Key takeaways
- Eli Lilly’s quarterly revenue jumped 48 per cent to US$22.97 billion as Mounjaro and Zepbound sales approached US$15 billion.
- Lilly raised its annual revenue forecast, while Novo Nordisk improved an outlook that still allows for declining 2026 sales and profit.
- The market rewarded Lilly’s injectable-drug strength but punished Novo after oral Wegovy sales narrowly missed expectations.
The global weight-loss drug boom continues to produce blockbuster growth, but its two biggest beneficiaries are moving in increasingly different directions.
Eli Lilly and Company (NYSE:LLY) shares jumped as much as 7 per cent Wednesday after Mounjaro and Zepbound powered another major earnings beat. Novo Nordisk (TSX:NOVO), meanwhile, saw its U.S.-listed shares fall 6 per cent Tuesday despite improving its full-year guidance.
Lilly revenue approaches US$23 billion
Lilly generated second-quarter revenue of US$22.97 billion, up 48 per cent from US$15.56 billion one year earlier and more than US$2 billion above Wall Street expectations.
Reported net income increased 25 per cent to US$7.10 billion. Adjusted earnings rose 33 per cent to US$8.38 per share, compared with the approximately US$6.01 analysts expected.
“Lilly’s momentum continues, as we delivered 48% revenue growth and raised our full-year guidance,” chair and chief executive David Ricks said in the company’s results.
Mounjaro revenue increased 91 per cent to US$9.94 billion. The diabetes medicine produced US$4.8 billion in the United States and US$5.2 billion internationally, with international sales surging 172 per cent.
Zepbound revenue climbed 46 per cent to US$4.93 billion, driven by higher prescription volumes despite lower realized prices.
Combined sales from the two tirzepatide brands reached US$14.87 billion, equivalent to almost 65 per cent of Lilly’s quarterly revenue. That compares with approximately US$12.9 billion during the first quarter.
The performance confirms that demand has remained resilient even as drugmakers reduce prices and governments seek to control the cost of GLP-1 treatments.
Lower prices unlock higher volumes
Lilly’s worldwide sales volume grew 60 per cent, more than offsetting a 13 per cent reduction in realized prices.
U.S. revenue increased 33 per cent to US$14.4 billion, led by Mounjaro and Zepbound. Excluding adjustments to earlier rebate estimates, domestic prices would have declined by approximately 9 per cent.
Outside the United States, revenue surged 80 per cent to US$8.6 billion. International volume more than doubled, driven primarily by Mounjaro.
The result supports Lilly’s argument that lower prices can expand the overall pool of patients rather than simply reducing revenue. It also demonstrates that the company’s growth is becoming less dependent on the comparatively high prices charged in the United States.
Manufacturing efficiency and the increasing contribution from higher-margin medicines helped lift Lilly’s adjusted gross margin to 86.3 per cent.
Patients continue choosing injections
The quarter also offered evidence that oral obesity drugs may expand the market without immediately replacing injections.
Injectable GLP-1 medicines account for approximately three-quarters of new patient starts, according to Lilly. In a new U.S. Medicare pilot, around 80 per cent of participating patients selected an injectable treatment.
That behaviour favours Zepbound and Mounjaro, which have established prescription bases and stronger commercial momentum.
Lilly’s recently launched oral medicine Foundayo generated US$98 million during the quarter, slightly below expectations. Novo’s competing Wegovy pill produced 3.22 billion Danish kroner, or approximately US$497 million.
Novo’s oral sales increased almost 43 per cent from the previous quarter and the drug has surpassed five million cumulative U.S. prescriptions. However, sales narrowly missed the 3.3 billion kroner consensus forecast.
That modest shortfall mattered because investors increasingly view the pill as Novo’s best opportunity to regain market share lost to Lilly’s injectable products.
Two raised outlooks tell different stories
Lilly increased its 2026 revenue forecast to between US$85 billion and US$87 billion, compared with its previous range of US$82 billion to US$85 billion.
Management also raised the underlying midpoint of its adjusted earnings expectations by US$2.78 per share.
However, research-and-development charges associated with recent acquisitions totalled US$3.03 per share. Those charges reduced the published earnings range to US$35.50 to US$36.50, from US$35.50 to US$37.00 previously.
Novo’s upgraded outlook still points to a considerably weaker year.
The Danish company now expects adjusted sales and operating profit to range between flat and a decline of 6 per cent at constant exchange rates. Its previous forecast allowed for declines of between 4 and 12 per cent.
Second-quarter adjusted sales reached 78.49 billion Danish kroner, up 7 per cent at constant currencies. Adjusted operating profit increased 11 per cent to 33.39 billion kroner, beating the company-compiled consensus forecast.
Novo’s diabetes and obesity portfolio generated approximately US$9.16 billion during the quarter. Lilly’s Mounjaro and Zepbound alone produced approximately US$5.7 billion more.
Pipeline adds to the valuation gap
The companies’ pipelines are reinforcing their diverging investment cases.
Lilly has completed the clinical package needed to seek approval for retatrutide in obesity, obstructive sleep apnea and knee osteoarthritis pain. A U.S. regulatory submission is planned for the first quarter of 2027.
Novo reported less convincing results for CagriSema. The medicine matched tirzepatide for weight loss in a trial involving people with Type 2 diabetes but did not demonstrate superior blood-sugar control.
That followed the failure of Novo’s experimental cardiovascular drug ziltivekimab to reduce major heart events in a separate Phase 3 trial.
Novo still possesses an early lead in oral obesity medicines, while Lilly’s Foundayo launch has been slower than some analysts anticipated. The success of those pills could determine whether Novo narrows the competitive gap or whether Lilly’s existing injectable leadership proves difficult to overcome.
What investors should watch
Three issues will shape the next stage of the GLP-1 contest: manufacturing capacity, pricing and access.
Lilly has committed another US$4.5 billion to expand manufacturing facilities in Indiana. Additional capacity should help it meet demand that previously exceeded available supply.
Pricing remains a more complicated variable. Lower costs can attract additional patients, but they also require substantial volume growth to protect margins. Government drug negotiations and broader insurance coverage will intensify that trade-off.
Finally, investors should watch whether oral treatments attract patients who would otherwise avoid injections or primarily take market share from existing GLP-1 brands.
The global obesity-drug market reached approximately US$66 billion in 2025, with analysts expecting annual U.S. sales alone to exceed US$100 billion by 2030.
Both companies remain positioned to benefit from that expansion. The latest results, however, show Lilly converting demand into revenue considerably faster while Novo works to prove that its turnaround can extend beyond one successful pill launch.
