Eli Lilly (NYSE: LLY) reported Q4 2025 revenue of $19.29 billion, a 43% year-over-year increase that beat Wall Street estimates of $17.9 billion by more than $1.3 billion, according to the company's Q4 2025 earnings release. Adjusted earnings per share came in at $7.54, surpassing the consensus forecast of approximately $6.91, a beat of more than 9%. The results were powered by explosive growth in Mounjaro (+110% YoY) and Zepbound (+122% YoY), the company's two tirzepatide-based GLP-1 receptor agonist drugs, cementing Lilly's position as the dominant force in the obesity and type 2 diabetes drug market. Shares surged approximately 7-10% following the announcement on February 4, 2026.

What makes this quarter particularly significant for institutional investors is less the headline beat than the widening gap between Eli Lilly and its primary rival, Novo Nordisk (NYSE: NVO), which issued guidance for a 5-13% sales decline in 2026. The divergence in trajectories between the world's two largest GLP-1 players is reshaping portfolio positioning across healthcare-focused funds.

Key Takeaways

• Q4 2025 Revenue: $19.29 billion (+43% YoY), beating the $17.9 billion consensus by over $1.3 billion
• Non-GAAP EPS: $7.54, beating the $6.91 estimate by more than 9% (+42% YoY)
• Mounjaro + Zepbound Combined: $11.67 billion in Q4 (+113% YoY), now over 60% of total revenue
• Full-Year 2025 Revenue: $65.2 billion (+45% YoY)
• 2026 Revenue Guidance: $80-83 billion, beating consensus of $77.62 billion
• U.S. Incretin Market Share: 60.5% in Q4, up 2.6 points sequentially
• Stock Reaction: LLY shares rose 7-10% on February 4, 2026

How Did Eli Lilly Perform in Q4 2025?

Eli Lilly delivered one of its strongest quarters in company history. Worldwide revenue reached $19.29 billion for the three months ending December 31, 2025, compared to $13.53 billion in Q4 2024. This 43% increase was driven by a 46% jump in prescription volume, partially offset by a 5% decline in realized prices due to expanded access programs and government pricing agreements, per the earnings call transcript.

In the United States, revenue grew 43% to $12.9 billion, fueled by a 50% increase in volume for Mounjaro and Zepbound. International revenue also climbed 43% to $6.4 billion, with Mounjaro driving the bulk of growth outside the U.S. as the drug expanded into new markets across Europe and Asia.

On the bottom line, reported net income rose 50% to $6.64 billion, while reported EPS jumped 51% to $7.39. On a non-GAAP basis, EPS reached $7.54, representing 42% growth over Q4 2024. Non-GAAP gross margin held steady at 83.2%, as favorable product mix and improved manufacturing costs offset pricing pressure.

For the full year 2025, Eli Lilly generated $65.2 billion in total revenue (a 45% increase over 2024) and non-GAAP EPS of $24.21, representing 86% growth year-over-year.

What Were Eli Lilly's Key Q4 2025 Financial Metrics?

What Drove Mounjaro and Zepbound Sales in Q4 2025?

The combined Mounjaro and Zepbound franchise generated $11.67 billion in Q4 2025 revenue, a 113% increase from $5.44 billion in Q4 2024. Together, these two drugs, both based on the molecule tirzepatide (a dual GIP and GLP-1 receptor agonist that regulates blood sugar and appetite), now represent over 60% of Eli Lilly's quarterly revenue and are the primary engine behind the company's transformation into one of the world's largest pharmaceutical companies by revenue.

How Much Revenue Did Mounjaro Generate in Q4 2025?

Mounjaro (tirzepatide for type 2 diabetes) posted Q4 2025 revenue of $7.41 billion, up 110% from $3.53 billion a year earlier. U.S. Mounjaro revenue rose 57% to $4.1 billion, driven by strong demand even as realized prices declined. International Mounjaro revenue surged from $899 million to $3.3 billion, reflecting rapid expansion into new geographies across Europe and Asia. For the full year 2025, Mounjaro generated $22.97 billion, nearly double the $11.54 billion recorded in 2024.

How Much Revenue Did Zepbound Generate in Q4 2025?

