<SEC-DOCUMENT>0001214659-24-005391.txt : 20240328
<SEC-HEADER>0001214659-24-005391.hdr.sgml : 20240328
<ACCEPTANCE-DATETIME>20240328122034
ACCESSION NUMBER:		0001214659-24-005391
CONFORMED SUBMISSION TYPE:	PX14A6G
PUBLIC DOCUMENT COUNT:		2
FILED AS OF DATE:		20240328
DATE AS OF CHANGE:		20240328
EFFECTIVENESS DATE:		20240328

SUBJECT COMPANY:	

	COMPANY DATA:	
		COMPANY CONFORMED NAME:			ELI LILLY & Co
		CENTRAL INDEX KEY:			0000059478
		STANDARD INDUSTRIAL CLASSIFICATION:	PHARMACEUTICAL PREPARATIONS [2834]
		ORGANIZATION NAME:           	03 Life Sciences
		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:		24796331

	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:			Trinity Health Corp
		CENTRAL INDEX KEY:			0001769794
		ORGANIZATION NAME:           	
		IRS NUMBER:				351443425

	FILING VALUES:
		FORM TYPE:		PX14A6G

	BUSINESS ADDRESS:	
		STREET 1:		30555 VICTOR PARKWAY
		CITY:			LIVONIA
		STATE:			MI
		ZIP:			48152
		BUSINESS PHONE:		734-343-0916

	MAIL ADDRESS:	
		STREET 1:		30555 VICTOR PARKWAY
		CITY:			LIVONIA
		STATE:			MI
		ZIP:			48152
</SEC-HEADER>
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<P STYLE="margin: 0">&nbsp;</P>

<P STYLE="margin: 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><IMG SRC="trinity_logo.jpg" ALT=""><B>&nbsp;</B></P>

