Eli Lilly & Co Earnings - Q4 2025 Analysis & Highlights
Eli Lilly and Co.'s Q4 2025 earnings call highlighted strong financial performance with robust revenue and EPS growth, driven by key product launches and international expansion. The company provided optimistic 2026 financial guidance, emphasizing volume growth despite anticipated price reductions, and discussed significant advancements in its R&D pipeline across immunology, oncology, neuroscience, and cardiometabolic health.
Key Financial Results
Full-year revenue for 2025 was $65.2 billion, an increase of 45% compared to 2024.
Q4 2025 revenue grew 43% compared to Q4 2024.
Earnings per share (EPS) for 2025 grew 86% to $24.21.
Q4 2025 EPS was $7.54, including $0.52 of acquired IPR&D charges, compared to $5.32 in Q4 2024, which included $0.19 of acquired IPR&D charges.
Gross margin as a percentage of revenue was 83.2% in Q4 2025, consistent with Q4 2024.
R&D expenses increased by 26% due to continued investments in the early and late-stage portfolio.
Marketing, selling, and administrative expenses increased 29%, driven by promotional efforts for ongoing and future launches.
Non-GAAP performance margin was 47.2%, an increase of 4.2 percentage points compared to Q4 2024.
Effective tax rate was 19.7%.
Business Segment Results
Key products contributed over $13 billion to revenue in Q4 2025, growing 91% compared to Q4 2024.
US revenue increased 43% in Q4, driven by volume growth of Mounjaro and Zepbound, partially offset by a 7% decline in price.
Revenue growth was strong outside the US, driven by double-digit volume growth in Europe, Japan, and China.
In the Rest of the World, volume doubled, driven by the launch of Mounjaro in new markets.
Kisunla revenue was $109 million, becoming the US market leader in the amyloid targeting therapy space with over 50% share of total prescriptions.
Ebglyss showed solid performance in atopic dermatitis, with US total prescriptions increasing 25% compared to Q3 2025.
Omvoh global revenue increased 55% compared to Q4 2024.
Jaypirca global sales grew 30% compared to Q4 2024, with an expanded US indication for patients previously treated with a covalent BTK inhibitor.
Verzenio global sales increased 3%, driven by volume growth outside the US, remaining the market leader in its early breast cancer indication.
Zepbound and Mounjaro delivered strong results in cardiometabolic health.
US Zepbound revenue more than doubled compared to Q4 2024, maintaining market leadership in the branded obesity market with nearly 70% share of new prescriptions.
Zepbound vials represented approximately one-third of total Zepbound prescriptions and nearly 50% of new Zepbound prescriptions in Q4.
Mounjaro expanded its market leadership in the type 2 diabetes incretin market in the US, exiting the quarter with over 55% of new prescriptions.
Capital Allocation
$1.3 billion was distributed in dividends.
$1.5 billion was used for share repurchases.
Over $55 billion has been committed since 2020 for manufacturing build-out.
Industry Trends and Dynamics
The US incretin analog market continued its robust growth trajectory, with total prescriptions increasing by 33% compared to Q4 2024.
Market penetration within the eligible population of people with obesity is only mid-single-digits, indicating room for market expansion and sustained growth.
The launch of oral GLP-1s is expected to expand the addressable market.
There is a substantial number of people with overweight and obesity waiting for an oral option, leading to market expansion.
Competitive Landscape
Kisunla became the US market leader in the amyloid targeting therapy space, with more than 50% share of total prescriptions.
Verzenio remains the market leader in its early breast cancer indication.
Zepbound continues to be the market leader in the branded obesity market, with nearly 70% share of new prescriptions.
Mounjaro is the incretin share of market leader outside the US.
The company has a substantial scientific lead in the incretin field and aims to widen the distance through R&D.
Growth Opportunities and Strategies
New medicines like Inluriyo were launched, and new indications were secured for Omvoh and Jaypirca.
International rollouts of Mounjaro and Kisunla were completed, entering new markets.
Positive clinical data was generated in more than 25 Phase 3 trials, including registrational trials for orforglipron and retatrutide.
Orforglipron was submitted for obesity in the US and over 40 countries globally.
14 new Phase 3 programs were started, including eloralintide and brenipatide.
39 business development transactions were executed, adding multiple clinical stage assets.
Investments in artificial intelligence continue, including a new collaboration with NVIDIA to accelerate drug discovery.
Manufacturing expansion efforts include plans to build multiple new sites in the US and Europe, increasing capacity.
An agreement with the US government provides access to obesity medicines for millions of Americans with insurance through Medicare and Medicaid at a cost of $50 per month out of pocket.
The LillyDirect direct-to-patient platform increased to over 1 million patients in 2025.
The company is exploring new ideas for incretins in complications and comorbidities, such as stress urinary incontinence, peripheral artery disease, and hypertension.
