Eli Lilly Q1 2026: Incretin Sales Hit $12.8B, Guidance Raised by $2B (LLY Q1 2026 Earnings Call)

Incretin Portfolio Drives Explosive Growth

Eli Lilly started 2026 with historic financial performance, reporting a massive 56% year-over-year increase in first-quarter revenue. This staggering growth was almost entirely fueled by the company's cardiometabolic franchise. The combined global revenue for Mounjaro (tirzepatide for diabetes) and Zepbound (tirzepatide for obesity) reached an incredible $12.8 billion in the quarter, representing $6.7 billion of absolute growth compared to Q1 2025. In the U.S., total prescriptions in the incretin anti-obesity market grew by over 80%. Bolstered by this underlying momentum, Eli Lilly raised its full-year 2026 revenue guidance by a massive $2.0 billion to a new range of $82.0 billion to $85.0 billion, which represents 28% growth at the midpoint. Non-GAAP earnings per share (EPS) for the first quarter was $8.55, and the company raised its full-year EPS guidance by $2.00 to a new range of $35.50 to $37.00.

Launching Foundayo: The First Oral GLP-1 for Obesity

A major milestone in the quarter was the U.S. FDA approval and rapid launch of Foundayo (orforglipron), Eli Lilly's novel oral non-peptide GLP-1 receptor agonist. Approved specifically for weight management, Foundayo offers the profound benefits of injectable GLP-1 therapies in a convenient daily pill without food or water restrictions. This marks the first time an incretin therapy has been launched with an obesity indication before diabetes. Management noted highly encouraging early launch dynamics, with over 20,000 patients treated to date (80% of whom are new to the incretin class) and commercial access already confirmed at two of the three largest U.S. pharmacy benefit managers. Beyond obesity, Lilly also reported data from the Phase III ACHIEVE trials demonstrating Foundayo's cardiovascular safety and its ability to lower the risk of all-cause death in adults with type 2 diabetes. The company plans to submit Foundayo for type 2 diabetes approval in the U.S. later this quarter.

Next-Generation Pipeline Breakthroughs

Lilly continues to aggressively advance its next-generation cardiometabolic pipeline. The company reported highly anticipated Phase III results from the TRANSCEND T2D-1 trial for retatrutide, its GIP/GLP-1/glucagon receptor triple agonist. In adults with type 2 diabetes, retatrutide lowered A1C by up to 2.0 percentage points while driving remarkable average weight loss of 11.1 to 16.6 kilograms (25 to 37 pounds), matching the glycemic control of tirzepatide but delivering significantly greater weight reduction. Outside of cardiometabolic health, Lilly reported positive Phase III data for Jaypirca (pirtobrutinib) in combination with a fixed-duration regimen in previously treated chronic lymphocytic leukemia (CLL). Notably, Jaypirca became the first medicine in history to outperform a venetoclax-containing control arm in a Phase III CLL trial, positioning it as a foundational therapy in blood cancers.

Aggressive Business Development and Access Expansion

Capitalizing on its massive cash generation, Eli Lilly was highly active in business development during the first quarter, announcing agreements to acquire four distinct clinical-stage companies. These include Orna Therapeutics (in vivo CAR-T for autoimmune diseases), Syntessa Pharmaceuticals (orexin receptor agonists for sleep disorders), Colonia Therapeutics (in vivo CAR-T for multiple myeloma), and Ajax Therapeutics (next-generation JAK2 inhibitors). On the patient access front, Lilly launched "Employer Connect," a new platform designed to help employers offer transparent, flexible obesity management coverage to their employees. Furthermore, the company highlighted the extension of the Medicare GLP-1 "Bridge Program" through December 2027, which will provide access to obesity medicines for millions of seniors while capping their out-of-pocket costs at $50 per month starting in July.