Eli Lilly delivered a stunning performance Wednesday, shattering fourth-quarter projections and unveiling ambitious 2026 targets that signal unstoppable momentum in the weight loss and diabetes medication market. The pharmaceutical powerhouse expects revenue between $80 billion and $83 billion this year, far exceeding Wall Street’s $77.62 billion estimate from LSEG.
The company projects adjusted earnings ranging from $33.50 to $35 per share for 2026, surpassing analyst expectations of $33.23 per share. This bullish forecast stands in sharp contrast to struggling rival Novo Nordisk, which warned Tuesday of potential sales and profit drops reaching 13 percent as pricing pressures intensify and patent protections expire across key international markets including China, Brazil and Canada.
Lilly’s revenue guidance midpoint suggests remarkable 25 percent sales growth this year, demonstrating the company’s ability to navigate challenging market conditions while maintaining its competitive edge. The pharmaceutical giant’s stock surged more than 7 percent in premarket trading following the announcement, reflecting investor confidence in the company’s strategic positioning.
Blockbuster Medications Drive Unprecedented Revenue Surge
The diabetes treatment Mounjaro generated $7.41 billion in fourth-quarter revenue, representing a spectacular 110 percent increase from the same period last year. U.S. sales reached $4.1 billion, climbing 57 percent as prescription volumes expanded despite lower realized prices, underscoring how advances in Science continue to reshape treatment demand. These figures exceeded analyst predictions compiled by StreetAccount.
Zepbound, the weight loss medication that entered the market approximately three years ago, delivered $4.2 billion in U.S. revenue during the fourth quarter. This marked a 122 percent surge from the previous year, fueled by soaring demand even as pricing declined. Analysts had anticipated $3.91 billion in U.S. sales for the medication.
Total fourth-quarter revenue hit $19.29 billion, representing a 43 percent jump from the year-earlier period. The company posted earnings of $7.54 per share on an adjusted basis, substantially beating the $6.67 consensus estimate. U.S. revenue alone climbed to $12.9 billion, propelled by a 50 percent volume increase for products, particularly Mounjaro and Zepbound.
Medicare Expansion Creates New Market Opportunities
CEO Dave Ricks recently highlighted upcoming government Medicare coverage of obesity treatments as a catalyst for market expansion this year, describing it as a significant multiplier for the eligible patient population. In Wednesday’s earnings presentation, Lilly identified several growth drivers for 2026, including Medicare coverage, sustained global demand for its flagship medications, and the anticipated second-quarter launch of its oral GLP-1 pill for obesity, pending regulatory approval.
However, the company acknowledged headwinds from global pricing declines in the low- to mid-teens percentage range. These reductions stem from the Trump administration deal, new direct-to-consumer rates for Zepbound, and lower Medicaid pricing on certain legacy products.
Market Dominance Amid Intensifying Competition
Lilly continues strengthening its position in the rapidly expanding GLP-1 market, even as Novo Nordisk prepares for an aggressive U.S. launch of its oral Wegovy pill for obesity. Lilly’s share of the U.S. obesity and diabetes medication market reached 60.5 percent in the fourth quarter, up 2.6 percent from the previous quarter. Novo’s market share stood at 39.1 percent during the same period.
The Trump administration deals require both Lilly and Novo Nordisk to slash prices for Medicare and Medicaid beneficiaries in 2026 while offering discounted rates through the forthcoming TrumpRx direct-to-consumer platform. In exchange, both pharmaceutical companies secured three-year tariff exemptions.
Ricks acknowledged the pricing step-down earlier this year but expressed confidence that volume growth would accelerate during the second half of 2026. Net income for the fourth quarter reached $6.64 billion, or $7.39 per share, compared with $4.41 billion, or $4.88 per share, in the year-earlier period.
The pharmaceutical giant’s ability to maintain robust growth despite pricing pressures demonstrates strategic resilience and strong market positioning. As Medicare coverage expands and new product launches approach, Lilly appears poised to capitalize on the massive opportunity in metabolic health treatments while navigating an increasingly complex regulatory and competitive landscape.
Source: CNBC
