Eli Lilly & Co Earnings - Q2 2026 Analysis & Highlights
Eli Lilly delivered exceptional Q2 2026 results driven by strong momentum in cardiometabolic products, particularly Mounjaro and Zepbound, while advancing a robust pipeline across oncology, immunology, and neuroscience through both internal development and strategic acquisitions.
Key Financial Results
Revenue grew 48% year-over-year to reach strong performance across all therapeutic areas and geographies.
Key products increased by approximately $6.8 billion, with Oncology, Immunology, and Neuroscience medicines collectively growing 121% compared to Q2 2025.
Gross margin as a percentage of revenue was 86.3% in Q2, an increase of approximately 1.3 percentage points versus Q2 2025, driven primarily by favorable product mix and improved cost of production.
Non-GAAP performance margin was 54.8%, an increase of 9 percentage points from Q2 2025 driven by revenue growth.
Non-GAAP earnings per share were $8.38, including acquired IPR&D charges of $3.03, compared to earnings per share of $6.31 in Q2 2025 inclusive of $0.14 of acquired IPR&D charges.
Mounjaro and Zepbound combined for $14.9 billion of revenue and contributed $6.3 billion of growth compared to Q2 2025.
Business Segment Results
US revenue increased 33% in Q2, primarily driven by volume growth from Zepbound and Mounjaro, as well as contributions from Immunology, Oncology, and Neuroscience portfolio.
US price declined by 3% driven by Zepbound and Mounjaro, though excluding rebate and discount estimate adjustments, US price declined by 9%.
Europe revenue grew 55% in constant currency, driven by sustained strong volume growth of Mounjaro and benefited from a $250 million Jardiance milestone payment.
Japan revenue grew 30% in constant currency driven by Mounjaro and Kisunla.
China revenue grew 93% in constant currency driven by the uptake of Mounjaro.
Rest of world revenue grew 136% in constant currency driven by Mounjaro primarily in Latin America and Asia.
Ebglyss worldwide sales more than doubled compared to Q2 2025, with US Ebglyss continuing to gain share of new prescriptions, increasing by approximately 4 percentage points in the specialty dermatology market since last year.
Jaypirca worldwide sales increased 56% compared to Q2 2025, with the company believing it has potential to be a foundational therapy across multiple settings and regimens within CLL.
Inluriyo is the leader in new prescriptions in the US metastatic breast cancer oral SERD market with more than 50% share after only two full quarters.
Kisunla posted strong revenue growth, expanding its leadership position in the US anti-amyloid target therapy market, with p-tau217 blood tests more than doubling compared to Q2 2025.
Capital Allocation
$1.5 billion in dividends distributed in the second quarter.
$1.6 billion in share repurchases executed in the second quarter.
Industry Trends and Dynamics
Total prescriptions in the US incretin analog market grew 31% compared to Q2 2025, with early uptake of oral GLP-1s expanding the market of people taking incretin therapy.
Injectable incretins continue to be an important growth driver and account for three out of four new patient starts.
Total prescriptions in the US incretin analog obesity market grew by 78% in Q2, with Lilly's anti-obesity portfolio continuing to lead at approximately 6 out of 10 total prescriptions and approximately 7 out of 10 injectable prescriptions.
Self-pay accounted for approximately 45% of total Zepbound prescriptions in Q2 and approximately 55% of new prescriptions.
US Type 2 diabetes incretin analogs market total prescriptions grew 9% compared to Q2 2025, reflecting a more mature market compared to obesity, with Lilly portfolio leading at more than 6 out of 10 prescriptions.
International incretin analogs market increased by 74% since the same period last year as measured by IQVIA gross sales.
Lilly is the global market leader in incretin analogs, strengthening position and gaining almost 2 percentage points of share compared to Q1 2026, reaching approximately 55%.
Mounjaro is now reimbursed for both Type 2 diabetes and obesity in France, showing incremental progress on securing reimbursed access.
Competitive Landscape
Lilly's portfolio continues to lead in the US incretin analog market with approximately 6 out of 10 total prescriptions and approximately 7 out of 10 injectable prescriptions for a Lilly medicine.
In the UAE, Lilly's combined incretin share held steady even with a second oral competitor entering the market, with patients titrating up steadily and showing that orals are expanding the market.
Tirzepatide differentiation appears to be a strong line of defense against generic semaglutide competition, with TRx growth continuing in India and Brazil even after generic semaglutide launch, and similar pace of growth in Canada.
Generic companies have experienced significant supply constraints, which the company is monitoring closely.
Macroeconomic Environment
The document does not contain specific discussion of macroeconomic factors such as inflation, tariffs, trade, recession, or business cycle conditions.
