<SEC-DOCUMENT>0001214659-23-005739.txt : 20230421
<SEC-HEADER>0001214659-23-005739.hdr.sgml : 20230421
<ACCEPTANCE-DATETIME>20230421140216
ACCESSION NUMBER:		0001214659-23-005739
CONFORMED SUBMISSION TYPE:	PX14A6G
PUBLIC DOCUMENT COUNT:		1
FILED AS OF DATE:		20230421
DATE AS OF CHANGE:		20230421
EFFECTIVENESS DATE:		20230421

SUBJECT COMPANY:	

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			ELI LILLY & Co
		CENTRAL INDEX KEY:			0000059478
		STANDARD INDUSTRIAL CLASSIFICATION:	PHARMACEUTICAL PREPARATIONS [2834]
		IRS NUMBER:				350470950
		STATE OF INCORPORATION:			IN
		FISCAL YEAR END:			1231

	FILING VALUES:
		FORM TYPE:		PX14A6G
		SEC ACT:		1934 Act
		SEC FILE NUMBER:	001-06351
		FILM NUMBER:		23835832

	BUSINESS ADDRESS:	
		STREET 1:		LILLY CORPORATE CTR
		STREET 2:		DROP CODE 1094
		CITY:			INDIANAPOLIS
		STATE:			IN
		ZIP:			46285
		BUSINESS PHONE:		3172762000

	MAIL ADDRESS:	
		STREET 1:		LILLY CORPORATE CENTER
		STREET 2:		DROP CODE 1094
		CITY:			INDIANAPOLIS
		STATE:			IN
		ZIP:			46285

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	LILLY ELI & CO
		DATE OF NAME CHANGE:	19941024

FILED BY:		

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			SERVICE EMPLOYEES INTERNATIONAL UNION
		CENTRAL INDEX KEY:			0001076439
		IRS NUMBER:				360852885

	FILING VALUES:
		FORM TYPE:		PX14A6G

	BUSINESS ADDRESS:	
		STREET 1:		1800 MASSACHUSETTS AVE NW
		CITY:			WASHINGTON
		STATE:			DC
		ZIP:			20036
		BUSINESS PHONE:		202-730-7000

