Lilly says weight-loss drug demand is strong as Mounjaro and Zepbound miss sales estimates

Eli Lilly reported fourth-quarter 2024 revenue of $13.53 billion on Feb. 6, up 45% from a year earlier, driven by volume growth from its tirzepatide medicines Mounjaro and Zepbound. Both drugs came in below analyst estimates for the second quarter in a row, but company executives told analysts demand was not a concern, and the shares rose nearly 5% ^[1][2].

Mounjaro, approved for type 2 diabetes, brought in $3.53 billion worldwide in the quarter, up 60%. Zepbound, approved for obesity, recorded $1.91 billion in U.S. sales, compared with $175.8 million in the same quarter of 2023, when it launched ^[1]. Analysts had expected $4.27 billion for Mounjaro and $2.03 billion for Zepbound, according to LSEG data cited by Reuters ^[2].

Lilly said the growth came from volume, which rose 48% worldwide, partly offset by a 4% decline from lower realized prices. The lower prices were driven mainly by Mounjaro ^[1]. On the analyst call, the company said it still saw large demand from hundreds of millions of patients, and it has previously attributed shortfalls to supply-chain issues ^[2].

For the full year, revenue was $45.04 billion, up 32%. Mounjaro sales were $11.54 billion, up 124% from $5.16 billion in 2023, and Zepbound recorded $4.93 billion ^[1]. Fourth-quarter earnings per share were $4.88 on a reported basis, up 102%, and $5.32 on a non-GAAP basis, up 114% ^[1]. Research and development spending rose 18% to $3.02 billion, which Lilly described as continued investment in its early and late-stage pipeline ^[1].

Lilly guided for 2025 revenue of $58.0 billion to $61.0 billion, with reported earnings per share of $22.05 to $23.55 and non-GAAP earnings per share of $22.50 to $24.00 ^[1]. Analysts had expected adjusted profit of $22.86 per share and revenue of $59.21 billion, according to LSEG ^[2]. Lilly said it expects U.S. growth of its diabetes and weight-loss drugs to be consistent with 2024 ^[2]. Rival Novo Nordisk, which makes Wegovy (semaglutide), forecast slower growth for 2025 the day before but said demand for obesity treatments remained strong ^[2]. Analysts estimate the weight-loss drug market could reach $150 billion by the early 2030s ^[2].

Lilly also said it is building manufacturing capacity for orforglipron, its experimental oral obesity drug, before it has seen much of the late-stage data ^[2]. Other recent items the company listed include FDA approval of Zepbound for moderate-to-severe obstructive sleep apnea in adults with obesity, and results from a head-to-head trial in which Zepbound produced 47% greater relative weight loss than Wegovy ^[1]. Lilly also announced a $3 billion expansion of its injectable-product manufacturing site in Kenosha County, Wisconsin ^[1].

Why it matters for patients

Sales figures are a rough signal about supply. Lilly says demand still outstrips what it can make and is spending billions to expand manufacturing, including a new oral drug that is not yet approved ^[1][2]. The company has not disclosed a specific timeline for when supply will match demand.

The price figures in the report are net of rebates and discounts, not what any one person pays. Lilly said lower realized prices in the quarter were driven mainly by Mounjaro ^[1]. What an individual pays depends on insurance, pharmacy and whether a prescription is for diabetes, obesity or the newer sleep apnea use, and none of that is in these results.

The quarter also shows how fast the market is shifting. Zepbound's U.S. sales went from $175.8 million a year earlier to $1.91 billion, and Mounjaro's full-year sales more than doubled ^[1]. Novo's forecast of slower 2025 growth and Lilly's 47% head-to-head weight-loss figure give patients and doctors two different data points when comparing the main options; that trial was open-label, meaning participants and researchers knew which drug was given ^[1][2].

What happens next

Lilly's 2025 guidance of $58.0 billion to $61.0 billion in revenue assumes launches of Mounjaro in new markets, including China, India, Brazil and Mexico, for both diabetes and obesity. No launch dates have been disclosed ^[2].

Orforglipron, the oral obesity drug, is still experimental. Lilly said it is preparing manufacturing capacity, but it has not seen much of the data, and no timing for late-stage results has been disclosed ^[2].

Lilly said it expects U.S. growth for its diabetes and weight-loss drugs in 2025 to be consistent with 2024, and it has not said when supply constraints might end ^[2].