LLY · Q1 2026 Earnings

Bullish

Eli Lilly

Reported April 30, 2026

30-second summary

30-second take: Lilly opened FY2026 with $19.8B in Q1 revenue (+56% YoY) and non-GAAP EPS of $8.55 (+156% YoY) — both prints driven by Mounjaro ($8.66B, +125%) and Zepbound ($4.16B, +80% YoY). Management raised FY2026 revenue guidance by $2B to $82–85B, non-GAAP EPS by $2.00 to $35.50–37.00, and performance margin by 100bps to 47.0–48.5%, with Lucas attributing the raise on the call to the strong underlying performance of Mounjaro and Zepbound in Q1 rather than embedded Foundayo contribution. The FDA approval of Foundayo — the only oral GLP-1 without food/water restrictions — landed in-quarter with broad pharmacy availability beginning April 9, but the meaningful financial impact is a 2027 story given the gradual Medicare ramp from July 1, 2026.

Headline numbers

EPS

Q1 FY2026

$8.55

+25.9% vs est.

Revenue

Q1 FY2026

$19.80B

+56.0% YoY

+11.2% vs est.

Gross margin

Q1 FY2026

81.9%

Operating margin

Q1 FY2026

45.1%

Key financials

Q1 FY2026

Metric	Q1 FY2026	YoY	Q4 FY2025	QoQ
Revenue	$19.80B	+56.0%	$19.29B	+2.6%
EPS	$8.55	—	$7.54	+13.4%
Gross margin	81.9%	—	82.5%	-60bps
Operating margin	45.1%	—	43.4%	+170bps

Guidance

Eli Lilly raised full-year FY2026 revenue guidance by $2B to $82–$85B and non-GAAP EPS by $2.00 to $35.50–$37.00, with Performance Margin expanded 100bps to 47–48.5%, reflecting exceptionally strong Q1 delivery (56% YoY revenue growth, EPS +26% surprise) driven by GLP-1 blockbuster momentum and new regulatory wins.

Guidance is issued for the full year only, refreshed each quarter. Prior and new below are the same FY updated this quarter.

Changes to prior guidance

Metric	Period	Prior guide	New guide	Δ	Result
Revenue	FY2026	$80.0B to $83.0B	$82.0B to $85.0B	+$2.0B (low and high both raised)	Raised
Non-GAAP EPS	FY2026	$33.50 to $35.00	$35.50 to $37.00	+$2.00 (low and high both raised)	Raised
Performance Margin	FY2026	46.0% to 47.5%	47.0% to 48.5%	+100bps (both low and high raised)	Raised

Reaffirmed unchanged this quarter: Tax Rate (18% to 19%)

Segment KPIs

Q1 FY2026

Segment	Q1 FY2026	YoY
Mounjaro	$8.662B	+125.0%
Zepbound	$4.16B	+80.0%
Key Products	$13.4B	+160.0%
Jaypirca	$0.165B	+79.0%
Ebglyss	$0.145B	+141.0%

Other KPIs

Q1 FY2026

Segment	Q1 FY2026	YoY
U.S. Revenue	$12.1B	+43.0%
International Revenue	$7.7B	+81.0%
Volume Growth	65%	—
Realized Price Change	-13%	—
R&D Expense	18% of revenue	—
U.S. Volume Growth	49%	—
International Volume Growth	95%	—
Effective Tax Rate (Non-GAAP)	16.5%	—
Non-GAAP Gross Margin	82.6%	—
Operating Income Growth	141%	—

Management tone

Q2 ATTAIN-1 readout / "price to value" → Q3 Orforglipron "foundational" / submission imminent → Q4 platform confidence and 2026 launch year → Q1 FY2026 Foundayo commercial reality.

The narrative arc has now completed the full pivot from clinical optionality to commercial execution. In Q2 2025 management framed orforglipron through trial readouts; in Q3 through regulatory submission; in Q4 through 2026 launch planning; this quarter it is a product called Foundayo, broadly available in pharmacies since April 9th, available on 12+ major telehealth platforms, with commercial access at two of three largest U.S. PBMs by mid-May and Medicare access landing no later than July 1. The shift from "we have the data" to "we have the prescribers" is the most important framing change of the post-ATTAIN-1 arc.

