Lilly reports tirzepatide revenue of $14.9 billion in one quarter and a 13% fall in realized prices

Eli Lilly reported on August 5, 2026 that second-quarter revenue rose 48% to $23.0 billion, with tirzepatide doing most of the work: Mounjaro brought in $9.943 billion worldwide and Zepbound $4.928 billion ^[1][2]. Reuters calculated that the two brands accounted for 64.7% of Lilly's total revenue for the quarter ^[3]. At the same time, the company said worldwide realized prices — what it actually collects after rebates and discounts — fell 13% ^[1][2].

The volume-versus-price split

Lilly's growth came from far more prescriptions, not higher prices. Worldwide volume grew 60%, offset in part by that 13% drop in realized prices ^[1][2]. The picture differs sharply by region. In the U.S., revenue rose 33% to $14.4 billion on 37% volume growth, with realized prices down only 3%. Lilly said that 3% figure was cushioned by accounting adjustments to its estimates for rebates and discounts on Trulicity, Zepbound and Mounjaro; without those adjustments, U.S. prices would have fallen about 9% ^[1][2].

Outside the U.S., revenue climbed 80% to $8.6 billion on 113% volume growth, while realized prices dropped 36% — a decline Lilly attributed mainly to adding Mounjaro to China's National Reimbursement Drug List ^[1][2].

On the individual brands, Lilly said U.S. Zepbound revenue rose 44% to $4.9 billion, driven by strong demand and partly offset by lower realized prices "including previously announced reductions in cash-pay prices" ^[1][2]. The company's revenue table shows total Zepbound sales up 46%, reflecting that tirzepatide is also sold as Zepbound in Canada and Japan ^[1][2]. Worldwide Mounjaro revenue rose 91%, with U.S. sales up 45% to $4.8 billion and sales outside the U.S. up 172% to $5.2 billion ^[1][2].

Pills are not yet taking over

Lilly executives said injectables still dominate new prescriptions. Chief Financial Officer Lucas Montarce said injectable GLP-1 medicines account for roughly three out of every four new patient starts, even with oral options on the market ^[3]. In the federal Medicare obesity drug pilot that launched the prior month — which Reuters describes as offering weight-loss drugs at the same $50 monthly co-pay — about 80% of patients started on an injectable, according to Lilly Executive Vice President Ilya Yuffa ^[3].

Lilly's own oral drug, Foundayo (orforglipron), posted $98 million in its first reported quarter, below the $105.6 million analysts expected ^[1][3]. Yuffa said Foundayo prescriptions in the last week of July were roughly double those a month earlier, with nearly one in four patients starting on the pill ^[3]. Rival Novo Nordisk reported oral Wegovy (semaglutide) sales of 3.22 billion Danish crowns, about $497 million, up 42.6% from the prior quarter but slightly below expectations ^[3].

Why it matters for patients

A falling "realized price" is not the same as a falling price at the pharmacy counter. It is the average Lilly collects per unit after rebates to insurers, government discounts and cash-pay programs. A 13% global decline alongside 60% volume growth suggests the company is trading price for broader access — but what any individual pays still depends on insurance status, plan design, cash-pay program eligibility and where they live.

The U.S. numbers make that gap clear: reported U.S. prices fell 3%, or about 9% excluding rebate-estimate adjustments ^[1][2], while prices outside the U.S. fell 36% largely because of one government reimbursement decision in China ^[1][2]. Lilly specifically named cash-pay price cuts as one reason U.S. Zepbound realized prices declined ^[1][2], which is the piece most visible to people buying without insurance coverage.

The demand data also suggests supply and competition dynamics are shifting. Reuters cited BMO Capital Markets analyst Evan Seigerman saying the consensus view is that "tirzepatide is the better product... efficacy is what's key" for consumers ^[3]. Whether that preference holds as more oral options arrive is not yet known.

What happens next

Lilly raised 2026 revenue guidance to $85 billion to $87 billion, up from $82 billion to $85 billion, and set adjusted EPS guidance at $35.50 to $36.50 ^[1][3]. The company said it has submitted orforglipron for type 2 diabetes in the U.S. ^[1][2], that Foundayo is under regulatory review in more than 40 markets with a major-market rollout expected in 2027 ^[3], and that it plans to submit a Biologics License Application for retatrutide, its next-generation obesity drug, to the FDA in the first quarter of 2027 ^[1][2].