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

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><B>NOTICE OF EXEMPT SOLICITATION </B></P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><B>NAME OF REGISTRANT: </B>Eli Lilly and Company</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><B>NAME OF PERSON RELYING ON EXEMPTION: </B>Trinity
Health</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><B>ADDRESS OF PERSON RELYING ON EXEMPTION: </B>Catherine
Rowan</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left">&lt;rowancm@trinity-health.org&gt;</P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left">Dear Fellow Eli Lilly Shareholder,</P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in">Trinity Health and co-filers
Adrian Dominican Sisters, Friends Fiduciary Corporation, Mercy Investment Services, Sisters of Charity of St. Elizabeth and Sisters of
St. Francis of Dubuque Charitable Trust, (&#8220;the Proponents&#8221;), write to urge you to vote <B>FOR </B>Item <B>8</B> &#8220;Proposal
to Establish and Report on a Process by which the Impact of Extended Patent Exclusivities on Product Access Would be Considered in Deciding
Whether to Apply for Secondary or Tertiary Patents&#8221; (the &#8220;Proposal&#8221;), at the upcoming Eli Lilly and Company (&#8220;Eli
Lilly&#8221; or &#8220;the Company&#8221;) annual shareholders&#8217; meeting on May 6, 2024. The Proposal asks the Company to adopt and
report on a policy (the &#8220;Policy&#8221;) by which the impact on patient access to medicines is considered when deciding whether to
apply for secondary or tertiary patents. <U>We believe that the Policy would be beneficial to Eli Lilly because extended exclusivity periods
gained from secondary patents, and the resulting delay in generic entry, limit patient access, create regulatory and reputational risk,
and saddle the health care system with unsustainable costs</U>.</P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in">An AARP Public Policy Institute
study found that the list prices for the top 25 brand name drugs with the highest amount of Medicare Part D spending increased by an average
of 226% - or more than tripled &#8211; since those drugs first entered the market. Eli Lilly&#8217;s drug Trulicity is on the list, with
a reported 91% increase in its list price since it entered the market in 2014.<SUP>1</SUP></P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in">The Commonwealth Fund noted in
2021 that <FONT STYLE="color: #1A1A1A; background-color: white">&#8220;several studies and Congressional investigations have pointed to
drugmakers&#8217; use of the patent system to extend monopolies, increase prices, and delay generic or biosimilar competition.&#8221;<SUP>2</SUP>
One study that analyzed all drugs on the market between 2005 and 2015 looked at &#8220;every instance in which a company added a new patent
or exclusivity. The results show startling departure from the classic conceptualization of intellectual property protection for pharmaceuticals&#8230;.78%
of the drugs with new patents were not new drugs, but existing ones, and extending protection is particularly pronounced among blockbuster
drugs.&#8221; <SUP>3</SUP></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt; text-align: left">&nbsp;</P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><FONT STYLE="font-size: 10pt"><SUP>1</SUP></FONT>
h<FONT STYLE="font-size: 10pt">ttps://www.aarp.org/content/dam/aarp/ppi/topics/health/prescription-drugs/prices-top-medicare-part-d-drugs-tripled-entering-market.doi.10.26419-2fppi.00202.001.pdf.coredownload.pdf</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><FONT STYLE="font-size: 10pt"><SUP>2</SUP></FONT>
h<FONT STYLE="font-size: 10pt">ttps://www.commonwealthfund.org/blog/2021/policymakers-attention-turns-drug-patents-debate-prices</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><FONT STYLE="font-size: 10pt"><SUP>3</SUP></FONT>