	MAIL ADDRESS:	
		STREET 1:		1800 MASSACHUSETTS AVE NW
		CITY:			WASHINGTON
		STATE:			DC
		ZIP:			20036

	FORMER COMPANY:	
		FORMER CONFORMED NAME:	SERVICE EMPLOYEE INTERNATIONAL
		DATE OF NAME CHANGE:	19990107
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<P STYLE="margin: 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white">Notice of Exempt Solicitation</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white">Name of Registrant: Eli Lilly and Company</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white">Name of Person Relying on Exemption: SEIU
Benefit Plans Master Trust<BR>
Address of Person Relying on Exemption: 1800 Massachusetts Avenue, NW, Washington, DC 20036</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white">April 20, 2023<BR>
<BR>
Dear Fellow Eli Lilly Shareholder,</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">Though companies have a legitimate business interest
in influencing laws and regulations, such activities carry numerous risks. Shareholders should receive full information about policy influence
activities to enable them to assess those risks as well as the adequacy of a company&rsquo;s oversight of them, and to evaluate whether
those activities are in the best interests of long-term shareholders.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">Eli Lilly and Company (&ldquo;Lilly&rdquo; or the
&ldquo;Company&rdquo;) shareholders can call for greater disclosure of Lilly&rsquo;s direct and indirect lobbying expenditures at the
Company&rsquo;s annual shareholder meeting on May 1, 2023. Item #7 on Lilly&rsquo;s proxy card, &ldquo;Proposal to Publish an Annual Report
Disclosing Lobbying Activities&rdquo; (the &ldquo;Proposal&rdquo;), asks Lilly to disclose policies and procedures governing lobbying,
payments used for direct or indirect lobbying as well as grassroots lobbying communications, membership in and payments to tax-exempt
organizations that write and endorse model legislation, and the board and management&rsquo;s decision-making process for making those
payments.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">Lilly claims that it &ldquo;already provides shareholders
with extensive disclosures regarding the company&rsquo;s direct and indirect lobbying activities and expenditures, and information necessary
to assess the consistency of the company&rsquo;s lobbying activities with its expressed goals through existing disclosures.&rdquo;<SUP>1</SUP>
But Lilly falls short on disclosure of state, foreign, and some indirect lobbying information the Proposal requests, which prevents shareholders
from seeing the complete picture of Lilly&rsquo;s policy influence activities.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white; text-indent: 0.5in">First, <B>Lilly&rsquo;s
disclosure of its state lobbying on its Political Participation Website<SUP>2</SUP> suffers from several major deficiencies</B>. Not all
states require disclosure of lobbying payments, and Lilly does not provide any disclosure regarding activities in such states. Lilly&rsquo;s
state lobbying potentially appears in more than fifty different places, since Lilly merely links to websites containing state lobbying
filings (and some states maintain separate sites for legislative and executive branch lobbying).</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in; background-color: white">Each website requires
users to search for the company of interest, and there is no way to know up front whether Lilly has even lobbied in a particular state.
Each of these state sites must be rechecked periodically to update information. Twenty-two state registries do not provide the amounts
spent on lobbying, of which the Proposal requests disclosure. What&rsquo;s more, some of Lilly&rsquo;s information is not reliable: Delaware&rsquo;s
provides inconsistent information; broken links or publicly inaccessible websites prevent shareholders from using Lilly&rsquo;s data to
gather information about lobbying in five states; and Montana&rsquo;s site does not produce results when it is searched using the search
instructions Lilly provides.<SUP>3</SUP> This unwieldy assemblage of links, some inoperative. cannot reasonably be characterized as implementing
the Proposal&rsquo;s request for a report disclosing expenditures for state lobbying.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;_____________________________</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>1</SUP> Definitive Proxy Statement, at 92.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>2</SUP> https://www.lilly.com/policies-reports/public-policy-political-participation</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>3</SUP> assets.ctfassets.net/srys4ukjcerm/G4lsb0i4D66TnFcSIwG1l/46dec82a9ea000317092047554c52c3c/Lilly_State_Lobbyist_Activity_2022.pdf</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 2.25pt 0pt 0; text-indent: 0.5in">Lilly does not even provide a link to
lobbying disclosures for Puerto Rico, where one of Lilly&rsquo;s &ldquo;[m]ajor production sites&rdquo;<SUP>4</SUP> is located. As of
2018, a Lilly subsidiary made Humalog , its fifth highest-selling medicine,<SUP>5</SUP> in Puerto Rico.<SUP>6</SUP> Lilly is listed as
a lobbying client on the Puerto Rico executive branch and Senate registries.<SUP>7</SUP> <FONT STYLE="font-size: 10pt">The Alliance for
Biopharmaceutical Competitiveness and Innovation (ABCI), which consists of Eli Lilly and 8 other &ldquo;U.S.-headquartered companies,&rdquo;<SUP>8</SUP>
has reported lobbying on Puerto Rico tax incentives, creditability of Puerto Rico excise taxes, repatriation of intellectual property,
and treatment of income and capital investments under US and PR tax laws.<SUP>9</SUP> Eli Lilly has directly lobbied the US Senate and
House of Representatives on &ldquo;Puerto Rico tax issues&rdquo; over the past 12 consecutive quarters.<SUP>10</SUP></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 2.15pt 0pt 0; text-indent: 0.5in">In its most recent 10-K, Lilly disclosed
to investors that it has &ldquo;a subsidiary operating in Puerto Rico under a tax incentive grant effective through the end of 2031, which
was amended in 2022 to apply the alternate tax regime established by recently enacted Puerto Rico legislation starting in 2023.&rdquo;<SUP>11</SUP>
The newly-enacted legislation referenced by Lilly in its 10-K overlaps with the issues on which ABCI reported lobbying in its federal
filings, as it allows &ldquo;companies to replace 4% excise tax on foreign corporations with new, possibly creditable, tax on industrial
development income,&rdquo; according to an Ernst &amp; Young tax alert.<SUP>12</SUP> Given Puerto Rico&rsquo;s seeming importance to Lilly,
