Lilly climbs and Novo slips as the obesity battle intensifies
Lilly's tirzepatide brands brought in $14.9 billion last quarter while Novo's Wegovy pill missed estimates — a sign of shifting leverage in a market where prices are already falling.
Eli Lilly and Novo Nordisk reported second-quarter 2026 results a day apart, and investors reacted in opposite directions. Lilly's shares rose about 2% in early trading Wednesday after revenue jumped 48% to almost $23 billion, beating a consensus estimate of $20.6 billion, according to an RBC Capital Markets note cited by BioPharma Dive [1]. Novo's shares fell 6% Tuesday before recovering some of those losses [1].
The engine behind Lilly's quarter was tirzepatide, sold as Mounjaro for type 2 diabetes and Zepbound for obesity. Mounjaro brought in $9.94 billion worldwide, up 91% from a year earlier, and Zepbound added $4.93 billion, up 46% — roughly $14.9 billion combined, or nearly 65% of Lilly's total second-quarter revenue [2]. Growth came mostly from volume. U.S. Mounjaro sales rose 45% to $4.8 billion and U.S. Zepbound sales rose 44% to $4.9 billion, both "despite lower realized prices" [2]. Outside the U.S., Mounjaro revenue jumped 172% to $5.2 billion [2].
Novo's injectables were flat. Ozempic (semaglutide for diabetes) generated $4.88 billion, or 31.4 billion Danish kroner, essentially unchanged at constant exchange rates, and injectable Wegovy brought in $3.03 billion, or 19.5 billion kroner, also flat [2].
The pill race is closer than the sales numbers suggest
Novo's oral Wegovy, launched in January 2026, has had the faster start of the two obesity pills [1][2]. But in the second quarter it posted sales of 3.2 billion kroner, about $494 million, short of the 3.6 billion kroner analysts expected [1]. Lilly's orforglipron pill, sold as Foundayo, also missed, coming in at $98 million against a $104 million consensus, per RBC's Huynh [1]. BioPharma Dive noted that expectations for Foundayo were already lower, which may explain why investors shrugged off that miss [1].
Access for Foundayo is widening. All three major U.S. pharmacy benefit managers now cover Lilly's obesity portfolio, and the Medicare GLP-1 Bridge program began providing eligible patients access to Foundayo and Zepbound in July [2]. Foundayo can be taken at any time of day without food or water restrictions, a practical difference from oral Wegovy [2]. Lilly is also seeking approval in more than 40 additional countries and pursuing a type 2 diabetes indication [2].
Novo, meanwhile, had a research setback the same week. Its experimental CagriSema, a weekly injectable now under FDA review, failed to control blood sugar as well as tirzepatide in a head-to-head trial in people with type 2 diabetes, known as Reimagine 4 [1].
Both companies raised their full-year outlooks. Lilly now expects $85 billion to $87 billion in revenue, up from $82 billion to $85 billion [1]. Novo said adjusted sales at constant currency will be flat to down 6%, an improvement over its prior forecast of a 4% to 12% decline [1].
Why it matters for patients
The repeated phrase in Lilly's results — growth "despite lower realized prices" — is the part that touches wallets. Lilly is selling far more tirzepatide while collecting less per prescription, and Novo said lower prices weighed on its revenue [2][1]. In a market where two big sellers are fighting for share, price pressure is the currency of that fight.
Coverage is the other lever. Full PBM coverage of Lilly's obesity portfolio and the July start of the Medicare GLP-1 Bridge program for Foundayo and Zepbound expand who can get these drugs paid for [2]. The sources do not spell out what patients themselves will pay under those arrangements, or how many people qualify, so that remains unclear.
For people weighing pills versus shots, the two oral options are now both on the market and both selling below what Wall Street hoped [1]. Neither miss says anything about how well either drug works.
What happens next
CagriSema remains under FDA review, with no decision date given in these sources [1]. Lilly's Foundayo filings in more than 40 countries and its type 2 diabetes application are pending [2]. Lilly expects tirzepatide to keep growing in the second half "despite increasing pricing pressure" [2].
Sources
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