h<FONT STYLE="font-size: 10pt">ttps://academic.oup.com/jlb/article/5/3/590/5232981?login=false</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt; text-align: left">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: center">This communication is not a solicitation of proxy
authority and no proxy cards will be accepted. Vote your proxies in accordance with the Company&#8217;s instructions.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt; text-align: left">&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt; text-align: left"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt; text-align: left">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify; text-indent: 0.5in">Federal law tries to strike
a balance between incentivizing innovation and promoting affordability. Obtaining a patent for a new drug gives the manufacturer a period
of exclusive marketing rights, generally for 20 years.<SUP>4</SUP> Once the patent expires, manufacturers are free to make generic versions
of the drug&#8212;or in the case of a biologic, a biosimilar version&#8212;which drives down prices.<SUP>5</SUP> An academic commentator
described the balance struck by this regulatory regime:</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0 0pt 0.5in; text-align: left; color: #1E1E1E">On the one hand, originators
play an important role in developing new and improved medicines for the benefit of society. On the other hand, generic companies benefit
society by supplying cheaper equivalents of the originators&#8217; medicines, which leads to the reduction of drug prices and facilitates
access to affordable medicines. When the interests of these two players are kept in balance, benefits are maximized for society, which
receives innovative and improved medicines, as well as timely access to generic drugs.<SUP>6</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt; text-align: left">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in">We believe that balance is now
out of whack. Given the high prices their drugs command absent competition, branded drug makers have strong incentives to delay generic
competition as long as possible. One strategy they use is creating so-called &#8220;patent thickets,&#8221; numerous overlapping patents
on a drug filed after the primary patent has been granted and the drug approved by the Food and Drug Administration (&#8220;FDA&#8221;)
that would be expensive and time-consuming for a potential generic manufacturer to challenge.<SUP>7</SUP> This strategy can allow branded
drug makers to hold off generic (or biosimilar, in the case of a biologic medicine) competition for several years or more. These patents
are placed on the FDA&#8217;s master list of approved medications, medical devices and other therapeutics, known as the &#8220;Orange
Book&#8221;.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt; text-align: left">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in">A recent study in <I>PLOS Medicine</I>,<SUP>8</SUP>
and subsequently reported in <I>Time, </I>looked at how insulin manufacturers such as Eli Lilly &#8220;have used patents and regulatory
exclusivities on insulin products approved from 1986 to 2019 to extend periods of market exclusivity.&#8221; During this period, patents
for 56 brand-name insulin products were approved. &#8220;<FONT STYLE="color: #202020; background-color: white">Protection on insulin was
enhanced by patents obtained after FDA approval, which lengthened expected market exclusivity in 9 cases by a median of 6 years. In addition,
two-thirds of drug-device combinations had last-to-expire patents that were on the delivery devices; these last-to-expire device patents
extended protection by a median of 5.2 years.&#8221; <SUP>9</SUP> The <I>PLOS</I> study also found that 17 cases in which the last-to-expire
patent on a drug-device combination was a device patent with claims that made no mention of insulin, and these <FONT STYLE="font-size: 10pt">patents
extended protection by a median of more than 4 years.&nbsp;</FONT></FONT></P>

