Lilly's Mounjaro and Zepbound sales jump as realized prices fall 13%

Eli Lilly said worldwide sales of Mounjaro (tirzepatide) reached $9.943 billion in the second quarter of 2026 and U.S. sales of Zepbound (tirzepatide) reached $4.928 billion, together 64.7% of the company's revenue for the quarter ^[1][3]. Total revenue rose 48% to $22.974 billion from $15.558 billion a year earlier, driven by a 60% increase in volume that was partly offset by a 13% decrease in realized prices, the company said ^[1].

Realized prices are the amounts Lilly actually collects after discounts and rebates ^[1]. In the U.S., where revenue rose 33% to $14.4 billion, volume grew 37% and realized prices fell 3%. Lilly said the U.S. price decline was driven primarily by Zepbound and Mounjaro, and that excluding adjustments to estimates for rebates and discounts, U.S. price would have declined about 9% ^[1].

U.S. Zepbound revenue rose 44% to $4.9 billion on strong demand, partly offset by lower realized prices "including previously announced reductions in cash-pay prices," Lilly said ^[1]. Mounjaro revenue rose 91% worldwide, with U.S. revenue of $4.8 billion, up 45%, and revenue outside the U.S. up 172% to $5.2 billion ^[1]. Outside the U.S., realized prices fell 36%, which Lilly attributed mainly to adding Mounjaro to China's National Reimbursement Drug List ^[1].

Reuters reported that both drugs beat analyst estimates and that Lilly shares rose 3.6% on the results ^[3]. Novo Nordisk's diabetes and obesity portfolio generated nearly 59.3 billion Danish crowns ($9.16 billion) in quarterly sales, led by Ozempic and Wegovy injections, while oral Wegovy (semaglutide) recorded 3.22 billion crowns ($497 million), up 42.6% from the previous quarter but slightly below analyst expectations ^[3].

Foundayo (orforglipron), Lilly's once-daily obesity pill, recorded $98 million in sales, matching its year-to-date total, below the $105.6 million analysts expected ^[1][3]. Lilly said Foundayo is under regulatory review in more than 40 markets and expects a rollout across all major markets in 2027 ^[3].

Lilly raised its full-year 2026 revenue guidance to $85.0 billion to $87.0 billion, up from $82 billion to $85 billion, and now expects adjusted earnings of $35.50 to $36.50 per share, trimming the top of that range by 50 cents because of charges tied to acquisitions ^[1][3]. Second-quarter adjusted earnings were $8.38 per share on a non-GAAP basis, up 33%, against an analyst average estimate of $6.01 ^[1][3].

Why it matters for patients

The falling prices Lilly reports are not what any individual patient pays, but the company names two drivers that touch out-of-pocket costs directly: cash-pay price reductions for Zepbound and Medicare coverage changes ^[1][3]. Reuters reported that a Medicare bridge program launched in July 2026 offers weight-loss drugs at the same $50 monthly co-pay, which removed some of the price advantage oral Wegovy had at launch ^[3].

Volume data also suggests more people are starting treatment. Lilly chief financial officer Lucas Montarce said injectable GLP-1 medicines accounted for roughly three of every four new patient starts, and Lilly executive vice president Ilya Yuffa said about 80% of patients in the Medicare pilot chose to begin with an injectable ^[3]. Yuffa also said Foundayo prescriptions in the last week of July were about double those a month earlier and that nearly one in four patients are starting on the pill ^[3]. Reuters reported that about 60% to 70% of people in the Medicare program are expected to be new to these drugs, according to Kevin Gade of investor Bahl & Gaynor ^[3].

What the results do not show: list prices for either drug, whether Lilly plans further price cuts, or what patients with commercial insurance pay. None of that has been disclosed in these reports ^[1][3].

What happens next

Lilly said its clinical data package for retatrutide is complete for obesity, obstructive sleep apnea and knee osteoarthritis pain, with a Biologics License Application planned for the first quarter of 2027 ^[1]. The company submitted orforglipron for type 2 diabetes in the U.S. ^[1] and expects Foundayo reviews to finish across major markets during 2027 ^[3]. Lilly also committed an additional $4.5 billion to expand its Indiana manufacturing sites ^[1].