Eli Lilly and Company (NYSE:LLY) executives said the drugmaker started 2026 with “a strong start,” pointing to sharp first-quarter revenue growth, continued demand for its incretin medicines, a newly approved oral obesity therapy, and a slate of pipeline and business development milestones.
Foundayo approval and early launch indicators
Chair and CEO Dave Ricks highlighted a key commercial milestone earlier in the month: U.S. FDA approval of orforglipron under the brand name Foundayo for weight management. Ricks said Foundayo offers “the benefits of GLP-1 therapy in a pill form” and can be taken “at any time of day without food or water restrictions.” He described the launch as the first time “a new incretin medicine has been launched with obesity as its indication first.”
President of Lilly USA and Global Customer Capabilities Ilya Yuffa said the company is watching three “key factors and catalysts of growth”: HCP familiarity, access, and consumer awareness. He reported early metrics including “over 8,000 prescribers of Foundayo,” with about “a third” who had not previously written an oral GLP-1. Yuffa also said Lilly had treated “just over 20,000 patients” to date, adding that “80% of those Foundayo prescriptions are new to class.”
On access and promotion, Montarce said Foundayo was broadly available in pharmacies on April 9 and available on more than 12 telehealth platforms. Yuffa said commercial access had been confirmed at two of the three largest U.S. pharmacy benefit managers by mid-May, while broader consumer promotion—direct-to-consumer TV advertising—is expected to begin in Q3.
Q1 financial results and 2026 guidance raise
Montarce said first-quarter revenue rose 56% versus Q1 2025, driven by Zepbound and Mounjaro, alongside “solid momentum across all therapeutic areas and geographies.” Gross margin was 82.6%, down about one percentage point year over year, which Montarce attributed “primarily [to] lower list prices.”
Marketing, selling, and administrative expenses increased 19% as Lilly invested behind new and planned launches, while R&D expenses rose 28%, reflecting ongoing pipeline investment, including 42 active phase III programs. Non-GAAP performance margin was 50%, up about seven points from the prior year period, “driven by revenue growth,” Montarce said.
Non-GAAP EPS was $8.55, including acquired R&D charges of $0.52, compared with non-GAAP EPS of $3.34 in Q1 2025, which included acquired R&D charges of $1.72.
Lilly also updated its full-year outlook. Montarce said the company increased the top and bottom ends of its revenue guidance by $2 billion to a range of $82 billion to $85 billion, citing “strong underlying performance of Mounjaro and Zepbound in Q1.” Lilly still expects price to be “a headwind in the low to mid-teens” for the full year. The company raised non-GAAP EPS guidance by $2 to $35.50 to $37 and maintained a non-GAAP performance margin outlook of 47% to 48.5%.
Commercial updates: incretin market growth, access, and pricing
Montarce said U.S. revenue increased 43%, driven mainly by volume growth from Zepbound and Mounjaro. U.S. price declined 7%, including the impact of previously announced direct-to-patient pricing for Zepbound. He noted a “one-time adjustment to estimates for rebates and discounts” that positively impacted price, primarily for Zepbound and Mounjaro; excluding that adjustment, U.S. price would have declined 10%.
In cardiometabolic health, Montarce said combined global revenue for Mounjaro and Zepbound was $12.8 billion, representing $6.7 billion of growth versus Q1 2025. In the U.S. incretin-analog obesity market, total prescriptions grew “over 80%” in Q1, with Zepbound prescriptions growing faster, he said. However, Montarce said “the loss of Medicaid access in certain states had a negative impact on Q1 prescription growth in the high single digits.”
Yuffa said self-pay remained a major channel for Zepbound, accounting for approximately 45% of total prescriptions in Q1 and 55% of new prescriptions. Ricks and the team also discussed the evolving digital channel, with Ricks saying consumer-driven digital platforms are “here to stay,” while Yuffa said that for Foundayo’s early launch, about “45%” of volume was coming through LillyDirect.
On international demand, President of Lilly International Patrik Jonsson said Mounjaro had “fully launched in more than 55 countries” with rapid uptake and share gains, including estimated share around “60%” in markets launched in the second half of 2025 such as Brazil and Korea. Jonsson also addressed early data from India following generic semaglutide entry, saying it appeared to stimulate overall market growth, while Mounjaro prescriptions were “about 10% higher” in recent weeks than before generics entered.