Dave Ricks's framing of obesity economics as fundamentally different from traditional pharma — "75% of ex-U.S. obesity business is out-of-pocket, volume expansion is often nonlinear to price reductions, fixed costs are either sunk or unmovable" — is a sharper, more confident statement of the margin-resilience thesis than the Q2 "price to value" hedge or the Q3 welcome of the Cigna GPO-fee shift. The framing is now that price erosion is an input that drives volume expansion that more than offsets it, not a risk to be managed.

Patrik Jonsson's commentary that Mounjaro prescriptions are "10% higher post-generic semaglutide entry in India" reframes generic competition from a threat into a market-expansion event. This is materially more confident than the cautious framing of Canadian generic semaglutide in Q2. The implicit thesis: generics legitimize the category and grow the pie faster than they steal share from differentiated assets.

Ken Custer's segmentation framework — Retatrutide for "greater weight loss seekers," Aloralintide for non-GLP-1 mechanism seekers or add-on, Foundayo for oral-preferring patients, all sharing common manufacturing platforms — is the most detailed articulation yet of the multi-asset strategy. The Q3 framing was "best molecule or first molecule or both" against logical targets; the Q1 FY2026 framing names the targets and assigns assets. The peak-penetration risk that has dogged investor sentiment is being explicitly answered with portfolio segmentation rather than denied.

Q&A highlights

Jeff Meacham · Citi

How do margins perform under different price scenarios for incretin medicines, and how do manufacturing investments and cost structures affect competitive positioning?

Dave Ricks explained that obesity medicines have different economics than traditional pharma due to high out-of-pocket costs driving volume expansion from price reductions. Unit economics are driven by fixed/sunk costs, providing margin latitude at the margin. The company has flexibility to invest in future medicines while maintaining profitability, noting the obesity category operates differently from other pharmaceutical categories.

75% of ex-U.S. obesity business is out-of-pocketVolume expansion is often nonlinear to price reductionsFixed costs are either sunk or unmovable depending on volumeRecord load of Phase III pipeline at Lilly

Chris Schott · J.P. Morgan

What learnings from the better-than-expected international Monjaro launch apply to future ramps, and how will generic semaglutide entry impact growth trajectories?

Patrick Gonson reported Monjaro has launched in 55+ countries with strong uptake and rapid market share gains (60% in Brazil/Korea launched H2 2025). Generic semaglutide in India is stimulating overall market growth; Monjaro prescriptions are 10% higher post-generic entry. Dual agonist advantage over single agonist is holding, with 53% average OUS market share. Future growth will be driven by patient activation as share gains become harder at high penetration levels.

55+ countries with full Monjaro launch60% market share in Brazil and KoreaMonjaro prescriptions 10% higher post-generic semaglutide entry in India53% average market share outside U.S.

Seamus Fernandez · Guggenheim

How will the obesity market segment with introduction of Retatrutide, Fundayo, and other next-generation assets, and where does each medicine fit in the patient spectrum?

Ken Custer outlined market segmentation strategy across billions of patients with different needs. Retatrutide targets patients seeking greater weight loss. Aloralentide positioned for patients seeking non-GLP-1 mechanisms due to tolerability concerns or as add-on therapy. Company also investing in less-frequent dosing, additional metabolic benefits, and genetic medicine approaches. Most ideas tied to common manufacturing platforms; market penetration percentages difficult to predict but company has leading position across approaches.

Billions of patients globally with overweight/obesity seeking different medicine optionsRetatrutide positioned for greater weight loss seekersAloralentide for non-GLP-1-mechanism seekers or add-on therapyInvestments in less-frequent dosing, metabolic benefits, genetic approaches

Alex Hammond · Wolf Research

What is the strategy for activating Medicare patients under the extended Bridge Program (July 2026-December 2027), and when will impact be realized in financials?

Ilya Yufa described a gradual activation path starting July 2026 through 2027, requiring education across physicians, pharmacies, and consumers. The $50/month copay is a key affordability lever. Historical data shows strong persistence for ZepFound and Monjaro relative to other chronic conditions. Patient education and provider familiarity will take time; significant growth expected 2027 rather than 2026, with millions of beneficiaries creating long trajectory.

Medicare access begins July 1, 2026, runs through December 2027$50/month copay for eligible seniorsGradual activation path expected 2026, continued growth 2027Strong historical persistence for ZepFound and Monjaro

Asad Hyder · Goldman Sachs

What is confidence level in Fundayo launch curve framing given early experience, and what Fundayo contribution is embedded in revised 2026 guidance?

