Lilly reports 136% international growth and flags generic semaglutide supply limits in Canada

Eli Lilly said revenue outside the United States grew 136% in the second quarter of 2026 while U.S. revenue rose 48%, and a company executive said generic semaglutide sellers in Canada are facing "significant supply constraints" ^[1].

Lilly chief financial officer Lucas Montarce gave the figures on the company's second-quarter earnings call. Global sales of Mounjaro, the tirzepatide brand for type 2 diabetes, rose 91% to US$9.94 billion ^[1]. That beat a consensus estimate of $8.99 billion, and U.S. Mounjaro revenue of $4.8 billion came in above expectations of $4.44 billion ^[2]. Zepbound, the tirzepatide brand for weight management, generated $4.93 billion ^[1]. U.S. Zepbound sales grew 44% in the quarter and 58% in the first half, although lower realized prices partly offset that demand ^[2].

Together the two products accounted for 64.7% of Lilly's revenue in April, May and June ^[1]. Montarce said roughly six of every 10 total prescriptions and about seven of every 10 injectable prescriptions in the quarter were for a Lilly medicine ^[1]. Lilly raised its full-year revenue forecast to $85 billion to $87 billion and narrowed adjusted earnings-per-share guidance to $35.50 to $36.50, cutting the top of that range; its shares rose 2.5% on the day it reported ^[1][2].

The 136% figure covers all of Lilly's revenue outside the United States ^[1]. Mounjaro's international sales grew faster: non-U.S. sales rose 172% to $5.2 billion, above its U.S. total of $4.8 billion, and most Mounjaro revenue was booked outside the United States in the quarter ^[2]. Montarce attributed the rest-of-world growth mainly to Mounjaro in Latin America and Asia ^[1]. International expansion has come with price pressure: realized prices fell 13% across the company, and adding Mounjaro to China's national reimbursement list expanded volume but lowered realized prices ^[2].

Canada shows brand and generic side by side

Patrik Jonsson, president of Lilly International, said the company was "pleasantly surprised" by its Canadian performance, and that Lilly has "also seen the generic companies actually having significant supply constraints." He said it was something Lilly needs to monitor closely ^[1]. Mounjaro has been authorized in Canada under the Lilly brand since 2022, and Zepbound received Health Canada authorization in May 2025. Both remain under patent protection in Canada, so the generic competition Jonsson described applies to the semaglutide market, not to tirzepatide ^[1]. Three of nine generic semaglutide products filed in Canada have been approved by Health Canada ^[1].

Novo Nordisk, which sells the semaglutide products Ozempic, Wegovy and Rybelsus, reported operating profit up 11% for the quarter. Sales of its oral Wegovy pill passed 5 million prescriptions in the U.S. since launch, though analysts described Wegovy sales as "slightly soft." CEO Mike Doustdar said the company is serving almost 70% more people than a year ago ^[1]. Emil Kongshøj Larsen, Novo's executive vice-president of international operations, said that in Canada "while the generic players have started to capture market share, we have so far been able to grow our absolute volumes," and that the savings-card program is the company's leading tactic there, with good volume retention for Ozempic and Wegovy in cash and private insurance channels ^[1].

Cash-pay pharmacy prices in Canada currently range from $271.62 to $800 for Mounjaro across 108 listings, $93.29 to $663 for Ozempic across 82 listings, $270 to $550 for Wegovy and $230 to $293.99 for Rybelsus, all in Canadian dollars ^[1].

Why it matters for patients

Canada is the closest market where authorized generic semaglutide is sold, and the earnings comments suggest that supply, not just price, has shaped what patients there can actually fill. If generic supply stays uneven, the brand product may remain the practical option for some people even when a cheaper copy exists ^[1].

Both companies are competing on discounts rather than headline list prices. Novo said savings cards are its main tactic in Canada and that it kept volume in cash and private insurance channels ^[1]. Lilly and Novo also each depend heavily on a small number of products, so a supply or regulatory problem at either company can affect a large share of patients: tirzepatide alone was 64.7% of Lilly's quarterly revenue ^[1]. Whether Canadian generic supply constraints affect availability or prices in the United States has not been reported.

What happens next

Lilly expects most international launches of its oral obesity drug, Foundayo (orforglipron), in 2027 ^[2]. The company says alenoglipron is scheduled to enter late-stage development in the second half of 2026 ^[2]. Both companies report again next quarter, when their Canadian commentary is likely to be updated. Health Canada's timing for decisions on the remaining generic semaglutide filings has not been reported ^[1].