Eli Lilly Tops Diabetes Advocacy Trust Across Most ELAVAY Categories
Archō Advocacy’s 2025/2026 ELAVAY Cardiometabolic Advocacy Intelligence Report places Eli Lilly at the front of the diabetes and cardiometabolic advocacy field, with first place or a tie for first in six of eight measured categories and top-three placement in every category analyzed. The report is built from the perspective of diabetes advocates, professional societies, and community-based organizations that have worked with companies in the past 12 to 18 months and then rated their top three on a seven-point scale. Recognition and rating were combined to produce each league table, creating a view of corporate reputation that is tied to lived advocacy experience rather than advertising reach.
The structure of the rankings is revealing. Lilly did not dominate because it was the loudest company in the room. It ranked because advocates described a funding model that supported planned work without steering the message toward commercial goals. One advocate said Lilly “consistently funds these initiatives with no expectation of deliverables or benefits to them commercially,” while another described a company that asked how it could help amplify patient-centered messaging, including psychosocial aspects of diabetes. A third comment tied the company’s reputation directly to patient affordability, citing insulin pricing reductions and broader access efforts.
A single category stands apart from the rest. On the report’s Scale of Selflessness, which asks how transparent a company is about what it wants from the relationship, Insulet scored a perfect 7.00, the only perfect score in the dataset. Lilly followed at 6.50 and Novo Nordisk at 6.00. The score did not translate into a broader podium finish for Insulet, largely because too few advocates had worked with it to convert goodwill into a top-three position. In a field where reputation depends on repeat contact, visibility still matters.
Device Makers Outran Much of Pharma in Equity and Relationship Scores
The most striking pattern in the report is the performance of device companies. Dexcom, Abbott Diabetes Care, Insulet, Medtronic, and Tandem Diabetes Care all appear in the rankings, and the first three outrank most pharmaceutical firms in several categories. Dexcom finishes first in health equity contribution and first in advocacy relationships, ahead of every drug maker measured. Abbott ties for first on RISE recognition — Reach, Include, Support & Educate — and ranks third in Partnerships, Corporate Image, and Health Equity.
The reason for that edge is practical. Continuous glucose monitor and pump makers sit closest to the daily work of diabetes care, and advocates respond to that proximity when it is paired with community engagement. One advocate credited Dexcom with connecting organizations to coordinate advocacy messaging. Another praised the company’s focus on the health gains that continuous glucose monitoring can offer all people with diabetes, especially its work on affordability. Abbott drew praise for a campaign aimed at diabetes stigma, an issue that often receives less corporate attention than access or technology adoption.
The same closeness can cut the other way. The device sector drew some of the sharpest criticism in the dataset, including a comment from one advocate who described a sponsor relationship in which pipeline information was obscured and funding was tied to messaging aligned with sales goals. In reputational work like this, access alone does not buy trust. The relationship has to feel reciprocal and clinically credible, especially when the company’s product is part of day-to-day self-management.
Policy Views on the Inflation Reduction Act Set Diabetes Advocates Apart
The report also captures a policy divide that stands out across therapeutic areas. In cardiometabolic care, four in five advocates expect the Inflation Reduction Act to have a positive effect, while the remainder expect no effect either way. No respondent anticipated harm. That is a sharp contrast with oncology and mental health advocates in the same study year, where views were far more divided. The result suggests that diabetes advocates see the law not as an abstract policy win, but as a direct lever on medication access, affordability, and adherence.
More than eight in ten respondents said they work on healthcare policy inside their organizations, and two thirds educate their communities about the law through coalitions rather than alone. Half run federal lobbying efforts, and half work at the state level. The advocacy burden remains grounded in front-line patient education, though. Two thirds ranked disease awareness and education as the most important challenge facing their patients, the widest first-place margin of any issue in the report. Two thirds also described non-medical medication switching as a high or extremely high threat, a sign that payer and formulary decisions remain a source of friction even when treatment options are expanding.
A separate pressure point is organizational capacity. Half of the organizations surveyed said workforce and budget reductions across the industry have significantly reduced collaboration with them. The field is asking for more education, more coordination, and more continuity at the very moment when staffing and funding are tightening. In that environment, companies are judged not only on what they sponsor, but on how predictably they show up and how little they try to reshape the agenda around themselves.
One line in the report captures the practical meaning of that shift: in diabetes advocacy, the company in the room every day is the one making the sensor or the pump. That is why device makers can outperform larger pharmaceutical brands in certain trust measures, and why the highest-ranked drug company still had to earn its position through restraint, affordability, and patient-centered support rather than volume alone.
Archō pairs ELAVAY with its Advocacy Influence Diagnostic, or AID, a companion tool that compares how a company is viewed outside the organization with how its own internal advocacy function sees itself. The four personas used in AID — Architect, Defender, Underdog, and Whisperer — are designed to expose gaps between external reputation and internal influence. For companies competing in cardiometabolic care, that gap may be as important as the ranking itself. A strong public reputation can still lose budget support inside the organization, and a weak internal position can limit the impact of otherwise well-regarded advocacy work.
The report offers a detailed snapshot of how diabetes advocates judge the companies that seek their partnership. The strongest takeaways are not about a single winner. They are about the tension between funding and control, technology and trust, and policy messaging that fits one disease area but not another.