Ilya Yufa reported encouraging early metrics: 8,000+ prescribers (one-third new to oral GLP-1), 20,000+ patients treated (80% new to class), positive HCP sentiment on efficacy and daily convenience. Three growth catalysts on track: HCP familiarity building, commercial access confirmed at 2 of 3 major PBMs by mid-May, Medicare access July 1. Full DTC launch planned Q3. Lucas noted guidance increase driven primarily by strength of entire portfolio (especially cardiometabolic); Fundayo three weeks into launch and tracking to plan but still too early to quantify specific contribution.

8,000+ prescribers of Fundayo; one-third new to oral GLP-120,000+ patients treated; 80% new to classCommercial access confirmed at 2 of 3 largest PBMs by mid-MayMedicare access begins July 1, 2026

Answers to last quarter's watch list

Orforglipron Q1 launch metrics — Resolved positively. Foundayo (the commercial name for orforglipron) launched with broad pharmacy availability on April 9 and 12+ telehealth platforms. Commercial access confirmed at two of three largest PBMs by mid-May; full DTC TV launch planned Q3.

Resolved positively

Medicare access ramp — Continue monitoring. Effective date confirmed at no later than July 1, 2026 with the $50/month copay intact. Yufa explicitly framed 2026 as a gradual activation year with the meaningful financial contribution arriving in 2027, which is more conservative than the "shift relatively quickly" Q4 framing. The thesis is intact but the timing is back-loaded.

Continue monitoring

International revenue base — Resolved positively. International revenue printed $7.7B in Q1 (+81% YoY) with international volume growth of 95% confirming the post-NRDL China demand pattern has stabilized into broad-based acceleration; Jonsson's Brazil/Korea 60% share and 10% Mounjaro lift post-Indian generic entry confirm the resilience thesis.

Resolved positively

FY2026 performance margin progression — Resolved positively. Operating income growth of 141% supported a 100bps raise to the FY non-GAAP performance margin guide (now 47.0–48.5%). The "front-loaded launch spend" concern did not compress margins; operating leverage is arriving faster than the prior guide assumed.

Resolved positively

Pricing dynamics on cash channel — Continue monitoring. Realized price fell 13% in Q1, but volume of +65% more than absorbed it. Ricks's framing that volume expansion is "nonlinear to price reductions" is the new bull-case framework; Jonsson's "Mounjaro prescriptions 10% higher post-generic semaglutide entry in India" data point materially de-risks the Canadian generic semaglutide concern. The dynamics are resolving favorably but the cash-channel realized-price line bears continued tracking, with Lucas guiding full-year price headwind in the low-to-mid teens.

Continue monitoring

What to watch into next quarter

Foundayo prescriber and patient curve through Q2 — With the Q3 DTC TV launch ahead, PBM access locking in by mid-May, and Medicare activation by July 1, watch whether prescription and patient metrics begin to scale materially into the Q2 print.

Foundayo contribution embedded in any further guide raise — The current raise is driven by Mounjaro/Zepbound, not Foundayo, per management's call commentary. Watch whether the Q2 guide raise (if any) starts to formally include a Foundayo line, which would signal management has commercial visibility worth underwriting.

International revenue durability above $7.7B — Q1 international revenue +81% YoY; watch whether Q2 sustains the run-rate or shows the seasonality Jonsson flagged around European holiday breaks. A second straight $7B+ quarter ratifies the global launch thesis.

Medicare access activation signal through H2 — July 1 effective date means Q2 reports near-zero contribution, but Yufa's "millions of beneficiaries, significant 2027 growth" framing sets up Q3 as the first measurable read on the Part D ramp. Watch for any disclosure on Medicare-eligible patient mix in Q2 commentary.

Realized price trajectory — Q1 realized price -13%; full-year guide assumes low-to-mid teens headwind. Watch whether the trend stabilizes within that range or continues to widen, and whether the India Mounjaro post-generic data point sustains as more markets see generic semaglutide entry.

Sources

Eli Lilly Q1 FY2026 earnings press release (SEC Form 8-K exhibit): https://www.sec.gov/Archives/edgar/data/59478/000005947826000043/q126lillysalesandearningsp.htm
Eli Lilly Q1 FY2026 earnings call Q&A
Tapebrief Q4 2025, Q3 2025, and Q2 2025 LLY briefs (internal)

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