Like another small-molecule firm, Novartis (NYSE:NVS), Eli Lilly (NYSE:LLY) presented modest results for the third quarter, with guidance for a better future if all goes according to plan. 

Lilly's sales were up 19% year over year, largely because sales of drug and depression treatment Cymbalta grew 47%, and, thanks to the ICOS acquisition, sales of Cialis were included on the top line. GAAP operating income growth of only 8% was significantly less spectacular because of a settlement of Zyprexa product liability claims.

Lilly's top drug, the antipsychotic Zyprexa, which accounted for 25% of revenue in the third quarter, is still experiencing some of the same problems as rival Pfizer's (NYSE:PFE) top drug, Lipitor: Generic and branded competition decreased U.S. prescriptions. Unlike Pfizer and its lead drug issues, Lilly was able to offset the Zyprexa declines with price increases, and overall Zyprexa sales 8% grew for the quarter and 9% in the first nine months of the year.

If its once-a-month injection form of the drug can make it to market, Zyprexa could return to a sustainable sales growth level, until it loses U.S. patent protection in 2011. Lilly would face one main competitor in Johnson & Johnson (NYSE:JNJ) and Alkermes' (NASDAQ:ALKS) twice-a-month Risperdal Consta if injectable Zyprexa were approved. Ironically, Alkermes is one of Lilly's most important partners on two other crucial projects.

Lilly's operating income growth was rather pedestrian in the third quarter. But in two weeks, Lilly will offer a better look at its future when it announces results of a phase 3 trial of its anticoagulant prasugrel at the American Heart Association conference.

Lilly went all out with its bet on prasugrel, testing the drug in a superiority trial head-to-head versus blockbuster treatment Plavix, from Bristol-Myers Squibb (NYSE:BMY) and Sanofi-Aventis (NYSE:SNY), rather than in a more conservative non-inferiority study versus Plavix.

Lilly's pipeline will dictate its near-term future. It's anyone's guess how the study results will turn out, but a drugmaker doesn't often hold back on whether or not goals were met before a medical meeting unless it was unsuccessful. Either way, we'll find out soon enough.

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