Zepbound (tirzepatide for chronic weight management in adults with obesity or overweight) delivered $4.26 billion in Q4 2025 U.S. revenue, up 122% from $1.91 billion in Q4 2024. Full-year 2025 Zepbound revenue reached $13.54 billion, a 175% increase from $4.93 billion in 2024. Zepbound has now become the U.S. market leader in obesity treatment by new prescriptions and continues to gain share against Novo Nordisk's Wegovy (semaglutide).

Verzenio (abemaciclib for breast cancer) contributed $1.6 billion in Q4 2025, up 3% year-over-year, with international sales growing 18%. Full-year 2025 Verzenio revenue reached $5.72 billion.

Across all key growth products (Mounjaro, Zepbound, Verzenio, Omvoh, Kisunla, Jaypirca, Ebglyss, and the newly launched Inluriyo), Eli Lilly generated $13.8 billion in Q4 revenue, up 91% compared to the prior year.

What Is the Full Q4 2025 Drug Revenue Breakdown for Eli Lilly?

How Does Eli Lilly Compare to Novo Nordisk in the GLP-1 Race?

The Q4 2025 earnings season produced a dramatic divergence between the world's two largest GLP-1 receptor agonist manufacturers. GLP-1 receptor agonists (glucagon-like peptide-1 agonists) are a class of drugs that mimic a natural gut hormone to regulate blood sugar, reduce appetite, and promote weight loss. The incretin drug market, which includes GLP-1 agonists and related therapies, is one of the fastest-growing categories in pharmaceutical history.

In the same week Eli Lilly reported 43% revenue growth and guided for $80-83 billion in 2026 revenue, Novo Nordisk warned that it expects sales and operating profit to decline by 5-13% this year. Novo's U.S.-listed shares fell more than 20% over five trading sessions around these disclosures.

Leerink Partners analyst David Risinger characterized the contrast: "The difference in sales momentum and market share trend was visible throughout 2025, but the dichotomy between the two companies' prospects was accentuated within this 24-hour period in which Novo guided below consensus and Lilly guided above consensus expectations. That really solidified an investor's mind that Lilly is going to be the dominant player in obesity going forward."

Mizuho Securities analyst Jared Holz was similarly direct, telling Bloomberg: "This is just more evidence they are dominating the category. Novo is playing from behind and everyone knows it."

Eli Lilly's share of the U.S. incretin market rose to 60.5% in Q4 2025, gaining 2.6 percentage points from the previous quarter. Novo Nordisk's corresponding share was 39.1%.

How Do Eli Lilly and Novo Nordisk Compare on Key Metrics?

The competitive picture is further complicated by the oral GLP-1 race. Novo Nordisk's Wegovy pill launched in the U.S. in January 2026, hitting 50,000 weekly prescriptions within three weeks. Eli Lilly has submitted orforglipron, its own oral GLP-1, to the FDA and expects potential approval and launch in Q2 2026. This upcoming head-to-head competition in the oral format will be one of the most closely watched commercial battles in pharmaceutical history.

What Is Eli Lilly's Revenue and Earnings Guidance for 2026?

Eli Lilly issued 2026 financial guidance that significantly exceeded Wall Street expectations across every metric, according to the Q4 2025 earnings release:

At the midpoint, this guidance implies approximately 25% revenue growth and roughly 40% earnings growth relative to 2025. Deutsche Bank reiterated its Buy rating with a $1,200 price target following the guidance, noting that Lilly's outlook implies volume growth of approximately 42% year-over-year, with significant international expansion potential.

How Will Pricing Pressure Affect Eli Lilly in 2026?

The guidance incorporates meaningful pricing headwinds. Management expects a global pricing decline in the low-to-mid teens percentage range for 2026, driven by:

• The U.S. government agreement announced in November 2025, which caps Medicare patient out-of-pocket costs at $50 per month
• Direct-to-consumer pricing initiatives, including the $299 Zepbound vial available through the company's LillyDirect platform
• Anticipated lower Medicaid pricing on older products
• Several key states, including California, expected to remove Medicaid obesity coverage in 2026

However, Lilly expects massive volume growth to more than compensate for pricing pressure. LillyDirect surpassed 1 million patients in 2025, and Medicare coverage for obesity treatments, expected by July 1, 2026, represents what CEO David Ricks called "a big multiplier on the eligible pool" of patients on the earnings call.

