Pharma's New Gambit: How 'It Takes 2' Aims to Solve a Silent Killer

RIDGEFIELD, CT – December 10, 2025 – In an age of unprecedented medical information, a startling paradox persists: a silent epidemic is afflicting more than 35 million Americans, yet nine out of ten of them don't even know they have it. The condition is chronic kidney disease (CKD), a slow, progressive loss of kidney function that often culminates in dialysis or the need for a transplant. Now, pharmaceutical titans Boehringer Ingelheim and Eli Lilly are stepping into this awareness vacuum with a high-profile public health initiative, “It Takes 2™,” designed to disrupt the cycle of silence and delayed diagnosis. The campaign’s premise is simple, yet it points to a complex intersection of patient empowerment, clinical practice, and long-term commercial strategy.

The Anatomy of a Silent Epidemic

Chronic kidney disease is insidious precisely because its early stages are asymptomatic. Patients can lose significant kidney function before feeling any effects, which often manifest as non-specific symptoms like fatigue or swelling. This diagnostic latency is a public health crisis hiding in plain sight. According to the Centers for Disease Control and Prevention, diabetes and high blood pressure—two of the most common chronic conditions in the nation—are responsible for up to two-thirds of all CKD cases. This means millions of people are living with major risk factors but remain unaware of the potential damage to their kidneys.

The human cost of this silence is profound. Thelma, a patient advocate for the “It Takes 2™” campaign, shares a story that is all too common. Despite experiencing symptoms from the age of 12, it took nearly a decade for her to receive a diagnosis of chronic kidney disease. Her journey ultimately led to two kidney transplants. “Knowledge is power,” she states in the campaign materials, a sentiment that underscores the initiative’s core message. Her experience highlights a critical flaw in the healthcare journey for at-risk individuals: the gap between experiencing risk factors and receiving a definitive, early diagnosis.

Redesigning Diagnosis: The 'Two-Test' Mandate

The campaign's name, “It Takes 2™,” refers to a dual partnership: one between the patient and their doctor, and another between two simple diagnostic tests. The initiative, developed with primary care physicians like Dr. Charles Vega of UC Irvine, urges a move toward “complete testing” by combining the estimated glomerular filtration rate (eGFR) blood test with the urine albumin-to-creatinine ratio (UACR) urine test.

The eGFR, a common component of routine blood work, estimates how well the kidneys are filtering waste from the blood. However, it only tells part of the story. The UACR test is crucial because it can detect small amounts of a protein called albumin in the urine, which is one of the earliest signs of kidney damage and a key predictor of both CKD progression and cardiovascular disease risk. The problem is that this second, vital test is frequently overlooked. A study cited by the campaign found that fewer than 20% of at-risk individuals received complete testing with both eGFR and UACR between 2013 and 2019.

What’s innovative here is not the science—these testing recommendations are already enshrined in the clinical guidelines of preeminent medical bodies like Kidney Disease: Improving Global Outcomes (KDIGO) and the American Diabetes Association (ADA). The true disruption is the campaign's strategic effort to force these established best practices from the pages of medical journals into the reality of primary care. It’s a design-led intervention targeting a systemic failure point in preventative health.

The Strategic Alliance Behind the Campaign

To understand the full scope of “It Takes 2™,” one must look at the long-standing alliance between Boehringer Ingelheim and Eli Lilly. Formed in 2011, their partnership has become a dominant force in the treatment of cardiorenal-metabolic diseases. Their most notable collaboration is the blockbuster drug Jardiance (empagliflozin), an SGLT2 inhibitor. Initially a diabetes drug, Jardiance and other drugs in its class have demonstrated powerful protective effects on both the heart and kidneys.

Crucially, these therapies are most effective at slowing disease progression when initiated in the earlier stages of CKD. This is where the campaign’s public health goals and the companies' commercial interests elegantly converge. By successfully increasing the rate of early CKD diagnosis, the initiative would naturally expand the population of patients eligible for and in need of treatments that can preserve kidney function—treatments that the alliance happens to market. The campaign’s focus on the UACR test is particularly strategic, as identifying albuminuria (protein in the urine) is a key trigger for prescribing kidney-protective therapies like SGLT2 inhibitors.

This is not a simple act of corporate social responsibility; it is a sophisticated, long-term market-shaping strategy. By investing in the diagnostic infrastructure and patient awareness, the companies are cultivating the very market that their products are designed to serve. It represents a new model where pharmaceutical innovation extends beyond the laboratory and into the architecture of public health itself.

Overcoming Inertia in Modern Healthcare

The low rate of complete CKD testing is not due to a single failure but a web of systemic barriers. In the high-pressure environment of a 15-minute primary care visit, physicians must prioritize a patient’s most pressing complaints. Chronic, asymptomatic conditions like early-stage CKD can fall down the list. This “clinical inertia” is compounded by electronic health record systems that may not automatically prompt for a UACR test and a general lack of patient awareness that would lead them to request one.

The “It Takes 2™” initiative attempts to dismantle these barriers from both sides. It empowers patients like Thelma to become active participants in their care, armed with the knowledge to ask, “Have I had both tests for kidney disease?” Simultaneously, it provides clear, guideline-backed messaging for physicians like Dr. Vega, reinforcing the importance of a comprehensive diagnostic approach. This dual-pronged strategy—creating both patient pull and physician push—is designed to overcome the inertia that has allowed CKD to remain a silent epidemic for so long.

By spotlighting the collaboration between a patient advocate and a physician dedicated to underserved communities, the campaign also subtly addresses the deep health disparities in CKD, which disproportionately affects Black and Brown Americans. As medicine continues its slow pivot from reactive treatment to proactive prevention, this type of corporate-led public health initiative may become an increasingly common and powerful tool. The ultimate impact of the “It Takes 2™” campaign will be measured not just in the number of early diagnoses, but in its potential to write a new playbook for how industries can drive change by aligning public welfare with strategic growth.