Eli Lilly reports $19.8 billion in first-quarter revenue as Mounjaro and Zepbound drive growth

Eli Lilly reported first-quarter 2026 revenue of $19.8 billion, a 56% increase from the same quarter a year earlier, according to the company's results ^[1]. Its two tirzepatide injections — Mounjaro for type 2 diabetes and Zepbound for obesity — together generated $12.82 billion, about 65% of total revenue ^[1][2].

Reported earnings per share rose 170% to $8.26, and non-GAAP earnings per share rose 156% to $8.55 ^[1]. Lilly raised its full-year 2026 revenue guidance to $82.0 billion to $85.0 billion, and its non-GAAP earnings guidance to $35.50 to $37.00 per share ^[1]. The company did not report a separate revenue figure for its new oral obesity drug, Foundayo (orforglipron) ^[1][2].

Foundayo reached the market at the end of the quarter

The FDA approved Foundayo on April 1, 2026, for adults with obesity or who are overweight with at least one weight-related condition, making it the first oral GLP-1 receptor agonist approved to treat obesity ^[1]. It launched in the United States in early April, just before the quarter closed, so its sales make up little or none of the $19.8 billion total ^[1][2]. Lilly has not disclosed Foundayo's launch sales, and the drug's initial commercial performance is expected to draw attention when the company reports second-quarter results ^[2].

Foundayo is a daily pill and a small-molecule drug, which the coverage describes as different from the peptide-based injectables semaglutide (Ozempic, Wegovy, Rybelsus) and tirzepatide (Mounjaro, Zepbound) ^[1]. The approval was supported by Phase 3 trials that include NCT05869903, which enrolled 3,127 people and ran 72 weeks, and NCT05872620, which enrolled 1,613 people with obesity or overweight and type 2 diabetes and ran 77 weeks, finishing in August 2025 ^[1]. A third trial, NCT06584916, enrolled 376 people and studied weight maintenance after tirzepatide or semaglutide treatment ^[1]. The approval came under the FDA's Commissioner's National Priority Voucher pilot program and was the first new molecular entity cleared under it, and the fastest such approval since 2002, according to the report ^[1].

The competing franchise and its pressures

Novo Nordisk's semaglutide medicines Ozempic (type 2 diabetes) and Wegovy (obesity) generated DKK 63.2 billion in the first quarter of 2026, about 65% of Novo's total sales ^[2]. Novo also sells an oral Wegovy pill, which was approved in late December and launched in the United States in early January ^[2]. Novo expects its adjusted sales and operating profit to decline in 2026, and the report cites US pricing pressure, weaker prescription trends for injectable GLP-1 drugs and reduced Medicaid obesity coverage as hurdles ^[2]. Other companies are working on oral options: Viking Therapeutics plans to move oral VK2735 into Phase 3 testing in the fourth quarter of 2026, and Structure Therapeutics expects to begin late-stage testing of aleniglipron in the second half of 2026 ^[2].

Why it matters for patients

Patients now have two companies selling both weekly injections and daily pills in this drug class, which is a shift from a market that until recently was injectable-only ^[1][2]. That means the choice between a pill and a shot is no longer a choice between manufacturers, though it is not yet known how Foundayo compares with injectable semaglutide or tirzepatide in head-to-head testing — no such comparison results appear in these reports, and no pricing information for Foundayo has been reported ^[1][2].

Supply has been a practical issue for this class. Both Lilly and Novo Nordisk have struggled to meet demand for injectable GLP-1 products, and the report notes that scaling production will remain critical for the oral products as well ^[1]. On coverage, the report cites reduced Medicaid obesity coverage as one of the pressures on the market, though it does not detail which plans cover which drugs ^[2]. Novo's guidance for falling 2026 sales does not by itself indicate any change in what is available to patients ^[2].

What happens next

Aug. 5, 2026: Lilly and Novo Nordisk are both scheduled to report second-quarter 2026 results, when the first reading on Foundayo's launch sales is expected ^[2].

Fourth quarter of 2026: Viking Therapeutics plans to advance oral VK2735 into Phase 3 development for obesity ^[2].

Second half of 2026: Structure Therapeutics expects to start its late-stage program for aleniglipron in obesity ^[2].