The company is also exploring combination therapies with Zepbound in immunology and other therapeutic areas.
Financial Guidance and Outlook
Revenue is expected to be between $80 billion and $83 billion in 2026, with the midpoint representing a 25% increase compared to 2025.
Industry-leading volume growth is expected, driven by key products, partially offset by lower realized prices.
Price is expected to be a drag on growth in the low to mid-teens.
US price will be impacted by the government access agreement for obesity medicines, updated direct-to-patient Zepbound pricing, and lower Medicaid prices for later lifecycle medicines.
Pricing outside the US will be impacted by Mounjaro's inclusion on the China National Reimbursement Drug List for type 2 diabetes.
Ebglyss, Jaypirca, Inluriyo, Kisunla, and Omvoh are expected to contribute to growth, while late lifecycle products like Trulicity, Taltz, and Verzenio are expected to be flat or decline.
Non-GAAP performance margin is expected to be between 46% and 47.5%.
Gross margin is expected to be relatively stable to slightly down compared to Q4 2025.
R&D expenses are expected to scale up in 2026, with 36 active Phase 3 programs and plans to initiate more new programs.
Marketing, selling, and administrative expenses are expected to grow to support new launches.
Earnings per share is expected to be between $33.50 and $35.
Orforglipron is expected to launch for chronic weight management in the US during Q2 2026 and in most international markets during 2027.
New Medicare access to obesity medicines is anticipated to become effective no later than July 1, 2026.
A reduction in Medicaid access is anticipated in 2026 due to key states removing obesity coverage, but new states are expected to add coverage in 2027.
Research and Development Pipeline
TOGETHER-PsA, a Phase 3b trial evaluating ixekizumab plus tirzepatide for psoriatic arthritis and obesity, met its primary endpoint.
Pirtobrutinib received full FDA approval and an expanded indication for relapsed or refractory CLL/SLL.
BRUIN CLL-313 showed pirtobrutinib improved progression-free survival, reducing the risk of progression or death by 80% versus bendamustine plus rituximab in treatment-naïve CLL/SLL patients.
BRUIN CLL-314 met the primary endpoint of non-inferiority of overall response rate for pirtobrutinib compared to ibrutinib.
Results from BRUIN CLL-322 are expected later this year, evaluating pirtobrutinib in addition to venetoclax and rituximab in previously treated CLL/SLL patients.
Updated combination data of imlunestrant with abemaciclib in metastatic breast cancer showed additional benefit.
EMBER-4, an 8,000-patient adjuvant breast cancer trial for imlunestrant, is fully enrolled.
Sofetabart mipitecan, an antibody drug conjugate targeting folate receptor alpha, advanced into Phase 3 testing for platinum-resistant ovarian cancer and received Breakthrough Therapy designation from FDA.
New Phase 3 programs are expected for TERSOLISIB (PI3-kinase alpha inhibitor) and VEPUGRATINIB (FGFR3 inhibitor).
Trials exploring incretins for substance use disorders and psychiatric conditions were initiated, including BRENIPATIDE in alcohol use disorder, tobacco use disorder, and bipolar disorder.
A Phase 3 trial for BRENIPATIDE in major depressive disorder is expected in 2026.
Results from TRAILBLAZER-ALZ 3, a study of donanemab in people with normal cognition but a positive blood test for Alzheimer's disease, are anticipated.
ATTAIN-MAINTAIN trial for orforglipron in weight maintenance showed positive topline results.
Orforglipron helped people maintain weight loss achieved on injectable therapies, with an average difference of just 0.9 kilograms when switching from semaglutide.
Orforglipron was submitted to the FDA for obesity, with approval expected in Q2 2026.
Orforglipron Phase 3 cardiovascular outcomes trials and a Phase 3 trial for peripheral artery disease were initiated.
The US regulatory submission of orforglipron for type 2 diabetes is expected later this year after the ACHIEVE-4 trial is complete.
TRIUMPH-4, the first Phase 3 trial for retatrutide in adults with obesity and knee osteoarthritis, showed participants lost an average of 29% of their body weight at 68 weeks.
Retatrutide reduced WOMAC pain scores by an average of 4.5 points, representing a 76% reduction in pain.
Six additional Phase 3 trials for retatrutide are expected to readout in 2026.
A Phase 3 trial in high-risk metabolic dysfunction-associated steatotic liver disease (MASLD) studying retatrutide and tirzepatide was started.
The results of the core TRIUMPH program for retatrutide are planned for submission in 2026 to support applications for overweight and obesity, obstructive sleep apnea, and osteoarthritis of the knee.
Zepbound was recently approved in the US in a multi-use KwikPen device.
The company has a robust pipeline of further incretin inventions, including eloralintide (selective amylin agonist) and brenipatide (next-generation GIP/GLP-1 dual agonist), both in Phase 3 trials.
