Lilly is selling $12.9 billion of GLP-1 drugs every three months - and expects to sell even more

By Jaimy Lee

Mounjaro and Zepbound both beat expectations, and 20,000 people have already been prescribed its new GLP-1 pill

Eli Lilly said its tirzepatide franchise had another stellar quarter, with Mounjaro bringing in $8.7 billion in sales.

Eli Lilly's GLP-1 franchise brought in a total of $12.9 billion in sales in the first quarter as demand continued to soar for the drugs commonly used for weight loss.

The drugmaker has three GLP-1 products, so to speak: Zepbound, its tirzepatide injection for weight loss; Mounjaro, the same injection that's used by people with Type 2 diabetes; and Foundayo, its new oral GLP-1 for weight loss.

Zepbound brought in $4.2 billion in sales in the first quarter of 2026, an 83% increase from $2.3 billion in the same three months last year. Mounjaro had $8.7 billion in sales, which is more than double the $3.8 billion it reported in the same quarter of 2025.

Both medications handily beat FactSet estimates of $4.1 billion for Zepbound and $7.3 billion for Mounjaro, respectively. Lilly's (LLY) stock closed 9.5% higher on Thursday.

Zepbound and Mounjaro are Lilly's top-selling drugs, responsible for about 65% of the company's total revenue. That success has put pressure on the company to spend its cash wisely and stay on top of the dynamics in the rapidly evolving weight-loss market in the U.S.

That's why all eyes are on Foundayo. Lilly hasn't yet shared sales numbers for the drug, though the drugmaker said more than 80% of people getting Foundayo prescriptions are patients new to GLP-1s.

"Orals are expanding the market vs. cannibalizing injectable share," BMO Capital Markets analyst Evan David Seigerman told investors.

The pill, which launched April 9, had a "robust" start in its first full week on the market, but the most recent numbers failed to impress Wall Street, especially compared with the early performance of Novo Nordisk's Wegovy pill. Lilly's shares closed 3.7% lower on Friday after analysts said Foundayo had 3,700 total prescriptions in its second week, compared with the Wegovy pill's 18,400 total prescriptions in its second week.

However, about 20,000 people have received a prescription for Foundayo, according to remarks made by Ilya Yuffa, president of Lilly USA and global customer capabilities, during Thursday's earnings call.

Analysts have been paying close attention to signals of sluggish uptake to see if Lilly could face competitive pressures in a market it has largely dominated. HSBC analysts also recently downgraded Lilly's stock, saying the weight-loss market is overhyped and the growing number of Americans paying cash for these medications rather than going through the health-insurance system won't last in an economic downturn.

Novo's U.S.-listed shares (NVO) also rose, closing 4.8% higher on Thursday, perhaps driven by Lilly seeing continued demand for its GLP-1s. The Danish drugmaker is set to report its first-quarter results on May 6.

During the analyst call, which mostly focused on GLP-1s, executives noted several market dynamics unique to these drugs. For example, 75% of Mounjaro's sales outside the U.S. were paid in cash; GLP-1 users in Europe often take a "drug holiday break" or delay starting treatment until after a holiday, which slow sales in the second half of the year; volume appears to offset price cuts (at least for now); and almost half of Foundayo's prescriptions are for patients paying cash through its telehealth platform, Lilly Direct.

Separately, both Lilly and Novo's shares are likely benefitting from a government notice that the Food and Drug Administration plans to propose that compounding pharmacies can't make tirzepatide; semaglutide, the main ingredient in Wegovy; and liraglutide, an older GLP-1 developed by Novo. "The regulatory pathway that supported scaled GLP-1 compounding appears to be narrowing significantly," Raymond James' Chris Meekins wrote in a note on Thursday.

Lilly's stock is down 21.2% so far this year, while the S&P 500 SPX is up 4.0%.

Lilly's overall performance

Lilly updated its guidance for the year, saying it expects $82 billion to $85 billion in sales for the year due to the "strong underlying performance of Mounjaro and Zepbound" in the first quarter, according to CFO Lucas Montarce's remarks on the call. Previously, it expected $80 billion to $83 billion in sales.

The company generated $19.8 billion in total sales in the first quarter, sailing past the $12.7 billion it reported a year ago and the FactSet estimate of $17.8 billion.

The breast-cancer pill Verzenio, which is Lilly's third top-selling drug, had $1.3 billion in sales, up from $1.2 billion a year ago.

With so much cash on hand, Lilly has been on a dealmaking spree, snapping up four biotechs in the last month alone that focus on different therapeutic fields than metabolic health. That includes $6.3 billion upfront for Centessa Pharmaceuticals, which is developing treatments for sleep disorders, and $3.25 billion upfront for in vivo CAR-T developer Kelonia Therapeutics.

Adjusted earnings per share came out to $8.55, against a FactSet estimate of $6.97.

Net income was $7.4 billion, surpassing a FactSet estimate of $6.1 billion.

-Jaimy Lee

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04-30-26 1622ET