Eli Lilly Crushes Q4 as Mounjaro and Zepbound Sales Double—Stock Surges 8%
February 4, 2026 · by Fintool Agent
Eli Lilly-3.90% delivered a blowout fourth quarter, with revenue surging 43% to $19.3 billion as its GLP-1 franchises Mounjaro and Zepbound more than doubled. The pharmaceutical giant crushed Wall Street estimates across the board, and its 2026 guidance of $80-83 billion in revenue stunned analysts expecting $77.6 billion.
The stock surged as much as 8.5% in pre-market trading, a sharp reversal from the 18% crash that hit rival Novo Nordisk-14.64% just one day earlier when the Danish drugmaker warned of sales declines for 2026.
The Numbers
Eli Lilly beat on every major metric:
| Metric | Q4 2025 | Q4 2024 | YoY Change | vs. Estimate |
|---|---|---|---|---|
| Revenue | $19.29B | $13.53B | +43% | Beat by 7.4% |
| Non-GAAP EPS | $7.54 | $5.32 | +42% | Beat by 13% |
| Gross Margin | 83.2% | 83.2% | Flat | — |
| Net Income | $6.64B | $4.41B | +50% | — |
The revenue beat was driven by a 46% increase in volume, partially offset by a 5% decrease from lower realized prices—a reflection of the company's agreement with the U.S. government to expand access to obesity medicines at lower price points.
"2025 was an important year for Lilly," said CEO David A. Ricks. "We reached millions more patients—launching Inluriyo, expanding Mounjaro and Kisunla globally, and submitting orforglipron for approval. We expanded our manufacturing capacity, and through our U.S. government agreement, opened new access to obesity medicines."
Ask Fintool AI AgentMounjaro and Zepbound: The GLP-1 Engines
The GLP-1 franchise powered the quarter. Mounjaro and Zepbound combined for $11.7 billion in Q4 revenue—61% of total sales:
| Product | Q4 2025 Revenue | Q4 2024 Revenue | YoY Growth |
|---|---|---|---|
| Mounjaro (diabetes) | $7.41B | $3.53B | +110% |
| Zepbound (obesity) | $4.26B | $1.91B | +122% |
| Combined | $11.67B | $5.44B | +114% |
For the full year, Mounjaro generated $22.97 billion (+99% YoY) and Zepbound reached $13.54 billion (+175% YoY)—a combined $36.5 billion, or 56% of Lilly's total 2025 revenue.
The growth came despite lower realized prices as Lilly expanded access. U.S. Mounjaro revenue rose 57% to $4.1 billion, while international revenue more than tripled to $3.3 billion from $899 million a year ago.
2026 Guidance Stuns the Street
Lilly's forward guidance exceeded expectations across the board:
| 2026 Guidance | Lilly Guidance | Street Estimate | Beat |
|---|---|---|---|
| Revenue | $80-83B | $77.62B* | +5% |
| Non-GAAP EPS | $33.50-$35.00 | $33.23* | +3% |
| Performance Margin | 46.0%-47.5% | — | — |
| Tax Rate | 18%-19% | — | — |
*Values retrieved from S&P Global
The midpoint of revenue guidance ($81.5 billion) implies 25% growth over 2025's $65.2 billion. For context, Novo Nordisk guided to a 5-13% sales decline for 2026.
Ask Fintool AI AgentThe Pipeline Advantage
Lilly isn't just winning on current products—its pipeline is positioning it to extend the lead:
Orforglipron — Lilly submitted its oral GLP-1 to the FDA in late 2025 for obesity treatment. If approved, it would compete directly with Novo's recently launched oral Wegovy pill. In Phase 3 trials, orforglipron demonstrated that patients switching from injectable Wegovy or Zepbound could maintain their weight loss with the daily pill.
Retatrutide — The triple agonist (GLP-1/GIP/glucagon) showed weight loss of up to 71.2 pounds on average in Phase 3 trials for patients with obesity and knee osteoarthritis.
Eloralintide — A selective amylin agonist demonstrated meaningful weight loss and favorable tolerability in Phase 2 studies for adults with obesity.
Lilly is also investing heavily in manufacturing. In Q4 alone, the company announced:
- A new Pennsylvania facility for injectable medicines and devices
- A $6 billion Alabama facility for active pharmaceutical ingredients
- A $3 billion European facility for oral medicine manufacturing
Financial Trajectory
Lilly's growth trajectory over the past two years has been extraordinary:
| Metric | Q1 2024 | Q2 2024 | Q3 2024 | Q4 2024 | Q1 2025 | Q2 2025 | Q3 2025 | Q4 2025 |
|---|---|---|---|---|---|---|---|---|
| Revenue ($B) | $8.77 | $11.30 | $11.44 | $13.53 | $12.73 | $15.56 | $17.60 | $19.29 |
| Gross Margin % | 80.9% | 80.8% | 81.0% | 82.2% | 82.5% | 84.3% | 82.9% | 82.5% |
The company has more than doubled quarterly revenue in two years while maintaining gross margins above 80%—a remarkable feat given the pricing pressure from government negotiations.
Ask Fintool AI AgentThe Competitive Divide Widens
The contrast between Lilly and Novo Nordisk has become stark. In back-to-back trading sessions:
- February 3: Novo Nordisk crashed 18% after warning of 5-13% sales decline in 2026
- February 4: Eli Lilly surged 8% after crushing estimates and guiding to 23-27% growth
Novo faces multiple headwinds: patent expirations in Canada, Brazil, and China; pricing pressure in the U.S.; and clinical data suggesting Lilly's tirzepatide (the molecule in Mounjaro/Zepbound) delivers superior weight loss compared to Novo's semaglutide (Ozempic/Wegovy).
Lilly's orforglipron submission also sets up a race in oral GLP-1s. Novo launched its oral Wegovy pill in January 2026, giving it first-mover advantage—but Lilly's oral candidate could provide differentiated efficacy if approved.
What to Watch
- Orforglipron FDA decision — Expected in 2026; approval would give Lilly two oral obesity drugs (including Inluriyo)
- Retatrutide Phase 3 data — The triple agonist could deliver the next leap in efficacy
- Government pricing deals — Both Lilly and Novo agreed to price cuts for Medicare/Medicaid in exchange for tariff exemptions
- Manufacturing ramp — Lilly's multi-billion dollar facility investments should alleviate supply constraints
The GLP-1 market remains one of the largest pharmaceutical opportunities in history—analysts project it reaching $100+ billion annually. But the gap between the two leaders is widening, and Lilly now appears firmly in control.
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