Eli Lilly and Company has reported impressive fourth-quarter earnings and set ambitious revenue guidance for 2026, exceeding market expectations. The pharmaceutical giant anticipates its revenue for 2026 will fall between $80 billion and $83 billion, significantly higher than analyst predictions of $77.62 billion. Furthermore, Lilly projects adjusted earnings in the range of $33.50 to $35 per share for the year, slightly above the consensus estimate of $33.23 per share.
This positive outlook follows an exclusive interview with Eli Lilly’s CEO, Dave Ricks, who highlighted the anticipated expansion of Medicare coverage for obesity treatments, which he believes will significantly increase the eligible patient pool in the U.S. for such drugs. Ricks characterized this shift as a potential “big multiplier” for market demand.
In contrast, rival Novo Nordisk has faced challenges, forecasting a decline in sales and profits this year due to falling prices and the expiration of exclusivity for its leading obesity and diabetes treatments in various international markets. Both companies had previously reached landmark agreements with the Trump administration to reduce drug costs, but unlike Eli Lilly, Novo expressed concerns about declining revenue.
Eli Lilly is striving to maintain its lead in the burgeoning GLP-1 drug market, particularly against the backdrop of Novo’s upcoming launch of the Wegovy pill. Lilly is also pursuing approval for its oral weight loss drug, orforglipron, within the year.
In the fourth quarter, Mounjaro contributed a remarkable $7.41 billion in revenue, a 110% increase from the same quarter last year, with U.S. sales amounting to $4.1 billion—up 57%, despite lower realized prices. Zepbound, which debuted three years ago, generated $4.2 billion in U.S. revenue for the quarter, reflecting a 122% year-over-year increase and exceeding analysts’ expectations of $3.91 billion.
For the fourth quarter, Eli Lilly reported total revenue of $19.29 billion, up 43% year-over-year, with U.S. revenue alone reaching $12.9 billion. This growth was attributed to a 50% rise in volume, mainly driven by Mounjaro and Zepbound, although partially offset by reduced drug prices.
The company netted $6.64 billion or $7.39 per share for the fourth quarter, compared to $4.41 billion or $4.88 per share in the previous year. Excluding special items associated with intangible asset valuations, Eli Lilly delivered adjusted earnings of $7.54 per share, surpassing expectations of $6.67.
While the deals with the Trump administration are anticipated to boost the total number of prescriptions, there are concerns regarding their long-term impact on overall sales. The agreements, which promise price reductions for Medicare and Medicaid beneficiaries in 2026, also include a three-year tariff exemption for both Eli Lilly and Novo. Ricks acknowledged the initial price reductions that would impact the beginning of the year but expressed confidence in robust volume growth for the latter part of the year.
Following the earnings announcement, Eli Lilly’s shares surged more than 7% in premarket trading, signaling investor optimism amid the company’s strong performance and positive future projections.
