzenio®
     . . . . . . . . . . . .  
Cyramza®
      . . . . . . . . . . . .  
Erbitux®
      . . . . . . . . . . . . . .  
Tyvyt®     . . . . . . . . . . . . . . .  
Other Oncology     . . . . . . .  

  1,233.9 
834.9 
358.1 
481.8 
— 
120.1 
Total Oncology      . . . . . . . . .   3,028.8 

  1,265.3 
618.2 
381.9 
480.1 
— 
46.6 
  2,792.1 

  1,219.5 
454.8 
335.3 
487.9 
— 
111.0 
  2,608.5 

827.5 
515.0 
674.8 
66.4 
418.1 
210.7 
  2,712.5 

  1,064.7 
294.4 
650.8 
56.3 
308.7 
152.3 
  2,527.2 

896.4 
124.9 
589.9 
55.4 
134.0 
205.3 
  2,005.9 

Immunology:
Taltz®
Olumiant® (4)
Other Immunology      . . . .
Total Immunology        . . . . . .

   . . . . . . . . . . . . . . . .   1,542.4 
324.1 
15.3 
  1,881.8 

      . . . . . . . . . .  

Neuroscience:

Cymbalta®     . . . . . . . . . . .
Emgality®      . . . . . . . . . . . .
Zyprexa®
     . . . . . . . . . . . . .  
Other Neuroscience   . . .  

Total Neuroscience     . . . . .

38.7 
434.5 
39.6 
102.0 
614.8 

Other:

  1,288.5 
63.8 
20.0 
  1,372.3 

  1,016.8 
42.2 
— 
  1,059.0 

670.4 
791.0 
17.6 
  1,479.0 

500.0 
575.0 
14.6 
  1,089.6 

349.6 
384.7 
— 
734.3 

42.1 
325.9 
46.1 
73.2 
487.3 

49.6 
154.9 
41.0 
111.0 
356.5 

542.8 
142.7 
390.7 
207.5 
  1,283.7 

725.6 
37.0 
360.5 
220.9 
  1,344.0 

675.8 
7.7 
377.6 
305.3 
  1,366.4 

COVID-19 Antibodies (5)
Forteo®      . . . . . . . . . . . . . .  
Cialis®
      . . . . . . . . . . . . . . .  
Other     . . . . . . . . . . . . . . . .  

— 
759.1 
658.8 
469.7 
  1,887.7 
Revenue      . . . . . . . . . . . . . . . . . . . . . $ 16,811.0  $ 14,229.3  $ 12,722.6  $ 11,507.4  $ 10,310.5  $  9,596.8 

      1,978.0 
441.6 
10.6 
136.1 
  2,566.4 

— 
645.5 
231.7 
291.9 
  1,169.1 

261.4 
360.3 
707.9 
233.9 
  1,563.5 

21.2 
536.0 
545.4 
321.8 
  1,424.4 

850.0 
510.3 
61.8 
246.4 
  1,668.4 

Total Other       . . . . . . . . . . . .

Numbers may not add due to rounding.
(1) Humalog revenue includes insulin lispro.
(2) Jardiance revenue includes Glyxambi®, Synjardy®, and Trijardy® XR.
(3) Trajenta revenue includes Jentadueto®.
(4) Olumiant revenue includes sales for baricitinib, for treatment in hospitalized COVID-19 patients, that were made pursuant to 

Emergency Use Authorization (EUA) or similar regulatory authorizations.

(5) COVID-19 antibodies include sales for bamlanivimab administered alone as well as sales for bamlanivimab and etesevimab 

administered together and were made pursuant to EUAs or similar regulatory authorizations. 

65 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The following table summarizes revenue by geographical area:

Revenue—to unaffiliated customers(1):

2021

2020

2019

U.S.    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  16,811.0  $  14,229.3  $  12,722.6 
Europe      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3,765.0 
Japan     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2,547.6 
China      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
939.4 
Other foreign countries       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2,344.9 
Revenue     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  28,318.4  $  24,539.8  $  22,319.5 

4,776.8 
2,367.0 
1,661.4 
2,702.2 

4,187.7 
2,583.1 
1,116.9 
2,422.7 

Numbers may not add due to rounding.
(1) Revenue is attributed to the countries based on the location of the customer.

Note 3: Acquisitions and Divestiture

In January 2021, February 2020 and 2019, we completed the acquisitions of Prevail Therapeutics Inc. 
(Prevail), Dermira, Inc. (Dermira) and Loxo Oncology, Inc. (Loxo), respectively. These transactions, as further 
discussed in this note below in Acquisitions of Businesses, were accounted for as business combinations 
under the acquisition method of accounting. Under this method, the assets acquired and liabilities assumed 
were recorded at their respective fair values as of the acquisition date in our consolidated financial 
statements. The determination of estimated fair value required management to make significant estimates 
and assumptions. The excess of the purchase price over the fair value of the acquired net assets, where 
applicable, has been recorded as goodwill. The results of operations of these acquisitions have been included 
in our consolidated financial statements from the date of acquisition.

We also acquired assets in development in 2021, 2020, and 2019, which are further discussed in this note 
below in Asset Acquisitions. Upon each acquisition, the cost allocated to acquired IPR&D was immediately 
expensed because the compound acquired had no alternative future use. For the years ended December 31, 
2021, 2020, and 2019, we recorded acquired IPR&D charges of $874.9 million, $660.4 million, and 
$239.6 million, respectively.

Acquisitions of Businesses

Prevail Acquisition

Overview of Transaction

In January 2021, we acquired all shares of Prevail for a purchase price that included $22.50 per share in cash 
(or an aggregate of $747.4 million, net of cash acquired) plus one non-tradable contingent value right (CVR) 
per share. The CVR entitles Prevail stockholders up to an additional $4.00 per share in cash (or an aggregate 
of approximately $160 million) payable, subject to certain terms and conditions, upon the first regulatory 
approval of a Prevail product in one of the following countries: U.S., Japan, United Kingdom, Germany, 
France, Italy or Spain. To achieve the full value of the CVR, such regulatory approval must occur by 
December 31, 2024. If such regulatory approval occurs after December 31, 2024, the value of the CVR will be 
reduced by approximately 8.3 cents per month until December 1, 2028, at which point the CVR will expire 
without payment.

Under the terms of the agreement, we acquired potentially disease-modifying AAV9-based gene therapies for 
patients with neurodegenerative diseases. The acquisition establishes a new modality for drug discovery and 
development, extending our research efforts through the creation of a gene therapy program that is being 
anchored by Prevail's portfolio of assets. The lead gene therapies in clinical development that we acquired 
were PR001 for patients with Parkinson's disease with GBA1 mutations and neuronopathic Gaucher disease 
and PR006 for patients with frontotemporal dementia with GRN mutations. Both PR001 and PR006 were 
granted Fast Track designation from the U.S. Food and Drug Administration (FDA). 

66 
 
 
 
 
 
 
 
 
 
 
 
Assets Acquired and Liabilities Assumed

The following table summarizes the amounts recognized for assets acquired and liabilities assumed in the 
acquisition of Prevail as of the acquisition date:

Estimated Fair Value at January 22, 2021
Cash
Acquired IPR&D(1)
Goodwill(2)
Deferred tax liabilities
Other assets and liabilities, net
Acquisition date fair value of consideration transferred 
Less: 
     Cash acquired
     Fair value of CVR liability(3)
Cash paid, net of cash acquired

$ 

$ 

90.5 
824.0
126.8
(106.0) 
(31.5) 
903.8

(90.5) 
(65.9) 
747.4 

(1) Acquired IPR&D intangibles primarily relate to PR001.
(2) The goodwill recognized from this acquisition is not deductible for tax purposes. 
(3) See Note 7 for a discussion on the estimation of the CVR liability. 

We are unable to provide the results of operations for the year ended December 31, 2021 attributable to 
Prevail as those operations were substantially integrated into our legacy business.

Pro forma information has not been included as this acquisition did not have a material impact on our 
consolidated statements of operations for the years ended December 31, 2021 and 2020.

Dermira Acquisition

Overview of Transaction

In February 2020, we acquired all shares of Dermira for a purchase price of approximately $849.3 million, net 
of cash acquired. Under terms of the agreement, we acquired lebrikizumab, a novel, investigational, 
monoclonal antibody being evaluated for the treatment of moderate-to-severe atopic dermatitis. Lebrikizumab 
was granted Fast Track designation from the FDA. We also acquired Qbrexza® (glycopyrronium) cloth, a 
medicated cloth approved by the FDA for the topical treatment of primary axillary hyperhidrosis (uncontrolled 
excessive underarm sweating). During the year ended December 31, 2021, we sold the rights to Qbrexza. 
See Note 5 for additional information.

Assets Acquired and Liabilities Assumed

The fair values recognized related to the assets acquired and liabilities assumed in this acquisition included 
goodwill of $86.8 million, other intangibles of $1.20 billion primarily related to lebrikizumab, deferred income 
tax liabilities of $49.5 million, and long-term debt of $375.5 million. After the acquisition, we repaid 
$276.2 million of long-term debt assumed as part of our acquisition of Dermira.

Revenue attributable to assets acquired in the Dermira acquisition did not have a material impact on our 
consolidated statement of operations for the year ended December 31, 2020. We are unable to provide the 
results of operations for the year ended December 31, 2020 attributable to Dermira as those operations were 
substantially integrated into our legacy business. 

Pro forma information has not been included because this acquisition did not have a material impact on our 
consolidated statements of operations for the years ended December 31, 2020 and 2019.

Loxo Acquisition

Overview of Transaction

In February 2019, we acquired all shares of Loxo for a purchase price of $6.92 billion, net of cash acquired. 
The accelerated vesting of Loxo employee equity awards was recognized as transaction expense included in 
asset impairment, restructuring, and other special charges during the year ended December 31, 2019 (see 
Note 5).

67 
 
 
 
Under the terms of the agreement, we acquired a pipeline of investigational medicines, including selpercatinib 
(LOXO-292), an oral RET inhibitor, and LOXO-305, an oral BTK inhibitor. In the second quarter of 2020, the 
FDA approved selpercatinib (Retevmo®) under its Accelerated Approval regulations and continued approval 
may be contingent upon verification and description of clinical benefit in confirmatory trials. At the time of 
approval, we reclassified our $4.60 billion intangible asset for selpercatinib (Retevmo) from indefinite-lived 
intangible assets to finite-lived intangible assets and began amortizing straight line over its estimated useful 
life.

Assets Acquired and Liabilities Assumed

The following table summarizes the amounts recognized for assets acquired and liabilities assumed in the 
acquisition of Loxo as of the acquisition date:

Estimated Fair Value at February 15, 2019
Acquired IPR&D(1)
Finite-lived intangibles(2)
Deferred income taxes
Other assets and liabilities - net
Total identifiable net assets
Goodwill(3)
Total consideration transferred - net of cash acquired

$ 

$ 

4,670.0 
980.0 
(1,032.8) 
(26.4) 
4,590.8 
2,326.9 
6,917.7 

(1) $4.60 billion of the acquired IPR&D relates to selpercatinib (LOXO-292).
(2) Contract-based intangibles for Vitrakvi and a Phase I molecule which were amortized to cost of sales on a straight-line basis over their 
estimated useful lives and were expected to have a weighted average useful life of approximately 12 years from the acquisition date. In 
the fourth quarter of 2021 we impaired the intangible for the Phase I molecule. See Note 5 for additional information. 
The goodwill recognized from this acquisition is attributable primarily to future unidentified projects and products and the assembled 
workforce for Loxo and is not deductible for tax purposes.

(3) 

Asset Acquisitions

The following table and narrative summarize our asset acquisitions during 2021, 2020, and 2019.

Counterparty

Compound(s),Therapy, or Asset

Acquisition 
Month

Phase of 
Development(1)

Acquired IPR&D 
Expense

Precision Biosciences, Inc. 

Potential in vivo therapies for 
genetic disorders

January 
2021

Pre-clinical

$ 

107.8 

Merus N.V. 

Asahi Kasei Pharma 
Corporation

Rigel Pharmaceuticals, Inc. 

MiNA Therapeutics Limited 

CD3-engaging T-cell re-
directing bispecific antibodies 
for the potential treatment of 
cancer

AK1780, an orally bioavailable 
P2X7 receptor antagonist for 
the potential treatment of 
chronic pain conditions

R552, a receptor-interacting 
serine/threonine-protein 
kinase 1 (RIPK1) inhibitor, for 
the potential treatment of 
autoimmune and inflammatory 
diseases

Pre-clinical targets that could 
lead to potential new 
medicines 

January 
2021

January 
2021

March 
2021

Pre-clinical

46.5 

Phase I

20.0 

Phase I

125.0 

May 2021

Pre-clinical

25.0 

57.3 

Protomer Technologies Inc. 

Glucose-sensing insulin 
program

July 2021

Pre-clinical

68 
 
 
 
 
 
 
 
 
 
Counterparty

Compound(s),Therapy, or Asset

Acquisition 
Month

Phase of 
Development(1)

Acquired IPR&D 
Expense

Kumquat Biosciences Inc.

Lycia Therapeutics, Inc.

ProQR Therapeutics N.V. 

QILU Regor Therapeutics Inc.

Pre-clinical small molecules 
that stimulate tumor-specific 
immune responses 

Several potential modalities 
across a spectrum of 
therapeutic areas and 
diseases
Pre-clinical targets that could 
lead to potential new 
medicines for genetic 
disorders in the liver and 
nervous system

Pre-clinical targets that could 
lead to potential new 
medicines for metabolic 
disorders

July 2021

Pre-clinical

55.0 

August 
2021

Pre-clinical

35.0 

September 
2021

Pre-clinical

26.7 

December 
2021

Pre-clinical

30.0 

Foghorn Therapeutics Inc.

Pre-clinical targets that could 
lead to potential new oncology 
medicines

December 
2021

Pre-clinical

316.6 

Entos Pharmaceuticals Inc.

Sitryx Therapeutics Limited

AbCellera Biologics Inc. 
(AbCellera)

Shanghai Junshi Biosciences 
Co., Ltd. (Junshi Biosciences)

Petra Pharma Corporation 
(Petra)

Evox Therapeutics Limited

Innovent Biologics, Inc. 
(Innovent)

Disarm Therapeutics, Inc. 

Pre-clinical targets that could 
lead to potential new nucleic 
acid-based therapies targeting 
the central and peripheral 
nervous system

Pre-clinical targets that could 
lead to potential new 
medicines for autoimmune 
diseases

Neutralizing antibodies for the 
treatment and prevention of 
COVID-19

Neutralizing antibodies for the 
treatment and prevention of 
COVID-19

Mutant-selective PI3Kα 
inhibitor that could lead to 
potential new medicine

Pre-clinical targets for the 
potential treatment of 
neurological disorders

Sintilimab injection, an anti-
PD-1 monoclonal antibody 
immuno-oncology medicine,  
for geographies outside of 
China
Disease-modifying 
therapeutics program for 
patients with axonal 
degeneration

December 
2021

Pre-clinical

30.0 

March 
2020

March 
2020(2)

Pre-clinical

52.3 

Pre-clinical

May 2020

Pre-clinical

25.0 

20.0 

May 2020

Pre-clinical

174.8 

June 2020

Pre-clinical

22.0 

October 
2020

October 
2020

Phase III

200.0 

Pre-clinical

126.3 

Fochon Pharmaceuticals, Ltd.

Pre-clinical molecule targeting  
hematological malignancies

November 
2020

Pre-clinical

40.0 

69 
 
 
 
 
 
 
 
 
 
 
 
 
 
Counterparty

AC Immune SA

ImmuNext, Inc.

Avidity Biosciences, Inc.

Centrexion Therapeutics 
Corporation

Compound(s),Therapy, or Asset
Tau aggregation inhibitor small 
molecules for the potential 
treatment of Alzheimer's 
disease and other 
neurodegenerative diseases
Novel immunometabolism 
target

Potential new medicines in 
immunology and other select 
indications

CNTX-0290, a novel, small 
molecule somatostatin 
receptor type 4 agonist

Acquisition 
Month

Phase of 
Development(1)

Acquired IPR&D 
Expense

January 
2019 & 
September 
2019(3)

Pre-clinical

127.1 

March 
2019

Pre-clinical

April 2019

Pre-clinical

July 2019

Phase I

40.0 

25.0 

47.5 

(1) The phase of development presented is as of the date of the arrangement and represents the phase of development of the most 

advanced asset acquired, where applicable.
We recognized acquired IPR&D expense of $25.0 million in May 2020 upon closing of the transaction. 

(2) 

(3) We recognized acquired IPR&D expenses of $96.9 million in January 2019 upon entering into a license agreement and $30.2 million in 

September 2019 upon entering into an amendment to the license agreement.

In connection with these arrangements, our partners may be entitled to future royalties and/or commercial 
milestones based on sales should products be approved for commercialization and/or milestones based on 
the successful progress of compounds through the development process.

Divestiture

In October 2019, we completed a transaction in which we sold the rights in China for two legacy antibiotic 
medicines, as well as a manufacturing facility in Suzhou, China to Eddingpharm, a China-based specialty 
pharmaceutical company. In connection with the sale, we received net cash proceeds of $354.8 million and 
$40.3 million from Eddingpharm in 2019 and 2020, respectively. We accounted for the transaction as the sale 
of a business. We recognized a gain of $309.8 million in other—net, (income) expense in our consolidated 
statement of operations during the year ended December 31, 2019. 

Note 4: Collaborations and Other Arrangements

We often enter into collaborative and other similar arrangements to develop and commercialize drug 
candidates. Collaborative activities may include research and development, marketing and selling (including 
promotional activities and physician detailing), manufacturing, and distribution. These arrangements often 
require milestone as well as royalty or profit-share payments, contingent upon the occurrence of certain future 
events linked to the success of the asset in development, as well as expense reimbursements from or 
payments to the collaboration partner. See Note 2 for amounts of collaboration and other revenue recognized 
from these types of arrangements.

Operating expenses for costs incurred pursuant to these arrangements are reported in their respective 
expense line item, net of any payments due to or reimbursements due from our collaboration partners, with 
such reimbursements being recognized at the time the party becomes obligated to pay. Each collaboration is 
unique in nature, and our more significant arrangements are discussed below.

Boehringer Ingelheim Diabetes Collaboration

We and Boehringer Ingelheim have a global agreement to jointly develop and commercialize a portfolio of 
diabetes compounds. Currently included in the collaboration are Boehringer Ingelheim's oral diabetes 
products: Jardiance, Glyxambi, Synjardy, Trijardy XR, Trajenta, and Jentadueto, as well as our basal insulin, 
Basaglar. Glyxambi, Synjardy, and Trijardy XR are included in the Jardiance product family. Jentadueto is 
included in the Trajenta product family. 

70 
 
 
 
In connection with the regulatory approvals of Jardiance, Trajenta and Basaglar in the U.S, Europe and 
Japan, milestone payments made for Jardiance and Trajenta were capitalized as intangible assets and are 
being amortized to cost of sales, and milestone payments received for Basaglar were recorded as contract 
liabilities and are being amortized to collaboration and other revenue. These milestones are being amortized 
through their respective term under the collaboration which, depending on country or region, is determined 
based on the latest to occur of (a) a defined number of years following launch date, (b) the expiration of the 
compound patent, or (c) any supplementary protection certificates or extensions thereto. The table below 
summarizes the net milestones capitalized (deferred) at December 31 for the compounds included in this 
collaboration: 

Net Milestones Capitalized (Deferred)(1) 

2021

2020

Jardiance   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Trajenta       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Basaglar     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  

136.1  $ 
88.5   
(149.3)  

156.2 
114.6 
(168.0) 

(1) This represents the amounts that have been capitalized (deferred) from the start of this collaboration through the end of the reporting 

period, net of amount amortized.

Through December 31, 2019, in the most significant markets, we and Boehringer Ingelheim shared equally 
the ongoing development costs, commercialization costs, and agreed upon gross margin for any product 
resulting from the collaboration. We recorded our portion of the gross margin associated with Boehringer 
Ingelheim's products as collaboration and other revenue. We recorded our sales of Basaglar to third parties 
as net product revenue with the payments made to Boehringer Ingelheim for their portion of the gross margin 
recorded as cost of sales. For all compounds under this collaboration, we recorded our portion of the 
development and commercialization costs as research and development expense and marketing, selling, and 
administrative expense, respectively. Each company was entitled to potential performance payments 
depending on the sales of the molecules it contributes to the collaboration. These performance payments may 
have resulted in the owner of the molecule retaining a greater share of the agreed upon gross margin of that 
product. Subject to achieving these thresholds, in a given period, our reported revenue for Trajenta and 
Jardiance may have been reduced by any performance payments we made related to these products. 
Similarly, performance payments we may have received related to Basaglar effectively reduced Boehringer 
Ingelheim's share of the gross margin, which reduced our cost of sales.

Effective January 1, 2020, we and Boehringer Ingelheim modernized the alliance. For the Jardiance product 
family, we and Boehringer Ingelheim share equally the ongoing development and commercialization costs in 
the most significant markets, and we record our portion of the development and commercialization costs as 
research and development expense and marketing, selling, and administrative expense, respectively. We 
receive a royalty on net sales of Boehringer Ingelheim's products in the most significant markets and 
recognize the royalty as collaboration and other revenue. Boehringer Ingelheim is entitled to potential 
performance payments depending on the net sales of the Jardiance product family; therefore, our reported 
revenue for Jardiance may be reduced by any potential performance payments we make related to this 
product family. Beginning January 1, 2021, the royalty received by us related to the Jardiance product family 
may also be increased or decreased depending on whether net sales for this product family exceed or fall 
below certain thresholds. We pay to Boehringer Ingelheim a royalty on net sales for Basaglar in the U.S. We 
record our sales of Basaglar to third parties as net product revenue with the royalty payments made to 
Boehringer Ingelheim recorded as cost of sales.

