Eli Lilly's Q1 revenue surged 56%, GLP-1 drug sales nearly doubled, annual guidance raised | Earnings Report

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Eli Lilly delivered a first-quarter performance that far exceeded market expectations thanks to the strong performance of its GLP-1 weight loss and diabetes drugs, immediately raising its full-year guidance, with pre-market share price surging over 5%.

Lilly’s total revenue for the first quarter reached $19.8 billion, up 56% year-on-year, significantly above FactSet’s forecast of $17.78 billion. Adjusted earnings per share were $8.55, up 156% from $3.34 a year ago and far above the market expectation of $6.97. The company raised its full-year revenue guidance to $82-85 billion, up from the previous $80-83 billion; adjusted earnings per share guidance was raised to $35.50-37.00, previously $33.50-35.00.

After the results were announced, Lilly’s U.S. shares rose more than 5% in pre-market trading. However, the market still harbors doubts about early prescription data for its newly launched oral GLP-1 drug, Foundayo, which poses potential resistance to further share price gains.

GLP-1 Duo Sales Nearly Doubled, Far Exceeding Expectations

The core growth driver for Lilly comes from the GLP-1 drugs Mounjaro and Zepbound, which together account for about 65% of total company revenue.

Mounjaro (tirzepatide, for type 2 diabetes) posted global revenue of $8.7 billion for the quarter, up 125% year-on-year, far exceeding FactSet’s estimate of $7.3 billion. U.S. revenue was $4.2 billion, up 59%; non-U.S. markets were $4.4 billion, a dramatic jump from $1.2 billion a year ago, mainly driven by expanded volume after China included the drug in its national insurance list (NRDL), but also facing substantial price pressure.

Zepbound (same molecule, for weight loss indication) generated U.S. revenue of $4.1 billion in the quarter, up 79% year-on-year, slightly above FactSet’s $4.1 billion forecast. According to MarketWatch, worldwide sales of Zepbound were about $4.2 billion, up approximately 83% from $2.3 billion a year ago. Sales growth for both drugs was mainly driven by increased demand, partially offset by realized price declines.

Early Performance of Oral Drug Foundayo Disappoints Market

Despite overall strong performance, the early market performance for Lilly’s newly launched oral GLP-1 weight loss drug Foundayo (orforglipron) has raised concerns among analysts. The drug officially launched on April 9, and Lilly did not disclose specific sales figures in this report, only stating that its first full launch week got off to a "strong" start.

However, according to MarketWatch, Foundayo’s total prescription volume in the second week after launch was only 3,700, compared to Novo Nordisk’s oral Wegovy’s 18,400 prescriptions in the same period—a huge gap. Leerink analyst David Risinger immediately lowered Lilly’s target price from $1,296 to $1,058, noting that oral Wegovy’s widespread adoption is squeezing Foundayo’s prescription demand. HSBC analysts also recently downgraded Lilly, believing the weight loss drug market is overhyped and, under an economic downturn, the sustainability of out-of-pocket payment models is questionable.

Lilly’s share price has dropped 21.2% so far this year, while the S&P 500 index has risen 4.0% over the same period.

Aggressive M&A Strategy, Pipeline Advancing Positively

Facing intensifying competition in the GLP-1 market, Lilly is actively deploying its ample cash flow for diversified acquisitions. According to MarketWatch, the company has acquired four biotech companies in the past month, covering therapeutic fields beyond metabolic health, including a $6.3 billion upfront acquisition of Centessa Pharmaceuticals, focused on sleep disorder treatments, and a $3.25 billion upfront acquisition of Kelonia Therapeutics, an in vivo CAR-T developer. The company has also agreed to acquire Orna Therapeutics and Ajax Therapeutics.

In pipeline progress, Foundayo’s phase 3 clinical trials in patients with type 2 diabetes who are obese or overweight and have cardiovascular risks yielded positive results; Jaypirca combined with venetoclax and rituximab for treating relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) also delivered positive phase 3 data; retatrutide’s phase 3 study in type 2 diabetes has also yielded promising results.

R&D expenses in the quarter rose 28% year-on-year to $3.5 billion, accounting for 18% of revenue; marketing, sales, and administrative expenses increased 19% to $2.9 billion, mainly supporting new product launches and promotions. The company also announced plans to hold an investor community meeting on December 7, 2026.

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