Growth Opportunities and Strategies
Foundayo US launch is progressing well with total prescriptions and share of new patients continuing to grow, supported by increased investment in promotional activities and physician and consumer brand awareness.
Medicare GLP-1 Bridge program launched on July 1, granting 20 million eligible Americans insurance coverage for GLP-1s for obesity at $50 per month out-of-pocket cost, expanding access to 35% more people in the United States.
Foundayo is under regulatory review in over 40 additional countries with a global rollout expected in all major markets in 2027.
Retatrutide demonstrated positive Phase 3 results across TRIUMPH program showing profound levels of weight loss and improvements in A1C and cardiovascular risk factors, osteoarthritis pain, and sleep apnea, with clinical data package supporting global registrations in obesity, obstructive sleep apnea, and knee osteoarthritis pain.
Orforglipron US submission completed in Type 2 diabetes supported by the ACHIEVE Phase 3 program, with ACHIEVE-3 showing superior glycemic control and weight reduction against oral semaglutide.
Insulin efsitora alfa received positive CHMP opinion for EU approval in Type 2 diabetes, with once weekly dosing achieving A1c reductions comparable to once daily basal insulin.
VERVE-102 gene editing program in cardiovascular disease showed a single infusion reduced PCSK9 by 88% and LDL cholesterol by 62% at the highest dose in Phase 1b study.
AtaiBeckley acquisition announced to advance pipeline of rapid acting neuroplastogens for treatment-resistant depression and other mental health conditions, with lead asset BPL-003 showing encouraging Phase 2B results.
Centessa acquisition completed, adding cleminorexton to pipeline in Phase 2 as a potential best-in-class orexin receptor 2 agonist for central hypersomnia.
BRUIN CLL-322 Phase 3 results showed pirtobrutinib added to venetoclax and rituximab reduced risk of disease progression or death by 45% in overall population and 68% in patients whose disease progressed after one prior covalent BTK inhibitor.
LIBRETTO-432 Phase 3 trial of selpercatinib in adjuvant RET fusion-positive non-small cell lung cancer showed selpercatinib reduced risk of disease recurrence or death by 83% versus placebo.
Ebglyss FDA approval for maintenance dosing once every eight weeks in atopic dermatitis, with potential for even less frequent dosing once every 12 weeks being explored.
Lebrikizumab pediatric atopic dermatitis indication submitted in US based on positive Phase 3 results in children 6 months to 18 years old in ADorable trial program.
Three vaccine platform acquisitions announced: Curevo adding amezosvatein for shingles prevention, LimmaTech Biologics developing vaccines for bacterial infections, and The Vaccine Company with lead program against Epstein-Barr virus.
Brenipatide Phase 2 trials initiated in irritable bowel syndrome, with incretin pathway signaling shown to reduce visceral pain sensitivity and modulate gut motility.
Manufacturing expansion completed with first dedicated genetic medicine manufacturing facility opened in Lebanon, Indiana, and first batch of commercial material produced at new manufacturing site in Limerick, Ireland.
Business development strategy emphasizes pursuing diseases with significant unmet need, exciting early science, and need for Lilly's development, regulatory, and manufacturing scale to create value.
Financial Guidance and Outlook
Full-year 2026 revenue guidance increased to between $85 billion and $87 billion, with low-end increased by $3 billion and high-end by $2 billion from previous guidance.
Non-GAAP performance margin expected to be between 49% and 50.5%, an increase of 2 percentage points at the low and high-end of the performance margin range.
Non-GAAP earnings per share guidance of $35.50 to $36.50, an increase of $2.78 per share at the midpoint of the range before updating for Q2 acquired IPR&D charges.
Retatrutide planned submission in US in Q1 2027 under the BLA pathway.
Foundayo readout in obstructive sleep apnea expected later this year with additional five ongoing Phase 3 programs studying Foundayo.
EMBER-4 readout expected in adjuvant breast cancer setting to evaluate if Inluriyo can help more people with breast cancer.
Lebrikizumab data on less frequent dosing once every 12 weeks expected in 2027.
Tersolisib Phase 3 program beginning for PI3K inhibitor initially combined with existing endocrine therapies, with plans to combine with Inluriyo and CDK4/6 inhibitors.
Chronic lower back pain study with retatrutide will read out sometime next year.
Pipeline and R&D Progress
More than 40 active Phase 3 programs are currently in development.
Slides 18 and 19 show pipeline movement since last earnings call and full list of potential key events expected in 2026.
Company has the strongest pipeline ever, and if incretin products were eliminated, would still represent a really strong and large pipeline.
