Eli Lilly and Co. (LLY) reported first-quarter adjusted earnings per share of $4.62 on Wednesday, beating the $4.44 consensus, as the GLP-1 franchise continued its dominance of the global obesity and diabetes treatment markets. Total revenue of $16.4 billion grew 31% year-on-year and topped the $15.8 billion estimate. Adjusted operating margin expanded to 41.2% from 38.4% in the year-ago quarter.
The Mounjaro (tirzepatide for type 2 diabetes) and Zepbound (tirzepatide for chronic weight management) franchises combined for $14.2 billion of revenue, up 47% year-on-year, with Zepbound at $7.4 billion (+62%) and Mounjaro at $6.8 billion (+34%). Tirzepatide is now the highest-revenue prescription medicine in pharmaceutical industry history within its second full year of dual-indication launch. The Wegovy/Ozempic franchise from Novo Nordisk delivered approximately $11.4 billion of combined revenue in the same period.
Guidance Raise and Pipeline Updates
CFO Anat Ashkenazi raised the full-year 2026 revenue guidance to $61-$63 billion from the prior $58-$60 billion, and lifted the adjusted EPS guide to $19.20-$19.80 from $18.40-$19.00. The capital expenditure forecast was held at $9-$10 billion, with the Cleveland, Mooresville, and Indianapolis tirzepatide manufacturing facilities each expected to reach steady-state production by mid-2027. Total tirzepatide capacity at year-end 2026 is now projected to support $80 billion of annualized peak revenue.
CEO Dave Ricks used the post-results call to update the next-generation pipeline. Orforglipron — the once-daily oral GLP-1 — is now in front of the FDA for both type 2 diabetes and obesity, with a PDUFA action date of August 31, 2026. Retatrutide, the triple-receptor agonist showing 24% mean weight loss in phase 3, is on track for a Q4 2026 BLA submission. The amylin/calcitonin compound, a potential muscle-preserving combination, enters phase 3 in Q3 2026.
Stock Reaction and Sector
Eli Lilly shares rose 3.4% in pre-market trade Thursday to $782.40. Novo Nordisk (NVO) ADRs traded up 1.6% in sympathy. The SPDR S&P Pharmaceuticals ETF (