What Did Eli Lilly's CEO Say on the Q4 2025 Earnings Call?

CEO David Ricks framed 2025 as a year of both commercial execution and manufacturing scale-up:

"We enter 2026 with tremendous momentum and a portfolio that is delivering for patients and shareholders. The growth we're seeing in Mounjaro and Zepbound is not simply a function of market tailwinds. It reflects the superior efficacy of tirzepatide and the investments we've made in manufacturing capacity to ensure consistent supply."

Management commentary emphasized three strategic priorities:

1. Manufacturing scale: Lilly has committed over $55 billion to manufacturing expansion since 2020, including a $6 billion active pharmaceutical ingredient facility in Alabama, a new injectable manufacturing site in Pennsylvania, and a $3 billion oral medicine manufacturing facility in Europe.
2. Expanding tirzepatide indications: Zepbound's approval for obstructive sleep apnea (OSA) broadens the addressable patient population, with additional indication studies ongoing in cardiovascular risk reduction, NASH/MASH, and chronic kidney disease.
3. Next-generation pipeline advancement: Regulatory submissions for orforglipron have been filed with the FDA, and retatrutide Phase 3 data continues to read out.

On the supply question, Ricks noted that Lilly expects to produce at least 1.6 times the amount of salable incretin doses in H1 2026 compared to H1 2025. The company confirmed that U.S. supply across all tirzepatide dose forms was available throughout Q4 2025, resolving the intermittent shortages that hampered prescribing in earlier periods.

What Are Analysts Saying About Eli Lilly Stock After Q4 2025?

Following the Q4 2025 earnings release, the analyst consensus on Eli Lilly stock (NYSE: LLY) remains overwhelmingly bullish. The stock carries a Strong Buy rating from the majority of covering analysts, with median price targets in the $1,145-$1,200 range.

One analyst described Lilly's growth profile in 2026 as the best in their coverage universe, projecting approximately 20% top-line growth and roughly 40% bottom-line growth with "a clear runway for growth into the next decade."

What Are Wall Street Price Targets for Eli Lilly Stock?

The bull case rests on Lilly's expanding manufacturing capacity, the potential orforglipron launch, the growing international opportunity for Mounjaro, and the massive untapped market for GLP-1 treatments, estimated by Goldman Sachs and other sell-side firms to reach $150 billion or more by the early 2030s.

Shares rose approximately 7-10% on the day of the earnings release (February 4, 2026), reaching approximately $1,082-$1,100 in early trading. The strong reaction reflected both the Q4 beat and above-consensus 2026 guidance.

What Is in Eli Lilly's Drug Pipeline for 2026 and Beyond?

Beyond the current Mounjaro and Zepbound franchise, Eli Lilly's pipeline contains several catalysts that could sustain revenue growth well into the next decade.

What Is Orforglipron and When Will It Launch?

Orforglipron is Eli Lilly's oral GLP-1 receptor agonist for obesity and type 2 diabetes, a pill-form alternative to the injectable tirzepatide. The company has submitted regulatory applications to the FDA, Japan's PMDA, and the European Medicines Agency. If approved, orforglipron would launch in the U.S. as early as Q2 2026, with international launches expected in the first half of 2027 for most markets. Phase 3 data demonstrated that orforglipron effectively maintained weight loss in patients switching from injectable incretins, a key differentiator for patients seeking the convenience of a daily pill over a weekly injection.

What Is Retatrutide and How Does It Differ from Tirzepatide?

Retatrutide is Eli Lilly's next-generation triple agonist (GIP/GLP-1/glucagon receptor agonist), which targets three hormonal pathways compared to tirzepatide's two. The TRIUMPH-4 Phase 3 trial delivered headline-grabbing results: patients with obesity and knee osteoarthritis who received the 12mg dose lost an average of 71.2 pounds (28.7% of body weight) while experiencing a 75.8% reduction in pain scores. These results represent the first successful Phase 3 trial showing that a single treatment can simultaneously address both severe obesity and its associated joint pain.

What Other Pipeline Drugs Does Eli Lilly Have?

What Does the Trump Administration Drug Pricing Deal Mean for Eli Lilly?

In November 2025, both Eli Lilly and Novo Nordisk struck agreements with the U.S. government to expand access to GLP-1 obesity medicines. Under the terms, both companies will reduce GLP-1 drug prices for Medicare and Medicaid beneficiaries in 2026 and offer direct-to-consumer sales at discounted rates through the administration's TrumpRx platform.