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

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><SUP>4</SUP> https://sgp.fas.org/crs/misc/R46221.pdf,
at 1.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><SUP>5</SUP> https://www.fda.gov/files/drugs/published/Exclusivity-and-Generic-Drugs--What-Does-It-Mean-.pdf;
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534750/ (&#8220;<FONT STYLE="color: #212121; background-color: white">Prices can drop as
much as 20% when the first generic enters the market; with multiple generics, the prices may eventually drop by 80&#8211;85%.&#8221;)</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><SUP>6</SUP> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7592140/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><SUP>7</SUP> <U>See</U> ncbi.nlm.nih.gov/pmc/articles/PMC7592140/(&#8220;
<FONT STYLE="color: #1E1E1E">The denser the web of secondary patents, the more difficult it is for generics to develop their generic equivalents,
even if they know that only a few patents of a large portfolio would, in fact, be valid and infringed by their products.&#8221;)</FONT>;
https://sgp.fas.org/crs/misc/R46221.pdf, at 1-2.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><SUP>8</SUP> https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1004309</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><SUP>9</SUP> https://time.com/6336840/patent-manipulation-insulin-prices/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left">&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 [company&#8217;s]
proxy statement.</P>

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

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt; text-align: left; background-color: white"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0.25in 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in">&#8220;For patients who&#8217;ve
long held out hope for cheaper alternatives to their life-saving medication, a six-year extension of exclusivity could easily represent
hundreds of thousands of dollars&#8212;or, if that expense is unmanageable, the forced use of cheaper and less-effective insulin delivery
systems.&#8221;<SUP>10</SUP></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt; text-align: left">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in">These later-filed patents, which
are referred to as secondary and tertiary<SUP>11</SUP> patents, relate to properties of the drug other than the active ingredient, such
as methods of administration, manufacturing processes, dosing regimens, and additional indications.<SUP>12</SUP> They allow drug makers
to benefit from extended exclusivity periods without engaging in additional innovation.<SUP>13</SUP></P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in"><U>Secondary patents have a significant
impact on health care spending, exacerbating inequalities in access to medicines and straining both public and private sector budgets</U>.
One study analyzed the 12 best-selling drugs, which had been on the market for an average of 15 years, and found large numbers of secondary
patents providing an average exclusivity period of 38 years.<SUP>14</SUP> That study called patent abuse the &#8220;root cause&#8221;
of unsustainably high drug prices.</P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in">The role of secondary and tertiary
patents in keeping prescription drug prices high has received increasing amounts of regulatory, legislative and media scrutiny.</P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in">On November 7, 2023, the Federal
Trade Commission announced a challenge of &#8220;<FONT STYLE="color: #1B1B1B">more than 100 patents held by manufacturers of brand-name
asthma inhalers, epinephrine autoinjectors, and other drug products as improperly or inaccurately listed in&#8230;. the &#8216;Orange
Book.&#8217; The Commission has also notified FDA that it disputes the accuracy or relevance of the listed information for these patents,
which may require that the manufacturers remove the listing or certify under penalty of perjury that the listings comply with applicable
statutory and regulatory requirements.&#8221;<SUP>15</SUP> &nbsp;This action came after the FTC warned in September 2023 that it </FONT><FONT STYLE="color: #363636; background-color: white">&#8220;&#8216;intends
to scrutinize&#8217; whether companies are illegally engaging in an unfair method of competition when they exploit a regulatory loophole
that can delay rivals from entering the market.&#8221;<SUP>16</SUP></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; color: #1B1B1B">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; color: #1B1B1B">_____________________________</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><FONT STYLE="color: #1B1B1B"><SUP>10</SUP></FONT>
<I>Ibid.</I></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><FONT STYLE="color: #1B1B1B"><SUP>11</SUP></FONT>
A secondary patent relates to &#8220;<FONT STYLE="background-color: white">peripheral features&#8221; of a drug, <FONT STYLE="color: #6B6B6B">while
a </FONT></FONT>tertiary patent applies to a drug-device combination, such as the EpiPen. https://blog.petrieflom.law.harvard.edu/2018/04/30/tertiary-patents-an-emerging-phenomenon/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><FONT STYLE="color: #1B1B1B"><SUP>12</SUP></FONT>
https://sgp.fas.org/crs/misc/R46221.pdf, at 9.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><FONT STYLE="color: #1B1B1B"><SUP>13</SUP></FONT>
<FONT STYLE="font-size: 10pt"><U>E.g.</U>, Editorial Board, &#8220;Save America&#8217;s Patent System,&#8221; The New York Times, Apr.
17, 2022<SUP>13</SUP> (&#8220;<FONT STYLE="background-color: white">Twelve of the drugs that Medicare spends the most on are protected
by more than 600 patents in total, according to the committee. Many of those patents contain little that's truly new. But the thickets
they create have the potential to extend product monopolies for decades. In so doing, they promise to add billions to the nation's soaring
health care costs -- and to pharmaceutical coffers.&#8221;); https://www.cnbc.com/2018/06/25/high-drug-prices-caused-by-us-patent-system.html;
https://www.i-mak.org/wp-content/uploads/2018/08/I-MAK-Overpatented-Overpriced-Report.pdf; </FONT>Robin Feldman, &#8220;Our patent system
is broken. And it could be stifling innovation,&#8221; The Washington Post, Aug. 8, 2021<SUP>13</SUP></FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><FONT STYLE="color: #1B1B1B"><SUP>14</SUP></FONT>
https://www.i-mak.org/wp-content/uploads/2018/08/I-MAK-Overpatented-Overpriced-Report.pdf</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><FONT STYLE="font-size: 10pt; color: #1B1B1B"><SUP>15</SUP></FONT>
h<FONT STYLE="font-size: 10pt">ttps://www.ftc.gov/news-events/news/press-releases/2023/11/ftc-challenges-more-100-patents-improperly-listed-fdas-orange-book</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><FONT STYLE="font-size: 10pt; color: #1B1B1B"><SUP>16</SUP></FONT>
h<FONT STYLE="font-size: 10pt">ttps://www.nytimes.com/2023/09/14/business/ftc-drug-patents-inhalers.html</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><FONT STYLE="font-size: 10pt">&nbsp;</FONT></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 [company&#8217;s]
proxy statement.</P>

