Lilly's fourth-quarter 2024 results reassure investors on obesity demand

Eli Lilly reported fourth-quarter 2024 revenue of $13.53 billion, a 45% increase from a year earlier, driven mainly by sales growth in its diabetes drug Mounjaro and its obesity drug Zepbound, both tirzepatide ^[1][2]. On an earnings call, company leaders told analysts they still see demand from hundreds of millions of potential patients for the two medicines, seeking to calm investor worries after two straight quarters of sales that came in below expectations ^[2].

Mounjaro brought in $3.53 billion in the quarter, up 60% from the prior year, while Zepbound generated $1.91 billion, compared with $175.8 million in the same period last year, when the drug had just launched ^[1]. Both figures fell short of what Wall Street analysts had forecast — $4.27 billion for Mounjaro and $2.03 billion for Zepbound, according to data cited by Reuters — extending a pattern Lilly has attributed to supply chain issues rather than weaker patient interest ^[2]. For the full year, Mounjaro revenue reached $11.54 billion, up 124%, and Zepbound totaled $4.93 billion ^[1]. Meanwhile, sales of Trulicity, an older Lilly diabetes drug, fell 25% in the quarter and 26% for the year, which the company linked to competition from newer treatments ^[1].

Lilly's stock rose nearly 5% to $882 in afternoon trading after the results were released ^[2]. The company forecast 2025 revenue of $58 billion to $61 billion, with reported earnings per share of $22.05 to $23.55 and non-GAAP earnings per share of $22.50 to $24.00 — guidance that came in largely above analyst estimates of $22.86 per share ^[1][2]. Lilly said it expects U.S. growth for its diabetes and weight-loss drugs to be consistent with 2024, and it is counting on new international launches of Mounjaro, including in China, India, Brazil and Mexico, to support 2025 growth ^[2].

During the quarter, Zepbound also won FDA approval as the first prescription medicine for moderate-to-severe obstructive sleep apnea in adults with obesity ^[1]. Lilly separately reported topline results from its SURMOUNT-5 trial showing Zepbound produced 47% greater relative weight loss than Wegovy (semaglutide) in a head-to-head study ^[1]. On the earnings call, Lilly said it is already building manufacturing capacity for orforglipron (branded Foundayo), its experimental oral obesity drug that has not yet been approved, which analysts said eased some concerns about the medicine's path to market ^[2].

Why it matters for patients

For patients currently taking or considering Mounjaro or Zepbound, the reassurance about demand and supply matters because both drugs have faced periods of shortage since their launches. Lilly's comments suggest the company does not see a slowdown in how many people want the drugs, even though quarterly sales numbers came in below what analysts had modeled ^[2]. The company's continued investment in manufacturing, including capacity for the future oral drug orforglipron, could affect how quickly new formulations become available, though that drug has not yet received FDA approval ^[2]. Zepbound's new sleep apnea approval also means more patients with obesity and moderate-to-severe obstructive sleep apnea now have this option covered under an approved indication, which can affect insurance coverage decisions ^[1].

What happens next

Lilly said it expects several important Phase 3 trial results in 2025 that could affect its broader portfolio, though specific dates were not detailed in the release ^[1]. The company's 2025 guidance depends partly on new market launches of Mounjaro in countries including China, India, Brazil and Mexico ^[2]. Novo Nordisk, which makes the competing drug Wegovy, forecast slower growth for 2025 compared with 2024 but said it also saw strong underlying U.S. demand for obesity treatments ^[2].