The following table summarizes our collaboration and other revenue recognized with respect to the Jardiance 
and Trajenta families of products and net product revenue recognized with respect to Basaglar:

Jardiance       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Basaglar    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Trajenta     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  

2021
1,490.8  $ 
892.5 
372.5 

2020
1,153.8  $ 
1,124.4 
358.5 

2019

944.2 
1,112.6 
590.6 

71 
 
 
 
 
Olumiant

We have a worldwide license and collaboration agreement with Incyte Corporation (Incyte), which provides us 
the development and commercialization rights to its Janus tyrosine kinase (JAK) inhibitor compound, now 
known as Olumiant (baricitinib), and certain follow-on compounds, for the treatment of inflammatory and 
autoimmune diseases. Incyte has the right to receive tiered, double digit royalty payments on worldwide net 
sales with rates ranging up to 20 percent. The agreement calls for payments by us to Incyte associated with 
certain development, success-based regulatory, and sales-based milestones. In 2020, the agreement was 
amended to include the treatment of COVID-19, with Incyte obtaining the right to receive an additional royalty 
ranging up to the low teens on worldwide net sales for the treatment of COVID-19 that exceed a specified 
aggregate worldwide net sales threshold. 

In connection with the regulatory approvals of Olumiant in the U.S., Europe, and Japan, as well as 
achievement of a sales-based milestone, milestone payments of $260.0 million and $210.0 million were 
capitalized as intangible assets as of December 31, 2021 and 2020, respectively, and are being amortized to 
cost of sales through the term of the collaboration. This represents the cumulative amounts that have been 
capitalized from the start of this collaboration through the end of each reporting period.

As of December 31, 2021, Incyte is eligible to receive up to $100.0 million of additional payments from us 
contingent upon certain success-based regulatory milestones. Incyte is also eligible to receive up to 
$100.0 million of potential sales-based milestones.

We record our sales of Olumiant, including sales of baricitinib that were made pursuant to an EUA or similar 
regulatory authorizations, to third parties as net product revenue with the royalty payments made to Incyte 
recorded as cost of sales. The following table summarizes our net product revenue recognized with respect to 
Olumiant:

Olumiant       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2021
1,115.1  $ 

2020

2019

638.9  $ 

426.9 

COVID-19 antibodies

In 2020, we entered into a worldwide license and collaboration agreement with AbCellera to co-develop 
therapeutic antibodies for the potential prevention and treatment of COVID-19, including bamlanivimab and 
bebtelovimab, for which we hold development and commercialization rights. AbCellera has the right to receive 
tiered royalty payments on worldwide net sales of bamlanivimab and bebtelovimab with percentages ranging 
in the mid-teens to mid-twenties. Royalty payments made to AbCellera are recorded as cost of sales. 

In 2020, we entered into a license and collaboration agreement with Junshi Biosciences to co-develop 
therapeutic antibodies for the potential prevention and treatment of COVID-19, including etesevimab, for 
which we hold development and commercialization rights outside of mainland China and the Special 
Administrative Regions of Hong Kong and Macau, and for which Junshi Biosciences currently maintains all 
rights in mainland China and the Special Administrative Regions of Hong Kong and Macau. Junshi 
Biosciences has the right to receive royalty payments in the mid-teens on our net sales of etesevimab. Junshi 
Biosciences also had the right to receive certain development, success-based regulatory and sales-based 
milestones. In connection with the regulatory authorizations of etesevimab (for administration with 
bamlanivimab) as well as achievement of sales-based milestones in 2021, milestone payments of 
$195.0 million were capitalized as intangible assets and are being amortized to cost of sales over the 
estimated useful life of etesevimab. During the year ended December 31, 2020, we recognized $50.0 million 
of research and development expenses related to development milestones.

Pursuant to EUAs or similar regulatory authorizations, we recognized $2.24 billion and $871.2 million of net 
product revenue associated with our sales of our COVID-19 antibodies during the years ended December 31, 
2021 and 2020, respectively. 

72Sintilimab Injection

We have a collaboration agreement with Innovent to jointly develop and commercialize sintilimab injection in 
China, where it is branded and trademarked as Tyvyt. In 2019, we and Innovent began co-commercializing 
Tyvyt in China. In 2020, we obtained an exclusive license for sintilimab injection from Innovent for 
geographies outside of China. Innovent, with collaboration from us, has filed the initial registration of sintilimab 
injection in the U.S., and we plan to pursue initial registration of sintilimab injection in other markets and all 
other subsequent registrations of sintilimab injection. We have exclusive commercialization rights outside of 
China. 

In connection with a regulatory approval for Tyvyt in China in 2021, we capitalized a milestone payment of 
$40.0 million as an intangible asset which is being amortized to cost of sales through the term of the 
collaboration. 

As of December 31, 2021, Innovent is eligible to receive up to $825.0 million for geographies outside of China 
and up to $195.0 million in China in success-based regulatory and sales-based milestones. Innovent is also 
eligible to receive tiered double digit royalties on net sales for geographies outside of China. 

We record our sales of Tyvyt to third parties as net product revenue, with payments made to Innovent for its 
portion of the gross margin reported as cost of sales. We report as collaboration and other revenue our 
portion of the gross margin for Tyvyt sales made by Innovent to third parties. The following table summarizes 
our revenue recognized in China with respect to Tyvyt: 

Tyvyt

Lebrikizumab

2021

2020

2019

$ 

418.1  $ 

308.7  $ 

134.0 

As a result of our acquisition of Dermira, we have a worldwide license agreement with F. Hoffmann-La Roche 
Ltd and Genentech, Inc. (collectively Roche), which provides us the worldwide development and 
commercialization rights to lebrikizumab. Roche has the right to receive tiered royalty payments on future 
worldwide net sales ranging in percentages from high single digits to high teens if the product is successfully 
commercialized. As of December 31, 2021, Roche is eligible to receive up to $180.0 million of payments from 
us contingent upon the achievement of success-based regulatory milestones, and up to $1.03 billion in a 
series of sales-based milestones, contingent upon the commercial success of lebrikizumab.

As a result of our acquisition of Dermira, we have a license agreement with Almirall, S.A. (Almirall), under 
which Almirall licensed the rights to develop and commercialize lebrikizumab for the treatment or prevention 
of dermatology indications, including, but not limited to, atopic dermatitis in Europe. We have the right to 
receive tiered royalty payments on future net sales in Europe ranging in percentages from low double digits to 
low twenties if the product is successfully commercialized. As of December 31, 2021, we are eligible to 
receive additional payments of $85.0 million from Almirall contingent upon the achievement of success-based 
regulatory milestones and up to $1.25 billion in a series of sales-based milestones, contingent upon the 
commercial success of lebrikizumab. As of December 31, 2021 and 2020, contract liabilities were not 
material. During the twelve months ended December 31, 2021 and 2020, milestones received and 
collaboration and other revenue recognized were not material. 

Petra

As a result of our acquisition of Petra, we are required to make milestone payments to Petra shareholders 
contingent upon the occurrence of certain future events linked to the success of the mutant-selective PI3Kα 
inhibitor. Our more significant, near term milestones include a development milestone of approximately 
$205 million in 2022 contingent upon initiation of its Phase I trial and a further development milestone of 
approximately $164 million in 2023 contingent upon achieving clinical proof of concept.

73Note 5: Asset Impairment, Restructuring, and Other Special Charges

The components of the charges included in asset impairment, restructuring, and other special charges in our 
consolidated statements of operations are described below: 

2021

2020

2019

Severance       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Asset impairment (gain) and other special charges       . . . . . . . . . . . . .
Total asset impairment, restructuring, and other special charges     . . $ 

13.0  $ 

303.1 
316.1  $ 

151.2  $ 
(20.0)   
131.2  $ 

77.8 
497.8 
575.6 

Severance costs recognized during the years ended December 31, 2020 and 2019 were incurred as a result 
of actions taken worldwide to reduce our cost structure. 

During the year ended December 31, 2021, we recognized $128.0 million of intangible asset impairment as a 
result of the decision by Bayer AG to discontinue the development of a Phase I molecule related to a contract-
based intangible asset from our acquisition of Loxo. Additionally, we recognized $108.1 million of intangible 
asset impairment from the sale of the rights to Qbrexza, as well as acquisition and integration costs 
associated with the acquisition of Prevail. 

Asset impairment and other special charges recognized during the year ended December 31, 2019 resulted 
primarily from $400.7 million of other special charges related to the acquisition of Loxo, substantially all of 
which is associated with the accelerated vesting of Loxo employee equity awards. 

Note 6: Inventories

We use the last-in, first-out (LIFO) method for the majority of our inventories located in the continental U.S. 
Other inventories are valued by the first-in, first-out (FIFO) method. FIFO cost approximates current 
replacement cost. Inventories measured using LIFO must be valued at the lower of cost or market. Inventories 
measured using FIFO must be valued at the lower of cost or net realizable value. 

Inventories at December 31 consisted of the following:

Finished products   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Work in process     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Raw materials and supplies      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total (approximates replacement cost)     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Increase to LIFO cost       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Inventories   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2021

2020

761.9  $ 

2,372.7 
717.2 
3,851.8 
34.2 
3,886.0  $ 

758.9 
2,535.4 
651.2 
3,945.5 
34.8 
3,980.3 

Inventories valued under the LIFO method comprised $1.36 billion and $1.21 billion of total inventories at 
December 31, 2021 and 2020, respectively.

We recognized a net inventory impairment charge related to our COVID-19 antibodies of $339.7 million during 
the year ended December 31, 2021 in cost of sales in our consolidated statements of operations. As part of 
our response to the COVID-19 pandemic, and at the request of the U.S. and international governments, we 
invested in large-scale manufacturing of COVID-19 antibodies at risk, in order to ensure rapid access to 
patients around the world. As the COVID-19 pandemic evolved during 2021, we incurred a net inventory 
impairment charge primarily due to the combination of changes to current and forecasted demand from U.S. 
and international governments, including changes to our agreement with the U.S. government, and near-term 
expiry dates of COVID-19 antibodies. 

74 
 
 
 
 
 
 
 
 
Note 7: Financial Instruments

Financial instruments that potentially subject us to credit risk consist principally of trade receivables and 
interest-bearing investments. Wholesale distributors of life-science products account for a substantial portion 
of our trade receivables; collateral is generally not required. We seek to mitigate the risk associated with this 
concentration through our ongoing credit-review procedures and insurance. A large portion of our cash is held 
by a few major financial institutions. We monitor our exposures with these institutions and do not expect any 
of these institutions to fail to meet their obligations. In accordance with documented corporate risk-
management policies, we monitor the amount of credit exposure to any one financial institution or corporate 
issuer. We are exposed to credit-related losses in the event of nonperformance by counterparties to risk-
management instruments but do not expect any counterparties to fail to meet their obligations given their high 
credit ratings.

We consider all highly liquid investments with a maturity of three months or less from the date of purchase to 
be cash equivalents. The cost of these investments approximates fair value.

Our equity investments are accounted for using three different methods depending on the type of equity 
investment:

•

•

Investments in companies over which we have significant influence but not a controlling interest are 
accounted for using the equity method, with our share of earnings or losses reported in other-net, 
(income) expense. 

For equity investments that do not have readily determinable fair values, we measure these 
investments at cost, less any impairment, plus or minus changes resulting from observable price 
changes in orderly transactions for the identical or similar investment of the same issuer. Any change 
in recorded value is recorded in other-net, (income) expense. 

• Our public equity investments are measured and carried at fair value. Any change in fair value is 

recognized in other-net, (income) expense. 

We review equity investments other than public equity investments for indications of impairment and 
observable price changes on a regular basis.

Our derivative activities are initiated within the guidelines of documented corporate risk-management policies 
and are intended to offset losses and gains on the assets, liabilities, and transactions being hedged. 
Management reviews the correlation and effectiveness of our derivatives on a quarterly basis.

For derivative instruments that are designated and qualify as fair value hedges, the derivative instrument is 
marked to market with gains and losses recognized currently in income to offset the respective losses and 
gains recognized on the underlying exposure. For derivative instruments that are designated and qualify as 
cash flow hedges, gains and losses are reported as a component of accumulated other comprehensive loss 
and reclassified into earnings in the same period the hedged transaction affects earnings. For derivative and 
non-derivative instruments that are designated and qualify as net investment hedges, the foreign currency 
translation gains or losses due to spot rate fluctuations are reported as a component of accumulated other 
comprehensive loss. Derivative contracts that are not designated as hedging instruments are recorded at fair 
value with the gain or loss recognized in earnings during the period of change.

We may enter into foreign currency forward or option contracts to reduce the effect of fluctuating currency 
exchange rates (principally the euro, British pound, and Japanese yen). Foreign currency derivatives used for 
hedging are put in place using the same or like currencies and duration as the underlying exposures. Forward 
and option contracts are principally used to manage exposures arising from subsidiary trade and loan 
payables and receivables denominated in foreign currencies. These contracts are recorded at fair value with 
the gain or loss recognized in other–net, (income) expense. We may enter into foreign currency forward and 
option contracts and currency swaps as fair value hedges of firm commitments. Forward contracts generally 
have maturities not exceeding 12 months. At December 31, 2021, we had outstanding foreign currency 
forward commitments to purchase 4.43 billion U.S. dollars and sell 3.92 billion euro; commitments to 
purchase 3.84 billion euro and sell 4.37 billion U.S. dollars; commitments to purchase 159.2 million U.S. 
dollars and sell 18.26 billion Japanese yen, and commitments to purchase 223.0 million British pounds and 
sell 296.0 million U.S. dollars, which all have settlement dates within 180 days.

75Foreign currency exchange risk is also managed through the use of foreign currency debt and cross-currency 
interest rate swaps. Our foreign currency-denominated notes had carrying amounts of $7.90 billion and 
$6.02 billion as of December 31, 2021 and 2020, respectively, of which $5.79 billion and $4.50 billion have 
been designated as, and are effective as, economic hedges of net investments in certain of our foreign 
operations as of December 31, 2021 and 2020, respectively. At December 31, 2021, we had outstanding 
cross currency swaps with notional amounts of $1.02 billion swapping U.S. dollars to euro and $1.00 billion 
swapping Swiss francs to U.S. dollars which have settlement dates ranging through 2028. Our cross-currency 
interest rate swaps, for which a majority convert a portion of our U.S. dollar-denominated fixed rate debt to 
foreign-denominated fixed rate debt, have also been designated as, and are effective as, economic hedges of 
net investments.

In the normal course of business, our operations are exposed to fluctuations in interest rates which can vary 
the costs of financing, investing, and operating. We seek to address a portion of these risks through a 
controlled program of risk management that includes the use of derivative financial instruments. The objective 
of controlling these risks is to limit the impact of fluctuations in interest rates on earnings. Our primary interest-
rate risk exposure results from changes in short-term U.S. dollar interest rates. In an effort to manage interest-
rate exposures, we strive to achieve an acceptable balance between fixed- and floating-rate debt and 
investment positions and may enter into interest rate swaps or collars to help maintain that balance. 

Interest rate swaps or collars that convert our fixed-rate debt to a floating rate are designated as fair value 
hedges of the underlying instruments. Interest rate swaps or collars that convert floating-rate debt to a fixed 
rate are designated as cash flow hedges. Interest expense on the debt is adjusted to include the payments 
made or received under the swap agreements. Cash proceeds from or payments to counterparties resulting 
from the termination of interest rate swaps are classified as operating activities in our consolidated statements 
of cash flows. At December 31, 2021, substantially all of our total long-term debt is at a fixed rate. We have 
converted approximately 13 percent of our long-term fixed-rate notes to floating rates through the use of 
interest rate swaps.

We also may enter into forward-starting interest rate swaps, which we designate as cash flow hedges, as part 
of any anticipated future debt issuances in order to reduce the risk of cash flow volatility from future changes 
in interest rates. The change in fair value of these instruments is recorded as part of other comprehensive 
income (loss) and, upon completion of a debt issuance and termination of the swap, is amortized to interest 
expense over the life of the underlying debt. As of December 31, 2021, the total notional amounts of forward-
starting interest rate contracts in designated cash flow hedging instruments were $1.75 billion, which have 
settlement dates ranging between 2023 and 2025.

The Effect of Risk Management Instruments on the Consolidated Statements of Operations

The following effects of risk-management instruments were recognized in other–net, (income) expense:

2021

2020

2019

Fair value hedges:

Effect from hedged fixed-rate debt   . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Effect from interest rate contracts     . . . . . . . . . . . . . . . . . . . . . . . . . . .  

(78.5)  $ 
78.5 

86.9  $ 
(86.9)   

112.1 
(112.1) 

Cash flow hedges:

Effective portion of losses on interest rate contracts reclassified 
from accumulated other comprehensive loss       . . . . . . . . . . . . . . . . .  

   Cross-currency interest rate swaps       . . . . . . . . . . . . . . . . . . . . . . . . .
Net (gains) losses on foreign currency exchange contracts not 
designated as hedging instruments        . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

16.6 
41.8 

16.4 
(102.4)   

204.6 
263.0  $ 

(123.7)   
(209.7)  $ 

15.9 
(17.1) 

61.9 
60.7 

During the years ended December 31, 2021, 2020, and 2019, the amortization of losses related to the portion 
of our risk management hedging instruments, fair value hedges, and cash flow hedges that was excluded 
from the assessment of effectiveness was not material. 

76 
 
 
 
 
 
The Effect of Risk-Management Instruments on Other Comprehensive Income (Loss)

The effective portion of risk-management instruments that was recognized in other comprehensive income 
(loss) is as follows:

Net investment hedges:
    Foreign currency-denominated notes     . . . . . . . . . . . . . . . . . . . . . . . $ 
    Cross-currency interest rate swaps      . . . . . . . . . . . . . . . . . . . . . . . . .  
Cash flow hedges:
    Forward-starting interest rate swaps     . . . . . . . . . . . . . . . . . . . . . . . .  
    Cross-currency interest rate swaps      . . . . . . . . . . . . . . . . . . . . . . . . .  

435.0  $ 
213.7 

(404.0)  $ 
(207.9)   

97.6 
42.3 

(110.9)   
(53.7)   

40.1 
47.4 

31.6 
(8.3) 

2021

2020

2019

During the next 12 months, we expect to reclassify $16.5 million of pretax net losses on cash flow hedges 
from accumulated other comprehensive loss to other–net, (income) expense. During the years ended 
December 31, 2021, 2020, and 2019, the amounts excluded from the assessment of hedge effectiveness 
recognized in other comprehensive income (loss) were not material. 

77 
 
 
Fair Value of Financial Instruments

The following tables summarize certain fair value information at December 31 for assets and liabilities 
measured at fair value on a recurring basis, as well as the carrying amount and amortized cost of certain 
other investments:

Fair Value Measurements Using

Description
December 31, 2021
Cash equivalents       . . . . . . . . . . . . . . . $  2,379.5  $  2,379.5  $ 
Short-term investments:

Cost (1)

Carrying
Amount

Quoted Prices 
in Active 
Markets for 
Identical 
Assets
(Level 1)

Significant
Other
Observable
Inputs
(Level 2)

Significant
Unobservable
Inputs
(Level 3)

Fair
Value

2,361.0  $ 

18.5  $ 

—  $  2,379.5 

U.S. government and agency 
securities     . . . . . . . . . . . . . . . . . . . . . $ 
Corporate debt securities      . . . . . . .
Mortgage-backed securities      . . . . .
Asset-backed securities        . . . . . . . .
Other securities       . . . . . . . . . . . . . . .
Short-term investments   . . . . . . . . . $ 

Noncurrent investments:

25.7  $ 
43.7 
0.2 
6.2 
14.3 
90.1 

U.S. government and agency 
securities     . . . . . . . . . . . . . . . . . . . . . $ 
Corporate debt securities      . . . . . . .
Mortgage-backed securities      . . . . .
Asset-backed securities        . . . . . . . .
Other securities       . . . . . . . . . . . . . . .
Marketable equity securities      . . . .
Equity investments without 
readily determinable fair values(2)
548.1 
Equity method investments(2)
   . . . .
771.5 
Noncurrent investments        . . . . . . . . $  3,212.6 

137.0  $ 
235.3 
109.8 
23.1 
108.1 
1,279.7 

25.6  $ 
43.7 
0.2 
6.2 
14.3 

25.7  $ 
— 
— 
— 
— 

—  $ 

43.7 
0.2 
6.2 
— 

—  $ 
— 
— 
— 
14.3 

25.7 
43.7 
0.2 
6.2 
14.3 

136.8  $ 
232.7 
108.1 
23.1 
22.2 
487.0 

137.0  $ 
— 
— 
— 
— 
1,279.7 

—  $ 

235.3 
109.8 
23.1 
— 
— 

—  $ 
— 
— 
— 
108.1 
— 

137.0 
235.3 
109.8 
23.1 
108.1 
1,279.7 

December 31, 2020
Cash equivalents       . . . . . . . . . . . . . . . $  2,097.9  $  2,097.9  $ 
Short-term investments:

2,097.9  $ 

—  $ 

—  $  2,097.9 

U.S. government and agency 
securities     . . . . . . . . . . . . . . . . . . . . . $ 
Corporate debt securities      . . . . . . .
Asset-backed securities        . . . . . . . .
Other securities       . . . . . . . . . . . . . . .
Short-term investments   . . . . . . . . . $ 

Noncurrent investments:

9.9  $ 
2.8 
1.2 
10.3 
24.2 

78.7  $ 

U.S. government and agency 
securities     . . . . . . . . . . . . . . . . . . . . . $ 
Corporate debt securities      . . . . . . .
Mortgage-backed securities      . . . . .
Asset-backed securities        . . . . . . . .
Other securities       . . . . . . . . . . . . . . .
Marketable equity securities      . . . .
Equity investments without 
readily determinable fair values(2)
373.9 
Equity method investments(2)
   . . . .
471.8 
Noncurrent investments        . . . . . . . . $  2,966.8 

137.0 
106.4 
24.3 
110.5 
1,664.2 

9.9  $ 
2.8 
1.2 
10.3 

9.9  $ 
— 
— 
— 

74.3  $ 

126.8 
101.4 
23.7 
31.8 
311.6 

78.7  $ 
— 
— 
— 
— 
1,664.2 

—  $ 
2.8 
1.2 
— 

—  $ 

137.0 
106.4 
24.3 
— 
— 

—  $ 
— 
— 
10.3 

9.9 
2.8 
1.2 
10.3 

—  $ 
— 
— 
— 
110.5 
— 

78.7 
137.0 
106.4 
24.3 
110.5 
1,664.2 

(1) For available-for-sale debt securities, amounts disclosed represent the securities' amortized cost.
(2) Fair value disclosures are not applicable for equity method investments and investments accounted for under the measurement 

alternative for equity investments.

