Eli Lilly Q3 Earnings: Mounjaro, Zepbound Push Outlook to $92B

A third raise in one year

Eli Lilly delivered another blowout quarter on Thursday, Oct. 29. It lifted its 2026 revenue forecast to $91 billion–$92 billion, up from $85 billion–$87 billion, as demand for its incretin drugs kept accelerating 12. This is the company's third guidance increase of the year 27. Third-quarter revenue rose 39% to $24.4 billion from $17.6 billion a year earlier 68.

Analysts had expected about $22.61 billion in revenue, according to LSEG figures 910. One outlet put consensus lower, at $22.42 billion 8. Adjusted earnings per share came in at $7.48, up from $7.02 6. Benchmarks for that figure also varied: one report cited a $6.26 estimate 9, another a $5.60 consensus 8. Either way, Lilly beat comfortably. Shares rose more than 4% in premarket trading 8.

Reported net income climbed 16% to $6.45 billion 3. Gross margin widened by a percentage point to 83.9% of revenue 8.

One molecule, two brands, most of the growth

The story is still tirzepatide, sold as Mounjaro for diabetes and Zepbound for obesity.

• Mounjaro: revenue jumped 65% to about $10.7 billion, from $6.52 billion a year earlier 26.
• Zepbound: sales rose to $5.35 billion from $3.59 billion 6. That beat the $5.09 billion analysts expected 2. Outlets rounded the growth rate to either 48% or 49% 28.
• Combined share of growth: one analysis estimated the two brands supplied about $6.0 billion of the $6.8 billion year-over-year revenue gain, or roughly 88% 7.

International expansion is a growing part of the picture. Mounjaro generated $5.7 billion outside the U.S., up 93%, and Lilly cited that as a factor in raising its forecast 5. U.S. revenue rose 34% to $15.1 billion, while non-U.S. revenue grew faster, up 47% to $9.3 billion 2. Overall incretin revenue increased 54%, which the company attributed to market expansion and rising global share 3.

Volume is beating price, for now

The headline growth hides a meaningful pricing squeeze. Worldwide volume rose 53%, while realized prices fell 15% 23. Pricing pressure was steeper outside the U.S. 6.

Part of that comes from Medicare's pilot obesity program, launched in July. Under it, eligible older and disabled Americans pay $50 a month. Lilly says the pilot has brought in more than 500,000 new customers 512. Historically, most of Lilly's non-reimbursed sales came through its $449-a-month cash-pay platform 12. That raises a question about how government channels will reshape the company's average selling price.

Reuters framed the quarter as something that could ease investor worries about price erosion in U.S. government plans 911. That reading looks right for now. A 53-point volume gain can absorb a 15-point price drop many times over. The open question is how long volume can keep compounding at that rate.

Caveats: Foundayo, one-offs and a trimmed EPS view

Not everything beat expectations.

• Foundayo: the oral GLP-1, launched in the U.S. in April, fell short of Wall Street forecasts 1. Reuters put the miss at about $30 million 5. That is small in dollar terms but worth watching, since an oral option is central to the case for broader market expansion.
• One-time benefits: revenue included about $900 million in favorable items 9. Those were mainly $410 million in Jardiance milestone payments, which Lilly says are the last it expects, plus adjustments to rebate and discount estimates 9.
• Lower EPS guidance: Lilly cut its full-year adjusted EPS outlook to $35–$36, from $35.50–$36.50 1. The cause is acquired in-process R&D charges of $4.57 per share tied to its AtaiBeckley and Curevo deals 210. Those charges more than offset a $4.07 improvement in underlying profit guidance at the midpoint 11.

One Carnegie Investment Counsel analyst dismissed the 50-cent reduction 5. That reaction seems reasonable, since the cut reflects dealmaking rather than weaker operations.

Outlets described the size of the revenue raise differently: "$5 billion" 5 versus "$5.5 billion" 6. The difference is simply midpoint math: $86 billion to $91.5 billion is a $5.5 billion increase.

The bigger picture

Lilly's lead over Novo Nordisk in the GLP-1 market has helped push its market value to about $1.2 trillion 511. The CEO argued there is still room for "dramatic" growth in the obesity market 1. Investors will be asking whether that pace can hold as Novo competes harder, and whether Foundayo's slow start is a blip or a warning 4.

This quarter suggests Lilly is trading price for reach, and winning that trade convincingly. The risks are durability and drug mix, not demand.