Eli Lilly and Company (NYSE:LLY) executives highlighted strong 2025 performance, continued demand for its incretin medicines, and an expanding late-stage pipeline during the company’s Q4 2025 earnings conference call. Management also outlined 2026 financial guidance that anticipates higher revenue despite expected pricing pressure tied to access initiatives and reimbursement dynamics.
2025 results and Q4 performance
Chair and CEO Dave Ricks called 2025 “a strong year” for Lilly, citing robust revenue growth, pipeline advancement, and manufacturing expansion. CFO Lucas Montarce said full-year revenue was $65.2 billion, up 45% versus 2024, while earnings per share increased 86% to $24.21.
On a non-GAAP basis, the company’s performance margin was 47.2%, up 4.2 percentage points year over year. Lilly reported an effective tax rate of 19.7% and Q4 EPS of $7.54, which included $0.52 of acquired IPR&D charges (versus $5.32 in Q4 2024, including $0.19 of acquired IPR&D charges).
Key product trends: incretins, neuroscience, immunology, and oncology
Montarce said the company’s key products contributed over $13 billion in revenue in the quarter and grew 91% compared to Q4 2024. He described growth in the U.S. as volume-driven but partially offset by a 7% price decline in the quarter, while volume growth outside the U.S. was aided by launches of Mounjaro in new markets.
Among notable product updates discussed on the call:
- Kisunla: Montarce said Kisunla became the U.S. market leader among amyloid-targeting therapies with more than 50% share of total prescriptions, generating $109 million in revenue.
- Omvoh: Global revenue increased 55% compared to the fourth quarter of 2024, according to Montarce.
- Jaypirca: Global sales grew 30% year over year. Montarce noted an expanded U.S. indication for patients previously treated with a covalent BTK inhibitor.
- Verzenio: Global sales increased 3%, driven by volume growth outside the U.S., though Montarce said overall market penetration in the U.S. has plateaued.
- Zepbound and Mounjaro: In the U.S., Lilly said the combined incretin analog market continued to grow, with total prescriptions up 33% versus Q4 2024. Zepbound revenue in the U.S. more than doubled year over year and held nearly 70% share of new prescriptions in the branded obesity market. Lilly also said Zepbound vials represented about one-third of total Zepbound prescriptions and nearly 50% of new Zepbound prescriptions in Q4. In type 2 diabetes, Lilly said Mounjaro exited the quarter with over 55% of new prescriptions in the U.S. incretin market.
2026 guidance: higher revenue, but pricing expected to be a drag
For 2026, Lilly guided to revenue of $80 billion to $83 billion, implying 25% growth at the midpoint. Montarce said the outlook reflects “industry-leading volume growth” from key products, partially offset by lower realized prices. Price is expected to be a drag in the low to mid-teens, with three primary U.S. drivers cited: the government access agreement for obesity medicines, updated direct-to-patient Zepbound pricing, and lower Medicaid prices for later lifecycle medicines.
Outside the U.S., the company expects pricing to be impacted by Mounjaro’s inclusion on China’s National Reimbursement Drug List for type 2 diabetes. Montarce argued that the price concessions are expected to be offset over time by volume as access expands.
Lilly expects its non-GAAP performance margin to be between 46% and 47.5%. The company anticipates gross margin will be relatively stable to slightly down, while R&D and marketing/selling/admin expenses are expected to increase as Lilly supports a large pipeline and new launches. The company guided to 2026 EPS of $33.50 to $35.
Pipeline and clinical updates: Orforglipron, retatrutide, and combination studies
Chief Scientific and Product Officer Dr. Dan Skovronsky highlighted progress across therapeutic areas, including clinical and regulatory updates for Lilly’s incretin portfolio and oncology programs.
In cardiometabolic health, Skovronsky said Lilly announced positive topline results from the phase III MAINTAIN trial evaluating Orforglipron for weight maintenance after patients switched from injectable incretins. He said the study met all primary and secondary endpoints. Lilly has submitted Orforglipron to the FDA for obesity, with Skovronsky stating approval is expected in Q2, and said Lilly initiated a phase III cardiovascular outcomes trial and a phase III peripheral artery disease trial for Orforglipron. Montarce said the company expects Orforglipron to launch for chronic weight management in the U.S. during Q2 2026, with most international launches expected during 2027.
Skovronsky also discussed phase III results for retatrutide, noting that in the TRIUMPH-4 trial in adults with obesity and knee osteoarthritis, participants taking 12 mg lost an average of 29% of body weight at 68 weeks. He said the trial showed a 76% reduction in pain scores (a 4.5-point average reduction), with more than 1 in 8 treated patients completely free from knee pain at the end of the trial. Skovronsky said gastrointestinal events were most common and that discontinuation due to adverse events was higher among participants with lower baseline BMI, including perceived excessive weight loss.
In immunology, Lilly highlighted the phase III-B TOGETHER-PsA trial evaluating ixekizumab plus tirzepatide versus ixekizumab alone in patients with psoriatic arthritis and obesity. Skovronsky said the combination met its primary endpoint (at least 50% reduction in psoriatic arthritis activity plus 10% weight reduction) and showed a 64% relative increase in the proportion of patients achieving a 50% reduction in symptoms compared to ixekizumab alone. Lilly Immunology President Adrienne Brown said the company is also pursuing additional combination studies, including a psoriasis trial with top-line results expected in the first half of 2026, as well as studies in ulcerative colitis and Crohn’s disease examining concomitant use of Omvoh and Zepbound.
In oncology, Skovronsky said the FDA granted full approval for pirtobrutinib, including an expanded indication for relapsed or refractory CLL/SLL in adults previously treated with a covalent BTK inhibitor. He also highlighted phase III trial data presented at ASH and published in the Journal of Clinical Oncology, including BRUIN CLL-313 and BRUIN CLL-314, and said Lilly has submitted results to regulators to support potential earlier-line use.
Access initiatives, self-pay dynamics, and capital allocation
Ricks said Lilly reached an agreement with the U.S. government aimed at expanding access to obesity medicines through Medicare and Medicaid, describing an out-of-pocket cost of $50 per month for patients. During Q&A, management said Medicare access is expected to become effective no later than July 1, 2026, and Montarce noted that a portion of patients currently using Lilly’s direct business may transition into Medicare coverage.
Executives repeatedly pointed to the growing role of self-pay and direct-to-patient channels. Ricks said engagement with LillyDirect increased to over 1 million patients in 2025. Ilya Yuffa, president of Lilly USA and global customer capabilities, said Lilly ended 2025 with Zepbound coverage in two of the three large PBMs and highlighted the impact of affordability on uptake, referencing the $299 entry price for Zepbound vials and the company’s expectation that oral GLP-1s will be market-expansive.
Ricks also said Lilly returned capital to shareholders in 2025 through $1.3 billion in dividends and $1.5 billion in share repurchases, while continuing to invest in manufacturing and R&D. He said Lilly has committed over $55 billion to manufacturing expansion since 2020 and noted the company began producing medicine at new sites in Wisconsin and North Carolina, exceeding its goal to produce 1.8 times the number of incretin doses in the second half of 2025 versus the second half of 2024.
About Eli Lilly and Company (NYSE:LLY)
Eli Lilly and Company (NYSE: LLY) is a global pharmaceutical company founded in 1876 and headquartered in Indianapolis, Indiana. The company researches, develops, manufactures and commercializes a broad range of medicines and therapies for patients worldwide. Eli Lilly maintains operations and commercial presence across North America, Europe, Asia and other regions, serving both developed and emerging markets. The company has been led in recent years by President and Chief Executive Officer David A.