78 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
Fair Value Measurements Using

Quoted 
Prices in 
Active 
Markets for 
Identical 
Assets
(Level 1)

Carrying
Amount

Significant
Other
Observable
Inputs
(Level 2)

Significant
Unobservable
Inputs
(Level 3)

Fair
Value

Description
Long-term debt, including current 
portion
December 31, 2021      . . . . . . . . . . . . . . . . . . . . . $ (16,884.7)  $  —  $ (18,157.7)  $ 
December 31, 2020      . . . . . . . . . . . . . . . . . . . . .

  (16,595.3)   

  (19,038.9)   

— 

—  $ (18,157.7) 
  (19,038.9) 
— 

79 
 
Fair Value Measurements Using

Quoted Prices 
in Active 
Markets for 
Identical 
Assets
(Level 1)

Significant
Other
Observable
Inputs
(Level 2)

Carrying
Amount

Significant
Unobservable
Inputs
(Level 3)

Fair
Value

Description
December 31, 2021
Risk-management instruments

Interest rate contracts designated as fair 
value hedges:

Other receivables      . . . . . . . . . . . . . . . . . . . . $ 
Other noncurrent assets      . . . . . . . . . . . . . .
Other noncurrent liabilities   . . . . . . . . . . . . .  

4.8  $ 

78.3 
(7.6)   

—  $ 
— 
— 

4.8  $ 

78.3 
(7.6)   

—  $ 
— 
— 

4.8 
78.3 
(7.6) 

Interest rate contracts designated as cash 
flow hedges:

Other noncurrent assets      . . . . . . . . . . . . . .
Other noncurrent liabilities   . . . . . . . . . . . . .  

49.2 
(31.7)   

Cross-currency interest rate contracts 
designated as net investment hedges:

Other noncurrent assets      . . . . . . . . . . . . . .
    Other current liabilities     . . . . . . . . . . . . . . . .  
Cross-currency interest rate contracts 
designated as cash flow hedges:

31.3 
(1.2)   

Other noncurrent assets      . . . . . . . . . . . . . .
Other noncurrent liabilities   . . . . . . . . . . . . .  

33.2 
(1.3)   

Foreign exchange contracts not 
designated as hedging instruments:

Other receivables      . . . . . . . . . . . . . . . . . . . .  
Other current liabilities    . . . . . . . . . . . . . . . .  

9.9 
(35.3)   

Contingent consideration liabilities:

Other noncurrent liabilities   . . . . . . . . . . . . .  

(70.5)   

— 
— 

— 
— 

— 
— 

— 
— 

— 

49.2 
(31.7)   

31.3 
(1.2)   

33.2 
(1.3)   

9.9 
(35.3)   

— 
— 

— 
— 

— 
— 

— 
— 

49.2 
(31.7) 

31.3 
(1.2) 

33.2 
(1.3) 

9.9 
(35.3) 

— 

(70.5)   

(70.5) 

December 31, 2020
Risk-management instruments

Interest rate contracts designated as fair 
value hedges:

Other noncurrent assets      . . . . . . . . . . . . . .
Interest rate contracts designated as cash 
flow hedges:

158.9 

— 

158.9 

— 

158.9 

Other noncurrent assets      . . . . . . . . . . . . . .
Other noncurrent liabilities   . . . . . . . . . . . . .  

38.1 
(97.8)   

Cross-currency interest rate contracts 
designated as net investment hedges:
    Other current liabilities     . . . . . . . . . . . . . . . .  
Other noncurrent liabilities   . . . . . . . . . . . . .  

Cross-currency interest rate contracts 
designated as cash flow hedges:

(92.6)   
(97.2)   

Other noncurrent assets      . . . . . . . . . . . . . .
Other noncurrent liabilities   . . . . . . . . . . . . .  

34.4 
(2.9)   

Foreign exchange contracts not 
designated as hedging instruments:

Other receivables      . . . . . . . . . . . . . . . . . . . .  
Other current liabilities    . . . . . . . . . . . . . . . .  

41.1 
(15.2)   

— 
— 

— 
— 

— 
— 

— 
— 

38.1 
(97.8)   

(92.6)   
(97.2)   

34.4 
(2.9)   

41.1 
(15.2)   

— 
— 

— 
— 

— 
— 

— 
— 

38.1 
(97.8) 

(92.6) 
(97.2) 

34.4 
(2.9) 

41.1 
(15.2) 

80 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Risk-management instruments above are disclosed on a gross basis. There are various rights of setoff 
associated with certain of the risk-management instruments above that are subject to enforceable master 
netting arrangements or similar agreements. Although various rights of setoff and master netting 
arrangements or similar agreements may exist with the individual counterparties to the risk-management 
instruments above, individually, these financial rights are not material.

We determine our Level 1 and Level 2 fair value measurements based on a market approach using quoted 
market values, significant other observable inputs for identical or comparable assets or liabilities, or 
discounted cash flow analyses. Level 3 fair value measurements for other investment securities are 
determined using unobservable inputs, including the investments' cost adjusted for impairments and price 
changes from orderly transactions. Fair values are not readily available for certain equity investments 
measured under the measurement alternative. As of December 31, 2021, we had approximately $828 million 
of unfunded commitments to invest in venture capital funds, which we anticipate will be invested over a period 
of up to 10 years.

Contingent consideration liability relates to our liability arising in connection with the CVR issued as a result of 
the Prevail acquisition. The fair value of the CVR liability was estimated using a discounted cash flow analysis 
and Level 3 inputs, including projections representative of a market participant's view of the expected cash 
payment associated with the first potential regulatory approval of a Prevail compound in the applicable 
countries based on probabilities of technical success, timing of the potential approval events for the 
compounds, and an estimated discount rate. See Note 3 for additional information related to the CVR 
arrangement. 

The table below summarizes the contractual maturities of our investments in debt securities measured at fair 
value as of December 31, 2021:

Maturities by Period

Total

Less Than
1 Year

1-5      

Years

6-10    
Years

More Than 
10 Years

Fair value of debt securities     . . . . . . . . . . . . . . . . $ 

581.0  $ 

75.9  $ 

216.5  $ 

126.4  $ 

162.2 

The net gains recognized in our consolidated statements of operations for equity securities were 
$176.9 million, $1.44 billion, and $401.2 million for the years ended December 31, 2021, 2020, and 2019, 
respectively. The net gains/losses recognized for the years ended December 31, 2021, 2020, and 2019 on 
equity securities sold during the respective periods were not material.

We adjust our equity investments without readily determinable fair values based upon changes in the equity 
instruments' values resulting from observable price changes in orderly transactions for an identical or similar 
investment of the same issuer. Downward adjustments resulting from an impairment are recorded based upon 
impairment considerations, including the financial condition and near term prospects of the issuer, general 
market conditions, and industry specific factors. Adjustments recorded for the years ended December 31, 
2021, 2020, and 2019 were not material.

A summary of the amount of unrealized gains and losses in accumulated other comprehensive loss and the 
fair value of available-for-sale securities in an unrealized gain or loss position follows:

2021

2020

Unrealized gross gains        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Unrealized gross losses       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fair value of securities in an unrealized gain position     . . . . . . . . . . . . . . . . . . . . . . . .
Fair value of securities in an unrealized loss position       . . . . . . . . . . . . . . . . . . . . . . . .

9.7  $ 
5.2 
250.7 
290.2 

20.9 
0.5 
348.9 
11.4 

We periodically assess our investment in available-for-sale securities for impairment losses and credit losses. 
The amount of credit losses are determined by comparing the difference between the present value of future 
cash flows expected to be collected on these securities and the amortized cost. Factors considered in 
assessing credit losses include the position in the capital structure, vintage and amount of collateral, 
delinquency rates, current credit support, and geographic concentration. Impairment and credit losses related 
to available-for-sale securities were not material for the years ended December 31, 2021, 2020, and 2019.

81 
 
 
 
 
 
 
As of December 31, 2021, the available-for-sale securities in an unrealized loss position include primarily 
fixed-rate debt securities of varying maturities, which are sensitive to changes in the yield curve and other 
market conditions. Approximately 97 percent of the fixed-rate debt securities in a loss position are investment-
grade debt securities. As of December 31, 2021, we do not intend to sell, and it is not more likely than not that 
we will be required to sell, the securities in a loss position before the market values recover or the underlying 
cash flows have been received, and there is no indication of default on interest or principal payments for any 
of our debt securities.

Activity related to our available-for-sale securities was as follows:

Proceeds from sales     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Realized gross gains on sales       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Realized gross losses on sales    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  

174.7  $ 
2.8 
1.7 

264.8  $ 
4.5 
8.2 

431.6 
4.9 
3.0 

2021

2020

2019

Realized gains and losses on sales of available-for-sale investments are computed based upon specific 
identification of the initial cost adjusted for any other-than-temporary declines in fair value that were recorded 
in earnings.

Accounts Receivable Factoring Arrangements

We have entered into accounts receivable factoring agreements with financial institutions to sell certain of our 
non-U.S. accounts receivable. These transactions are accounted for as sales and result in a reduction in 
accounts receivable because the agreements transfer effective control over and risk related to the receivables 
to the buyers. Our factoring agreements do not allow for recourse in the event of uncollectibility, and we do 
not retain any interest in the underlying accounts receivable once sold. We derecognized $550.5 million and 
$754.9 million of accounts receivable as of December 31, 2021 and 2020, respectively, under these factoring 
arrangements. The costs of factoring such accounts receivable on our consolidated results of operations for 
the years ended December 31, 2021, 2020, and 2019 were not material.

Note 8: Goodwill and Other Intangibles

Goodwill

Goodwill results from excess consideration in a business combination over the fair value of identifiable net 
assets acquired. Goodwill is not amortized but is reviewed for impairment at least annually, or more frequently 
if impairment indicators are present, by first assessing qualitative factors to determine whether it is more likely 
than not that the fair value is less than its carrying amount. If we conclude it is more likely than not that the fair 
value is less than the carrying amount, a quantitative test that compares the fair value to its carrying value is 
performed to determine the amount of any impairment. The changes in goodwill during 2021 and 2020 were 
primarily related to our acquisitions of Prevail and Dermira, respectively. See Note 3 for additional information.

No impairments occurred with respect to the carrying value of goodwill for the years ended December 31, 
2021, 2020, and 2019.

82 
 
 
 
 
Other Intangibles

The components of intangible assets other than goodwill at December 31 were as follows:

Description
Finite-lived intangible assets:

2021

2020

Carrying
Amount, 
Gross

Accumulated
Amortization

Carrying
Amount, 
Net

Carrying
Amount, 
Gross

Accumulated
Amortization

Carrying
Amount, 
Net

Marketed products    . . . . . . . $  7,987.2  $  (2,229.2)  $  5,758.0  $  7,984.0  $  (1,659.5)  $  6,324.5 
Other     . . . . . . . . . . . . . . . . . . .  
24.5 
Total finite-lived intangible 
assets      . . . . . . . . . . . . . . . . . .  

(1,727.8)   

(2,289.7)   

6,349.0 

8,056.6 

5,766.9 

8,076.8 

(60.5)   

(68.3)   

69.4 

92.8 

8.9 

Indefinite-lived intangible 
assets:

Acquired IPR&D      . . . . . . . . .  

1,101.0 
— 
Other intangibles      . . . . . . . . . . $  9,981.6  $  (2,289.7)  $  7,691.9  $  9,177.8  $  (1,727.8)  $  7,450.0 

1,925.0 

1,101.0 

1,925.0 

— 

Marketed products consist of the amortized cost of the rights to assets acquired in business combinations and 
approved for marketing in a significant global jurisdiction (U.S., Europe, and Japan) and capitalized milestone 
payments. For transactions other than a business combination, we capitalize milestone payments incurred at 
or after the product has obtained regulatory approval for marketing.

Other finite-lived intangible assets consist primarily of the amortized cost of licensed platform technologies 
that have alternative future uses in research and development, manufacturing technologies, and customer 
relationships from business combinations. 

Acquired IPR&D consists of the fair values of acquired IPR&D projects acquired in business combination, 
adjusted for subsequent impairments, if any. The costs of acquired IPR&D projects acquired directly in a 
transaction other than a business combination are capitalized as other intangible assets if the projects have 
an alternative future use; otherwise, they are expensed immediately. See Note 3 for acquired IPR&D projects 
that had no alternative future use. 

Several methods may be used to determine the estimated fair value of other intangibles acquired in a 
business combination. We utilize the "income method," which is a Level 3 fair value measurement and applies 
a probability weighting that considers the risk of development and commercialization to the estimated future 
net cash flows that are derived from projected revenues and estimated costs. These projections are based on 
factors such as relevant market size, patent protection, historical pricing of similar products, analyst 
expectations, and expected industry trends. The estimated future net cash flows are then discounted to the 
present value using an appropriate discount rate. This analysis is performed for each asset independently. 
The acquired IPR&D assets are treated as indefinite-lived intangible assets until completion or abandonment 
of the projects, at which time the assets are tested for impairment and amortized over the remaining useful life 
or written off, as appropriate. 

The change in marketed products in 2021 primarily related to the sale of rights to Qbrexza in 2021 as well as 
the impairment of a Phase I molecule related to a contract-based intangible. See Note 5 for additional 
information. These decreases were more than offset by the recognition of several milestones related to the 
COVID-19 therapies that occurred in 2021. The increase in the acquired IPR&D in 2021 is due to the 
acquisition of Prevail. See Note 3 for additional information regarding intangible assets acquired in a recent 
business combination and Note 4 for additional information regarding capitalized milestone payments. 

Indefinite-lived intangible assets are reviewed for impairment at least annually, or more frequently if 
impairment indicators are present, by first assessing qualitative factors to determine whether it is more likely 
than not that the fair value of the asset is less than its carrying amount. If we conclude it is more likely than 
not that the fair value is less than the carrying amount, a quantitative test that compares the fair value of the 
intangible asset to its carrying value is performed to determine the amount of any impairment. Finite-lived 
intangible assets are reviewed for impairment when an indicator of impairment is present. When required, a 
comparison of fair value to the carrying amount of assets is performed to determine the amount of any 
impairment. When determining the fair value of indefinite-lived acquired IPR&D as well as the fair value of 
finite-lived intangible assets for impairment testing purposes, we utilize the "income method" discussed 
above. 

83 
 
 
 
 
 
 
 
 
 
 
 
Intangible assets with finite lives are capitalized and are amortized primarily to cost of sales over their 
estimated useful lives, ranging from one to 20 years. As of December 31, 2021, the remaining weighted-
average amortization period for finite-lived intangible assets was approximately 14 years. 

Amortization expense related to finite-lived intangible assets was as follows:

Amortization expense    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

628.8  $ 

428.2  $ 

225.8 

2021

2020

2019

The estimated amortization expense for each of the next five years associated with our finite-lived intangible 
assets as of December 31, 2021 is as follows:

Estimated amortization expense     . . . . . . . . . . . . . . . . . . . $  570.9  $  483.5  $  433.7  $  417.1  $  408.8 

2022

2023

2024

2025

2026

Note 9: Property and Equipment

Property and equipment is stated on the basis of cost. Provisions for depreciation of buildings and equipment 
are computed generally by the straight-line method at rates based on their estimated useful lives (12 to 50 
years for buildings and three to 25 years for equipment). We review the carrying value of long-lived assets for 
potential impairment on a periodic basis and whenever events or changes in circumstances indicate the 
carrying value of an asset may not be recoverable. Impairment is determined by comparing projected 
undiscounted cash flows to be generated by the asset to its carrying value. If an impairment is identified, a 
loss is recorded equal to the excess of the asset's net book value over its fair value, and the cost basis is 
adjusted.

At December 31, property and equipment consisted of the following:

Land     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Buildings        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Equipment      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Construction in progress     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  

Less accumulated depreciation     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Property and equipment, net        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2021

2020

258.7  $ 

7,588.1 
8,937.2 
2,177.8 
18,961.8 
(9,976.7)   
8,985.1  $ 

226.8 
7,326.1 
8,560.9 
2,138.8 
18,252.6 
(9,570.7) 
8,681.9 

84 
 
 
 
 
 
Depreciation expense related to property and equipment was as follows:

Depreciation expense   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  787.0  $  765.2  $  814.7 

2021

2020

2019

Capitalized interest costs were not material for the years ended December 31, 2021, 2020, and 2019. 

The following table summarizes long-lived assets by geographical area:

Long-lived assets(1):

U.S. and Puerto Rico    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  6,620.0  $  6,113.6 
Ireland      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1,786.9 
Other foreign countries   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1,747.7 
Long-lived assets    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  10,013.3  $  9,648.2 

1,702.3 
1,691.0 

(1) Long-lived assets consist of property and equipment, net, operating lease assets, and certain other noncurrent assets.

2021

2020

Note 10: Leases

We determine if an arrangement is a lease at inception. We have leases with terms up to 14 years primarily 
for corporate offices, research and development facilities, vehicles, and equipment, including some of which 
have options to extend and/or early-terminate the leases. We determine the lease term by assuming the 
exercise of any renewal and/or early-termination options that are reasonably assured.

Operating lease right-of-use assets are presented as other noncurrent assets in our consolidated balance 
sheets, and the current and long-term portions of operating lease liabilities are included in other current 
liabilities and other noncurrent liabilities, respectively, in our consolidated balance sheets. Short-term leases, 
which are deemed at inception to have a lease term of 12 months or less, are not recorded on the 
consolidated balance sheets. 

Operating lease assets represent our right to use an underlying asset for the lease term and operating lease 
liabilities represent our obligation to make lease payments arising from the lease. Operating lease assets and 
liabilities are recognized at commencement date based on the present value of lease payments over the 
lease term. As most of our leases do not provide an implicit rate, we use our incremental borrowing rate 
based on the information available at commencement date in determining the present value of lease 
payments. 

Lease expense for operating lease assets, which is recognized on a straight-line basis over the lease term, 
was $159.4 million, $154.6 million, and $172.8 million during the years ended December 31, 2021, 2020, and 
2019, respectively. Variable lease payments, which represent non-lease components such as maintenance, 
insurance and taxes, and which vary due to changes in facts or circumstances occurring after the 
commencement date other than the passage of time, are expensed in the period in which the payment 
obligation is incurred and were not material during the years ended December 31, 2021, 2020, and 2019. 
Short-term lease expense was not material during the years ended December 31, 2021, 2020, and 2019.

85 
 
 
 
Supplemental balance sheet information related to operating leases as of December 31, 2021 and 2020 was 
as follows:

Weighted-average remaining lease term      . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Weighted-average discount rate     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2021

2020

7 years
 3.0 %

7 years
 3.3 %

Supplemental cash flow information related to operating leases during the years ended December 31, 2021, 
2020, and 2019 was as follows:

Operating cash flows from operating leases     . . . . . . . . . . . $ 
Right-of-use assets obtained in exchange for new 
operating lease liabilities     . . . . . . . . . . . . . . . . . . . . . . . . . . .

2021

2020

2019

156.7  $ 

160.9  $ 

153.6 

163.5 

136.7

81.2

The annual minimum lease payments of our operating lease liabilities as of December 31, 2021 were as 
follows:

2022       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
2023       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2024       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2025       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2026       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
After 2026      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total lease payments     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Less imputed interest        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Total       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

148.4 
117.6 
95.4 
79.7 
64.5 
270.2 
775.8 
90.1 
685.7 

Finance leases are included in property and equipment, short-term borrowings and current maturities of long-
term debt, and long-term debt in our consolidated balance sheets. Finance leases are not material to our 
consolidated financial statements.

Note 11: Borrowings

Debt at December 31 consisted of the following:

Long-term notes         . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  16,741.2  $  16,348.7 
Other long-term debt     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14.8 
Unamortized debt issuance costs      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(89.1) 
Fair value adjustment on hedged long-term notes   . . . . . . . . . . . . . . . . . . . . . . . . . . .  
320.9 
Total debt     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
16,595.3 
Less current portion     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
(8.7) 
Long-term debt      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  15,346.4  $  16,586.6 

10.8 
(84.2)   
216.9 
16,884.7 
(1,538.3)   

2021

2020

86 
 
 
 
 
 
 
 
The following table summarizes long-term notes at December 31:

2.35% notes due 2022       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
3.00% notes due 2022       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.00% euro denominated notes due 2022    . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
0.15% Swiss franc denominated notes due 2024     . . . . . . . . . . . . . . . . . . . . . . .  
7.125% notes due 2025       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.75% notes due 2025       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.625% euro denominated notes due 2026     . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
5.5% notes due 2027     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
3.1% notes due 2027     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
0.45% Swiss franc denominated notes due 2028     . . . . . . . . . . . . . . . . . . . . . . .  
3.375% notes due 2029       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
0.42% Japanese yen denominated notes due 2029       . . . . . . . . . . . . . . . . . . . .
2.125% euro denominated notes due 2030     . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
0.625% euro denominated notes due 2031     . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
0.50% euro denominated notes due 2033
0.56% Japanese yen denominated notes due 2034       . . . . . . . . . . . . . . . . . . . .
6.77% notes due 2036       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.55% notes due 2037       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.95% notes due 2037       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.875% notes due 2039       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.625% British pound denominated notes due 2043
4.65% notes due 2044       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.7% notes due 2045     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
3.95% notes due 2047       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.95% notes due 2049       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.70% euro denominated notes due 2049    . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
0.97% Japanese yen denominated notes due 2049       . . . . . . . . . . . . . . . . . . . .
2.25% notes due 2050       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.125% euro denominated notes due 2051
4.15% notes due 2059       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.50% notes due 2060       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.375% euro denominated notes due 2061
Unamortized note discounts      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Total long-term notes      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2021

2020

750.0  $ 
99.2   
678.2   
654.7   
217.5   
560.6   
847.7   
364.3   
401.5   
436.4   
930.6   
199.0   
847.7   
678.2   
678.2   
80.5   
158.6   
444.7   
266.8   
240.3   
337.1   
38.3   
386.8   
347.0   
958.2   
1,130.3   
66.3   

750.0 
99.2 
737.9 
679.7 
229.7 
560.6 
922.4 
377.5 
401.5 
453.2 
1,150.0 
222.4 
922.4 
737.9 
— 
90.0 
174.4 
476.2 
284.1 
360.7 
— 
43.0 
412.5 
436.1 
1,500.0 
1,229.9 
74.1 

1,250.0   
565.2   
591.3   
850.0   
791.2   
(105.2)  
16,741.2  $ 

1,250.0 
— 
1,000.0 
850.0 
— 
(76.7) 
16,348.7 

The weighted-average effective borrowing rate for each issuance of the long term-notes approximates the 
stated interest rate. 

