Zepbound sales reach $175.8 million in its first partial quarter as Lilly's Mounjaro revenue climbs

Eli Lilly's weight loss drug Zepbound (tirzepatide) recorded $175.8 million in sales in its first partial quarter on the market, the company said on Feb. 6, 2024, in fourth-quarter 2023 results that also showed $2.21 billion in revenue from its diabetes drug Mounjaro (tirzepatide) ^[1][2].

Zepbound won FDA approval in early November, making the fourth quarter the first to include its sales ^[2]. By the time the quarter closed, the drug had been on the market about seven weeks ^[1].

Mounjaro's quarterly revenue of $2.21 billion was up from $279.2 million in the same period a year earlier and came in above the $1.73 billion analysts had expected, according to estimates compiled by FactSet ^[2]. Both drugs use the same active ingredient, tirzepatide, but are approved for different uses: Mounjaro for type 2 diabetes and Zepbound for weight loss ^[2].

Lilly's total fourth-quarter revenue was $9.35 billion, up 28% from a year earlier, and adjusted earnings were $2.49 per share. Analysts surveyed by LSEG had expected $8.93 billion in revenue and $2.22 per share ^[2]. Net income was $2.19 billion, or $2.42 a share, compared with $1.94 billion, or $2.14 a share, a year earlier ^[2].

For 2024, Lilly forecast adjusted earnings of $12.20 to $12.70 per share and revenue of $40.4 billion to $41.6 billion. Analysts had expected $12.43 per share and $39.38 billion in sales ^[2].

Supply and prices

Chief financial officer Anat Ashkenazi said on an earnings call that Lilly expects demand for incretin drugs — the category that includes Mounjaro and Zepbound — to outpace supply in 2024. She said the company met its goal of doubling incretin production capacity by the end of 2023 and expects sellable doses in the second half of 2024 to be at least 1.5 times the level of the second half of 2023 ^[2].

A new Lilly manufacturing site in Concord, North Carolina, is expected to begin producing incretin drugs as early as the end of 2024, with products available to ship in 2025, Ashkenazi said ^[2].

Mounjaro's higher revenue reflected both increased demand and "higher realized prices" in the US, which Lilly attributed to less use of its savings card programs as access to the drug expanded during the quarter. Those programs are designed to lower out-of-pocket costs for patients ^[2]. Lilly said it expects a high single-digit percentage price decline across its core business in 2024, with a larger decrease in the second half of the year ^[2].

Lilly shares closed flat on the day of the report, after rising almost 60% in 2023. The company's market value was roughly $673 billion ^[2].

Why it matters for patients

How quickly Lilly can make more doses affects whether people can start or stay on these drugs without gaps. The company says supply will remain tight through 2024, with the biggest increases coming in the second half ^[2].

Cost is a separate hurdle. Lilly said lower use of its savings cards helped lift Mounjaro's realized US prices ^[2], and the company expects overall prices to fall later in 2024 ^[2]. Zepbound's list price, typical out-of-pocket cost and the share of insurance plans covering it were not disclosed in the earnings coverage ^[1][2]. Broader context in that coverage notes that weight loss drugs carry high prices and face mixed insurance coverage and supply shortages ^[2].

Sales figures also say nothing about how many people are taking either drug, and no patient counts were reported ^[1][2].

What happens next

Lilly's guidance puts 2024 revenue at $40.4 billion to $41.6 billion and adjusted earnings at $12.20 to $12.70 per share ^[2]. The company says incretin production in the second half of 2024 should be at least 1.5 times the second half of 2023 ^[2]. The Concord, North Carolina, plant may start making incretin drugs as early as the end of 2024, with shipments in 2025 ^[2]. Whether those capacity gains translate into fewer shortages for patients has not yet been reported ^[2].