Eli Lilly delivered a first-quarter performance that significantly exceeded market expectations, driven by the strong performance of its GLP-1 weight loss and diabetes drugs, and subsequently raised its full-year outlook. The company's stock rose over 5% in pre-market trading.
First-quarter total revenue reached $19.8 billion, a 56% increase year-over-year, substantially surpassing the FactSet consensus estimate of $17.78 billion. Adjusted earnings per share were $8.55, a 156% increase from $3.34 in the prior-year period, also far exceeding the market expectation of $6.97. The company raised its full-year revenue guidance to a range of $82 billion to $85 billion, up from the previous forecast of $80 billion to $83 billion. The full-year adjusted EPS guidance was raised to $35.50-$37.00, from the prior range of $33.50-$35.00.
Following the earnings release, Eli Lilly's shares gained over 5% in pre-market trading. However, lingering market concerns about early prescription data for its newly launched oral GLP-1 drug, Foundayo, present a potential headwind for further stock appreciation.
GLP-1 Duo Sales Nearly Double, Far Exceeding Expectations The core drivers of Lilly's performance were its two GLP-1 drugs, Mounjaro and Zepbound, which together accounted for approximately 65% of total company revenue.
Global revenue for Mounjaro (tirzepatide, for type 2 diabetes) reached $8.7 billion in the first quarter, a 125% increase year-over-year, significantly exceeding the FactSet estimate of $7.3 billion. U.S. revenue was $4.2 billion, up 59% year-over-year. Revenue outside the U.S. was $4.4 billion, a substantial jump from $1.2 billion in the prior-year period, primarily driven by volume expansion following inclusion in China's National Reimbursement Drug List (NRDL), though this was accompanied by significant pricing pressure.
U.S. revenue for Zepbound (the same molecule, approved for weight loss) was $4.1 billion in the first quarter, a 79% increase year-over-year, slightly above the FactSet estimate of $4.1 billion. On a global basis, Zepbound sales were approximately $4.2 billion, an increase of about 83% from $2.3 billion a year earlier. Sales growth for both drugs was primarily driven by increased demand, partially offset by lower realized prices.
New Oral Drug Foundayo's Early Performance Disappoints Market Despite the strong overall results, the early market performance of Lilly's newly launched oral GLP-1 weight loss drug, Foundayo (orforglipron), raised concerns among analysts. The drug was officially launched on April 9th, and Lilly did not disclose specific sales figures in this earnings report, stating only that it had a "strong" first full week on the market.
However, according to reports, Foundayo's total prescription count in its second week on the market was only 3,700, a stark contrast to the 18,400 prescriptions for Novo Nordisk's oral Wegovy during the same period. Leerink analyst David Risinger subsequently lowered his price target for Lilly from $1,296 to $1,058, noting that the market uptake of Wegovy oral tablets is compressing the prescription demand opportunity for Foundayo. HSBC analysts also recently downgraded Lilly, suggesting the weight-loss drug market may be overhyped and questioning the sustainability of out-of-pocket payment models in a potential economic downturn.
Eli Lilly's stock is down 21.2% year-to-date, while the S&P 500 index has gained 4.0%.
Aggressive M&A Strategy and Positive Pipeline Progress Amid increasing competition in the GLP-1 market, Eli Lilly is actively deploying its substantial cash flow into diversified acquisitions. Reports indicate the company acquired four biotechnology firms in the past month, spanning therapeutic areas beyond metabolic health. These include the acquisition of Centessa Pharmaceuticals, focused on sleep disorders, for a $6.3 billion upfront payment, and the acquisition of in vivo CAR-T therapy developer Kelonia Therapeutics for a $3.25 billion upfront payment. The company also entered into agreements to acquire Orna Therapeutics and Ajax Therapeutics.
Regarding pipeline progress, Foundayo reported positive Phase 3 trial results in patients with type 2 diabetes and obesity or overweight with cardiovascular risk. Positive Phase 3 data was also reported for Jaypirca in combination with venetoclax and rituximab for relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). Furthermore, positive news came from a Phase 3 study of retatrutide in type 2 diabetes.
First-quarter R&D expenses increased 28% year-over-year to $3.5 billion, representing 18% of revenue. Marketing, selling, and administrative expenses grew 19% to $2.9 billion, primarily to support new product launches. The company also announced plans to hold an investor community meeting on December 7, 2026.
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