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Eli Lilly’s latest earnings report has sent a clear signal to markets: the company is emerging as the dominant force in the booming GLP-1 weight-loss and diabetes drug market. While rival Novo Nordisk is warning of falling sales and mounting pricing pressure, Lilly is forecasting robust growth into 2026, underpinned by soaring demand for Zepbound and Mounjaro and the anticipated launch of its oral obesity pill.
The contrast between the two pharmaceutical giants could hardly be any sharper.
Eli Lilly comfortably exceeded Wall Street expectations in the fourth quarter, delivering adjusted earnings per share of $7.54 versus forecasts of $6.67. Revenue climbed to $19.29 billion, well ahead of the $17.96 billion analysts expected and up 43% from the same period last year.
The strength of the quarter was driven primarily by surging volumes of Mounjaro, Lilly’s blockbuster diabetes treatment, and Zepbound, its fast-growing obesity drug. Combined, the two products continue to support Lilly’s growth trajectory.
The real surprise came from Lilly’s forward guidance. The company expects full-year revenue of between $80 billion and $83 billion in 2026, comfortably above consensus estimates of roughly $77.6 billion. Adjusted earnings are forecast at $33.50 to $35 per share, with even the lower end exceeding Wall Street expectations.
At the midpoint, Lilly’s guidance implies revenue growth of around 25% this year, a particularly strong outlook at a time when pricing pressure across the pharmaceutical industry are mounting.
By contrast, Novo Nordisk has warned that its sales and profits could fall by as much as 13% in 2026, citing lower U.S. prices and the expiry of exclusivity for key products in major international markets. The divergent outlooks underline how differently the two companies are positioned despite operating in the same therapeutic space.
Sales figures for Lilly’s flagship GLP-1 drugs highlight why the company’s confidence appears well founded. Mounjaro generated $7.41 billion in revenue in the fourth quarter, significantly above expectations and more than doubling year-on-year. U.S. sales alone reached $4.1 billion, driven by strong prescription growth despite lower realised prices.
Zepbound posted $4.3 billion in quarterly sales, well ahead of forecasts, as robust demand more than offset price reductions. Internationally, sales of Mounjaro used for both diabetes and weight loss outside the U.S. were similarly fuelled by rising patient uptake.
By the end of the fourth quarter, Lilly’s share of the U.S. obesity and diabetes drug market had climbed to 60.5%, up from 57.9% the previous quarter. Novo Nordisk’s market share stood at just over 39%, underscoring Lilly’s expanding lead.
Despite the strong outlook, Lilly has been clear that pricing will act as a headwind. The company expects global pricing to decline by a low- to mid-teens percentage, driven largely by its agreement with the U.S. government to lower obesity and diabetes drug prices for Medicare and Medicaid patients.
Additional pressure will come from updated direct-to-consumer pricing and lower Medicaid prices for older products. Both Lilly and Novo have already reduced the cash price of their weight-loss drugs from around $1,000 per month to a range of $199 to $299, following political pressure to improve affordability.
Crucially, Lilly believes higher patient volumes will more than compensate for lower prices. Management has emphasised that expanding access, particularly through expected Medicare coverage of obesity treatments could significantly increase the eligible patient pool in the U.S.
Another key driver of investor optimism is Lilly’s oral obesity pill, orforglipron. The drug is currently under FDA review, with a regulatory decision expected in April. Lilly plans to launch the pill in the U.S. in the second quarter if approved, with international markets following in 2027.
Novo Nordisk has already rolled out an oral version of Wegovy at a starting price of $149 per month, rising to $199 later this year. Lilly sees this early uptake as validation rather than a threat. Management has argued that a substantial segment of patients has been waiting for a pill-based option, suggesting the market could expand rather than fragment.
If approved, Lilly has said it intends to cap the price of higher doses of its pill at $399 per month for repeat cash-paying patients, reinforcing its push into the rapidly growing direct-to-consumer segment.
Source: TradingView. LLY daily price chart as of 04 February 2026.
Markets responded swiftly to Lilly’s earnings and guidance, with shares jumping more than 10% after the earnings release. Lilly’s market capitalisation has now surpassed $1 trillion, making it the first pharmaceutical company to reach that milestone. Given Lilly’s strong earnings results and guidance, we raise our 12 month price target to $1,350.
While Lilly and Novo operate in the same markets, the pressures they face are not identical. Where Novo is grappling with expiring exclusivity and sharper near-term revenue declines, Lilly is benefiting from product momentum, market share gains and a pipeline that continues to excite investors.
Eli Lilly’s latest earnings report highlights how quickly leadership can change in one of the most competitive and lucrative segments in the pharmaceutical industry. Robust demand for Zepbound and Mounjaro, growing confidence in the company’s long-term growth trajectory, and a credible approach to managing pricing pressures have helped Lilly distinguish itself at an important moment.
While pricing headwinds are real and unavoidable, Lilly’s results suggest that volume growth, market expansion and innovation, particularly in oral GLP-1 therapies may ultimately prove more powerful forces. In the global race to dominate obesity and diabetes treatment, Eli Lilly is not just keeping pace, it is pulling ahead.
Professional investors looking for magnified exposure to Eli Lilly may consider Leverage Shares +3x Long Eli Lilly ETP or -3x Short Eli Lilly
Websim is the retail division of Intermonte, the primary intermediary of the Italian stock exchange for institutional investors. Leverage Shares often features in its speculative analysis based on macros/fundamentals. However, the information is published in Italian. To provide better information for our non-Italian investors, we bring to you a quick translation of the analysis they present to Italian retail investors. To ensure rapid delivery, text in the charts will not be translated. The views expressed here are of Websim. Leverage Shares in no way endorses these views. If you are unsure about the suitability of an investment, please seek financial advice. View the original at
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