Ricks responded to investor questions on incretin pricing by emphasizing a relationship between price reductions and volume expansion, noting that in this category out-of-pocket spending can be significant and demand may be more price sensitive than in other pharmaceutical markets. He also said unit economics are influenced heavily by fixed costs, giving Lilly “latitude” at the margin, while the company continues to invest in its pipeline.
Pipeline milestones and business development activity
Ricks and Chief Scientific and Product Officer Dr. Daniel Skovronsky pointed to multiple clinical and regulatory developments across Lilly’s four therapeutic areas. In cardiometabolic health, Skovronsky discussed positive top-line results from ACHIEVE-4, which evaluated Foundayo versus insulin glargine on cardiovascular outcomes in adults with type 2 diabetes and obesity or overweight at increased cardiovascular risk. He said Foundayo met the primary endpoint of non-inferiority, showing a “16% lower risk of MACE-4 events,” and met a secondary endpoint with a “23% lower risk of MACE-3 events.” Skovronsky also cited a pre-planned analysis (not controlled for multiplicity) indicating a survival advantage of “57%” versus insulin glargine. He added that no hepatic safety signal was observed across the registrational program.
Skovronsky said Lilly plans to complete its U.S. submission for type 2 diabetes for Foundayo in “late Q2” and anticipates regulatory action “before the end of this year.” Ricks also said regulatory reviews are ongoing in “over 40 countries” for obesity and type 2 diabetes.
In addition, Skovronsky highlighted positive top-line phase III data for retatrutide in type 2 diabetes (TRANSCEND-T2D1), including A1C reductions of “1.7 to 2.0 percentage points” and weight loss of “11.1 kg to 16.6 kg.” He said discontinuation due to adverse events was “5% or less” across arms and that detailed results would be presented at the American Diabetes Association Scientific Sessions in June. He added that a key upcoming readout is TRIUMPH-1, an 80-week obesity study expected later in the quarter.
In immunology, Skovronsky discussed longer-term data for Ebglyss in atopic dermatitis, including durable disease control in an open-label extension study and positive phase III outcomes in children as young as six months old. He said Lilly expects regulatory action later this year on an Ebglyss maintenance regimen under FDA review.
In oncology, Skovronsky highlighted positive top-line results from BRUIN CLL-322, a phase III pirtobrutinib trial in previously treated CLL or SLL, and said Lilly plans to submit those results to regulators later this year. He also noted the initiation of a second phase III trial for sofetabart mipitecan in platinum-sensitive ovarian cancer.
Across neuroscience, Skovronsky said Lilly initiated a phase III program for brimapitide in major depressive disorder, as well as phase II trials in opioid use disorder and schizophrenia and phase II trials for two pain assets.
Ricks and Skovronsky also described a series of business development actions, including announced agreements to acquire Orna Therapeutics, Centessa Pharmaceuticals, Kelonia Therapeutics, and Ajax Therapeutics, and Skovronsky said Lilly completed its acquisition of Ventyx Biosciences. Ricks said Lilly expects to remain active in business development while maintaining “discipline to create shareholder value.”
Access initiatives: Medicare Bridge and Employer Connect
Management discussed two access initiatives highlighted by Ricks. First, Lilly launched Lilly Employer Connect, which Ricks described as a platform aimed at helping employers offer obesity management medicines. Yuffa said employer coverage for obesity drugs has been “pretty steady around 50%,” and that Employer Connect offers a transparent price and flexibility in benefit design. He cautioned that the selling cycle for 2026 decisions has largely passed, so the impact may be “gradual” in the back half of 2026, with “incremental opt-ins for 2027.”
Second, executives addressed the extension of the Medicare GLP-1 Bridge program. Ricks said the program will begin no later than July 1, 2026, and run through December 2027, capping out-of-pocket costs at $50 per month. Yuffa said Lilly expects a “gradual path in 2026” with continued growth in 2027 as education and adoption build, adding that the company has seen “great persistency” for Zepbound and Mounjaro and expects affordability to support persistence among seniors.
Ricks also said the extended Bridge timeline sets up a discussion about “normalizing obesity care” within Medicare Part D in 2028, suggesting additional developments could emerge as the program progresses.
About Eli Lilly and Company (NYSE:LLY)
Eli Lilly and Company (NYSE: LLY) is a global pharmaceutical company founded in 1876 and headquartered in Indianapolis, Indiana. The company researches, develops, manufactures and commercializes a broad range of medicines and therapies for patients worldwide. Eli Lilly maintains operations and commercial presence across North America, Europe, Asia and other regions, serving both developed and emerging markets. The company has been led in recent years by President and Chief Executive Officer David A.