At December 31, 2021, we had a total of $5.26 billion of unused committed bank credit facilities, which 
consisted primarily of a $3.00 billion credit facility that expires in December 2026 and a $2.00 billion 364-day 
facility that expires in November 2022, both of which are available to support our commercial paper program. 
We have not drawn against the $3.00 billion and $2.00 billion facilities as of December 31, 2021. Of the 
remaining committed bank credit facilities, the outstanding balances as of December 31, 2021 and 2020 were 
not material. Compensating balances and commitment fees are not material, and there are no conditions that 
are probable of occurring under which the lines may be withdrawn. 

87 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
In September 2021, we issued euro-denominated notes consisting of €600.0 million of 0.50 percent fixed-rate 
notes due in September 2033, with interest to be paid annually. The net proceeds from the offering have 
been, and will continue to be, used to fund, in whole or in part, eligible projects designed to advance one or 
more of our environmental, social, and governance objectives.

In September 2021, we issued euro-denominated notes consisting of €500.0 million of 1.125 percent fixed-
rate notes due in September 2051 and €700.0 million of 1.375 percent fixed-rate notes due in September 
2061, with interest to be paid annually, and British pound-denominated notes consisting of £250.0 million of 
1.625 percent fixed-rate notes due in September 2043, with interest to be paid annually. We paid $1.91 billion 
of the net cash proceeds from the offering to purchase and redeem certain higher interest rate U.S. dollar-
denominated notes with an aggregate principal amount of $1.50 billion, resulting in a debt extinguishment loss 
of $405.2 million. This loss was included in other-net, (income) expense in our consolidated statement of 
operations for the year ended December 31, 2021. The $1.50 billion principal amount of higher interest rate 
U.S. dollar-denominated notes that were redeemed primarily included $541.8 million of 3.95 percent notes 
due 2049, $408.7 million of 4.15 percent notes due 2059, and $219.4 million of 3.375 percent notes due 
2029. We used the remaining net proceeds from the offering to prefund certain 2022 debt maturities and for 
general corporate purposes. 

In May 2020, we issued $1.00 billion of 2.25 percent fixed-rate notes due in May 2050, with interest to be paid 
semi-annually. We used the net cash proceeds from the offering of $988.6 million for general corporate 
purposes, including the repayment of outstanding commercial paper. 

In August 2020, we issued $850.0 million of 2.50 percent fixed-rate notes due in September 2060 and an 
additional $250.0 million of our 2.25 percent fixed-rate notes due in May 2050, with interest to be paid semi-
annually. We used the net cash proceeds from the offering of $1.07 billion for general corporate purposes, 
including the repayment of outstanding commercial paper. 

In February 2019, we issued $1.15 billion of 3.375 percent fixed-rate notes due in March 2029, $850.0 million 
of 3.875 percent fixed-rate notes due in March 2039, $1.50 billion of 3.95 percent fixed-rate notes due in 
March 2049, and $1.00 billion of 4.15 percent fixed-rate notes due in March 2059, with interest to be paid 
semi-annually. We used the net cash proceeds of $4.45 billion from the offering to repay commercial paper 
that was issued in connection with the acquisition of Loxo and for general corporate purposes.

In November 2019, we issued euro-denominated notes consisting of €600.0 million of 0.625 percent fixed-
notes due November 2031 and €1.00 billion of 1.70 percent fixed-rate notes due in November 2049 with 
interest to be paid annually. We paid $2.27 billion, comprised of $1.75 billion of net cash proceeds from the 
offering and proceeds from commercial paper, to purchase and redeem certain higher interest rate U.S. dollar 
denominated notes with an aggregate principal amount of $2.00 billion and a net carrying value of 
$2.01 billion, resulting in a debt extinguishment loss of $252.5 million. This loss was included in other-net, 
(income) expense in our consolidated statement of operations during the year ended December 31, 2019.

In November 2019, we issued Japanese Yen-denominated notes consisting of ¥22.92 billion of 0.42 percent 
fixed-rate notes due in November 2029, ¥9.28 billion of 0.56 percent fixed-rate notes due in November 2034, 
and ¥7.64 billion of 0.97 percent fixed-rate notes due in November 2049, with interest to be paid semi-
annually. We used the net cash proceeds from the offering of $356.6 million for general corporate purposes, 
including the repayment of outstanding commercial paper.

The aggregate amounts of maturities on long-term debt for the next five years are as follows:

Maturities on long-term debt     . . . . . . . . . . . . . . . . . . . . . . . $ 1,531.5  $ 

3.3  $  657.1  $  778.9  $  847.9 

2022

2023

2024

2025

2026

We have converted approximately 13 percent of our long-term fixed-rate notes to floating rates through the 
use of interest rate swaps. The weighted-average effective borrowing rates based on long-term debt 
obligations and interest rates at December 31, 2021 and 2020, including the effects of interest rate swaps for 
hedged debt obligations, were 2.27 percent and 2.61 percent, respectively.

88The aggregate amount of cash payments for interest on borrowings, net of capitalized interest, are as follows:

Cash payments for interest on borrowings     . . . . . . . . . . . . . . . . . . . . . $ 

338.0  $ 

345.8  $ 

305.5 

2021

2020

2019

In accordance with the requirements of derivatives and hedging guidance, the portion of our fixed-rate debt 
obligations that is hedged as a fair value hedge is reflected in the consolidated balance sheets as an amount 
equal to the sum of the debt's carrying value plus the fair value adjustment representing changes in fair value 
of the hedged debt attributable to movements in market interest rates subsequent to the inception of the 
hedge.

Note 12: Stock-Based Compensation

Our stock-based compensation expense consists of performance awards (PAs), shareholder value awards 
(SVAs), relative value awards (RVAs), and restricted stock units (RSUs). We recognize the fair value of stock-
based compensation as expense over the requisite service period of the individual grantees, which generally 
equals the vesting period. We provide newly issued shares of our common stock and treasury stock to satisfy 
the issuance of PA, SVA, RVA, and RSU shares.

Stock-based compensation expense and the related tax benefits were as follows:

Stock-based compensation expense     . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Tax benefit    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

342.8  $ 

308.1  $ 

72.0 

64.7 

306.8 
64.4 

At December 31, 2021, stock-based compensation awards may be granted under the 2002 Lilly Stock Plan 
for not more than 50.6 million additional shares. 

2021

2020

2019

Performance Award Program

PAs are granted to officers and management and are payable in shares of our common stock. The number of 
PA shares actually issued, if any, varies depending on the achievement of certain pre-established earnings-
per-share targets over a two-year period. PA shares are accounted for at fair value based upon the closing 
stock price on the date of grant and fully vest at the end of the measurement period. The fair values of PAs 
granted for the years ended December 31, 2021, 2020, and 2019 were $198.57, $137.33, and $112.09, 
respectively. The number of shares ultimately issued for the PA program is dependent upon the EPS achieved 
during the vesting period. Pursuant to this program, approximately 0.7 million shares, 1.1 million shares, and 
1.2 million shares were issued during the years ended December 31, 2021, 2020, and 2019, respectively. 
Approximately 0.7 million shares are expected to be issued in 2022. As of December 31, 2021, the total 
remaining unrecognized compensation cost related to nonvested PAs was $66.1 million, which will be 
amortized over the weighted-average remaining requisite service period of 12 months.

89 
 
 
Shareholder Value Award Program

SVAs are granted to officers and management and are payable in shares of our common stock. The number 
of shares actually issued, if any, varies depending on our stock price at the end of the three-year vesting 
period compared to pre-established target stock prices. We measure the fair value of the SVA unit on the 
grant date using a Monte Carlo simulation model. The model utilizes multiple input variables that determine 
the probability of satisfying the market condition stipulated in the award grant and calculates the fair value of 
the award. Expected volatilities utilized in the model are based on implied volatilities from traded options on 
our stock, historical volatility of our stock price, and other factors. Similarly, the dividend yield is based on 
historical experience and our estimate of future dividend yields. The risk-free interest rate is derived from the 
U.S. Treasury yield curve in effect at the time of grant. The weighted-average fair values of the SVA units 
granted during the years ended December 31, 2021, 2020, and 2019 were $230.19, $139.14, and $95.01, 
respectively, determined using the following assumptions:

(Percents)
Expected dividend yield      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Risk-free interest rate     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Volatility    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2021

2020

2019

 2.50 %
 0.19 
 31.42 

 2.50 %
 1.38 
 20.90 

 2.50 %
 2.46 
 21.00 

Pursuant to this program, approximately 1.0 million shares, 0.8 million shares, and 1.0 million shares were 
issued during the years ended December 31, 2021, 2020, and 2019, respectively. Approximately 0.5 million 
shares are expected to be issued in 2022. As of December 31, 2021, the total remaining unrecognized 
compensation cost related to nonvested SVAs was $47.0 million, which will be amortized over the weighted-
average remaining requisite service period of 21 months.

Relative Value Award Program

Beginning in 2020, we granted RVAs to officers and management that are payable in shares of our common 
stock. The number of shares actually issued, if any, varies depending on the growth of our stock price at the 
end of the three-year vesting period compared to our peers. We measure the fair value of the RVA unit on the 
grant date using a Monte Carlo simulation model. The model utilizes multiple input variables that determine 
the probability of satisfying the market condition stipulated in the award grant and calculates the fair value of 
the award. Expected volatilities utilized in the model are based on implied volatilities from traded options on 
our stock, historical volatility of our stock price and our peers' stock price, and other factors. Similarly, the 
dividend yield is based on historical experience and our estimate of future dividend yields. The risk-free 
interest rate is derived from the U.S. Treasury yield curve in effect at the time of grant. The weighted-average 
fair value of the RVA units granted during the years ended December 31, 2021 and 2020 were $286.71 and 
$179.90, respectively, determined using the following assumptions:

(Percents)
Expected dividend yield     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Risk-free interest rate      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Volatility       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2021

2020

 2.50 %
 0.19 
 30.95 

 2.50 %
 1.38 
 19.89 

As of December 31, 2021, the total remaining unrecognized compensation cost related to nonvested RVAs 
was $18.6 million, which will be amortized over the weighted-average remaining requisite service period of 21 
months.

90Restricted Stock Units

RSUs are granted to certain employees and are payable in shares of our common stock. RSU shares are 
accounted for at fair value based upon the closing stock price on the date of grant. The corresponding 
expense is amortized over the vesting period, typically three years. The fair values of RSU awards granted 
during the years ended December 31, 2021, 2020, and 2019 were $196.30, $135.42, and $108.43, 
respectively. The number of shares ultimately issued for the RSU program remains constant with the 
exception of forfeitures. Pursuant to this program, 0.7 million, 1.1 million, and 1.5 million shares were granted 
and approximately 0.6 million, 0.6 million, and 0.8 million shares were issued during the years ended 
December 31, 2021, 2020, and 2019, respectively. Approximately 0.9 million shares are expected to be 
issued in 2022. As of December 31, 2021, the total remaining unrecognized compensation cost related to 
nonvested RSUs was $161.4 million, which will be amortized over the weighted-average remaining requisite 
service period of 25 months.

Note 13: Shareholders' Equity

In 2021, 2020, and 2019, we repurchased $1.25 billion, $500.0 million, and $4.40 billion, respectively, of 
shares associated with our share repurchase programs. 

In 2021, we repurchased $1.00 billion of shares, which completed our $8.00 billion share repurchase program 
authorized in June 2018. Additionally, our board authorized a $5.00 billion share repurchase program in May 
2021. In 2021, we repurchased $250.0 million of shares under the $5.00 billion share repurchase program. As 
of December 31, 2021, we had $4.75 billion remaining under the $5.00 billion share repurchase program. 

We have 5.0 million authorized shares of preferred stock. As of December 31, 2021 and 2020, no preferred 
stock was issued.

We have an employee benefit trust that held 50.0 million shares of our common stock at both December 31, 
2021 and 2020, to provide a source of funds to assist us in meeting our obligations under various employee 
benefit plans. The cost basis of the shares held in the trust was $3.01 billion at both December 31, 2021 and 
2020, and is shown as a reduction of shareholders' equity. Any dividend transactions between us and the trust 
are eliminated. Stock held by the trust is not considered outstanding in the computation of EPS. The assets of 
the trust were not used to fund any of our obligations under these employee benefit plans during the years 
ended December 31, 2021, 2020, and 2019.

Note 14: Income Taxes

Deferred taxes are recognized for the future tax effects of temporary differences between financial and 
income tax reporting based on enacted tax laws and rates. Deferred taxes related to global intangible low-
taxed income (GILTI) are also recognized for the future tax effects of temporary differences.

We recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax 
position, based on its technical merits, will be sustained upon examination by the taxing authority. The tax 
benefits recognized in the financial statements from such a position are measured based on the largest 
benefit that has a greater than 50 percent likelihood of being realized upon ultimate resolution.

91Following is the composition of income tax expense:

2021

2020

2019

Current:

Federal(1)    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Foreign      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
State      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Total current tax expense      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  

938.5  $ 
466.0 
(28.4)   

567.6  $ 
650.4 
(47.3)   

1,376.1 

1,170.7 

Deferred:

Federal      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Foreign      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
State      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Total deferred tax (benefit) expense     . . . . . . . . . . . . . . . . . . . . . . .  

Income taxes     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

(977.5)   
174.6 
0.6 
(802.3)   
573.8  $ 

(97.4)   
(16.6)   
(20.5)   
(134.5)   
1,036.2  $ 

280.2 
299.8 
(14.4) 
565.6 

141.3 
(24.1) 
(54.8) 
62.4 
628.0 

(1) The 2021, 2020, and 2019 current tax expense includes $64.7 million, $144.4 million, and $153.1 million of tax benefit, respectively, 

from utilization of net operating loss and tax credit carryforwards. 

Significant components of our deferred tax assets and liabilities as of December 31 were as follows:

2021

2020

Deferred tax assets:

Purchases of intangible assets        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Compensation and benefits      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Tax credit carryforwards and carrybacks     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Tax loss and other tax carryforwards and carrybacks    . . . . . . . . . . . . . . . . . . . . . . .  
Sales rebates and discounts       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Correlative tax adjustments    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Foreign tax redeterminations     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Operating lease liabilities   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Capitalized research and development      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Other        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Total gross deferred tax assets    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Valuation allowances     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Total deferred tax assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,347.4  $ 
634.7 
463.7 
645.4 
832.3 
560.8 
274.9 
150.0 
275.1 
477.9 
6,662.2 
(875.6)   
5,786.6 

2,560.6 
1,045.6 
523.5 
488.3 
461.3 
404.2 
242.8 
150.7 
135.2 
605.8 
6,618.0 
(816.3) 
5,801.7 

Deferred tax liabilities:

Earnings of foreign subsidiaries       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Intangibles   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Inventories       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Prepaid employee benefits   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Property and equipment       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Financial instruments        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Operating lease assets    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Total deferred tax liabilities       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Deferred tax assets - net     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

(1,583.3)   
(1,516.1)   
(596.4)   
(560.6)   
(338.7)   
(303.0)   
(132.6)   
(5,030.7)   

755.9  $ 

(1,905.3) 
(1,465.7) 
(623.7) 
(410.1) 
(315.2) 
(216.9) 
(134.3) 
(5,071.2) 
730.5 

The deferred tax asset and related valuation allowance amounts for U.S. federal, international, and state net 
operating losses and tax credits shown above have been reduced for differences between financial reporting 
and tax return filings.

92 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
At December 31, 2021, based on filed tax returns we have tax credit carryforwards and carrybacks of 
$859.9 million available to reduce future income taxes; $148.8 million, if unused, will expire by 2026, and 
$21.5 million, if unused, will expire between 2030 and 2040. The remaining portion of the tax credit 
carryforwards is related to federal tax credits of $76.2 million, international tax credits of $115.3 million, and 
state tax credits of $498.1 million, all of which are fully reserved.

At December 31, 2021, based on filed tax returns we had net operating losses and other carryforwards for 
international and U.S. federal income tax purposes of $2.21 billion: $832.6 million will expire by 2026; 
$818.2 million will expire between 2027 and 2041; and $561.5 million of the carryforwards will never expire. 
Net operating losses and other carryforwards for international and U.S. federal income tax purposes are 
partially reserved. Deferred tax assets related to state net operating losses and other carryforwards of 
$230.0 million are fully reserved as of December 31, 2021.

Domestic and Puerto Rican companies contributed approximately 28 percent, 39 percent, and 44 percent for 
the years ended December 31, 2021, 2020, and 2019, respectively, to consolidated income before income 
taxes. We have a subsidiary operating in Puerto Rico under a tax incentive grant effective through the end of 
2031.

Substantially all of the unremitted earnings of our foreign subsidiaries are considered not to be indefinitely 
reinvested for continued use in our foreign operations. At December 31, 2021 and December 31, 2020, we 
accrued an immaterial amount of foreign withholding taxes and state income taxes that would be owed upon 
future distributions of unremitted earnings of our foreign subsidiaries that are not indefinitely reinvested. For 
the amount considered to be indefinitely reinvested, it is not practicable to determine the amount of the 
related deferred income tax liability due to the complexities in the tax laws and assumptions we would have to 
make.

Cash payments of U.S. federal, state, and foreign income taxes, net of refunds, were as follows: 

Cash payments of income taxes    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2021
1,598.8  $ 

2020

954.6  $ 

2019
1,180.5 

In December 2017, the Tax Cuts and Job Act (2017 Tax Act) was signed into law. The 2017 Tax Act included 
significant changes to the U.S. corporate income tax system, including a one-time repatriation transition tax 
(also known as the 'Toll Tax') on unremitted foreign earnings. The 2017 Tax Act provided an election to 
taxpayers subject to the Toll Tax to make payments over an eight-year period beginning in 2018 through 2025. 
Having made this election, our future cash payments relating to the Toll Tax as of December 31, 2021 are as 
follows:

2017 Tax Act Toll Tax       . . . . . . . . . . . . . . . . . . . . $ 

2,149.5  $ 

253.7  $ 

1,109.9  $ 

785.9 

Total

Less than 1 Year

1-3 Years

3-5 Years 

We have additional noncurrent income tax payables of $2.02 billion unrelated to the Toll Tax; we cannot 
reasonably estimate the timing of future cash outflows associated with these liabilities. 

Following is a reconciliation of the consolidated income tax expense applying the U.S. federal statutory rate to 
income before income taxes to reported consolidated income tax expense: 

Income tax at the U.S. federal statutory tax rate       . . . . . . . . . . . . . . . . $ 
Add (deduct):

2021
1,292.6  $ 

2020
1,518.3  $ 

2019
1,105.8 

International operations, including Puerto Rico(1)     . . . . . . . . . . . . . .
General business credits    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Foreign-derived intangible income deduction      . . . . . . . . . . . . . . . . .
Other     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Income taxes     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
(1) Includes the impact of Puerto Rico Excise Tax, GILTI tax, and other U.S. taxation of foreign income.

(458.2)   
(100.5)   
(86.7)   
(73.4)   
573.8  $ 

(297.2)   
(97.9)   
(71.5)   
(15.5)   
1,036.2  $ 

(242.0) 
(108.8) 
(15.5) 
(111.5) 
628.0 

93 
 
A reconciliation of the beginning and ending amount of gross unrecognized tax benefits is as follows:

Beginning balance at January 1        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Additions based on tax positions related to the current year     . . . . . .  
Additions for tax positions of prior years        . . . . . . . . . . . . . . . . . . . . . . .  
Reductions for tax positions of prior years      . . . . . . . . . . . . . . . . . . . . .
Settlements       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Lapses of statutes of limitation      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Changes related to the impact of foreign currency translation        . . . .
Ending balance at December 31       . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2021
2,551.9  $ 
310.3 
98.6 
(8.1)   
(38.5)   
(49.7)   
(66.2)   
2,798.3  $ 

2020
2,108.6  $ 
225.6 
310.8 
(52.4)   
(72.0)   
(41.7)   
73.0 
2,551.9  $ 

2019
2,034.6 
187.2 
425.3 
(100.3) 
(260.5) 
(161.5) 
(16.2) 
2,108.6 

The total amount of unrecognized tax benefits that, if recognized, would affect our effective tax rate was 
$1.70 billion and $1.67 billion at December 31, 2021 and 2020, respectively.

We file U.S. federal, foreign, and various state and local income tax returns. We are no longer subject to U.S. 
federal income tax examination for years before 2016. In most major foreign and state jurisdictions, we are no 
longer subject to income tax examination for years before 2012.

The U.S. examination of tax years 2016-2018 began in 2019 and remains ongoing; therefore, the resolution of 
this audit period will likely extend beyond the next 12 months. For tax years 2013-2015, all matters were 
effectively settled in 2019. As a result, our gross uncertain tax positions were reduced by approximately 
$200 million, we made a cash payment of approximately $125 million, and our consolidated results were 
benefited by an immaterial reduction in tax expense. 

