Lilly first-quarter revenue rises 45% as CVS picks Wegovy over Zepbound

Eli Lilly reported first-quarter 2025 revenue of $12.73 billion on May 1, up 45% from $8.77 billion a year earlier, driven by its diabetes drug Mounjaro and weight-loss drug Zepbound ^[1][2]. The company also cut its full-year profit outlook ^[1][2]. The same day, CVS Health said its pharmacy benefit manager would make Novo Nordisk's Wegovy the preferred weight-loss medication on its main formularies instead of Zepbound, and Lilly shares closed down more than 11% ^[2].

Where the money came from

Mounjaro, whose active ingredient is tirzepatide, brought in $3.84 billion worldwide, up 113% from $1.81 billion a year earlier. U.S. Mounjaro revenue was $2.66 billion, up 75% ^[1]. Zepbound, also tirzepatide, recorded $2.31 billion in U.S. revenue, compared with $517.4 million in the first quarter of 2024 ^[1]. Analysts had expected $3.81 billion for Mounjaro and $2.28 billion for Zepbound, according to StreetAccount estimates cited by CNBC ^[2].

Total U.S. revenue rose 49% to $8.49 billion. Lilly attributed that to a 57% increase in volume, partly offset by 7% lower realized prices, meaning the average price the company collected per unit fell ^[1]. Net income was $2.76 billion, or $3.06 per share, up from $2.24 billion, or $2.48 per share a year earlier ^[1]. Excluding one-time items, earnings were $3.34 per share, against the $3.02 analysts expected ^[2].

Lilly lowered its 2025 adjusted earnings guidance to $20.78 to $22.28 per share from $22.50 to $24, citing a $1.57 billion first-quarter charge tied mainly to its purchase of an oral cancer drug program from Scorpion Therapeutics ^[1][2]. It kept its sales guidance of $58 billion to $61 billion, saying that figure reflects President Donald Trump's existing tariffs as of May 1 but not his planned tariffs on imported pharmaceuticals ^[2].

The CVS decision

CVS Health said its pharmacy benefit manager would make Novo Nordisk's Wegovy, which is semaglutide, the preferred weight-loss medication on its main formularies instead of Zepbound, which is tirzepatide ^[2]. Those are different molecules, so the two drugs are not identical products. The reports did not disclose the terms of the CVS arrangement, when it takes effect, or what it means for people who already take Zepbound.

Why it matters for patients

Pharmacy benefit managers run the formularies that set which drugs an insurance plan pays for, and a drugmaker's sales can keep rising even while its place on those lists changes. A medication can be approved by the Food and Drug Administration and still not be the one a particular plan covers. For patients, that means the drug a prescriber recommends and the drug a plan will pay for can be two different things.

That is why this CVS decision overshadowed Lilly's sales numbers in the market ^[2]. Which steps a patient would need to take after a formulary change have not been reported. What has been reported is that the FDA reaffirmed in December 2024 that the U.S. shortage of tirzepatide was over, a decision that effectively bars many compounding pharmacies from marketing and selling cheaper, unapproved versions of the drug ^[2].

Lilly has also launched additional Zepbound vial doses and new savings for self-pay patients, announced in February 2025 ^[1]. Pricing and eligibility details for those programs were not included in these reports.

What happens next

Lilly reaffirmed 2025 sales guidance of $58 billion to $61 billion and lowered profit guidance ^[1][2]. On the pipeline, an oral GLP-1 called orforglipron produced positive Phase 3 results in type 2 diabetes, the first of seven late-stage trials in obesity and diabetes; Lilly did not give dates for the remaining six ^[1]. Lilly also said it plans to more than double its U.S. manufacturing investment since 2020, exceeding $50 billion ^[1].

Asked about tariffs, Lilly CEO Dave Ricks told CNBC that "the threat of tariffs is already bringing back critical supply chains into important industries, chips and pharma" ^[2]. Neither the timing of the CVS formulary change nor its effect on current Zepbound prescriptions has been disclosed.