Lilly raises 2026 outlook as Mounjaro and Zepbound sales climb 48%
Lilly's growth came from selling more doses rather than charging more, as U.S. prices slipped and Medicare's new obesity drug coverage began.
Eli Lilly reported second-quarter 2026 revenue of $23.0 billion, a 48% increase from the same quarter a year earlier, and raised its full-year revenue guidance to $85 billion to $87 billion from a previous range of $82 billion to $85 billion [1][2]. The company said the increase was driven by a 60% rise in volume, partly offset by a 13% decline in realized prices [1].
Mounjaro, Lilly's diabetes drug, generated $9.9 billion worldwide, up 91%, including $4.8 billion in the United States and $5.2 billion outside it [1]. Sales abroad rose 172%, which Lilly attributed to volume growth and lower prices after Mounjaro was added to China's national reimbursement drug list [1]. Zepbound (tirzepatide), the company's obesity drug, posted $4.9 billion, up 46% from a year earlier, with U.S. revenue up 44% [1]. Lilly said Zepbound's U.S. price fell, including from previously announced reductions in cash-pay prices [1][2].
Foundayo (orforglipron), the oral GLP-1 pill that won U.S. approval in April, recorded $98 million in its first quarter of sales [1][2]. Analysts surveyed by FactSet had expected nearly $103 million [2]. CEO David Ricks said the company had to build physician and consumer awareness and pharmacy coverage. "Just in a month we've doubled consumer awareness, and prescriptions have doubled in a month for Foundayo," he said, adding that about a quarter of new patients starting oral GLP-1 medications are taking Lilly's pill [2].
The volume gains came with lower prices. Inside the U.S., volume rose 37% while realized prices fell 3%; Lilly said that excluding adjustments to estimates for rebates and discounts, U.S. price would have fallen about 9% [1]. Outside the U.S., volume rose 113% and realized prices fell 36% [1]. Reported earnings per share were $7.94, up 26%, and non-GAAP earnings per share were $8.38, up 33%; both included $3.03 per share in charges tied to acquisitions completed in the quarter [1][2]. Lilly kept its full-year adjusted earnings guidance at $35.50 to $36.50 per share, saying it raised underlying guidance by $2.78 at the midpoint, an increase more than offset by those $3.03 in charges [1][2].
Lilly also said it committed an additional $4.5 billion to expand its Indiana manufacturing sites [1]. According to an earnings presentation, Lilly held 60.9% of the U.S. obesity and diabetes drug market in the second quarter, while Novo Nordisk held 38.8% [2].
Why it matters for patients
Lilly's revenue growth came almost entirely from selling more medicine rather than charging more for it, and realized prices fell in both the U.S. and overseas [1]. That matters because U.S. list prices and what an individual patient pays at the pharmacy are separate things, and the sources do not give list prices or typical out-of-pocket costs. What patients pay still depends on their insurance plan, formulary coverage and any discount programs.
A second factor is Medicare. New Medicare coverage of obesity drugs began in early July and allows eligible seniors to get branded GLP-1 medicines for a $50 monthly copay [2]. Ricks said the rollout is "off to a strong start" and that he expects both Lilly and Novo Nordisk to benefit in the second half of the year [2]. The sources do not include enrollment figures or how many seniors have used the benefit so far.
A third is competition among oral options. Ricks said the oral part of the market is "expansionary, it's not cannibalizing Zepbound" demand, meaning the pill appears to be adding patients rather than pulling them off the injected drug [2]. Whether that holds as more oral products launch has not been established. In an April interview, Ricks estimated global GLP-1 use would rise from about 20 million patients at the end of last year to 30 million at the end of 2026 [2]. That is a company projection, not a reported result.
What happens next
Lilly has submitted orforglipron for type 2 diabetes in the United States; the sources do not give a decision date [1]. The company said its clinical data package for retatrutide is complete for obesity, obstructive sleep apnea and knee osteoarthritis pain, with plans to submit a Biologics License Application to the U.S. Food and Drug Administration in the first quarter of 2027 [1]. Lilly's fourth-quarter and full-year 2026 results, which would show whether price declines and Medicare coverage changed the trend, have not been scheduled in the sources. The company said its momentum continued, with Ricks calling it "a really strong start to the year for Lilly" [2].
Sources
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