In exchange, both companies received three-year tariff exemptions, a meaningful benefit given ongoing trade policy uncertainty. Eli Lilly's agreement includes a $50 per month patient out-of-pocket cap for Medicare beneficiaries, with full Medicare access expected by July 1, 2026.

CEO David Ricks acknowledged that the deal will create "a step down in pricing" in early 2026, but emphasized that expanded access and volume growth will more than offset the impact. The company estimates that Medicare coverage alone will significantly expand the eligible patient pool, with 20-25 million patients currently taking GLP-1 medicines from both companies combined and significant room for market expansion.

The pricing dynamic is a key area for institutional investors to monitor. While near-term margins may face pressure, the volume opportunity from Medicare coverage, direct-to-consumer channels, and international expansion could fundamentally reshape the revenue trajectory for the entire GLP-1 category.

How Large Is the GLP-1 and Obesity Drug Market?

The GLP-1 receptor agonist market has emerged as one of the largest pharmaceutical categories in history. The combined obesity and diabetes incretin market (which includes all GLP-1 agonists and dual/triple agonists from manufacturers including Eli Lilly, Novo Nordisk, Amgen, and others) is estimated to reach approximately $150 billion by the early 2030s, according to forecasts from Goldman Sachs, Morgan Stanley, and other major sell-side research firms.

This projection rests on several demand drivers that remain in early stages:

• Low penetration rates: Fewer than 10% of clinically eligible obesity patients currently receive GLP-1 therapy, according to company presentations and CDC obesity prevalence data
• Expanding indications: Cardiovascular risk reduction, NASH/MASH (metabolic dysfunction-associated steatohepatitis), sleep apnea, and chronic kidney disease trials are ongoing
• Oral formulations: Both Lilly (orforglipron) and Novo Nordisk (oral semaglutide) are bringing pill-form GLP-1 drugs to market, removing the injection barrier for millions of potential patients
• Medicare coverage: Expected by July 2026, opening access for the largest insured population in the U.S.
• Global launch expansion: Tirzepatide and semaglutide are still in early launch phases across Europe, Asia, and Latin America

The combined U.S. incretin market grew 45% year-over-year in 2025. Both Lilly and Novo Nordisk have signaled that manufacturing capacity, not demand, remains the binding constraint on near-term revenue growth.

Frequently Asked Questions

What was Eli Lilly's Q4 2025 revenue and EPS?

Eli Lilly (NYSE: LLY) reported Q4 2025 revenue of $19.29 billion, a 43% increase from $13.53 billion in Q4 2024. This surpassed Wall Street consensus estimates of approximately $17.9 billion by more than $1.3 billion. Non-GAAP adjusted EPS was $7.54, beating the $6.91 consensus by 9%. Reported EPS was $7.39, up 51% year-over-year. Full-year 2025 revenue was $65.2 billion (+45% YoY).

How much did Mounjaro earn in Q4 2025?

Mounjaro generated $7.41 billion in Q4 2025 revenue, a 110% increase from $3.53 billion in Q4 2024. U.S. Mounjaro revenue was $4.1 billion (+57% YoY), while international revenue surged to $3.3 billion from $899 million. For the full year 2025, Mounjaro generated $22.97 billion in total revenue, nearly doubling its 2024 figure of $11.54 billion.

How much did Zepbound earn in Q4 2025?

Zepbound generated $4.26 billion in Q4 2025 U.S. revenue, a 122% increase from $1.91 billion in Q4 2024. Full-year 2025 Zepbound revenue reached $13.54 billion, up 175% from $4.93 billion in 2024. Zepbound is now the U.S. market leader in obesity treatment by new prescriptions, surpassing Novo Nordisk's Wegovy.

What is Eli Lilly's revenue guidance for 2026?

Eli Lilly guided for 2026 revenue of $80 billion to $83 billion and non-GAAP EPS of $33.50 to $35.00. Both figures exceeded analyst consensus estimates of $77.62 billion in revenue and $33.23 in EPS. At the midpoint, this implies approximately 25% revenue growth and roughly 40% EPS growth compared to 2025.

Is Zepbound more effective than Wegovy for weight loss?

