Eli Lilly Blows Past Estimates as Zepbound & Mounjaro Demand Soars

Eli Lilly exceeded expectations for both fourth-quarter earnings and full-year 2026 guidance, fueled by surging demand for its weight loss drug Zepbound and diabetes treatment Mounjaro. The pharmaceutical giant anticipates revenue between $80 billion and $83 billion for 2026, significantly surpassing the $77.62 billion predicted by analysts, according to LSEG.

Adjusted earnings are projected to fall between $33.50 and $35 per share, also exceeding analyst estimates of $33.23 per share, as reported by LSEG. This strong outlook contrasts sharply with the forecast of competitor Novo Nordisk, which anticipates a potential decline of up to 13% in both sales and profit this year due to price reductions and expiring exclusivity for key drugs in several major markets.

Lilly’s revenue guidance suggests a 25% growth rate for the year. This positive trajectory follows comments from Eli Lilly CEO David Ricks, who stated in a recent CNBC interview that anticipated Medicare coverage for obesity treatments will significantly expand the U.S. Market for these drugs. He described the expanded coverage as a “big multiplier on the eligible pool” of patients.

Several factors are expected to contribute to Lilly’s success in 2026, including the aforementioned Medicare coverage, continued global demand for Mounjaro and Zepbound, and the anticipated launch of a GLP-1 pill for obesity, pending U.S. Approval. However, the company also acknowledged that it will face a global pricing decline in the low- to mid-teens percentage range, driven by agreements with the Trump administration, direct-to-consumer pricing for Zepbound, and reduced Medicaid pricing on older products.

Lilly’s market share in the U.S. Obesity and diabetes drug market increased to 60.5% in the fourth quarter, a 2.6% increase from the previous quarter, while Novo Nordisk’s share stood at 39.1%. This comes as Novo prepares to launch its own obesity pill, Wegovy, in January.

Mounjaro generated $7.41 billion in revenue during the fourth quarter, a 110% increase year-over-year. U.S. Sales for Mounjaro reached $4.1 billion, rising 57%, despite lower realized prices. Zepbound contributed $4.2 billion in U.S. Revenue for the fourth quarter, a 122% increase from the same period last year, also with lower realized prices.

Here’s a summary of Eli Lilly’s fourth-quarter results compared to Wall Street expectations:

• Earnings per share: $7.54 adjusted vs. $6.67 expected
• Revenue: $19.29 billion vs. $17.96 billion expected

Eli Lilly shares rose more than 7% in premarket trading following the announcement.

The company reported total fourth-quarter revenue of $19.29 billion, a 43% increase compared to the same period last year. U.S. Revenue climbed to $12.9 billion, driven by a 50% increase in volume for its products, primarily Mounjaro and Zepbound, partially offset by lower realized prices for those drugs.

Net income for the fourth quarter totaled $6.64 billion, or $7.39 per share, compared to $4.41 billion, or $4.88 per share, in the same quarter of the previous year. Excluding one-time items, earnings per share reached $7.54.

The contrasting outlooks of Lilly and Novo Nordisk are largely attributed to differing strategies in the face of recent agreements with the Trump administration to lower drug prices. Both companies agreed to reduce prices for Medicare and Medicaid beneficiaries and offer discounts directly to consumers through the TrumpRx platform. In exchange, they received a three-year exemption from tariffs.

While acknowledging a “step down in pricing” as a result of the agreement, Lilly’s CEO David Ricks expressed confidence that volume growth would accelerate in the latter half of the year. The company’s strong performance in the fourth quarter and optimistic outlook for 2026 suggest a successful navigation of the evolving pharmaceutical landscape.