We recognize both accrued interest and penalties related to unrecognized tax benefits in income tax expense. 
We recognized income tax (benefit) expense related to interest and penalties as follows:

Income tax (benefit) expense      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

20.5  $ 

34.0  $ 

(26.4) 

2021

2020

2019

At December 31, 2021 and 2020, our accruals for the payment of interest and penalties totaled $220.1 million 
and $196.7 million, respectively.

94 
 
 
 
 
 
 
 
Note 15: Retirement Benefits

We use a measurement date of December 31 to develop the change in benefit obligation, change in plan 
assets, funded status, and amounts recognized in the consolidated balance sheets at December 31 for our 
defined benefit pension and retiree health benefit plans, which were as follows: 

Change in benefit obligation:

Defined Benefit
Pension Plans

Retiree Health
Benefit Plans

2021

2020

2021

2020

Benefit obligation at beginning of year   . . . . . . . . . . . . . . . $ 18,225.5  $ 16,251.0  $  1,753.7  $  1,601.4 
Service cost     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
40.8 
Interest cost     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
43.7 
Actuarial (gain) loss    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
142.1 
Benefits paid         . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(75.1) 
Curtailment loss      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
— 
Foreign currency exchange rate changes and other 
adjustments      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Benefit obligation at end of year      . . . . . . . . . . . . . . . . . . . .   17,565.0 

369.2 
337.8 
(564.3)   
(630.1)   
— 

49.2 
32.5 
(86.1)   
(79.3)   
— 

325.5 
425.8 
1,563.1 

245.1 
  18,225.5 

(587.2)   
2.2 

0.8 
1,753.7 

(173.1)   

1,663.8 

(6.2)   

Change in plan assets:

Fair value of plan assets at beginning of year     . . . . . . . .
Actual return on plan assets     . . . . . . . . . . . . . . . . . . . . . . .
Employer contribution     . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Benefits paid         . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Foreign currency exchange rate changes and other 
adjustments      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Fair value of plan assets at end of year   . . . . . . . . . . . . . .   16,416.0 

  14,579.0 
2,458.1 
131.2 
(630.1)   

(122.2)   

  12,858.0 
1,802.4 
318.8 
(587.2)   

187.0 
  14,579.0 

3,227.0 
202.6 
11.1 
(79.3)   

2,768.2 
539.0 
(5.1) 
(75.1) 

— 
3,361.4 

— 
3,227.0 

Funded status   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Unrecognized net actuarial (gain) loss      . . . . . . . . . . . . . . . .  
Unrecognized prior service (benefit) cost     . . . . . . . . . . . . .
Net amount recognized   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  2,770.4  $  2,884.4  $  1,082.8  $ 

(1,149.0)   
3,908.2 
11.2 

(3,646.5)   
6,515.5 
15.4 

1,697.6 
(497.2)   
(117.6)   

1,473.3 
(349.1) 
(177.6) 
946.6 

Amounts recognized in the consolidated balance sheet 
consisted of:

Other noncurrent assets   . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Other current liabilities      . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Accrued retirement benefits  . . . . . . . . . . . . . . . . . . . . . . . .  
Accumulated other comprehensive (income) loss 
before income taxes    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Net amount recognized     . . . . . . . . . . . . . . . . . . . . . . . . . . . $  2,770.4  $  2,884.4  $  1,082.8  $ 

299.6  $  1,910.2  $  1,697.0 
(7.4) 
(67.9)   
(216.3) 
(3,878.2)   

668.5  $ 
(68.3)   
(1,749.3)   

(7.9)   
(204.8)   

(526.7) 
946.6 

(614.7)   

6,530.9 

3,919.5 

The unrecognized net actuarial (gain) loss and unrecognized prior service (benefit) cost have not yet been 
recognized in net periodic pension costs and were included in accumulated other comprehensive loss at 
December 31, 2021 and 2020.

95 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The $750.4 million decrease in benefit obligation in 2021 was driven primarily by an increase in the discount 
rate. The $2.13 billion increase in the benefit obligation in 2020 was driven by a decrease in the discount rate.

The following represents our weighted-average assumptions as of December 31:

Defined Benefit
Pension Plans

Retiree Health
Benefit Plans

(Percents)

Discount rate for benefit obligation   . . . . . . . . . . . . . . . . . . . . . .
Discount rate for net benefit costs    . . . . . . . . . . . . . . . . . . . . . .
Rate of compensation increase for benefit obligation     . . . . . .
Rate of compensation increase for net benefit costs    . . . . . .
Expected return on plan assets for net benefit costs     . . . . . .

2019

2019

2020

2021

2020

2021
 2.8 %  2.4 %  3.0 %  3.0 %  2.6 %  3.3 %
 2.4 
 3.5 
 3.3 
 6.8 

 3.0 
 3.3 
 3.3 
 7.3 

 4.0 
 3.3 
 3.4 
 7.4 

 5.0 

 6.0 

 2.6 

 6.0 

 3.3 

 4.4 

We annually evaluate the expected return on plan assets in our defined benefit pension and retiree health 
benefit plans. In evaluating the expected rate of return, we consider many factors, with a primary analysis of 
current and projected market conditions; asset returns and asset allocations; and the views of leading 
financial advisers and economists. We may also review our historical assumptions compared with actual 
results, as well as the assumptions and trend rates utilized by similar plans, where applicable. 

Given the design of our retiree health benefit plans, healthcare-cost trend rates do not have a material impact 
on our financial condition or results of operations.

The following benefit payments, which reflect expected future service, as appropriate, are expected to be paid 
as follows:

Defined benefit pension plans    . . $ 
Retiree health benefit plans     . . . .  

631.9  $ 

641.8  $ 

669.4  $ 

686.6  $ 

89.4 

89.5 

93.1 

93.9 

707.5  $  3,919.7 
477.7 

94.5 

2022

2023

2024

2025

2026

2027-2031

Amounts relating to defined benefit pension plans with projected benefit obligations in excess of plan assets 
were as follows at December 31:

Projected benefit obligation        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $  3,360.3  $ 15,770.7 
Fair value of plan assets      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   1,542.8 
  11,824.4 

Amounts relating to defined benefit pension plans and retiree health benefit plans with accumulated benefit 
obligations in excess of plan assets were as follows at December 31:

2021

2020

Defined Benefit
Pension Plans

Retiree Health 
Benefit Plans

2021

2020

2021

2020

Accumulated benefit obligation    . . . . . . . . . . . . . . . . . . . . . . . . $  2,532.0  $ 14,682.3  $ 
Fair value of plan assets       . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  

  11,824.4 

973.4 

212.6  $ 
— 

223.8 
— 

The total accumulated benefit obligation for our defined benefit pension plans was $16.44 billion and 
$17.03 billion at December 31, 2021 and 2020, respectively.

96 
 
 
 
 
 
 
 
 
 
Net pension and retiree health benefit expense included the following components:

Components of net periodic (benefit) 
cost:

Defined Benefit
Pension Plans

Retiree Health
Benefit Plans

2021

2020

2019

2021

2020

2019

Service cost     . . . . . . . . . . . . . . . . . . . . . . . . $  369.2  $  325.5  $  250.4  $ 
Interest cost      . . . . . . . . . . . . . . . . . . . . . . . .  
Expected return on plan assets   . . . . . . .  
Amortization of prior service (benefit) 
cost     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
(62.9) 
Recognized actuarial (gain) loss     . . . . . .
1.9 
Curtailment loss   . . . . . . . . . . . . . . . . . . . .
— 
Net periodic (benefit) cost     . . . . . . . . . . . . $  249.6  $  250.6  $  190.0  $  (120.9)  $  (136.1)  $  (111.0) 

40.8  $ 
43.7 
(158.1)   

49.2  $ 
32.5 
(146.2)   

(59.5)   
(3.0)   
— 

(59.6)   
3.2 
— 

36.3 
58.0 
(144.3) 

4.5 
396.3 
— 

4.2 
487.7 
— 

6.1 
284.9 
2.2 

425.8 
(901.5)   

486.0 
(839.6)   

337.8 
(949.3)   

The following represents the amounts recognized in other comprehensive income (loss) for the years ended 
December 31, 2021, 2020, and 2019:

Defined Benefit
Pension Plans

Retiree Health
Benefit Plans

2021

2020

2019

2021

2020

2019

— 
— 

Actuarial gain (loss) arising during 
period     . . . . . . . . . . . . . . . . . . . . . . . . . . $  2,072.4  $ 
Plan amendments during period        . . .
Curtailment gain          . . . . . . . . . . . . . . . .
Amortization of prior service 
(benefit) cost included in net income      
Amortization of net actuarial (gain) 
loss included in net income    . . . . . . . .  
Foreign currency exchange rate 
changes and other     . . . . . . . . . . . . . . .  
Total other comprehensive income 
(loss) during period        . . . . . . . . . . . . . . $  2,611.5  $ 

487.7 

47.2 

4.2 

(663.0)  $ (1,461.0)  $  142.5  $  238.8  $  246.1 
— 
— 

(2.2)   
— 

— 
19.0 

— 
— 

— 
— 

4.5 

6.1 

(59.6)   

(59.5)   

(62.9) 

396.3 

284.9 

(71.5)   

(7.7)   

3.2 

1.9 

(3.0)   

2.4 

1.9 

3.6 

(335.9)  $ (1,158.7)  $ 

88.0  $  178.7  $  188.7 

We have defined contribution savings plans that cover our eligible employees worldwide. The purpose of 
these plans is generally to provide additional financial security during retirement by providing employees with 
an incentive to save. Our contributions to the plans are based on employee contributions and the level of our 
match. Expenses under the plans totaled $167.3 million, $164.3 million, and $145.2 million for the years 
ended December 31, 2021, 2020, and 2019, respectively.

We provide certain other postemployment benefits primarily related to disability benefits and accrue for the 
related cost over the service lives of employees. Expenses associated with these benefit plans for the years 
ended December 31, 2021, 2020, and 2019 were not material.

Benefit Plan Investments

Our benefit plan investment policies are set with specific consideration of return and risk requirements in 
relationship to the respective liabilities. U.S. and Puerto Rico plans represent approximately 80 percent of our 
global investments. Given the long-term nature of our liabilities, these plans have the flexibility to manage an 
above-average degree of risk in the asset portfolios. At the investment-policy level, there are no specifically 
prohibited investments. However, within individual investment manager mandates, restrictions and limitations 
are contractually set to align with our investment objectives, ensure risk control, and limit concentrations.

We manage our portfolio to minimize concentration of risk by allocating funds within asset categories. In 
addition, within a category we use different managers with various management objectives to eliminate any 
significant concentration of risk.

97 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Our global benefit plans may enter into contractual arrangements (derivatives) to implement the local 
investment policy or manage particular portfolio risks. Derivatives are principally used to increase or decrease 
exposure to a particular public equity, fixed income, commodity, or currency market more rapidly or less 
expensively than could be accomplished through the use of the cash markets. The plans utilize both 
exchange-traded and over-the-counter instruments. The maximum exposure to either a market or 
counterparty credit loss is limited to the carrying value of the receivable, and is managed within contractual 
limits. We expect all of our counterparties to meet their obligations. The gross values of these derivative 
receivables and payables are not material to the global asset portfolio, and their values are reflected within 
the tables below.

The defined benefit pension and retiree health benefit plan allocation for the U.S. and Puerto Rico currently 
comprises approximately 75 percent growth investments and 25 percent fixed-income investments. The 
growth investment allocation encompasses U.S. and international public equity securities, hedge funds, 
private equity-like investments, and real estate. These portfolio allocations are intended to reduce overall risk 
by providing diversification, while seeking moderate to high returns over the long term.

Public equity securities are well diversified and invested in U.S. and international small-to-large companies 
across various asset managers and styles. The remaining portion of the growth portfolio is invested in private 
alternative investments.

Fixed-income investments primarily consist of fixed-income securities in U.S. treasuries and agencies, 
emerging market debt obligations, corporate bonds, bank loans, mortgage-backed securities, commercial 
mortgage-backed obligations, and any related repurchase agreements.

Hedge funds are privately owned institutional investment funds that generally have moderate liquidity. Hedge 
funds seek specified levels of absolute return regardless of overall market conditions, and generally have low 
correlations to public equity and debt markets. Hedge funds often invest substantially in financial market 
instruments (stocks, bonds, commodities, currencies, derivatives, etc.) using a very broad range of trading 
activities to manage portfolio risks. Hedge fund strategies focus primarily on security selection and seek to be 
neutral with respect to market moves. Common groupings of hedge fund strategies include relative value, 
tactical, and event driven. Relative value strategies include arbitrage, when the same asset can 
simultaneously be bought and sold at different prices, achieving an immediate profit. Tactical strategies often 
take long and short positions to reduce or eliminate overall market risks while seeking a particular investment 
opportunity. Event strategy opportunities can evolve from specific company announcements such as mergers 
and acquisitions, and typically have little correlation to overall market directional movements. Our hedge fund 
investments are made through limited partnership interests in fund-of-funds structures and directly into hedge 
funds. Plan holdings in hedge funds are valued based on net asset values (NAVs) calculated by each fund or 
general partner, as applicable, and we have the ability to redeem these investments at NAV.

Private equity-like investment funds typically have low liquidity and are made through long-term partnerships 
or joint ventures that invest in pools of capital invested in primarily non-publicly traded entities. Underlying 
investments include venture capital (early stage investing), buyout, special situations, private debt, and 
private real estate investments. Private equity management firms typically acquire and then reorganize private 
companies to create increased long term value. Private equity-like funds usually have a limited life of 
approximately 10-15 years, and require a minimum investment commitment from their limited partners. Our 
private equity-like investments are made both directly into funds and through fund-of-funds structures to 
ensure broad diversification of management styles and assets across the portfolio. Plan holdings in private 
equity-like investments are valued using the value reported by the partnership, adjusted for known cash flows 
and significant events through our reporting date. Values provided by the partnerships are primarily based on 
analysis of and judgments about the underlying investments. Inputs to these valuations include underlying 
NAVs, discounted cash flow valuations, comparable market valuations, and may also include adjustments for 
currency, credit, liquidity and other risks as applicable. The vast majority of these private partnerships provide 
us with annual audited financial statements including their compliance with fair valuation procedures 
consistent with applicable accounting standards.

Real estate is composed of public holdings. Real estate investments in registered investment companies that 
trade on an exchange are classified as Level 1 on the fair value hierarchy. Real estate investments in funds 
measured at fair value on the basis of NAV provided by the fund manager are classified as such. These NAVs 
are developed with inputs including discounted cash flow, independent appraisal, and market comparable 
analyses.

Other assets include cash and cash equivalents and mark-to-market value of derivatives.

98The cash value of the trust-owned insurance contract is primarily invested in investment-grade publicly traded 
equity and fixed-income securities.

Other than hedge funds, private equity-like investments, and a portion of the real estate holdings, which are 
discussed above, we determine fair values based on a market approach using quoted market values, 
significant other observable inputs for identical or comparable assets or liabilities, or discounted cash flow 
analyses.

The fair values of our defined benefit pension plan and retiree health plan assets as of December 31, 2021 by 
asset category were as follows:

Fair Value Measurements Using

Quoted Prices in 
Active 
Markets for
Identical Assets
(Level 1)

Total

Significant
Observable 
Inputs
(Level 2)

Significant
Unobservable 
Inputs
(Level 3)

Investments 
Valued at Net 
Asset Value(1)

Asset Class
Defined Benefit Pension Plans
Public equity securities:

U.S.        . . . . . . . . . . . . . . . . . . . . . . . . $ 
International    . . . . . . . . . . . . . . . . .

1,325.4  $ 
2,722.7 

430.4  $ 
815.0 

0.1  $ 
— 

1.2  $ 
— 

893.7 
1,907.7 

Fixed income:

Developed markets     . . . . . . . . . . .  
Developed markets - 
repurchase agreements    . . . . . . .  
Emerging markets      . . . . . . . . . . . .  

Private alternative investments:

4,496.0 

2.6 

3,356.6 

(1,376.2)   
611.0 

— 
11.3 

(1,376.2)   
250.5 

Hedge funds     . . . . . . . . . . . . . . . . .  
Equity-like funds       . . . . . . . . . . . . .
Real estate       . . . . . . . . . . . . . . . . . . .
Other . . . . . . . . . . . . . . . . . . . . . . . . .  
Total    . . . . . . . . . . . . . . . . . . . . . . . . . $  16,416.0  $ 

3,046.8 
3,816.4 
630.3 
1,143.6 

— 
2.1 
363.8 
103.2 
1,728.4  $ 

— 
— 
7.5 
263.2 
2,501.7  $ 

— 

— 
0.1 

1,136.8 

— 
349.1 

3,046.8 
— 
3,808.8 
5.5 
248.3 
10.7 
(2.1)   
779.3 
15.4  $  12,170.5 

Retiree Health Benefit Plans
Public equity securities:

U.S.        . . . . . . . . . . . . . . . . . . . . . . . . $ 
International    . . . . . . . . . . . . . . . . .

124.7  $ 
180.6 

40.9  $ 
47.7 

—  $ 
— 

0.1  $ 
— 

83.7 
132.9 

Fixed income:

Developed markets     . . . . . . . . . . .  
Emerging markets      . . . . . . . . . . . .  

Private alternative investments:

Hedge funds     . . . . . . . . . . . . . . . . .  
Equity-like funds       . . . . . . . . . . . . .

Cash value of trust owned 
insurance contract     . . . . . . . . . . . . .
Real estate       . . . . . . . . . . . . . . . . . . .
Other . . . . . . . . . . . . . . . . . . . . . . . . .  
Total    . . . . . . . . . . . . . . . . . . . . . . . . . $ 

102.2 
51.6 

275.4 
317.8 

2,166.8 
36.2 
106.1 
3,361.4  $ 

— 
— 

— 
— 

— 
34.5 
24.4 

147.5  $ 

80.5 
23.7 

— 
— 

— 
— 

— 
0.5 

2,166.8 
0.7 
18.3 
2,290.0  $ 

— 
1.0 
(0.1)   
1.5  $ 

21.7 
27.9 

275.4 
317.3 

— 
— 
63.5 
922.4 

(1) Certain investments that are measured at fair value using the NAV per share (or its equivalent) as a practical expedient have not been 

classified in the fair value hierarchy.

No material transfers between Level 1, Level 2, or Level 3 occurred during the year ended December 31, 
2021. The activity in the Level 3 investments during the year ended December 31, 2021 was not material.

99 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The fair values of our defined benefit pension plan and retiree health plan assets as of December 31, 2020 by 
asset category were as follows:

Fair Value Measurements Using

Quoted Prices in 
Active 
Markets for 
Identical Assets
(Level 1)

Total

Significant 
Observable 
Inputs
(Level 2)

Significant 
Unobservable 
Inputs
(Level 3)

Investments 
Valued at Net 
Asset Value(1)

Asset Class
Defined Benefit Pension Plans
Public equity securities:

U.S.        . . . . . . . . . . . . . . . . . . . . . . . . $ 
International    . . . . . . . . . . . . . . . . .

737.6  $ 

476.1  $ 

2,635.8 

1,102.3 

—  $ 
— 

1.0  $ 
— 

260.5 
1,533.5 

Fixed income:

Developed markets     . . . . . . . . . . .  
Developed markets - 
repurchase agreements    . . . . . . .  
Emerging markets      . . . . . . . . . . . .  

Private alternative investments:

4,301.3 

2.9 

3,179.2 

(1,670.8)   
631.0 

— 
14.2 

(1,670.8)   
262.7 

Hedge funds     . . . . . . . . . . . . . . . . .  
Equity-like funds       . . . . . . . . . . . . .
Real estate       . . . . . . . . . . . . . . . . . . .
Other . . . . . . . . . . . . . . . . . . . . . . . . .  
Total    . . . . . . . . . . . . . . . . . . . . . . . . . $  14,579.0  $ 

2,661.3 
2,844.7 
558.9 
1,879.2 

— 
— 
259.6 
60.4 
1,915.5  $ 

— 
— 
6.9 
301.2 
2,079.2  $ 

— 

— 
0.1 

1,119.2 

— 
354.0 

2,661.3 
— 
2,827.8 
16.9 
286.6 
5.8 
18.0 
1,499.6 
41.8  $  10,542.5 

Retiree Health Benefit Plans
Public equity securities:

U.S.        . . . . . . . . . . . . . . . . . . . . . . . . $ 
International    . . . . . . . . . . . . . . . . .

68.3  $ 

162.3 

45.0  $ 
58.1 

—  $ 
— 

0.1  $ 
— 

23.2 
104.2 

Fixed income:

Developed markets     . . . . . . . . . . .  
Emerging markets      . . . . . . . . . . . .  

Private alternative investments:

Hedge funds     . . . . . . . . . . . . . . . . .  
Equity-like funds       . . . . . . . . . . . . .

Cash value of trust owned 
insurance contract     . . . . . . . . . . . . .
Real estate       . . . . . . . . . . . . . . . . . . .
Other . . . . . . . . . . . . . . . . . . . . . . . . .  
Total    . . . . . . . . . . . . . . . . . . . . . . . . . $ 

101.5 
53.5 

229.7 
223.4 

2,204.6 
25.8 
157.9 
3,227.0  $ 

— 
— 

— 
— 

— 
24.5 
14.1 

141.7  $ 

80.3 
24.7 

— 
— 

2,204.6 
0.7 
21.1 
2,331.4  $ 

— 
— 

— 
1.6 

— 
0.6 
1.7 
4.0  $ 

21.2 
28.8 

229.7 
221.8 

— 
— 
121.0 
749.9 

(1) Certain investments that are measured at fair value using the NAV per share (or its equivalent) as a practical expedient have not been 

classified in the fair value hierarchy.

