Lilly raises guidance on incretin demand even as the obesity pill lands with a thud

Eli Lilly reported second-quarter 2025 revenue of $15.56 billion on August 7, up 38% from a year earlier, and raised its full-year forecast ^[1][2]. On the same morning, the company released the first pivotal phase 3 obesity results for its experimental daily pill orforglipron, and the numbers came in below Wall Street expectations, sending Lilly shares down as much as 12% in premarket trading ^[2].

The quarter itself was strong by almost any measure. Adjusted earnings were $6.31 per share against the $5.57 analysts expected, and revenue topped the $14.71 billion consensus ^[2]. Reported net income nearly doubled to $5.66 billion from $2.97 billion a year earlier ^[1]. Lilly lifted the midpoint of its 2025 revenue guidance by $1.5 billion, to a range of $60 billion to $62 billion from $58 billion to $61 billion, and raised non-GAAP earnings guidance to $21.75–$23.00 per share ^[1][2].

Incretin sales are driving nearly all of it

Mounjaro (tirzepatide) for type 2 diabetes brought in $5.20 billion worldwide, up 68% year over year, with $3.30 billion of that in the U.S. ^[1]. Zepbound (tirzepatide) for obesity generated $3.38 billion in U.S. sales, up 172% ^[1]. Both beat analyst estimates of $4.49 billion and $3.06 billion, respectively ^[2].

One detail matters for anyone paying attention to pricing: U.S. revenue rose 38% on a 46% jump in volume, offset by an 8% decline in realized prices, which Lilly attributed to Zepbound and Mounjaro ^[1]. In other words, Lilly is selling far more units but collecting less per unit than it did a year ago. CEO David Ricks told CNBC that tirzepatide "will likely become the bestselling drug in the industry in its third year in the market" ^[2].

The pill that disappointed the market

Orforglipron is an oral GLP-1 that, unlike semaglutide tablets, is a small molecule that does not require injection. Lilly said the highest dose helped patients lose more than 12% of their body weight in the trial, an average of up to 27.3 pounds ^[1][2]. CNBC reported that result "came under Wall Street's expectations" ^[2]. Lilly itself described the data as "positive" and a "strong" showing for its oral incretin ^[1]. The company's materials describe this as the first of two pivotal phase 3 obesity trials ^[1].

The precise trial design details — comparison arms, side-effect rates, dropout numbers — are not spelled out in the sources here, and the exact percentage at each dose level is not broken out beyond the "more than 12%" figure ^[2].

Why it matters for patients

For people using or considering these drugs, the sales figures are a supply signal as much as a financial one. Lilly said it "expanded manufacturing capacity to meet increasing demand" during the quarter ^[1], and the 46% U.S. volume increase suggests more product reaching more pharmacies ^[1].

The falling realized prices are worth noting too. Lower net prices for Lilly do not automatically mean lower prices at the counter, since what a patient pays depends on insurance, rebates and cash-pay programs. The sources do not break out what patients paid.

On orforglipron: a pill that works without refrigeration or needles could eventually broaden access, but investor disappointment is not the same as clinical failure. Lilly has not announced an FDA submission or approval date in these sources, and no pricing has been disclosed. Whether orforglipron reaches pharmacies, and at what cost, is not yet known.

What happens next

Lilly said its guidance reflects tariffs in effect as of August 7 but excludes President Trump's planned levies on pharmaceuticals imported into the U.S. ^[2]. Separately, Trump sent letters to Lilly and other drugmakers asking them to take steps to lower U.S. drug prices by September 29, tied to a "most favored nation" policy that would benchmark some U.S. prices to lower prices abroad ^[2]. A second pivotal phase 3 obesity trial of orforglipron is pending; no readout date appears in these sources ^[1].