Lilly reports Q1 2026 revenue of $19.8 billion, up 56%, and raises guidance to $82 to $85 billion

Eli Lilly reported first-quarter 2026 revenue of $19.8 billion on April 30, a 56% increase over the same quarter of 2025, and raised its full-year revenue forecast to $82 billion to $85 billion from $80 billion to $83 billion ^[1][3]. The growth came from a 65% jump in volume, partly offset by a 13% drop in realized prices ^[1]. Shares rose 9.7% to $933.76 after the report, following a roughly 20% decline earlier in the year ^[3].

Mounjaro, the tirzepatide brand sold for type 2 diabetes in the U.S. and for both diabetes and weight loss in some other countries, generated $8.66 billion, up 125% ^[1]. For the first time, sales outside the U.S. ($4.4 billion, up from $1.2 billion a year earlier) exceeded U.S. sales of $4.2 billion, which grew 59% ^[1]. Zepbound, the U.S. tirzepatide brand for weight management, brought in $4.16 billion, up 80% ^[1].

Prices moved in the opposite direction from volume. In the U.S., revenue rose 43% to $12.1 billion on a 49% volume increase and a 7% decline in realized prices, which Lilly attributed mainly to Zepbound and Taltz ^[1]. Outside the U.S., revenue rose 81% to $7.7 billion, with volume up 95% and realized prices down 25%, driven largely by adding Mounjaro to China's National Reimbursed Drug List ^[1]. Lilly and Novo Nordisk both agreed in November with the Trump administration to lower U.S. prices of their obesity drugs ^[3]. "Pretty much every time we reduce pricing, we see a pretty large expansion," CEO Dave Ricks said on the earnings call ^[3].

Foundayo's first weeks

Foundayo (orforglipron), Lilly's GLP-1 pill for obesity or overweight with weight-related medical problems, was approved by the FDA earlier in April and went on sale in the U.S. in early April ^[1][3]. Because of the launch timing, it contributed nothing to first-quarter results ^[4]. Ricks told CNBC that more than 20,000 people had started the pill in its first few weeks, with more than 1,000 starting per day, and said more than 80% of them were new to GLP-1 medicines ^[4]. Lilly executives said the drug has more than 8,000 prescribers, a third of whom had not previously written an oral GLP-1 prescription, and that more than 12 large telehealth firms account for about 35% of launch volume ^[3].

Some analysts said the launch was trailing Novo Nordisk's oral Wegovy, which reached the U.S. market in January ^[3]. "This is going to play out over quarters, not days," Ricks said ^[4]. Lilly said it held a 60.1% share of the U.S. obesity and diabetes drug market in the quarter, versus 39.4% for Novo Nordisk, according to its earnings presentation ^[4].

Why it matters for patients

The numbers show a market where more people are getting these drugs while the amount Lilly collects per prescription keeps falling — the company itself linked the U.S. price decline partly to "previously announced reductions in cash pay prices" for Zepbound ^[1]. That pattern matters for anyone comparing cash-pay, insurance and telehealth options, because list prices, rebates and coverage are all in motion.

Coverage is also shifting for the pill. Lilly said two of the three largest U.S. pharmacy benefit managers will begin covering Foundayo next month ^[3]. Separately, the FDA on the same day proposed rules that would limit compounded versions of Lilly's and Novo's weight-loss medicines ^[3]. What individual plans will charge, and which doses will be stocked, is not detailed in these sources.

What happens next

PBM coverage of Foundayo is expected to begin in May 2026 ^[3]. Lilly has scheduled an Investment Community Meeting for December 7, 2026 ^[1]. The company also reported positive Phase 3 results for retatrutide in type 2 diabetes and for Foundayo in adults with type 2 diabetes and obesity or overweight at increased cardiovascular risk; regulatory timing for those was not stated ^[1].