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

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt; text-align: left; background-color: white"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0.25in 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in"><FONT STYLE="color: #1B1B1B">The
<I>Time</I> article notes that &#8220;t</FONT>he FTC&#8217;s current list of patents under scrutiny doesn&#8217;t include insulin products,
but the changes it causes could affect them. It&#8217;s possible that could trigger pharma companies to evaluate their patents in other
areas&#8212;including insulin&#8212;as well.&#8221;</P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in">In January 2024, a bipartisan
bill was introduced in the Senate (Sens. Welch, Braun and Klobuchar) and a similar bill in the House by Republican Rep. Arrington that
would address patent thickets by codifying &#8220;the practice that many federal district courts across the country already apply to limit
the number of patents or patent claims a company can assert in litigation.&nbsp;&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left">Specifically, this bipartisan bill:</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"></P>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-family: Symbol; font-size: 10pt">&middot;</FONT></TD><TD STYLE="text-align: left"><FONT STYLE="font-family: Times New Roman, Times, Serif">Streamlines patent litigation by limiting to one,
the number of patents per patent thicket a pharmaceutical company can assert in litigation.&nbsp;</FONT></TD></TR></TABLE>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-family: Symbol; font-size: 10pt">&middot;</FONT></TD><TD STYLE="text-align: left"><FONT STYLE="font-family: Times New Roman, Times, Serif">Prohibits a patent owner from asserting multiple
patents from the same thicket in separate actions against the same alleged infringer to circumvent the intent of the law.&nbsp;</FONT></TD></TR></TABLE>

<TABLE CELLPADDING="0" CELLSPACING="0" WIDTH="100%" STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-bottom: 0pt"><TR STYLE="vertical-align: top">
<TD STYLE="width: 0.25in"></TD><TD STYLE="width: 0.25in"><FONT STYLE="font-family: Symbol; font-size: 10pt">&middot;</FONT></TD><TD STYLE="text-align: left"><FONT STYLE="font-family: Times New Roman, Times, Serif">Safeguards quality patents that improve existing
drugs, benefiting patients.&#8221;&nbsp;<SUP>17</SUP></FONT></TD></TR></TABLE>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left">The Senate Committee on Health, Education, Labor
and Pensions held a hearing in February 2024 on US drug pricing that raised concerns about patent thickets and other uses of the patent
system and received wide press coverage. <SUP>18</SUP></P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in">Pharmaceutical firms argue that
secondary and tertiary patents are necessary to incentivize continued innovation related to a drug. But the Proposal does not seek to
prohibit the Company from applying for secondary and tertiary patents on its medicines, only for the impact on patient access to be part
of the mix of considerations. There is evidence that companies delay marketing an innovation on an existing drug by filing for secondary
patents strategically, close to the primary patent&#8217;s expiration, in order to provide the longest exclusivity extension.<SUP>19</SUP>
This timing suggests that patient benefit is not always the sole motivation for such innovations on approved medicines.</P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in">More generally, reliance on patent
thickets may actually diminish branded drug manufacturers&#8217; incentives to continue developing innovative medicines. If a manufacturer
can obtain a longer period of exclusivity for a top-selling drug, it has a reduced motivation to develop new drugs.<SUP>20</SUP> As one
academic study put it: &#8220;<FONT STYLE="color: #212121; background-color: white">Rather than creating new medicines&#8212;sallying
forth into new frontiers for the benefit of society&#8212;drug companies are focusing their time and effort extending the patent life
of old products. This, of course, is not the innovation one would hope for. The greatest creativity at pharmaceutical companies should
be in the lab, not in the legal department.&#8221;<SUP>21</SUP></FONT></P>

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

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><SUP>17</SUP> https://www.welch.senate.gov/welch-braun-and-klobuchar-introduce-bipartisan-legislation-to-streamline-drug-patent-litigation-lower-cost-of-prescription-drugs/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"><SUP>18</SUP> https://edition.cnn.com/2024/02/08/health/senate-hearing-drug-prices/index.html
https://www.nytimes.com/2024/02/08/us/politics/senate-hearing-drug-prices.html</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: justify"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left">https://www.cnbc.com/2024/02/08/jj-merck-bristol-myers-squibb-ceos-senate-drug-price-hearing.html</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><SUP>19</SUP> <U>See</U> ncbi.nlm.nih.gov/pmc/articles/PMC7592140/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><SUP>20</SUP> ncbi.nlm.nih.gov/pmc/articles/PMC7592140/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><SUP>21</SUP> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534750/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left">&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 [company&#8217;s]
proxy statement.</P>

