Lilly posts $19.8 billion in first-quarter revenue, up 56%

Eli Lilly reported first-quarter 2026 revenue of $19.8 billion, up 56% from a year earlier, with reported earnings per share rising 170% to $8.26 [4]. Mounjaro and Zepbound, Lilly's tirzepatide-based drugs for diabetes and obesity, brought in a combined $12.82 billion, about 65% of total company revenue ^[2][4]. Lilly also raised its full-year guidance to $82.0 billion to $85.0 billion in revenue and $35.50 to $37.00 in non-GAAP earnings per share ^[1][4].

The quarter came just after the FDA approved Foundayo (orforglipron), Lilly's oral GLP-1 pill for obesity, on April 1, 2026 ^[1]. Foundayo is the first oral GLP-1 receptor agonist approved for obesity in adults with weight-related health conditions, and it was cleared under the FDA's Commissioner's National Priority Voucher pilot program, which Lilly describes as the fastest approval of a new molecular entity since 2002 ^[1]. Because Foundayo had only just launched, it contributed little to first-quarter results, and its initial sales performance was not yet public ^[1][2].

The approval was backed by two large Phase 3 trials. One, involving 3,127 participants with obesity or overweight and weight-related conditions, ran 72 weeks, with a subset of participants who had prediabetes continuing into a two-year extension ^[1]. A second trial of 1,613 participants with obesity or overweight and type 2 diabetes ran 77 weeks and finished in August 2025 ^[1]. Lilly also reported positive Phase 3 results for orforglipron in people with type 2 diabetes and obesity who face higher cardiovascular risk, which could expand who the drug is eventually approved to treat ^[1].

Lilly's rival, Novo Nordisk, reported that its semaglutide drugs Ozempic and Wegovy generated 63.2 billion Danish kroner in the same quarter, also about 65% of that company's total sales ^[2]. Novo Nordisk's oral Wegovy pill, approved in the U.S. in late December 2025, had already surpassed three million prescriptions by the time of this report, and the FDA separately approved an oral version of Ozempic in May 2026 ^[2]. Novo Nordisk's own 2026 outlook calls for a decline in adjusted sales and operating profit, which the company has linked to pricing pressure, weaker injectable prescription trends, reduced Medicaid obesity coverage, and competition from Lilly ^[2].

Why it matters for patients

The numbers show how central weight-loss and diabetes drugs have become to both companies' businesses, which can affect supply, pricing, and how much attention each company puts into improving these products. With Foundayo now on the market as a pill rather than an injection, patients who have avoided GLP-1 treatment because of needle aversion or convenience concerns have another option to discuss with a clinician ^[1]. But because Foundayo had barely launched during this reporting period, real-world data on how many patients are actually getting prescriptions, how insurance is covering it, and how it performs outside of clinical trials is not yet available ^[1][2].

Competition between Lilly and Novo Nordisk, plus smaller companies developing their own oral GLP-1 drugs, could eventually affect pricing and access, though the sources do not say when or by how much ^[2]. Novo Nordisk's weaker 2026 outlook and mention of reduced Medicaid obesity coverage suggests that insurance coverage for these drugs may vary and could change further as the market gets more crowded ^[2].

What happens next

Eli Lilly and Novo Nordisk are both scheduled to report second-quarter 2026 results on August 5, 2026, which should offer the first look at how Foundayo is selling commercially ^[2]. Investors and patients alike will also be watching other oral GLP-1 candidates in development, including Viking Therapeutics' VK2735, expected to enter Phase 3 testing for obesity in the fourth quarter of 2026, and Structure Therapeutics' aleniglipron, expected to begin late-stage testing in obesity in the second half of 2026 ^[2].