Clinical data suggests Zepbound (tirzepatide) delivers greater weight loss than Wegovy (semaglutide). In the SURMOUNT-5 head-to-head trial, Zepbound demonstrated 47% greater relative weight loss compared to Wegovy. Tirzepatide-based drugs achieve approximately 20-25% body weight loss in clinical studies, compared to approximately 14-16% for semaglutide. This efficacy advantage is a primary driver of Zepbound's rapid market share gains in the U.S.

How does Eli Lilly's outlook compare to Novo Nordisk in 2026?

The two companies diverged sharply. Eli Lilly guided for approximately 25% revenue growth to $80-83 billion in 2026, while Novo Nordisk warned of a 5-13% decline in sales and operating profit. Eli Lilly held 60.5% of the U.S. incretin market in Q4 2025, compared to Novo's 39.1%. Lilly's shares rose 7-10% on earnings day while Novo's fell more than 20% over the surrounding week.

What is orforglipron and when will it launch?

Orforglipron is Eli Lilly's oral GLP-1 receptor agonist pill for obesity and type 2 diabetes. Unlike Mounjaro and Zepbound, which are weekly injections, orforglipron is a daily oral tablet. The company has submitted regulatory applications to the FDA, Japan, and the EU, with a potential U.S. launch expected in Q2 2026 pending approval. It would compete directly with Novo Nordisk's oral Wegovy pill, which launched in January 2026.

What is retatrutide and how is it different from Mounjaro?

Retatrutide is Eli Lilly's next-generation triple-agonist drug that targets three hormone receptors (GIP, GLP-1, and glucagon), compared to Mounjaro's dual-agonist mechanism (GIP and GLP-1). In the TRIUMPH-4 Phase 3 trial, the 12mg dose produced an average weight loss of 71.2 pounds (28.7% of body weight) and a 75.8% reduction in pain scores for patients with obesity and knee osteoarthritis.

What happened to Eli Lilly's stock price after Q4 2025 earnings?

Eli Lilly (NYSE: LLY) shares surged approximately 7-10% following the Q4 2025 earnings release on February 4, 2026, reaching approximately $1,082-$1,100 in early trading. The rally reflected both the Q4 revenue and EPS beat and above-consensus 2026 guidance. The analyst consensus remains Strong Buy with median price targets between $1,145 and $1,200, and a street-high target of $1,500 from Citigroup.

What was Eli Lilly's full-year 2025 revenue?

Eli Lilly generated $65.2 billion in total revenue for fiscal year 2025, a 45% increase over 2024's $45.04 billion. Full-year non-GAAP EPS was $24.21, representing 86% growth year-over-year. Mounjaro contributed $22.97 billion and Zepbound contributed $13.54 billion for the full year, with the combined tirzepatide franchise accounting for over 56% of total company revenue.

What is Eli Lilly's market capitalization?

As of February 2026, Eli Lilly's market capitalization is approximately $950 billion to $1 trillion, making it one of the most valuable pharmaceutical companies in the world and among the ten largest publicly traded companies by market cap. The stock trades on the New York Stock Exchange under the ticker symbol LLY.

What are the biggest risks to Eli Lilly stock?

Key risks include: (1) pricing pressure from the U.S. government access agreement and potential future regulatory action on GLP-1 drug prices; (2) manufacturing constraints limiting revenue upside; (3) competitive threats from Novo Nordisk's oral Wegovy pill and next-generation semaglutide products; (4) clinical trial risk on pipeline assets retatrutide and orforglipron; (5) potential for state-level Medicaid coverage removals for obesity treatments; and (6) compounding pharmacy competition for tirzepatide formulations.

Sources

Data and figures in this analysis are sourced from official company filings, earnings call transcripts, sell-side research, and major financial news outlets, powered by AllMind AI:

• Eli Lilly Q4 2025 Earnings Release: Primary financial data
• Eli Lilly Q4 2025 Earnings Call Transcript: Management commentary and guidance
• Novo Nordisk Investor Relations: Competitive benchmarking
• SEC EDGAR: Eli Lilly & Co. Filings (CIK: 0000059478): Regulatory filings
• FDA Drug Approvals Database: Pipeline and approval data
• CDC Obesity Prevalence Data: Market sizing context

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Anwaar Malik

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