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

<!-- Field: Page; Sequence: 4 -->
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    <DIV STYLE="break-before: page; margin-top: 6pt; margin-bottom: 8pt"><TABLE CELLPADDING="0" CELLSPACING="0" STYLE="width: 100%"><TR><TD STYLE="text-align: right; width: 100%"><FONT STYLE="font-size: 10pt"><!-- Field: Sequence; Type: Arabic; Name: PageNo -->5<!-- Field: /Sequence --></FONT></TD></TR></TABLE></DIV>
    <!-- Field: /Page -->

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt; text-align: left; background-color: white"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0.25in 0pt 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in">In its proxy statement, Eli Lilly
describes its process for patent protection for new innovations and secondary and tertiary patents. However, it does not disclose whether
access is considered when deciding whether to apply for secondary or tertiary patents. This issue is at the heart of the Proposal, and
the Company does not address it. Eli Lilly provides information on its approach to access to medicine, but it does not make a connection
between its access approach and its patenting strategy.</P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in; color: #212121"><FONT STYLE="background-color: white">We
recognize that Eli Lilly participates in the IP Principles for Advancing Cures and Therapies (IP-PACT).<SUP>22</SUP> However, the Principles
do not address what the Proponents are seeking to understand: whether the impact on patient access is considered in secondary and/or tertiary
patenting strategies.</FONT></P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in; color: #212121"><FONT STYLE="background-color: white">Finally,
the existence of disclosure on a company&#8217;s pricing and/or access programs is sometimes held up as a reason the Proposal is unnecessary.
Disclosures, standing alone, are insufficient because they do not effect a change in policy like the one sought by the Proposal. The policy
change is the Proposal&#8217;s core element, and the reporting component is designed to ensure that shareholders are apprised of Eli Lilly&#8217;s
adoption of the Policy.</FONT></P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; text-indent: 0.5in"><FONT STYLE="font-size: 10pt">We
recognize the value created by pharmaceutical innovation, and the Proposal would not limit in any way the Company&#8217;s ability to obtain
so-called primary patents covering drugs&#8217; active ingredients or require a particular outcome when the Company analyzes whether to
pursue secondary and tertiary patents. The Proposal simply asks </FONT>the C<FONT STYLE="font-size: 10pt">ompany to take the impact on
patient access into account when making decisions about applying for such patents. It would not impose a specific weighting for access
considerations, nor would it dictate how access should be measured. The Company would have total discretion over those and other details.
</FONT></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0pt; margin-right: 0; margin-bottom: 0pt; text-align: left">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><B>We therefore urge shareholders to vote FOR Item
8. </B></P>

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left">For more information, please contact Catherine Rowan,
Director, Socially Responsible Investments, Trinity Health rowancm@trinity-health.org</P>

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

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"></P>

<!-- Field: Rule-Page --><DIV STYLE="margin-top: 3pt; margin-bottom: 3pt; width: 100%"><DIV STYLE="font-size: 1pt; border-top: Black 1pt solid">&nbsp;</DIV></DIV><!-- Field: /Rule-Page -->

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

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

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left"><SUP>22</SUP> https://www.interpat.org/ip-pact/</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0pt 0; text-align: left; background-color: white">&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 [company&#8217;s]
proxy statement.</P>

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





<P STYLE="margin: 0">&nbsp;</P>

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

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

<P STYLE="margin: 0"></P>

<!-- Field: Rule-Page --><DIV ALIGN="LEFT" STYLE="margin-top: 3pt; margin-bottom: 3pt"><DIV STYLE="font-size: 1pt; border-top: Black 2px solid; width: 100%">&nbsp;</DIV></DIV><!-- Field: /Rule-Page -->

<P STYLE="margin: 0">&nbsp;</P>

<P STYLE="margin: 0">&nbsp;</P>

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end
</TEXT>
</DOCUMENT>
</SEC-DOCUMENT>
