Lilly raises 2026 outlook as Mounjaro and Zepbound surge while Foundayo lags

Eli Lilly reported second-quarter 2026 revenue of $23.0 billion, up 48% from a year earlier, as sales of its injectable GLP-1 medicines Mounjaro and Zepbound kept climbing ^[1][4]. The same report included the first quarterly sales figures for Foundayo, the company's new oral GLP-1 pill, and they came in below analyst expectations ^[3][5].

Worldwide Mounjaro (tirzepatide) revenue rose 91% to $9.94 billion, with U.S. sales of $4.8 billion, up 45%, and sales outside the U.S. up 172% to $5.2 billion ^[1][4]. Zepbound, also tirzepatide, brought in $4.93 billion, up 46% ^[1][4]. The two drugs accounted for 64.7% of Lilly's quarterly revenue ^[3]. Lilly said global volume rose 60% while realized prices fell 13% ^[1].

The pill's slower start

Foundayo (orforglipron) recorded $98 million in its first quarter on the U.S. market ^[1][4]. Reuters reported analysts expected $105.6 million ^[3]; CNBC, citing FactSet, said analysts forecast nearly $103 million ^[5]. Novo Nordisk's oral Wegovy, which launched in the U.S. on Jan. 5, generated 3.22 billion Danish kroner ($497 million), up 42.6% from the prior quarter but slightly below expectations ^[2][3]. Lilly received FDA approval for Foundayo on April 1, about three months after Novo's pill ^[2].

Leerink Partners analyst David Risinger called Foundayo's overall result "disappointed," though he noted the drug's sales in the United Arab Emirates were $31 million, which "bodes well for Foundayo's global potential" ^[2]. Lilly executives said the launch is accelerating. "Just in a month we've doubled consumer awareness, and prescriptions have doubled in a month for Foundayo," CEO David Ricks said ^[5]. Lilly's president of U.S. operations, Ilya Yuffa, said the company is "doubling the volume that we had just a month ago and we're starting to see new starts coming in nearly around one out of four" ^[2].

Lilly raised its full-year 2026 revenue guidance to $85 billion to $87 billion, from $82 billion to $85 billion ^[3][5]. It trimmed the top of its adjusted earnings forecast by 50 cents, to $35.50 to $36.50 per share, citing $3.03 per share in acquired in-process research and development charges tied to deals in the quarter ^[1][3][4]. Non-GAAP earnings per share for the quarter were $8.38, above the $6.01 analysts expected ^[3][5]. Lilly said it held 60.9% of the U.S. obesity and diabetes drug market in the quarter, against Novo Nordisk's 38.8% ^[5].

Why it matters for patients

Lilly's injectables are still gaining users even as pills become available. The company said injectable incretins account for roughly three out of every four new patient starts ^[2][3], and about 80% of patients in Medicare's new obesity drug pilot chose to begin with an injection, according to Yuffa ^[3]. Many industry experts had expected patients to prefer pills for convenience ^[3]. Ricks said the oral market is "expansionary, it's not cannibalizing Zepbound" demand ^[5].

Prices, meanwhile, are moving in patients' favor. Lilly's realized prices fell 13% worldwide, and U.S. prices would have declined about 9% excluding adjustments to rebate and discount estimates ^[1]. Zepbound's decline reflected previously announced cuts to its cash-pay price ^[1]. Medicare's obesity drug coverage, which began in early July, offers eligible seniors branded GLP-1s at a $50 monthly copay ^[3][5]. Ricks said that rollout is "off to a strong start" ^[5].

What these earnings do not show is how Foundayo compares with injectables on weight loss or other outcomes in real-world use, which has not been reported here. The figures also do not disclose plan-by-plan insurance coverage for the pill.

What happens next

Foundayo is under regulatory review in more than 40 markets, and Lilly expects a rollout across all major markets in 2027 ^[3]. Lilly has also submitted orforglipron for type 2 diabetes in the U.S. ^[1][4]. Separately, Lilly said its clinical data package for retatrutide, an experimental triple agonist, is complete for obesity, obstructive sleep apnea and knee osteoarthritis pain, with a planned U.S. application in the first quarter of 2027 ^[1].