Zepbound books $175.8 million in its first partial quarter

Eli Lilly reported on Feb. 6, 2024, that Zepbound, its tirzepatide injection for chronic weight management, generated $175.8 million in revenue in the fourth quarter of 2023, covering roughly the first seven weeks after the drug's Nov. 8 approval ^[1][2]. The same earnings report showed Mounjaro, the identical tirzepatide molecule sold for type 2 diabetes, booked $2.21 billion in quarterly sales, up sharply from $279.2 million a year earlier ^[2].

Analysts surveyed by FactSet had expected Mounjaro to bring in $1.73 billion for the quarter, so the actual figure beat forecasts by roughly $480 million ^[2]. Lilly said the jump reflected both higher demand and "higher realized prices" in the U.S., driven in part by reduced use of the company's savings-card discount programs as more pharmacies gained supply ^[2]. Some analysts have said Zepbound could top $1 billion in sales in its first full year and eventually become one of the best-selling drugs ever ^[2].

Across the whole company, fourth-quarter revenue reached $9.35 billion, a 28% increase from the same period a year earlier, beating the $8.93 billion Wall Street had expected ^[2]. Adjusted earnings per share came in at $2.49, above the $2.22 analysts had projected, and net income rose to $2.19 billion from $1.94 billion 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, both roughly in line with or slightly above what analysts expected ^[2].

Lilly's chief financial officer, Anat Ashkenazi, said the company doubled its manufacturing capacity for tirzepatide and related incretin drugs by the end of 2023 and plans to keep expanding with "equal urgency," with the biggest gains expected in the second half of 2024 ^[2]. Even so, the company said it expects demand for these drugs to outpace supply again this year ^[2].

Why it matters for patients

The sales figures show how fast demand grew for tirzepatide-based drugs even as supply stayed tight. Lilly's own comments that demand will likely keep exceeding supply through 2024 suggest patients may keep facing shortages, waitlists, or difficulty finding certain dose strengths at pharmacies ^[2]. The pricing shift Lilly described, tied to less use of manufacturer savings cards as the drug became more available, points to a pattern where wider access can come with less discounting, a factor that affects what patients pay out of pocket depending on their insurance and pharmacy ^[2]. Stock market reaction was muted despite the earnings beat, with shares closing flat, even though the company's market value was reported at roughly $673 billion, underscoring that investors had already priced in strong obesity-drug demand ^[2].

What happens next

Lilly said it is building a new manufacturing plant in Concord, North Carolina, expected to begin producing incretin drugs as early as the end of 2024, with product available to ship in 2025 ^[2]. The company also said its second-half 2024 production of sellable incretin doses is expected to be at least 1.5 times what it produced in the second half of 2023, which could ease some supply pressure later in the year if that target is met ^[2]. Lilly reiterated it expects an FDA decision in the first quarter of 2024 on its Alzheimer's drug donanemab, a separate product not related to Zepbound or Mounjaro ^[2].