Eli Lilly on Wednesday posted fourth-quarter earnings and revenue and 2026 guidance that blew past estimates, as demand for its blockbuster weight loss drug Zepbound and diabetes treatment Mounjaro soars.
The pharmaceutical giant anticipates its 2026 revenue will come in between $80 billion and $83 billion. Analysts expected revenue of $77.62 billion, according to LSEG.
Lilly also expects adjusted earnings to be between $33.50 and $35 per share for the year. That compares with analysts’ estimate of $33.23 per share, according to LSEG.
The guidance comes in stark contrast to the outlook of rival Novo Nordisk, which is also grappling with lower prices in the U.S. following landmark deals both companies struck with President Donald Trump to slash obesity and diabetes drug costs. Unlike Lilly, Novo warned on Tuesday that it sees sales and profit declining as much as 13% this year, as prices fall in the U.S. and exclusivity expires for its blockbuster obesity and diabetes drugs in China, Brazil and Canada.
Meanwhile, the midpoint of Lilly’s revenue guidance sees sales growing by 25% this year.
The strong outlook comes days after Lilly CEO Dave Ricks told CNBC in an exclusive interview that he expects upcoming government Medicare coverage of obesity treatments to expand the U.S. market for those drugs this year, saying it’s a “big multiplier on the eligible pool” of patients.
In an earnings presentation Wednesday, Lilly cited several factors that it will benefit from this year, including Medicare coverage, continued worldwide demand for Mounjaro and Zepbound and the expected launch of its GLP-1 pill for obesity in the second quarter, pending U.S. approval.
But Lilly said it will be hit by a global pricing decline by a low- to mid-teens percentage, driven by the deal with Trump, new direct-to-consumer rates for Zepbound and lower Medicaid pricing on some older products, among other factors.
Lilly is working to maintain its dominance in the booming market for those drugs, called GLP-1s, as Novo sees an explosive U.S. launch for its new Wegovy pill for obesity. Ahead of that rollout in January, Lilly’s share of the U.S. obesity and diabetes drug market increased to 60.5% in the fourth quarter, up 2.6% from the previous quarter, according to the presentation. Novo’s market share in the fourth quarter was 39.1%.
Mounjaro raked in $7.41 billion in revenue for the quarter, up 110% from the same period a year ago. U.S. sales for Mounjaro were $4.1 billion, up 57%, as demand climbed but realized prices were lower. Those numbers surpassed what analysts were expecting for the quarter, according to StreetAccount.
Zepbound, which entered the market roughly three years ago, posted $4.2 billion in U.S. revenue for the fourth quarter. That’s up 122% from the year-earlier period, as demand for the drug also rose while realized prices dropped. Analysts were expecting $3.91 billion in U.S. sales for Zepbound, according to StreetAccount.
Here’s what Eli Lilly reported for the fourth quarter compared with what Wall Street was expecting, based on a survey of analysts by LSEG:
Earnings per share: $7.54 adjusted vs. $6.67 expectedRevenue: $19.29 billion vs. $17.96 billion expected
Eli Lilly shares climbed more than 7% in premarket trading.
The company posted fourth-quarter revenue of $19.29 billion, up 43% from the same period a year ago.
Revenue in the U.S. climbed to $12.9 billion. Eli Lilly said that was driven by a 50% increase in volume — or the number of prescriptions or units sold — for its products, primarily for Mounjaro and Zepbound. That was partially offset by lower realized prices of those drugs, the company said.
The pharmaceutical giant booked net income of $6.64 billion, or $7.39 per share, for the fourth quarter. That compares with net income of $4.41 billion, or $4.88 per share, a year earlier.
Excluding one-time items associated with the value of intangible assets and other adjustments, Eli Lilly posted earnings of $7.54 per share for the fourth quarter.
Novo and Lilly’s deals with Trump are expected to eventually increase the number of prescriptions but ultimately hurt total sales.
Under the agreements, Lilly and Novo agreed to slash the prices of those treatments for Medicare and Medicaid beneficiaries in 2026 and offer them directly to consumers at a discount on the Trump administration’s direct-to-consumer platform, TrumpRx, which has yet to launch.
In return, both companies will also get a three-year exemption from tariffs.
In the interview with CNBC on Friday, Lilly’s Ricks acknowledged that under the drug pricing deal, there will be “a step down in pricing” early this year. But he said volume growth of the company’s drugs “will ramp on the back half of the year.”