the omission of Puerto Rico from Lilly&rsquo;s page of links&mdash;as difficult to use as it is&mdash;is problematic.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 2.25pt 0pt 0; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white; text-indent: 0.5in">Second, <B>Lilly&rsquo;s
disclosures include no information on lobbying done outside the United States</B>, which can create risks relating to the Foreign Corrupt
Practices Act (&ldquo;FCPA&rdquo;).<SUP>13</SUP> In 2012, Lilly settled SEC charges that it violated the FCPA by making improper payments
to government officials in Russia, China, Brazil and Poland.<SUP>14</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">Finally, bringing down U.S. drug prices, which
are the highest in the world, is a goal supported by large majorities of both Democrats and Republicans.<SUP>15</SUP> For that reason,
pharmaceutical companies may seek less visible avenues of influence over public policy related to pricing. In addition to lobbying through
trade associations, <B>Lilly appears to engage in indirect lobbying through its relationships with groups that present themselves as patient
advocacy organizations.<SUP>16</SUP></B> These relationships are not disclosed on the Political Participation Website.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B>&nbsp;</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B>_____________________________</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>4</SUP> <A HREF="https://www.sec.gov/ix?doc=/Archives/edgar/data/59478/000005947823000082/lly-20221231.htm">https://www.sec.gov/ix?doc=/Archives/edgar/data/59478/000005947823000082/lly-20221231.htm</A>,
at 34.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-family: Times New Roman, Times, Serif"><SUP>5</SUP></FONT>
<A HREF="https://www.sec.gov/ix?doc=/Archives/edgar/data/59478/000005947823000082/lly-20221231.htm"><FONT STYLE="font-family: Times New Roman, Times, Serif">https://www.sec.gov/ix?doc=/Archives/edgar/data/59478/000005947823000082/lly-20221231.htm</FONT></A><FONT STYLE="font-family: Times New Roman, Times, Serif">,
at 46.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>6</SUP> https://www.federalregister.gov/documents/2018/05/18/2018-10646/foreign-trade-zone-ftz-7-mayaguez-puerto-rico-notification-of-proposed-production-activity-lilly-del</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>7</SUP> https://registrodecabilderos.pr.gov/Lobbyist/Details;
https://senado.pr.gov/document_vault/lobbylist_registry/207/Reichard%20&amp;%20Escalera,%20LLC.pdf</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>8</SUP> https://www.taxnotes.com/research/federal/other-documents/public-comments-on-regulations/biopharm-group-focuses-on-r%2526d-issues-in-ftc-regs/296kz</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>9</SUP> https://projects.propublica.org/represent/lobbying/r/300928555</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>10</SUP> https://projects.propublica.org/represent/lobbying/r/300937518</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-family: Times New Roman, Times, Serif"><SUP>11</SUP></FONT>
<A HREF="https://www.sec.gov/ix?doc=/Archives/edgar/data/59478/000005947823000082/lly-20221231.htm"><FONT STYLE="font-family: Times New Roman, Times, Serif">https://www.sec.gov/ix?doc=/Archives/edgar/data/59478/000005947823000082/lly-20221231.htm</FONT></A><FONT STYLE="font-family: Times New Roman, Times, Serif">,
at 91.</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>12</SUP> https://www.ey.com/en_gl/tax-alerts/puerto-rico-enacts-legislation-allowing-companies-to-replace-4-excise-tax-on-foreign-corporations-with-new-possibly-creditable-tax-on-industrial-development-income</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>13</SUP> <U>See</U>, <U>e.g.</U>, Peter Fritsch and Timothy Mapes,
&ldquo;Seedy Indonesian Saga: Monsanto Pays to Settle Allegations of Bribery, <U>The Asian Wall Street Journal</U>, Apr. 5, 2005</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>14</SUP> https://www.sec.gov/news/press-release/2012-2012-273htm</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>15</SUP> https://khn.org/news/article/public-opinion-prescription-drug-prices-democratic-plan/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>16</SUP> Examples of astroturfing organizations used by pharmaceutical
companies, directly or through their trade associations, include the Alliance for Patient Access (APA), Partnership for Safe Medicines
(PSM), Partnership to Improve Patient Care (PIPC), Patients Rising (https://patientsforaffordabledrugs.org/the-hidden-hand/); Partnership
to Fight Chronic Disease (https://rollcall.com/2021/09/30/nonprofit-linked-to-phrma-behind-ads-opposing-drug-pricing-changes/); Citizens
Against Government Waste (https://prospect.org/power/astroturf-campaign-attacks-discount-drug-program-for-poor/); and Coalition Against
Socialized Medicine (https://prospect.org/health/pharma-backed-astroturf-group-drug-prices/)</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center; background-color: white">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center; background-color: white">We are not asking for
authority to vote your proxy and no proxy cards will be accepted. Please vote your proxy according to the instructions in Lilly&rsquo;s
proxy statement.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><B>&nbsp;</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">As of July 2021<B>, </B>Lilly was in the highest
corporate donation bracket for JDRF,<SUP>17</SUP> which funds Type 1 diabetes research and &ldquo;advocate[s] for policies that accelerate
access to new therapies.&rdquo;<SUP>18</SUP> People with Type 1 diabetes depend on insulin,<SUP>19</SUP> and Lilly&rsquo;s insulin products
account for 13.5% of its revenues.<SUP>20</SUP> JDRF&rsquo;s &ldquo;Insulin Access and Innovation&rdquo; principles<SUP>21</SUP> state
that it is &ldquo;vital that any adopted policy impacting drug pricing does not stymie innovation and the development of newer and better
insulins.&rdquo;<SUP>22</SUP> Two of JDRF&rsquo;s three 2021 advocacy priorities&mdash;the most recent available on its website&mdash;focus
on innovation, including &ldquo;[e]nsur[ing] United States regulatory policies provide clear and reasonable pathways for scientific research
and therapy approvals.&rdquo;<SUP>23</SUP> Lilly&rsquo;s 10-K describes aspects of the FDA&rsquo;s drug approval process that could affect