No material transfers between Level 1, Level 2, or Level 3 occurred during the year ended December 31, 
2020. The activity in the Level 3 investments during the year ended December 31, 2020 was not material.

In 2022, we expect to contribute approximately $40 million to our defined benefit pension plans to satisfy 
minimum funding requirements for the year. We do not currently expect to make material discretionary 
contributions in 2022.

100 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Note 16: Contingencies

We are involved in various lawsuits, claims, government investigations and other legal proceedings that arise 
in the ordinary course of business. These claims or proceedings can involve various types of parties, including 
governments, competitors, customers, suppliers, service providers, licensees, employees, or shareholders, 
among others. These matters may involve patent infringement, antitrust, securities, pricing, sales and 
marketing practices, environmental, commercial, contractual rights, licensing obligations, health and safety 
matters, consumer fraud, employment matters, product liability and insurance coverage, among others. The 
resolution of these matters often develops over a long period of time and expectations can change as a result 
of new findings, rulings, appeals or settlement arrangements. Legal proceedings that are significant or that we 
believe could become significant or material are described below. 

We believe the legal proceedings in which we are named as defendants are without merit and we are 
defending against them vigorously. It is not possible to determine the final outcome of these matters, and we 
cannot reasonably estimate the maximum potential exposure or the range of possible loss in excess of 
amounts accrued for any of these matters; however, we believe that the resolution of all such matters will not 
have a material adverse effect on our consolidated financial position or liquidity, but could possibly be material 
to our consolidated results of operations in any one accounting period.

Litigation accruals, environmental liabilities, and the related estimated insurance recoverables are reflected on 
a gross basis as liabilities and assets, respectively, on our consolidated balance sheets. With respect to the 
product liability claims currently asserted against us, we have accrued for our estimated exposures to the 
extent they are both probable and reasonably estimable based on the information available to us. We accrue 
for certain product liability claims incurred but not filed to the extent we can formulate a reasonable estimate 
of their costs. We estimate these expenses based primarily on historical claims experience and data 
regarding product usage. Legal defense costs expected to be incurred in connection with significant product 
liability loss contingencies are accrued when both probable and reasonably estimable.

Because of the nature of pharmaceutical products, it is possible that we could become subject to large 
numbers of additional product liability and related claims in the future. Due to a very restrictive market for 
litigation liability insurance, we are self-insured for litigation liability losses for all our currently and previously 
marketed products. 

Patent Litigation

Alimta Patent Litigation 

U.S. Patent Litigation

Alimta (pemetrexed) was protected by a vitamin regimen patent until November 2021, and since then has 
been protected by pediatric exclusivity through May 2022.

In December 2019, we settled a lawsuit we filed against Eagle Pharmaceuticals, Inc. (Eagle) in response to its 
application to market a product using an alternative form of pemetrexed. Per the settlement agreement, Eagle 
has a limited initial entry into the market with its product starting February 2022 (up to an approximate three-
week supply) and subsequent unlimited entry starting April 2022. 

European Patent Litigation

In Europe, Alimta was protected by the vitamin regimen patent through June 2021. Despite the recent patent 
expiration, a number of legal proceedings that were initiated prior to expiration are ongoing. 

Emgality Patent Litigation

In September 2018, we were named as a defendant in litigation filed by Teva Pharmaceuticals International 
GMBH and Teva Pharmaceuticals USA, Inc. (collectively, Teva) in the U.S. District Court for the District of 
Massachusetts seeking a ruling that various claims in nine different Teva patents would be infringed by our 
launch and continued sales of Emgality for the prevention of migraine in adults. Trial is currently scheduled to 
begin in October 2022. In June 2021, we were named as a defendant in a second litigation filed by Teva in the 
U.S. District Court for the District of Massachusetts seeking a ruling that two of Teva's patents, which are 
directed toward use of the active ingredient in Emgality to treat migraine, would be infringed by our continued 
sales of Emgality.

101Jardiance Patent Litigation

In November 2018, Boehringer Ingelheim (BI), our partner in marketing and development of Jardiance, 
initiated U.S. patent litigation in the U.S. District Court of Delaware alleging infringement arising from 
submissions of Abbreviated New Drug Applications (ANDA) by a number of generic companies seeking 
approval to market generic versions of Jardiance, Glyxambi, and Synjardy in accordance with the procedures 
set out in the Drug Price Competition and Patent Term Restoration Act of 1984 (the Hatch-Waxman Act). 
Particularly with respect to Jardiance, the generic companies' ANDAs seek approval to market generic 
versions of Jardiance prior to the expiration of the relevant patents, and allege that certain patents, including 
in some allegations the compound patent, are invalid or would not be infringed. We are not a party to this 
litigation. This litigation has been stayed. 

Taltz Patent Litigation

In April 2021, we petitioned the High Court of Ireland to declare invalid the patent that Novartis Pharma AG 
(Novartis) purchased from Genentech, Inc. in 2020. Novartis responded by filing a claim against us alleging 
patent infringement related to our commercialization of Taltz and seeking damages for past infringement and 
an injunction against future infringement. This matter is ongoing. 

In April 2021 and November 2021, Novartis petitioned the Court of Rome Intellectual Property Division and 
the Swiss Federal Patent Court, respectively, in preliminary injunction (PI) and main infringement proceedings 
against us related to our commercialization of Taltz. In June 2021, the Court of Rome Intellectual Property 
Division dismissed Novartis' PI action. Novartis appealed the ruling and in October 2021, the panel hearing 
Novartis' appeal appointed a technical expert to assess the merits of the case. Both matters are ongoing. 
Hearings on the Italian and Swiss PI requests are scheduled for May 2022.

In June 2021, Novartis petitioned the Commercial Court of Vienna in PI proceedings and in November 2021, 
the Austrian court denied Novartis' request. Novartis did not appeal the ruling, and this matter is now closed.

Zyprexa Canada Patent Litigation

Beginning in the mid-2000s, several generic companies in Canada challenged the validity of our Zyprexa 
compound patent. In 2012, the Canadian Federal Court of Appeals denied our appeal of a lower court's 
decision that certain patent claims were invalid for lack of utility. In 2013, Apotex Inc. and Apotex Pharmachem 
Inc. (collectively, Apotex) brought claims against us in the Ontario Superior Court of Justice at Toronto for 
damages related to our enforcement of the Zyprexa compound patent under Canadian regulations governing 
patented drugs. Apotex seeks compensation based on novel legal theories under the Statute of Monopolies, 
Trade-Mark Act, and common law. In March 2021, the Ontario Superior Court granted our motion for summary 
judgement, thereby dismissing Apotex's case. Apotex appealed that ruling to the Court of Appeal for Ontario in 
April 2021 and a hearing occurred February 2022. We await a decision.

Product Liability Litigation

Actos® Product Liability

We are named along with Takeda Chemical Industries, Ltd. and Takeda affiliates (collectively, Takeda) as a 
defendant in four purported product liability class actions in Canada related to Actos, which we 
commercialized with Takeda in Canada until 2009, including one in Ontario filed December 2011 (Casseres et 
al. v. Takeda Pharmaceutical North America, Inc., et al.), one in Quebec filed July 2012 (Whyte et al. v. Eli 
Lilly et al.), one in Saskatchewan filed November 2017 (Weiler v. Takeda Canada Inc. et al.), and one in 
Alberta filed January 2013 (Epp v. Takeda Canada Inc. et al.). In general, plaintiffs in these actions alleged 
that Actos caused or contributed to their bladder cancer. An agreement to settle these actions became 
effective in May 2021. The relevant courts approved the settlement and the deadline for class members to 
seek settlement funds has now expired. The lawsuits have been dismissed or discontinued. 

102Byetta® Product Liability

We are named as a defendant in approximately 570 Byetta product liability lawsuits in the U.S. which were 
first initiated in March 2009 and involve approximately 805 plaintiffs. Approximately 55 of these lawsuits, 
covering about 285 plaintiffs, are filed in California state court and coordinated in a Los Angeles Superior 
Court. Approximately 515 of the lawsuits, covering about 515 plaintiffs, are filed in federal court, the majority 
of which are coordinated in a multi-district litigation (MDL) in the U.S. District Court for the Southern District of 
California. Two lawsuits, representing approximately two plaintiffs, have also been filed in various state courts. 
Approximately 565 of the lawsuits, involving approximately 800 plaintiffs, contain allegations that Byetta 
caused or contributed to the plaintiffs' cancer (primarily pancreatic cancer or thyroid cancer); while six 
plaintiffs allege Byetta caused or contributed to pancreatitis. In addition, one case alleges that Byetta caused 
or contributed to ampullary cancer. The federal and state trial courts granted summary judgment in favor of us 
and our co-defendants on the claims alleging pancreatic cancer. The plaintiffs appealed those rulings. 

In November 2017, the U.S. Court of Appeals for the Ninth Circuit reversed the U.S. District Court for the 
Southern District of California's grant of summary judgment in the MDL based on that court's discovery rulings 
and remanded the cases back to the U.S. District Court for further proceedings. In March 2021, the U.S. 
District Court granted summary judgment for the defendants. In April 2021, the plaintiffs filed a notice of 
appeal to the U.S. Court of Appeals for the Ninth Circuit, but we have now been dismissed from that appeal. 
Certain plaintiffs have agreed to dismiss their lawsuits in exchange for a waiver of costs, and individual 
plaintiffs have begun dismissing their claims based upon this agreement. Approximately 311 of the MDL 
lawsuits have been dismissed as of February 2022. In the state court actions, in November 2018, the 
California Court of Appeal reversed the Los Angeles County Superior Court of California's grant of summary 
judgment based on that court's discovery rulings and remanded for further proceedings. In April 2021, the Los 
Angeles County Superior Court of California granted summary judgment for the defendants and the parties 
await entry of the order of judgment. Approximately 17 of the state court lawsuits have been dismissed as of 
February 2022. 

We are aware of approximately 20 additional potential claimants who have not yet filed suit. These additional 
possible claims allege damages for pancreatic cancer or thyroid cancer.

Cialis Product Liability

We are named as a defendant in approximately 350 Cialis product liability lawsuits in the U.S. which were first 
initiated in August 2015. These cases, many of which were originally filed in various federal courts, contain 
allegations that Cialis caused or contributed to the plaintiffs' cancer (melanoma). In December 2016, the 
Judicial Panel on Multidistrict Litigation (JPML) granted the plaintiffs' petition to have filed cases and an 
unspecified number of future cases coordinated into a federal MDL in the U.S. District Court for the Northern 
District of California, alongside an existing coordinated proceeding involving Viagra®. The JPML ordered the 
transfer of the existing cases to the now-renamed MDL In re: Viagra (Sildenafil Citrate) and Cialis (Tadalafil) 
Products Liability Litigation. In April 2020, the MDL court granted summary judgment to the defendants on all 
of the claims brought against them by the plaintiffs. In May 2020, plaintiffs filed an appeal in the U.S. Court of 
Appeals for the Ninth Circuit. The parties have reached agreement to resolve the majority of claims pending in 
the appeal and expect those claims to soon be dismissed.

Jardiance Product Liability 

First initiated in January 2019, we and Boehringer Ingelheim Pharmaceuticals, Inc., a subsidiary of BI, have 
been named as a defendant in 5 currently pending product liability lawsuits in Stamford Superior Court in 
Connecticut, alleging that Jardiance caused or contributed to plaintiffs' Fournier's gangrene. Our agreement 
with BI calls for BI to defend and indemnify us against any damages, costs, expenses, and certain other 
losses with respect to product liability claims in accordance with the terms of the agreement. All pending 
cases have been paused to allow for settlement negotiations and dismissals. 

Environmental Proceedings 

Under the Comprehensive Environmental Response, Compensation, and Liability Act, commonly known as 
"Superfund," we have been designated as one of several potentially responsible parties with respect to the 
cleanup of fewer than 10 sites. Under Superfund, each responsible party may be jointly and severally liable 
for the entire amount of the cleanup.

103Other Matters

340B Litigation and Investigations

We are the plaintiff in a lawsuit filed in January 2021 in the U.S. District Court for the Southern District of 
Indiana against the U.S. Department of Health and Human Services (HHS), the Secretary of HHS, the Health 
Resources and Services Administration (HRSA), and the Administrator of HRSA. The lawsuit challenges the 
HHS's December 30, 2020 advisory opinion stating that drug manufacturers are required to deliver discounts 
under the 340B program to all contract pharmacies. We seek a declaratory judgment that the defendants 
violated the Administrative Procedures Act and the U.S. Constitution, a preliminary injunction enjoining 
implementation of the administrative dispute resolution process created by defendants and, with it, their 
application of the advisory opinion, and other related relief. In March 2021, the court entered an order 
preliminarily enjoining the government's enforcement of the administrative dispute resolution process against 
us. In May 2021, HRSA notified us that it determined that our policy was contrary to the 340B statute. In 
response, in May 2021, we filed a motion for preliminary injunction and temporary restraining order requesting 
that the U.S. District Court for the Southern District of Indiana enjoin defendants from taking any action 
against us relating to the 340B drug pricing program until after the court issues a final judgment on the 
aforementioned litigation. In May 2021, the court denied our motion for a temporary restraining order but 
deferred resolution of our motion for preliminary injunction. In June 2021, the defendants withdrew the HHS 
December 30, 2020 advisory opinion. In July 2021, the court held oral argument on the parties' cross motions 
for summary judgment, the defendants' motion to dismiss, and our motion for preliminary injunction related to 
HRSA's May 2021 enforcement letter. In October 2021, the court denied the defendants' motion to dismiss, 
and granted in part and denied in part the parties' cross motions for summary judgment. We have filed a 
notice of appeal. This matter is ongoing.

In January 2021, we, along with other pharmaceutical manufacturers, were named as a defendant in a 
petition currently pending before the HHS Administrative Dispute Resolution Panel. Petitioner seeks 
declaratory and other injunctive relief related to the 340B program. As described above, the U.S. District Court 
for the Southern District of Indiana has entered a preliminary injunction enjoining the government's 
enforcement of this administrative dispute resolution process against us. 

In July 2021, we, along with Sanofi-Aventis U.S., LLC (Sanofi), Novo Nordisk Inc. (Novo Nordisk), and 
AstraZeneca Pharmaceuticals LP, were named as a defendant in a purported class action lawsuit filed in the 
U.S. District Court for the Western District of New York by Mosaic Health, Inc. alleging antitrust and unjust 
enrichment claims related to the defendants' 340B distribution programs. We, with Sanofi and Novo Nordisk, 
filed a motion to dismiss the lawsuit. This matter is ongoing.

We received a civil investigative subpoena in February 2021 from the Office of the Attorney General for the 
State of Vermont relating to the sale of pharmaceutical products to Vermont covered entities under the 340B 
program. We are cooperating with this subpoena. 

Branchburg Manufacturing Facility 

In May 2021, we received a subpoena from the United States Department of Justice requesting the 
production of certain documents relating to our manufacturing site in Branchburg, New Jersey. We are 
cooperating with the subpoena.

104Brazil Litigation – Cosmopolis Facility 

Labor Attorney Litigation

First initiated in 2008, our subsidiary in Brazil, Eli Lilly do Brasil Limitada (Lilly Brasil), is named in a Public 
Civil Action brought by the Labor Attorney for the 15th Region in the Labor Court of Paulinia, State of Sao 
Paulo, Brazil, (the Labor Court) alleging possible harm to employees and former employees caused by 
alleged exposure to soil and groundwater contaminants at a former Lilly Brasil manufacturing facility in 
Cosmopolis, Brazil, operated by the company between 1977 and 2003. In May 2014, the Labor Court judge 
ruled against Lilly Brasil, ordering it to undertake several actions, including some with unspecified financial 
impact, consisting primarily of paying lifetime health coverage for the employees and contractors who worked 
at the Cosmopolis facility for more than six months during the affected years and their children who were born 
during and after this period. We appealed this decision. In July 2018, the appeals court (TRT) generally 
affirmed the Labor Court's ruling, which included a liquidated award of 300 million Brazilian real. This 
300 million Brazilian real liquidated award, when adjusted for inflation and the addition of pre and post 
judgment interest using the current Central Bank of Brazil's special system of clearance and custody rate, is 
approximately 950 million Brazilian real (approximately $170 million as of December 31, 2021). The TRT also 
restricted the broad health coverage awarded by the Labor Court to health problems that claimants could 
prove in a separate evidentiary proceeding arose from exposure to the alleged contamination. In August 
2019, Lilly Brasil filed an appeal to the superior labor court (TST) and in June 2021, the TRT published its 
decision on the admissibility of Lilly Brasil's appeal, allowing the majority of the elements of the appeal to 
proceed; elements not proceeding are subject to an interlocutory appeal to the TST that was filed in June 
2021. In September 2019, the TRT stayed a number of elements of its trial court decision pending the 
determination of Lilly Brasil's appeal to the TST.

In June 2019, the Labor Public Attorney (LPA) filed an application in the Labor Court for enforcement of the 
healthcare coverage granted by the TRT in its July 2018 ruling, requested restrictions on Lilly Brasil’s assets 
in Brazil, and required Lilly Brasil and Antibióticos do Brasil Ltda. (ABL) to submit a list of potential 
beneficiaries of the Public Civil Action for the LPA to identify and contact those individuals. In July 2019, the 
Labor Court issued a ruling requiring a freeze of Lilly Brasil’s immovable property or, alternatively, a security 
deposit or lien of 500 million Brazilian real. Lilly Brasil filed a writ of mandamus challenging this ruling. In June 
2021, the court reduced the security deposit or lien to 100 million Brazilian real and limited the scope of the 
initial order. ABL and LPA appealed to the TST, which appeal is currently still under review. In addition, in 
September 2020, the LPA initiated a second preliminary enforcement of the portion of the July 2018 TRT 
decision in the Labor Court that prohibits the exposure of workers to the contaminated areas. The Labor Court 
is currently assessing the status of Lilly Brasil’s compliance with such portion of the July 2018 TRT decision. 
These matters are ongoing.

Individual Former Employee Litigation

Lilly Brasil is also named in approximately 25 pending lawsuits filed in the Labor Court by individual former 
employees making similar claims. These lawsuits are each at various stages in the litigation process, with 
judgments being handed down in more than half of the lawsuits by the trial courts, of which, approximately 
half of those judgements are on appeal in the labor courts.

China NDRC Antitrust Matter

The competition authority in China has investigated our distributor pricing practices in China in connection 
with a broader inquiry into pharmaceutical industry pricing. We cooperated with this investigation. In July 2021 
Lilly divested Cialis in China. We consider this matter closed.

105Puerto Rico Tax Matter

In May 2013, the Municipality of Carolina in Puerto Rico (Municipality) filed a lawsuit against us alleging 
noncompliance with respect to a contract with the Municipality and seeking a declaratory judgment. In 
December 2020, the Puerto Rico Appellate Court (AP) reversed the summary judgment previously granted by 
the Court of First Instance (CFI) in our favor, dismissing the Municipality's complaint in its entirety. The AP 
remanded the case to the CFI for trial on the merits.

In October 2021, the Municipality filed a motion to execute a purported judgment, and the CFI scheduled a 
hearing in March 2022 to consider the Municipality's motion. We have opposed the Municipality's motion. This 
matter is ongoing. 

Eastern District of Pennsylvania Pricing (Average Manufacturer Price) Inquiry

In November 2014, we, along with another pharmaceutical manufacturer, were named as co-defendants in 
United States et al. ex rel. Streck v. Takeda Pharm. Am., Inc., et al., which was filed in November 2014 and 
unsealed in the U.S. District Court for the Northern District of Illinois. The complaint alleges that the 
defendants should have treated certain credits from distributors as retroactive price increases and included 
such increases in calculating average manufacturer prices. In October 2021 the parties filed cross motions for 
summary judgment. Trial is scheduled for April 2022. 

Health Choice Alliance 

We are named as a defendant in a lawsuit filed in June 2017 in the U.S. District Court for the Eastern District 
of Texas seeking damages under the federal anti-kickback statute and state and federal false claims acts for 
certain patient support programs related to our products Humalog, Humulin, and Forteo. In September 2019, 
the U.S. District Court granted the U.S. Department of Justice's motion to dismiss the relator's second 
amended complaint. In January 2020, the relator appealed the District Court's dismissal to the U.S. Court of 
Appeals for the Fifth Circuit. In July 2021, the U.S. Court of Appeals for the Fifth Circuit affirmed the dismissal 
of the lawsuit, and the relator did not petition the U.S. Supreme Court for certiorari. We are also named as a 
defendant in two similar lawsuits filed in Texas and New Jersey state courts in October 2019 seeking 
damages under the Texas Medicaid Fraud Prevention Act and New Jersey Medicaid False Claims Act, 
respectively. In November 2020, the Texas state court action was stayed pending a final determination with 
respect to the aforementioned federal lawsuit. In April 2021, the New Jersey state court action was dismissed 
with prejudice and in June 2021, the relator appealed the state court's decision to the Appellate Division of the 
New Jersey Superior Court. In January 2022, the relator filed its appellate brief. 

