Eli Lilly on Wednesday issued a 2026 profit and sales outlook that surpassed analyst expectations, attributing the stronger forecast to accelerating demand for its obesity drugs despite intensifying price pressure.
The U.S. drugmaker predicted 2026 adjusted earnings of $33.50 to $35.00 per share, with the bottom of that range above the average analyst forecast of $33.23, according to LSEG data. Lilly also projected full-year revenue of $80 billion to $83 billion, well ahead of the Wall Street estimate of $77.62 billion.
Investors reacted positively to the guidance, with shares of the company rising more than 8% in premarket trading. The company has been a dominant force in the expanding obesity market, becoming the first pharmaceutical firm to reach a $1 trillion valuation last year as sales of its branded weight-loss treatment grew rapidly.
Quarterly results that underpinned the outlook
For the fourth quarter, Lilly reported adjusted earnings of $7.54 per share, above the $6.67 that analysts were expecting. Revenue for the quarter reached $19.3 billion, topping the consensus estimate of $17.96 billion.
Key product lines contributed materially to the quarter. Sales of the diabetes treatment Mounjaro, which shares its active ingredient with Lilly's weight-loss brand Zepbound, were $7.41 billion in the quarter versus analysts' expectations of $6.63 billion. Zepbound itself generated $4.3 billion in quarterly sales, above the $3.41 billion estimate.
The company said U.S. sales of Zepbound were driven by increased volume even as some price reductions took effect. International sales of Mounjaro were likewise described as volume-led.
Pricing agreements and market differences
Investor attention has shifted to how Lilly will manage the pricing environment after reaching an agreement with the U.S. government that included steep price reductions for its obesity treatments for Medicare, Medicaid and for some cash-paying customers. That arrangement has left market observers watching for the effect on revenue per patient.
Analysts and market participants noted that Lilly's situation is not identical to that of some competitors. As BMO Capital Markets analyst Evan Seigerman said, "reminds us that while Lilly and Novo play in the same markets, the pressures they face are not identical."
For its part, competitor Novo Nordisk earlier warned of "unprecedented" pricing pressure in 2026, including in the U.S., and forecast a significant sales decline for the year. Novo indicated its U.S. agreement will reduce revenue by about 2% to 4% this year. Lilly, by contrast, said higher patient volumes should help blunt the impact of similar pricing concessions.
Retail and cash-pay pricing trends
The retail price landscape for leading injectable weight-loss medicines has shifted sharply from initial pharmacy list prices. Products that initially sold for roughly $1,000 per month at U.S. pharmacies are now being offered on company sites starting in the $199 to $299 per month range following political and commercial measures to lower consumer costs.
In the daily oral market, Novo has begun selling lower-dose versions of its pill in the U.S. at $149 per month, with that starting price set to rise to $199 from April. Lilly has announced that, if approved, it would cap the price of higher doses of its oral obesity candidate at $399 per month for repeat cash-paying patients.
Pipeline developments and product cadence
Looking ahead, market attention is also focused on Lilly's oral obesity candidate, orforglipron, which is under U.S. Food and Drug Administration review with a decision expected in April. The potential approval and launch of an oral therapy are viewed within the company as a significant future growth driver. Novo has also entered the oral space with its own pill version of Wegovy.
Cantor analyst Carter Gould commented on Lilly's updated guidance, saying, "The high-end, the low-end, the narrower guide - all of it - express a far more confident view of the market than most of the Street were anticipating."
Outlook considerations
Lilly's updated 2026 forecast and its stronger-than-expected quarterly results highlight a market where volume expansion appears capable of offsetting some price reductions. Yet the company remains exposed to continuing pricing pressure linked to government agreements and competitive pricing actions in both injectable and oral formats.
As the obesity treatment market evolves, observers will be watching how volume growth, price concessions, and the timing of new product launches interact to shape revenue and profitability for Lilly and its peers.