the Company&rsquo;s financial results, including the process for approving biosimilar versions of insulin products.<SUP>24</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">Lilly also supports the Alliance for Patient Access
(&ldquo;APA&rdquo;), a 501(c)(4) or &ldquo;social welfare&rdquo; group that Lilly has joined as an associate member.<SUP>25</SUP> All
but one of APA&rsquo;s 31 &ldquo;Associate Members and Financial Supporters&rdquo; are pharmaceutical or biotechnology companies.<SUP>26</SUP>
Although APA describes its mission as defending the primacy of the &ldquo;physician-patient relationship&rdquo;<SUP>27</SUP> in treatment
decision making, some of its activities involve pushing back against regulation.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-indent: 0.5in">For example, APA has highlighted the &ldquo;dangers&rdquo;
of &ldquo;bad drug&rdquo; advertising&mdash;advertising that allegedly overemphasizes potential side effects&mdash;targeting newer and
pricier classes of diabetes drugs. Lilly&rsquo;s drug Trulicity falls into one of those classes. APA encouraged physicians to &ldquo;support
efforts to enhance regulations on &lsquo;bad drug&rsquo; advertising by writing to their state legislators and members of Congress.&rdquo;<SUP>28</SUP>
Such efforts could help Lilly, which received a letter from the FDA&rsquo;s Office of Prescription Drug Promotion (&ldquo;OPDP&rdquo;)
instructing Lilly to discontinue using a social media post that downplayed side effects and failed to note limitations on Trulicity&rsquo;s
use; the letter noted that the OPDP had communicated with Lilly four times about its promotion of the drug starting in 2014.<SUP>29</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">_____________________________</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>17</SUP> patientsforaffordabledrugs.org/wp-content/uploads/2023/06-28-21_P4AD_HiddenHandReport_V24.pdf,
at 9</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>18</SUP> https://www.jdrf.org/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>19</SUP> https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><FONT STYLE="font-family: Times New Roman, Times, Serif"><SUP>20</SUP>
<FONT STYLE="font-size: 10pt"><U>See</U></FONT></FONT> <A HREF="https://www.sec.gov/ix?doc=/Archives/edgar/data/59478/000005947823000082/lly-20221231.htm"><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">https://www.sec.gov/ix?doc=/Archives/edgar/data/59478/000005947823000082/lly-20221231.htm</FONT></A><FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">,
at 46 (adding Humalog, Humulin and Basaglar revenues, then dividing by 2022 total).</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>21</SUP> https://www.jdrf.org/impact/advocacy/insulin-access/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>22</SUP> https://www.jdrf.org/impact/advocacy/insulin-access/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>23</SUP> https://www.jdrf.org/impact/advocacy/agenda/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>24</SUP> <A HREF="https://www.sec.gov/ix?doc=/Archives/edgar/data/59478/000005947823000082/lly-20221231.htm">https://www.sec.gov/ix?doc=/Archives/edgar/data/59478/000005947823000082/lly-20221231.htm</A>,
at 8, 13-16, 25-26</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>25</SUP> <FONT STYLE="font-size: 10pt">https://admin.allianceforpatientaccess.org/wp-content/uploads/2023/01/AfPADonorsDecember2022.pdf;
https://allianceforpatientaccess.org/about</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>26</SUP> https://admin.allianceforpatientaccess.org/wp-content/uploads/2023/01/AfPADonorsDecember2022.pdf</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0"><SUP>27</SUP> <U>See</U> https://allianceforpatientaccess.org/about#membership</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white"><SUP>28</SUP> <FONT STYLE="font-size: 10pt">static1.squarespace.com/static/5adfaa0755b02c9316fa91b4/t/60522ec3414ef14cd0a59498/1615998660110/PPPH_Dr.+Lavernia+Q%26A_March+2021.pdf;
<U>see also</U> static1.squarespace.com/static/5adfaa0755b02c9316fa91b4/t/609170b327854b67eb83cbbf/1620144308758/PPPH_ChloeOnePager_May2021.pdf</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white"><SUP>29</SUP> https://www.fda.gov/media/155627/download</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center; background-color: white">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center; background-color: white">We are not asking for
authority to vote your proxy and no proxy cards will be accepted. Please vote your proxy according to the instructions in Lilly&rsquo;s
proxy statement.</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white; text-indent: 0.5in">APA&rsquo;s lobbying and
use of &ldquo;patient access&rdquo; language have spurred negative publicity. A 2019 article spotlighted APA&rsquo;s ties to drug makers
and its sponsorship of an advertisement opposing a proposal to lower drug prices.<SUP>30</SUP> A <U>Washington Post</U> article on the
advertisement called APA an example of an organization engaged in &ldquo;astroturfing,&rdquo; which is <FONT STYLE="color: #303336; background-color: white">&ldquo;activity
that is intended to create a false impression of a widespread, spontaneously arising, grassroots movement in support of or in opposition
to something (such as a political policy) but that is in reality initiated and controlled by a concealed group or organization (such as
a corporation)</FONT>.&rdquo;<SUP>31</SUP> Botched astroturfing campaigns have embarrassed companies and even, in one example, led to
fines for vendors executing the campaign.<SUP>32</SUP></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white; text-indent: 0.5in">Corporate reputation can
translate into financial consequences. A good reputation allows a company to hire and retain better talent, charge a premium for its product
or service, and enjoy greater customer loyalty.<SUP>33</SUP> Estimates peg the value of corporate reputation at over one-third of market
capitalization<SUP>34 </SUP>&mdash;one estimate put it as high as 63%<SUP>35</SUP>&mdash;and research has found that reputation drives
between three and 7.5% of annual revenues.<SUP>36&nbsp;</SUP>According to the Reputation Institute, a one-point increase in overall reputation
score is correlated with a 2.6% increase in share value.<SUP>37</SUP></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white; text-indent: 0.5in">For the reasons discussed
above, we urge you to vote FOR Item #7 on Lilly&rsquo;s proxy card. If you have any questions, please contact Renaye Manley via email
at renaye.manley@seiu.org.</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white"><SUP>_____________________________</SUP></P>