Pricing Litigation, Investigations, and Inquiries

Litigation

In December 2017, we, along with Sanofi and Novo Nordisk were named as defendants in a consolidated 
purported class action lawsuit, In re. Insulin Pricing Litigation, in the U.S. District Court for the District of New 
Jersey relating to insulin pricing seeking damages under various state consumer protection laws and the 
Federal Racketeer Influenced and Corrupt Organization Act (federal RICO Act). Separately, in February 2018, 
we, along with Sanofi and Novo Nordisk, were named as defendants in MSP Recovery Claims, Series, LLC et 
al. v. Sanofi Aventis U.S. LLC et al., in the same court, seeking damages under various state consumer 
protection laws, common law fraud, unjust enrichment, and the federal RICO Act. In both In re. Insulin Pricing 
Litigation and the MSP Recovery Claims litigation, the court dismissed claims under the federal RICO Act and 
certain state laws. In April 2021, the plaintiffs in In re. Insulin Pricing Litigation amended their complaint to 
allege additional state law claims for civil conspiracy and violations of state RICO statutes. The court has 
allowed the Arizona RICO statute and certain state civil conspiracy law claims to proceed. Also, we, along 
with Sanofi, Novo Nordisk, CVS, Express Scripts, and Optum, have been sued in a purported class action, 
FWK Holdings, LLC v. Novo Nordisk Inc., et al., filed in the same court in November 2020, for alleged 
violations of the federal RICO Act as well as the New Jersey RICO Act and antitrust law. That same group of 
defendants, along with Medco Health and United Health Group, also have been sued in other purported class 
actions in the same court, Rochester Drug Co-Operative Inc. v. Eli Lilly & Co. et al. and Value Drug Co. v. Eli 
Lilly & Co. et al. both initiated in March 2020, for alleged violations of the federal RICO Act. In September 
2020, the U.S. District Court for the District of New Jersey granted plaintiffs' motion to consolidate FWK 
Holdings, LLC v. Novo Nordisk Inc., et al., Rochester Drug Co-Operative Inc. v. Eli Lilly & Co. et al., and Value 
Drug Co. v. Eli Lilly & Co. et al. In July 2021, the U.S. District Court for the District of New Jersey dismissed 
the three antitrust claims alleged by plaintiffs in the consolidated litigation and denied dismissal of the RICO 
claims.

106In October 2018, the Minnesota Attorney General's Office initiated litigation against us, Sanofi, and Novo 
Nordisk, State of Minnesota v. Sanofi-Aventis U.S. LLC et al., in the U.S. District Court for the District of New 
Jersey, alleging unjust enrichment, violations of various Minnesota state consumer protection laws, and the 
federal RICO Act. In March 2021, the U.S. District Court for the District of New Jersey dismissed with 
prejudice the Minnesota Attorney General's federal RICO claims and false advertising claims under state law; 
the consumer fraud and other related state law claims remain ongoing. Additionally, in May 2019, the 
Kentucky Attorney General's Office filed a complaint against us, Sanofi, and Novo Nordisk, Commonwealth of 
Kentucky v. Novo Nordisk, Inc. et al., in Kentucky state court, alleging violations of the Kentucky consumer 
protection law, false advertising, and unjust enrichment. In November 2019, Harris County in Texas initiated 
litigation against us, Sanofi, Novo Nordisk, Express Scripts, CVS, Optum, and Aetna, County of Harris Texas 
v. Eli Lilly & Co., et al., in federal court in the Southern District of Texas alleging violations of the federal RICO 
Act, the state deceptive trade practices-consumer protection act, and common law claims such as fraud, 
unjust enrichment, and civil conspiracy. Harris County also alleged violations of federal and state antitrust law, 
but voluntarily dismissed them. This lawsuit relates to our insulin products as well as Trulicity. 

In June 2021, the City of Miami, Florida initiated litigation against us, Sanofi, Novo Nordisk, ESI, CVS/
Caremark/Aetna, and Optum, asserting state law antitrust, common law fraud, money had and received, 
unjust enrichment, and civil conspiracy claims. After removing the case to federal court, we, along with the 
other defendants, filed a motion to dismiss the lawsuit. In January 2022, the court granted the motion in part 
but has allowed the antitrust and conspiracy claims to proceed against us, Sanofi and Novo Nordisk. We, 
along with Sanofi and Novo Nordisk, have moved the court to reconsider its denial of our motion to dismiss 
the antitrust and conspiracy claims.

In June 2021, the Mississippi Attorney General's Office (Mississippi AG) initiated litigation against us, Sanofi, 
Novo Nordisk, Evernorth/ESI, CVS/Caremark, and United/Optum in the Hinds County, Mississippi Chancery 
Court, alleging state law consumer protection, unjust enrichment, and civil conspiracy claims. After the case 
was removed to federal court, we, along with the other defendants, filed a motion to dismiss the lawsuit. In 
response, the Mississippi AG filed a motion to amend its complaint, which the court granted. This matter is 
ongoing.

Investigations, Subpoenas, and Inquiries

We received subpoenas from the New York and Vermont Attorney General Offices and civil investigative 
demands from the Washington, New Mexico, and Colorado Attorney General Offices relating to the pricing 
and sale of our insulin products. The Offices of the Attorney General in Mississippi, Washington D.C., 
California, Florida, Hawaii, and Nevada have requested information relating to the pricing and sale of our 
insulin products. We also received interrogatories and a subpoena from the California Attorney General's 
Office regarding our competition in the long-acting insulin market, which was subsequently withdrawn in June 
2021. In January 2022, the Michigan Attorney General filed against us in state court a petition seeking 
authorization to investigate Lilly for potential violations of the Michigan Consumer Protection Act (MCPA), and 
a complaint seeking a declaratory judgment that the MCPA applies to the conduct it seeks to investigate and 
allows it to conduct the investigation. The state court granted the State's petition to investigate, authorizing the 
State to issue civil investigative subpoenas. The State's complaint for declaratory judgment remains pending.

We received a request in January 2019 from the House of Representatives' Committee on Oversight and 
Reform seeking commercial information and business records related to the pricing of insulin products, 
among other issues. We also received requests from the Senate Finance Committee and the Senate 
Committee on Health, Education, Labor, and Pensions, and separate requests from the House Committee on 
Energy and Commerce majority and minority members. Those requests sought pricing and other commercial 
information regarding Lilly's insulin products. In January 2021, the Senate Finance Committee released a 
report summarizing the findings of its investigation. In December 2021 the House of Representatives' 
Committee on Oversight and Reform majority and minority staffs released separate reports with findings from 
their investigations into drug pricing, including of insulin products.

We are cooperating with all of these aforementioned investigations, subpoenas, and inquiries.

107Research Corporation Technologies, Inc. 

In April 2016, we were named as a defendant in litigation filed by Research Corporation Technologies, Inc. 
(RCT) in the U.S. District Court for the District of Arizona. RCT is seeking damages for breach of contract, 
unjust enrichment, and conversion related to processes used to manufacture certain products, including 
Humalog and Humulin. Both parties moved for summary judgment and hearing on the motions took place in 
August 2021. In October 2021, the Court issued a summary judgment decision finding in favor of RCT on 
certain issues, including with respect to a disputed royalty. Both parties filed motions for reconsideration, 
which are underway. Potential damages payable under the litigation, if finally awarded after an appeal, could 
be material but are not currently reasonably estimable. A trial date has not been set.

Note 17: Other Comprehensive Income (Loss)

The following table summarizes the activity related to each component of other comprehensive income (loss):

(Amounts presented net of taxes)
Beginning balance at January 
1, 2019(1)

Continuing Operations

Foreign 
Currency 
Translation 
Gains (Losses)

Unrealized 
Net Gains 
(Losses) 
on Securities

Defined Benefit 
Pension and 
Retiree Health 
Benefit Plans

Effective 
Portion of 
Cash Flow 
Hedges

Discontinued 
Operations

Accumulated 
Other 
Comprehensive 
Loss

$  (1,569.7)  $ 

(22.1)  $ 

(3,852.7)  $  (238.9)  $ 

(56.8)  $ 

(5,740.2) 

Other comprehensive 
income (loss) before 
reclassifications    . . . . . . . . . . .  
Net amount reclassified 
from accumulated other 
comprehensive loss   . . . . . . .  
Net other comprehensive 
income (loss)      . . . . . . . . . . . . .  

Balance at December 31, 
2019    . . . . . . . . . . . . . . . . . . . . . .  

Other comprehensive 
income (loss) before 
reclassifications    . . . . . . . . . . .  
Net amount reclassified 
from accumulated other 
comprehensive loss   . . . . . . .  
Net other comprehensive 
income (loss)      . . . . . . . . . . . . .  

Balance at December 31, 
2020    . . . . . . . . . . . . . . . . . . . . . .  

Other comprehensive 
income (loss) before 
reclassifications    . . . . . . . . . . .  
Net amount reclassified 
from accumulated other 
comprehensive loss   . . . . . . .  
Net other comprehensive 
income (loss)      . . . . . . . . . . . . .  

(46.2)   

28.9 

(967.6)   

14.5 

(27.2)   

(997.6) 

(62.1)   

(1.9)   

181.7 

12.5 

84.0 

214.2 

(108.3)   

27.0 

(785.9)   

27.0 

56.8 

(783.4) 

(1,678.0)   

4.9 

(4,638.6)   

(211.9)   

— 

(6,523.6) 

250.5 

6.8 

(379.7)   

(133.8)   

— 

250.5 

3.1 

9.9 

267.3 

13.0 

(112.4)   

(120.8)   

(1,427.5)   

14.8 

(4,751.0)   

(332.7)   

— 

— 

— 

— 

(256.2) 

283.4 

27.2 

(6,496.4) 

(122.7)   

(11.9)   

1,823.4 

106.6 

— 

1,795.4 

— 

0.8 

344.0 

13.1 

(122.7)   

(11.1)   

2,167.4 

119.7 

— 

— 

357.9 

2,153.3 

Ending balance at December 
31, 2021   . . . . . . . . . . . . . . . . . . $  (1,550.2)  $ 

3.7  $ 

(2,583.6)  $  (213.0)  $ 

—  $ 

(4,343.1) 

(1) Accumulated other comprehensive loss as of January 1, 2019 consists of $5.73 billion of accumulated other comprehensive loss 

attributable to controlling interest and $11.0 million of accumulated other comprehensive loss attributable to noncontrolling interest.

108 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The tax effects on the net activity related to each component of other comprehensive income (loss) for the 
years ended December 31, were as follows:

Tax benefit (expense)
Foreign currency translation gains/losses         . . . . . . . . . . . . . . . . . . . . . . $ 
Unrealized net gains/losses on securities       . . . . . . . . . . . . . . . . . . . . . .
Defined benefit pension and retiree health benefit plans    . . . . . . . . . .  
Effective portion of cash flow hedges     . . . . . . . . . . . . . . . . . . . . . . . . . .  
Benefit/(provision) for income taxes allocated to other 
comprehensive income (loss) items         . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2021

2020

2019

(136.2)  $ 
4.7 
(532.0)   
(31.8)   

128.3  $ 
(4.3)   
44.8 
32.1 

(18.4) 
(7.4) 
184.1 
(7.3) 

(695.3)  $ 

200.9  $ 

151.0 

Except for the tax effects of foreign currency translation gains and losses related to our foreign currency-
denominated notes, cross-currency interest rate swaps, and other foreign currency exchange contracts 
designated as net investment hedges (see Note 7), income taxes were not provided for foreign currency 
translation. Generally, the assets and liabilities of foreign operations are translated into U.S. dollars using the 
current exchange rate. For those operations, changes in exchange rates generally do not affect cash flows; 
therefore, resulting translation adjustments are made in shareholders' equity rather than in the consolidated 
statements of operations.

Reclassifications out of accumulated other comprehensive loss were as follows:

Details about Accumulated Other 
Comprehensive Loss Components
Amortization of retirement 
benefit items:

Year Ended December 31,

2021

2020

2019

Affected Line Item in the Consolidated 
Statements of Operations

Prior service benefits, net     . . . . $ 
Actuarial losses    . . . . . . . . . . . .  
Total before tax      . . . . . . . . . . .  
Tax benefit     . . . . . . . . . . . . . . . . .  
Net of tax     . . . . . . . . . . . . . . . .  

(55.4)  $ 
490.9 
435.5 
(91.5)   
344.0 

(55.0)  $ 
393.3 
338.3 
(71.0)   
267.3 

(56.8)  Other—net, (income) expense
286.8  Other—net, (income) expense
230.0 
(48.3) 
181.7 

Income taxes

Other, net of tax      . . . . . . . . . . . . . .  
Reclassifications from 
continuing operations (net of 
tax)      . . . . . . . . . . . . . . . . . . . . . . . . .  
Reclassifications from 
discontinued operations (net of 
tax)      . . . . . . . . . . . . . . . . . . . . . . . . .  
Total reclassifications for the 
period, net of tax    . . . . . . . . . . . . . . $ 

13.9 

16.1 

(51.5)  Other—net, (income) expense

357.9 

283.4 

130.2 

— 

— 

84.0 

Net income from discontinued 
operations

357.9  $ 

283.4  $ 

214.2 

109 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Note 18: Other–Net, (Income) Expense

Other–net, (income) expense consisted of the following:

Interest expense     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 
Interest income     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Net investment gains on equity securities (Note 7)     . . . . . . . . . . . . . .  
Debt extinguishment loss (Note 11)      . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Gain on sale of antibiotic business in China (Note 3)        . . . . . . . . . . . .  
Retirement benefit plans     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other (income) expense     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Other–net, (income) expense     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 

2021

2020

2019

339.8  $ 
(25.4)   
(176.9)   
405.2 
— 
(289.7)   
(51.4)   
201.6  $ 

359.6  $ 
(33.0)   
(1,442.2)   

— 
— 
(251.8)   
195.5 
(1,171.9)  $ 

400.6 
(80.4) 
(401.2) 
252.5 
(309.8) 
(209.9) 
56.6 
(291.6) 

Note 19: Discontinued Operations

On March 11, 2019, we completed the disposition of our remaining 80.2 percent ownership of Elanco common 
stock through a tax-free exchange offer. The earnings attributable to the divested, noncontrolling interest for 
the period from the initial public offering until disposition were not material. 

As a result of the disposition, in the first quarter of 2019, we recognized a gain related to the disposition of 
approximately $3.7 billion, and we presented Elanco, including the gain related to the disposition, as 
discontinued operations in our consolidated financial statements for all periods presented. 

Revenue and net income from discontinued operations in 2019 was $580.0 million and $3.68 billion, 
respectively. There were no discontinued operations in 2020 and 2021. 

The gain related to the disposition of Elanco in the consolidated statement of cash flows includes the 
operating results of Elanco through the disposition date, which were not material. Net cash flows of our 
discontinued operations for operating and investing activities were not material for the year ended December 
31, 2019. 

We entered into a transitional services agreement (TSA) with Elanco to facilitate the orderly transfer of various 
services to Elanco. The TSA related primarily to administrative services, which were generally provided over 
24 months from the date of disposition, and is now complete. This agreement was not material and did not 
confer upon us the ability to influence the operating and/or financial policies of Elanco subsequent to the 
disposition date.

110 
 
 
 
 
 
 
Management's Reports

Management's Report for Financial Statements—Eli Lilly and Company and Subsidiaries

Management of Eli Lilly and Company and subsidiaries is responsible for the accuracy, integrity, and fair 
presentation of the financial statements. The statements have been prepared in accordance with generally 
accepted accounting principles in the United States and include amounts based on judgments and estimates 
by management. In management's opinion, the consolidated financial statements present fairly our financial 
position, results of operations, and cash flows.

In addition to the system of internal accounting controls, we maintain a code of conduct (known as "The Red 
Book") that applies to all employees worldwide, requiring proper overall business conduct, avoidance of 
conflicts of interest, compliance with laws, and confidentiality of proprietary information. All employees must 
take training annually on The Red Book and are required to report suspected violations. A hotline number is 
available on our lilly.com website and on the internal LillyNow website to enable reporting of suspected 
violations anonymously. Employees who report suspected violations are protected from discrimination or 
retaliation by the company. In addition to The Red Book, the chief executive officer and all financial 
management must sign a financial code of ethics, which further reinforces their ethical and fiduciary 
responsibilities.

The consolidated financial statements have been audited by Ernst & Young LLP, an independent registered 
public accounting firm (PCAOB ID: 42). Their responsibility is to examine our consolidated financial 
statements in accordance with generally accepted auditing standards of the Public Company Accounting 
Oversight Board (United States). Ernst & Young's opinion with respect to the fairness of the presentation of 
the statements is included in Item 8 of our Annual Report on Form 10-K. Ernst & Young reports directly to the 
audit committee of the board of directors.

Our audit committee includes six nonemployee members of the board of directors, all of whom are 
independent from our company. The committee charter, which is available on our website, outlines the 
members' roles and responsibilities. It is the audit committee's responsibility to appoint an independent 
registered public accounting firm subject to shareholder ratification, pre-approve both audit and non-audit 
services performed by the independent registered public accounting firm, and review the reports submitted by 
the firm. The audit committee meets several times during the year with management, the internal auditors, 
and the independent public accounting firm to discuss audit activities, internal controls, and financial reporting 
matters, including reviews of our externally published financial results. The internal auditors and the 
independent registered public accounting firm have full and free access to the committee.

We are dedicated to ensuring that we maintain the high standards of financial accounting and reporting that 
we have established. We are committed to providing financial information that is transparent, timely, complete, 
relevant, and accurate. Our culture demands integrity and an unyielding commitment to strong internal 
practices and policies. Finally, we have the highest confidence in our financial reporting, our underlying 
system of internal controls, and our people, who are objective in their responsibilities, operate under a code of 
conduct and are subject to the highest level of ethical standards.

Management's Report on Internal Control Over Financial Reporting—Eli Lilly and Company and 
Subsidiaries

Management of Eli Lilly and Company and subsidiaries is responsible for establishing and maintaining 
adequate internal control over financial reporting as defined in Rules 13a-15(f) and 15d-15(f) under the 
Securities Exchange Act of 1934. We have global financial policies that govern critical areas, including internal 
controls, financial accounting and reporting, fiduciary accountability, and safeguarding of corporate assets. 
Our internal accounting control systems are designed to provide reasonable assurance that assets are 
safeguarded, that transactions are executed in accordance with management's authorization and are properly 
recorded, and that accounting records are adequate for preparation of financial statements and other financial 
information. A staff of internal auditors regularly monitors, on a worldwide basis, the adequacy and 
effectiveness of internal accounting controls. The general auditor reports directly to the audit committee of the 
board of directors.

We conducted an evaluation of the effectiveness of our internal control over financial reporting based on the 
framework in "Internal Control—Integrated Framework" (2013) issued by the Committee of Sponsoring 
Organizations of the Treadway Commission. 

111Based on our evaluation under this framework, we concluded that our internal control over financial reporting 
was effective as of December 31, 2021. However, because of its inherent limitations, internal control over 
financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of 
effectiveness to future periods are subject to the risk that controls may become inadequate because of 
changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.

The effectiveness of internal control over financial reporting as of December 31, 2021 has been audited by 
Ernst & Young LLP, an independent registered public accounting firm, as stated in their attestation report, 
which appears herein. Their responsibility is to evaluate whether internal control over financial reporting was 
designed and operating effectively.

David A. Ricks
Chair, President, and Chief Executive Officer

Anat Ashkenazi
Senior Vice President and Chief Financial Officer

February 23, 2022 

112Report of Independent Registered Public Accounting Firm 

To the Board of Directors and Shareholders of Eli Lilly and Company

Opinion on the Financial Statements

We have audited the accompanying consolidated balance sheets of Eli Lilly and Company and subsidiaries 
(the Company) as of December 31, 2021 and 2020, the related consolidated statements of operations, 
comprehensive income (loss), shareholders' equity and cash flows for each of the three years in the period 
ended December 31, 2021, and the related notes (collectively referred to as the "consolidated financial 
statements"). In our opinion, the consolidated financial statements present fairly, in all material respects, the 
financial position of the Company at December 31, 2021 and 2020, and the results of its operations and its 
cash flows for each of the three years in the period ended December 31, 2021, in conformity with U.S. 
generally accepted accounting principles.

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board 
(United States) (PCAOB), the Company's internal control over financial reporting as of December 31, 2021, 
based on criteria established in Internal Control-Integrated Framework issued by the Committee of 
Sponsoring Organizations of the Treadway Commission (2013 framework), and our report dated February 23, 
2022 expressed an unqualified opinion thereon.

Basis for Opinion

These financial statements are the responsibility of the Company's management. Our responsibility is to 
express an opinion on the Company's financial statements based on our audits. We are a public accounting 
firm registered with the PCAOB and are required to be independent with respect to the Company in 
accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and 
Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we 
plan and perform the audit to obtain reasonable assurance about whether the financial statements are free of 
material misstatement, whether due to error or fraud. Our audits included performing procedures to assess 
the risks of material misstatement of the financial statements, whether due to error or fraud, and performing 
procedures that respond to those risks. Such procedures included examining, on a test basis, evidence 
regarding the amounts and disclosures in the financial statements. Our audits also included evaluating the 
accounting principles used and significant estimates made by management, as well as evaluating the overall 
presentation of the financial statements. We believe that our audits provide a reasonable basis for our 
opinion.

Critical Audit Matters 

The critical audit matters communicated below are matters arising from the current period audit of the 
financial statements that were communicated or required to be communicated to the audit committee and 
that: (1) relate to accounts or disclosures that are material to the financial statements and (2) involved our 
especially challenging, subjective or complex judgments. The communication of critical audit matters does not 
alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by 
communicating the critical audit matters below, providing separate opinions on the critical audit matters or on 
the accounts or disclosures to which they relate.

113Description of the 
Matter

How We 
Addressed the 
Matter in Our 
Audit

Medicaid, Managed Care, and Medicare sales rebate accruals
As described in Note 2 to the consolidated financial statements under the caption "Net 
Product Revenue," the Company establishes provisions for sales rebate and discounts 
in the same period as the related sales occur. At December 31, 2021 the Company had 
$6,845.8 million in sales rebate and discount accruals. A large portion of these accruals 
are rebates associated with sales in the United States for which payment for purchase 
of the product is covered by Medicaid, Managed Care, and Medicare. 

Auditing the Medicaid, Managed Care, and Medicare sales rebate and discount liabilities 
is challenging because of the subjectivity of certain assumptions required to estimate 
the rebate liabilities. In calculating the appropriate accrual amount, the Company 
considers historical Medicaid, Managed Care, and Medicare rebate payments by 
product as a percentage of their historical sales as well as any significant changes in 
sales trends, the lag in payment timing, an evaluation of the current Medicaid and 
Medicare laws and interpretations, the percentage of products that are sold via 
Medicaid, Managed Care, and Medicare, and product pricing. For Medicaid, there is 
significant complexity associated with calculating the legislated Medicaid rebates. 
Management utilizes employees with legislative experience and knowledge in 
developing assumptions used to calculate Medicaid rebates. Similarly, for Managed 
Care and Medicare, given variability in prescription drug costs, continued historical year 
over year increases in enrollees and variability in prescription data, historical rebate 
information may not be predictive for management to estimate the rebate accrual and 
thus, management supplements its historical data analysis with qualitative adjustments 
based upon current utilization.