<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white"><SUP>30</SUP> <FONT STYLE="font-size: 10pt">https://www.nbcwashington.com/news/national-international/alliance-for-patient-access-pharmaceutical-industry-lobby-drug-prices/87268/;
https://apnews.com/article/politics-business-ap-top-news-donald-trump-north-america-7c8d0728c38345cd8dfc0fe1abd456ae</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white"><SUP>31</SUP> https://www.merriam-webster.com/dictionary/astroturfing</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white"><SUP>32</SUP> <U>See</U> https://ag.ny.gov/sites/default/files/oag-fakecommentsreport.pdf</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white"><SUP>33</SUP> https://hbr.org/2007/02/reputation-and-its-risks;
https://ccsenet.org/journal/index.php/ijbm/article/download/10087/7199, at 201-202.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white"><SUP>34</SUP> <FONT STYLE="font-size: 10pt">&ldquo;The
2018 U.K. Reputation Dividend Report,&rdquo; at 1 (http://reputationdividend.com/files/6215/1939/6597/UK_2018_report_Final.pdf); https://mumbrella.com.au/new-research-finds-strong-corporate-reputation-helps-companies-weather-financial-storms-587354</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white"><SUP>35</SUP> https://www.webershandwick.com/wp-content/uploads/2020/01/The-State-of-Corporate-Reputation-in-2020_executive-summary_FINAL.pdf,
at 13.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white"><FONT STYLE="font-family: Times New Roman, Times, Serif"><SUP>36</SUP>
<FONT STYLE="font-size: 10pt"><U>See</U></FONT></FONT> <FONT STYLE="font-family: Times New Roman, Times, Serif; font-size: 10pt">https://instituteforpr.org/reputation/</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; background-color: white"><SUP>37</SUP> www.reputationinstitute.com</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center; background-color: white">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center; background-color: white">We are not asking for
authority to vote your proxy and no proxy cards will be accepted. Please vote your proxy according to the instructions in Lilly&rsquo;s
proxy statement.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0">&nbsp;</P>

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