We tested the Company's controls addressing the identified risks of material 
misstatement related to the valuation of the sales rebate and discount liabilities. This 
included testing controls over management's review of the significant assumptions used 
to calculate the Medicaid, Managed Care, and Medicare rebate liabilities, including the 
significant assumptions discussed above. This testing also included management's 
control to compare actual activity to forecasted activity and controls to ensure the data 
used to evaluate the significant assumptions was complete and accurate.

Our audit procedures included, among others, evaluating for reasonableness the 
significant assumptions in light of economic trends, product profiles, and other 
regulatory factors. Our testing involved assessing the historical accuracy of 
management's estimates by comparing actual activity to previous estimates and 
performing analytical procedures, based on internal and external data sources, to 
evaluate the completeness of the reserves. Additionally, our procedures included 
reviewing a sample of contracts, testing a sample of rebate payments and testing the 
underlying data used in management's evaluation. For Medicaid, we involved our 
professionals with an understanding of the statutory reimbursement requirements to 
assess the consistency of the Company's calculation methodologies with the applicable 
government regulations and policy. For Medicare we evaluated the reasonableness of 
assumptions made by management in estimating the Medicare coverage gap liability.

114Description of the 
Matter

Retirement Benefits - Valuation of Alternative Investments
As described in Note 15 to the consolidated financial statements under the caption 
"Benefit Plan Investments," the Company's benefit plan investment policies are set with 
specific consideration of return and risk requirements in relationship to the respective 
liabilities. At December 31, 2021 the Company had $19,777.4 million in plan assets 
related to the defined benefit pension plans and retiree health benefit plans. 
Approximately 38 percent of the total pension and retiree health assets are in hedge 
funds and private equity-like investment funds ("alternative investments"). These 
alternative investments are valued using significant unobservable inputs or are valued at 
net asset value (NAV) reported by the counterparty, adjusted as necessary.

Auditing the fair value of these alternative investments is challenging because of the 
higher estimation uncertainty of the inputs to the fair value calculations, including the 
underlying net asset values ("NAVs"), discounted cash flow valuations, comparable 
market valuations, and adjustments for currency, credit, liquidity and other risks. 
Additionally, certain information regarding the fair value of these alternative investments 
is based on unaudited information available to management at the time of valuation. 

How We 
Addressed the 
Matter in Our 
Audit

We tested the Company's controls addressing the risks of material misstatement 
relating to valuation of alternative investments. This included testing management's 
review controls over alternative investment valuation, which included a comparison of 
returns to benchmarks and in-person or telephonic meetings with investment firms to 
discuss valuation policies and procedures, as well as portfolio performance. 

Our audit procedures included, among others, comparing fund returns to selected 
relevant benchmarks and understanding variations, obtaining the latest audited financial 
statements and comparing to the Company's estimated fair values and reconciling any 
differences. We also inquired of management about changes to the investment portfolio 
and/or related investment strategies and considerations. We assessed the historical 
accuracy of management's estimates by comparing actual activity to previous estimates. 
We evaluated for contrary evidence by confirming the fair value of the investments and 
ownership interest directly with the trustees and a sample of managers at year end. 

/s/    Ernst & Young LLP

We have served as the Company's auditor since 1940. 

Indianapolis, Indiana

February 23, 2022 

115Report of Independent Registered Public Accounting Firm

To the Board of Directors and Shareholders of Eli Lilly and Company

Opinion on Internal Control Over Financial Reporting

We have audited Eli Lilly and Company and subsidiaries' internal control over financial reporting as of 
December 31, 2021, based on criteria established in Internal Control — Integrated Framework issued by the 
Committee of Sponsoring Organizations of the Treadway Commission (2013 framework) (the COSO criteria). 
In our opinion, Eli Lilly and Company and subsidiaries (the Company) maintained, in all material respects, 
effective internal control over financial reporting as of December 31, 2021, based on the COSO criteria.

We also have audited, in accordance with the standards of the Public Company Accounting Oversight Board 
(United States) (PCAOB), the consolidated balance sheets of the Company as of December 31, 2021 and 
2020, the related consolidated statements of operations, comprehensive income (loss), shareholders' equity 
and cash flows for each of the three years in the period ended December 31, 2021, and the related notes and 
our report dated February 23, 2022 expressed an unqualified opinion thereon.

Basis for Opinion

The Company's management is responsible for maintaining effective internal control over financial reporting 
and for its assessment of the effectiveness of internal control over financial reporting included in the 
accompanying Management's Report on Internal Control Over Financial Reporting. Our responsibility is to 
express an opinion on the Company's internal control over financial reporting based on our audit. We are a 
public accounting firm registered with the PCAOB and are required to be independent with respect to the 
Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the 
Securities and Exchange Commission and the PCAOB.

We conducted our audit in accordance with the standards of the PCAOB. Those standards require that we 
plan and perform the audit to obtain reasonable assurance about whether effective internal control over 
financial reporting was maintained in all material respects. 

Our audit included obtaining an understanding of internal control over financial reporting, assessing the risk 
that a material weakness exists, testing and evaluating the design and operating effectiveness of internal 
control based on the assessed risk, and performing such other procedures as we considered necessary in the 
circumstances. We believe that our audit provides a reasonable basis for our opinion.

Definition and Limitations of Internal Control Over Financial Reporting

A company's internal control over financial reporting is a process designed to provide reasonable assurance 
regarding the reliability of financial reporting and the preparation of financial statements for external purposes 
in accordance with generally accepted accounting principles. A company's internal control over financial 
reporting includes those policies and procedures that (1) pertain to the maintenance of records that, in 
reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; 
(2) provide reasonable assurance that transactions are recorded as necessary to permit preparation of 
financial statements in accordance with generally accepted accounting principles, and that receipts and 
expenditures of the company are being made only in accordance with authorizations of management and 
directors of the company; and (3) provide reasonable assurance regarding prevention or timely detection of 
unauthorized acquisition, use, or disposition of the company's assets that could have a material effect on the 
financial statements.

116Because of its inherent limitations, internal control over financial reporting may not prevent or detect 
misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that 
controls may become inadequate because of changes in conditions, or that the degree of compliance with the 
policies or procedures may deteriorate.

/s/    Ernst & Young LLP

Indianapolis, Indiana

February 23, 2022 

117Item 9. Changes in and Disagreements with 

Accountants on Accounting and Financial 
Disclosure

None.

Item 9A. Controls and Procedures

Evaluation of Disclosure Controls and Procedures

Under applicable Securities and Exchange Commission (SEC) regulations, management of a reporting 
company, with the participation of the principal executive officer and principal financial officer, must 
periodically evaluate the company's "disclosure controls and procedures," which are defined generally as 
controls and other procedures designed to ensure that information required to be disclosed by the reporting 
company in its periodic reports filed with the SEC (such as this Form 10-K) is recorded, processed, 
summarized, and reported on a timely basis.

Our management, with the participation of David A. Ricks, president and chief executive officer, and Anat 
Ashkenazi, senior vice president and chief financial officer, evaluated our disclosure controls and procedures 
(as such term is defined in Rules 13a-15(e) and 15d-15(e) under the Securities Exchange Act of 1934) as of 
December 31, 2021, and concluded that they were effective.

Management's Report on Internal Control over Financial Reporting

Mr. Ricks and Ms. Ashkenazi provided a report on behalf of management on our internal control over financial 
reporting, in which management concluded that the company's internal control over financial reporting is 
effective at December 31, 2021 based on the framework in "Internal Control—Integrated Framework" (2013) 
issued by the Committee of Sponsoring Organizations of the Treadway Commission. Our internal control over 
financial reporting is designed to provide reasonable assurance regarding the reliability of financial reporting 
and the preparation of financial statements for external purposes in accordance with generally accepted 
accounting principles in the United States. Due to the inherent limitations, no evaluation over internal control 
can provide absolute assurance that no material misstatements or fraud exist. 

In addition, Ernst & Young LLP, the company's independent registered public accounting firm, issued an 
attestation report on the company's internal control over financial reporting as of December 31, 2021. 

You can find the full text of management's report and Ernst & Young's attestation report in Item 8.

Changes in Internal Control over Financial Reporting

During the fourth quarter of 2021, there were no changes in our internal control over financial reporting that 
materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

Item 9B. Other Information

None.

Item 9C. Disclosure Regarding Foreign Jurisdictions 
that Prevent Inspections

Not applicable.

118Part III
Item 10. Directors, Executive Officers, and Corporate 

Governance

Directors and Executive Officers

Information relating to our board of directors is found in our Definitive Proxy Statement, to be dated on or 
about March 18, 2022 (Proxy Statement), under "Governance - Board Operations and Governance" and is 
incorporated in this Annual Report on Form 10-K by reference.

Information relating to our executive officers is found at Item 1, "Business - Executive Officers of the 
Company" and is incorporated by reference herein. 

Code of Ethics

Information relating to our code of ethics is found in our Proxy Statement under "Governance - Board 
Oversight of Strategy, Compliance, and Risk Management - Code of Ethics" and is incorporated in this Annual 
Report on Form 10-K by reference.

Corporate Governance

Information about the procedures by which shareholders can recommend nominees to our board of directors 
is found in our Proxy Statement under "Shareholder Engagement on Governance Issues - Shareholder 
Recommendations and Nominations for Director Candidates" and is incorporated in this Annual Report on 
Form 10-K by reference.

The board of directors has appointed an audit committee consisting entirely of independent directors in 
accordance with applicable Securities and Exchange Commission and New York Stock Exchange 
requirements for audit committees. Information about our audit committee is found in our Proxy Statement 
under "Governance - Membership and Meetings of the Board and Its Committees - Audit Committee" and is 
incorporated in this Annual Report on Form 10-K by reference.

Item 11. Executive Compensation

Information on director compensation, executive compensation, and compensation committee matters can be 
found in the Proxy Statement under "Governance - Director Compensation," "- Membership and Meetings of 
the Board and Its Committees - Compensation Committee," "Compensation - Compensation Discussion and 
Analysis," and "- Executive Compensation." Such information is incorporated in this Annual Report on Form 
10-K by reference. 

119Item 12. Security Ownership of Certain Beneficial 

Owners and Management and Related 
Stockholder Matters

Security Ownership of Certain Beneficial Owners and Management

Information relating to ownership of the company's common stock by management and by persons known by 
the company to be the beneficial owners of more than five percent of the outstanding shares of common stock 
is found in the Proxy Statement under "Ownership of Company Stock" and incorporated in this Annual Report 
on Form 10-K by reference.

Securities Authorized for Issuance Under Equity Compensation Plans

The following table presents information as of December 31, 2021 regarding the company's compensation 
plans under which shares of the company's common stock have been authorized for issuance.

Plan category
Equity compensation plans approved by 
security holders    . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Equity compensation plan not approved by 
security holders    . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Total        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(a) Number of 
securities to be 
issued upon 
exercise of 
outstanding 
options, warrants, 
and rights (1)

(b) Weighted-
average exercise 
price of 
outstanding 
options, warrants, 
and rights

(c) Number of securities 
remaining available for 
future issuance under 
equity compensation plans 
(excluding securities 
reflected in column (a))

—  $ 

—   
—   

— 

— 
— 

50,646,706 

— 
50,646,706 

(1) 5,605,694 shares are underlying outstanding equity awards other than options.

Item 13. Certain Relationships and Related Transactions, 

and Director Independence

Related Person Transactions

Information relating to the policies and procedures for approval of related person transactions by our board of 
directors can be found in the Proxy Statement under "Governance - Highlights of the Company's Corporate 
Governance - Conflicts of Interest and Transactions with Related Persons." Such information is incorporated 
in this Annual Report on Form 10-K by reference.

Director Independence

Information relating to director independence can be found in the Proxy Statement under "Governance - 
Director Independence" and is incorporated in this Annual Report on Form 10-K by reference.

Item 14. Principal Accountant Fees and Services

Information related to the fees and services of our principal independent accountants, Ernst & Young LLP, can 
be found in the Proxy Statement under "Audit Matters - Item 3. Ratification of the Appointment of the 
Independent Auditor - Audit Committee Report - Services Performed by the Independent Auditor" and "- 
Independent Auditor Fees." Such information is incorporated in this Annual Report on Form 10-K by 
reference.

120 
 
 
 
Item 15. Exhibits and Financial Statement Schedules

(a)1.    Financial Statements

The following consolidated financial statements of the company and its subsidiaries are found at Item 8:

•

•

•

•

•

•

Consolidated Statements of Operations—Years Ended December 31, 2021, 2020, and 2019 

Consolidated Statements of Comprehensive Income (Loss)—Years Ended December 31, 2021, 2020, 
and 2019

Consolidated Balance Sheets—December 31, 2021 and 2020

Consolidated Statements of Shareholders' Equity—Years Ended December 31, 2021, 2020, and 2019

Consolidated Statements of Cash Flows—Years Ended December 31, 2021, 2020, and 2019

Notes to Consolidated Financial Statements

(a)2.    Financial Statement Schedules

The consolidated financial statement schedules of the company and its subsidiaries have been omitted 
because they are not required, are inapplicable, or are adequately explained in the financial statements.

Financial statements of interests of 50 percent or less, which are accounted for by the equity method, have 
been omitted because they do not, considered in the aggregate as a single subsidiary, constitute a significant 
subsidiary.

(a)3.    Exhibits

The following documents are filed as part of this report:

Exhibit

   Location

3.1

Amended Articles of Incorporation

3.2

Bylaws, as amended

Incorporated by reference to Exhibit 3.1 to 
the Company's Annual Report on Form 10-
K for the year ended December 31, 2013 

Incorporated by reference to Exhibit 3.1 to 
the Company's Current Report on Form 8-K 
filed on December 16, 2021 

Incorporated by reference to Exhibit 4.1 to 
the Company's Registration Statement on 
Form S-3, Registration No. 333-186979

Indenture, dated February 1, 1991, between the 
Company and Deutsche Bank Trust Company 
Americas, as successor trustee to Citibank, N.A., 
as Trustee

4.1

4.2

Tripartite Agreement, dated September 13, 2007, 
appointing Deutsche Bank Trust Company 
Americas as Successor Trustee under the 
Indenture listed in Exhibit 4.1

Incorporated by reference to Exhibit 4.2 to 
the Company's Annual Report on Form 10-
K for the year ended December 31, 2008

4.3

Description of the Company's Common Stock

Incorporated by reference to Exhibit 4.3 to 
the Company's Annual Report on Form 10-
K for the year ended December 31, 2019

4.4

4.5

4.6

Description of the Company's 1.000% Notes due 
2022, 1.625% Notes due 2026, and 2.125% Notes 
due 2030

Incorporated by reference to Exhibit 4.4 to 
the  Company's Annual Report on Form 10-
K for the year ended December 31, 2019

Description of the Company's 6.77% Notes due 
2036

Description of the Company's 7 1/8% Notes due 
2025

Incorporated by reference to Exhibit 4.5 to 
the Company's Annual Report on Form 10-
K for the year ended December 31, 2019

Incorporated by reference to Exhibit 4.6 to 
the Company's Annual Report on Form 10-
K for the year ended December 31, 2019

121  
 
  
  
  
  
  
  
  
  
4.7

4.8

4.9

Description of the Company's 0.625% Notes due 
2031 and 1.700% Notes due 2049

Incorporated by reference to Exhibit 4.7 to 
the Company's Annual Report on Form 10-
K for the year ended December 31, 2019

Description of the Company's 0.500% Notes due 
2033, 1.125% Notes due 2051, and 1.375% Notes 
due 2061

Attached 

Description of the Company's 1.625% Notes due 
2043

Attached

10.1

Amended and Restated 2002 Lilly Stock Plan(1)

Incorporated by reference to Exhibit 10.1 to 
the Company's Quarterly Report on Form 
10-Q for the quarter ended June 30, 2018

10.2

10.3

10.4

10.5

10.6

10.7

10.8

10.9

10.10

10.11

Form of Performance Award under the 2002 Lilly 
Stock Plan(1)

Form of Performance Award under the 2002 Lilly 
Stock Plan (with non-compete)(1)

Form of Performance Award under the 2002 Lilly 
Stock Plan (non-executive officer)(1)

Form of Shareholder Value Award under the 2002 
Lilly Stock Plan(1)

Form of Shareholder Value Award under the 2002 
Lilly Stock Plan (with non-compete)(1)

Form of Shareholder Value Award under the 2002 
Lilly Stock Plan (non-executive officer)(1)

Attached

Attached

Attached

Attached

Attached

Attached

Form of Relative Value Award under the 2002 Lilly 
Stock Plan(1)

Attached

Form of Relative Value Award under the 2002 Lilly 
Stock Plan (with non-compete)(1)

Attached

Form of Relative Value Award under the 2002 Lilly 
Stock Plan (non-executive)(1)

Attached

Form of Restricted Stock Unit Award under the 
2002 Lilly Stock Plan(1)

Attached 

10.12

Form of Restricted Stock Unit Award under the 
2002 Lilly Stock Plan (with non-compete)(1)

Incorporated by reference to Exhibit 10.1 to 
the Company's Quarterly Report on Form 
10-Q for the quarter ended March 31, 2021

10.13

Release Agreement, effective as of February 9, 
2021, by and between Eli Lilly and Company and 
Joshua L. Smiley(1)

Incorporated by reference to Exhibit 10.2 to 
the Company's Quarterly Report on Form 
10-Q for the quarter ended March 31, 2021

10.14

The Lilly Deferred Compensation Plan, as 
amended(1)

10.15

The Lilly Directors' Deferral Plan, as amended(1)

10.16

The Eli Lilly and Company Bonus Plan, as 
amended(1)

Incorporated by reference to Exhibit 10.5 to 
the Company's annual report on Form 10-K 
for the year ended December 31, 2013

Incorporated by reference to Exhibit 10 to 
the Company's Quarterly Report on Form 
10-Q for the quarter ended June 30, 2017

Incorporated by reference to Exhibit 10.14 
to the Company's Annual Report on Form 
10-K for the year ended December 31, 
2020

10.17

The Loxo Oncology, Inc. Bonus Plan(1)

Attached 

122  
  
  
  
  
  
  
  
  
  
  
  
10.18

2007 Change in Control Severance Pay Plan for 
Select Employees, as amended(1)

Incorporated by reference to Exhibit 10.15 
to the Company's Annual Report on Form 
10-K for the year ended December 31, 
2020

21

23

31.1

31.2

32

101

104

   List of Subsidiaries

Consent of Independent Registered Public 
Accounting Firm

Rule 13a-14(a) Certification of David A. Ricks, 
Chair, President, and Chief Executive Officer

Rule 13a-14(a) Certification of Anat Ashkenazi, 
Senior Vice President and Chief Financial Officer

   Section 1350 Certification

   Interactive Data File

Cover Page Interactive Data File (formatted in 
Inline XBRL and contained in Exhibit 101)

   Attached

Attached

Attached

Attached

   Attached

   Attached

Attached

(1) Indicates management contract or compensatory plan.

Item 16. Form 10-K Summary

Not applicable.

123  
  
  
  
  
  
  
  
Signatures

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the Registrant 
has duly caused this report to be signed on its behalf by the undersigned thereunto duly authorized.

Eli Lilly and Company

By   /s/    David A. Ricks
David A. Ricks
Chair, President, and Chief Executive Officer

February 23, 2022 

124Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below on 
February 23, 2022 by the following persons on behalf of the Registrant and in the capacities indicated.

Signature

/s/    David A. Ricks
DAVID A. RICKS

/s/    Anat Ashkenazi
ANAT ASHKENAZI

/s/    Donald A. Zakrowski
DONALD A. ZAKROWSKI

/s/    Ralph Alvarez
RALPH ALVAREZ

/s/    Katherine Baicker, Ph.D.
KATHERINE BAICKER, Ph.D.

/s/    Michael L. Eskew
MICHAEL L. ESKEW

/s/    J. Erik Fyrwald
J. ERIK FYRWALD

/s/    Jamere Jackson
JAMERE JACKSON

/s/    Kimberly H. Johnson
KIMBERLY H. JOHNSON

/s/    William G. Kaelin, Jr., M.D.
WILLIAM G. KAELIN, JR., M.D.

/s/    Juan R. Luciano
JUAN R. LUCIANO

/s/    Marschall S. Runge, M.D., Ph.D.
MARSCHALL S. RUNGE, M.D., Ph.D.

/s/    Gabrielle Sulzberger
GABRIELLE SULZBERGER

/s/    Jackson P. Tai
JACKSON P. TAI

/s/    Karen Walker
KAREN WALKER

Title

Chair, President, and Chief Executive Officer 
(principal executive officer)

Senior Vice President and Chief Financial Officer 
(principal financial officer)

Vice President, Finance, and Chief Accounting 
Officer (principal accounting officer)

Director

Director

Director

Director

Director

Director

Director

Director

Director

Director

Director

Director

125Trademarks Used In This Report

Trademarks or service marks owned by Eli Lilly and Company or its affiliates, when first used in each item of 
this report, appear with an initial capital and are followed by the symbol ® or ™, as applicable. In subsequent 
uses of the marks in the item, the symbols may be omitted.

Actos® is a trademark of Takeda Pharmaceutical Company Limited.

Byetta® is a trademark of Amylin Pharmaceuticals, Inc.

Glyxambi®, Jardiance®, Jentadueto®, Synjardy®, Trajenta®, and Trijardy® are trademarks of Boehringer 
Ingelheim International GmbH.

Tyvyt® is a trademark of Innovent Biologics (Suzhou) Co., Ltd. 

Viagra® is a trademark of G.D. Searle LLC, a Viatris Company.

126BR532457-0222-10K