Eli Lilly and Co: 2Q26 results beat expectations; near-term catalyst is expanded Medicare coverage opening up incremental markets

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I. 2Q26 results beat expectations; full-year guidance raised

It should be noted that the full-year 2026 revenue guidance of USD 86 billion (average) implies second-half 2026 (2H26) revenue guidance of USD 43.2 billion versus first-half 2026 (1H26) actual revenue of USD 42.8 billion. Addressing market concerns about slowing revenue growth in the second half, Eli Lilly’s CFO stated that the apparent sequential slowdown is primarily driven by one-time factors, a high base effect, and seasonality—not weak demand. 1H26 revenue included positive impacts from prior-period accounting adjustments related to U.S. rebate and discount modifications. Additionally, Q3 in Europe is affected by summer holidays, and U.S. type 2 diabetes business experiences seasonal fluctuations in Q4—all of which have been factored into the full-year guidance. Excluding these factors, the company still expects strong growth for its GLP-1 products in both the U.S. and international markets, with future growth drivers gradually shifting from new market expansion toward increased patient penetration.

During 2Q26, Eli Lilly’s blockbuster GLP-1 drugs continued robust growth: Mounjaro generated USD 9.9 billion in sales, surging 91% year-over-year; Zepbound delivered USD 4.9 billion in sales, up 46% year-over-year; and Foundayo recorded USD 98 million in sales, currently in the early launch phase.

Immunology segment: In 2Q26, Ebglyss generated USD 210 million in sales, soaring 131% year-over-year.

Oncology segment: In Q2 2026, Jaypirca generated sales of USD 190 million, a significant year-over-year increase of 56%; Inluriyo generated sales of USD 75 million.

Neuroscience segment: In Q2 2026, Kisunla generated sales of USD 167 million.

Second, Eli Lilly and Co continues to lead the global incretin mimetic market, with its Medicare Bridge program expected to add coverage for 20 million potential patients.

According to IQVIA data, as of June 26, 2026, the U.S. incretin (GLP-1 + GIP) mimetic market recorded approximately 2.7 million total prescriptions over the most recent four-week rolling period. The U.S. market grew by 31% year-over-year in Q2 2026, with weight-loss prescriptions increasing by 78% and type 2 diabetes prescriptions rising by 9%.

Eli Lilly and Co held a 60.9% share of total prescriptions in the U.S. market, significantly higher than Novo-Nordisk A/S’s 38.8% share. During Q2 2026, nearly half of all weight-loss prescriptions in the U.S. were paid out-of-pocket. For Zepbound, approximately 45% of total prescriptions and 55% of new prescriptions were out-of-pocket.

Chart 1: U.S. Incretin (GLP-1 + GIP) Mimetic Market

Source: Eli Lilly and Co presentation materials

As of May 2026, the international incretin (GLP-1 + GIP) mimetic market outside the U.S. recorded average sales of approximately USD 2.8 billion over the most recent three-month rolling period. The international market grew by 74% year-over-year in Q2 2026. Eli Lilly and Co held a 54.9% market share, significantly higher than Novo-Nordisk A/S’s 45.1% share. As shown in the chart below, Eli Lilly and Co has continuously gained market share from Novo-Nordisk A/S since 2025.

Chart 2: International Incretin (GLP-1 + GIP) Mimetic Market

Source: Eli Lilly and Co press release

As shown in the two charts above, both U.S. and international incretin mimetics (GLP-1 + GIP) remain in a phase of rapid growth.

Recent growth catalysts in the U.S. market stem from improved payment accessibility driven by the Medicare GLP-1 Bridge Program. Effective July 1, this program aims to expand access to GLP-1-based weight-loss medications for eligible patients. Medicare primarily covers Americans aged 65 and older, as well as certain individuals with disabilities. According to Eli Lilly and Co management, the program is expected to reach approximately 20 million potential patients and reduce their monthly out-of-pocket costs to around USD 50, significantly enhancing affordability for weight-loss drugs.

Notably, about 60%–70% of patients covered under this program have never previously used GLP-1/incretin-based therapies, indicating that the growth driven by the Medicare Bridge Program primarily originates from a previously underserved new patient pool rather than migration from existing users. With expanded Medicare coverage, the proportion of patients covered by both public and commercial insurance for Eli Lilly and Co’s weight-loss drugs is projected to increase by roughly 35%, potentially further boosting patient penetration for Zepbound and Foundayo.

Related report: (Join this community circle for limited-time free access)

Novo-Nordisk A/S, Eli Lilly and Co, and the U.S. government reached an agreement to lower GLP-1 drug prices; actual impact is limited, with overall implications more favorable to Eli Lilly and Co

Eli Lilly and Co 2025 earnings commentary: Tirzepatide becomes the world's top-selling drug, with its leadership in the GLP-1 space continuing to widen

Quarter by quarter, from Q3 2025 to Q2 2026, Eli Lilly and Co’s tirzepatide (Mounjaro + Zepbound) sales grew sequentially by 18%, 16%, 10%, and 16%, respectively. Despite already generating over USD 10 billion per quarter in absolute sales, it maintained high sequential growth rates. By market, Mounjaro (the diabetes indication) generated USD 9.94 billion in Q2 2026, split roughly evenly between the U.S. and international markets. Zepbound (the weight-loss indication) recorded USD 4.93 billion in sales, over 95% of which came from the U.S. Foundayo launched in April 2026 and achieved USD 98 million in sales in Q2 2026, with 70% from the U.S. and 30% from international markets. Foundayo is a direct competitor to Novo-Nordisk A/S’s oral Wegovy...

For comparison, during the same period from Q3 2025 to Q2 2026, semaglutide (Ozempic + Wegovy + Rybelsus) posted sequential sales growth of 6%, 4%, -10%, and 12%, respectively.Following a sequential decline last quarter, semaglutide’s Q2 2026 growth rebounded into double digits, primarily driven by the rapid uptake of oral Wegovy.In Q2 2026, oral Wegovy generated global sales of USD 510 million (not yet launched a year ago). Of this, 98% came from the U.S. market and 2% from international markets. In the same quarter, injectable Wegovy achieved global sales of USD 3.09 billion, up 1% year-over-year—USD 1.53 billion from the U.S. (down 22% YoY) and USD 1.56 billion from international markets outside the U.S. (up 46% YoY).

Eli Lilly and Co's weight-loss version of Zepbound continues to erode the U.S. market share of Wegovy injections. Currently, Novo Nordisk A/S maintains a relatively rapid growth rate in international markets outside the United States. As Eli Lilly and Co expands further into overseas markets, it will be important to monitor the sales trends of both companies abroad. Eli Lilly and Co's Mounjaro (tirzepatide), branded as Zepbound for weight loss and referred to here as Foundayo, is still in the early stages of its launch, with priority given to supplying the U.S. market while simultaneously expanding internationally. As manufacturing capacity increases, Foundayo is expected to become another near-term growth driver for Eli Lilly and Co. In the U.S. market, by June 2026, Foundayo has already secured commercial insurance coverage from the three major pharmacy benefit managers (PBMs). The company has submitted a marketing application for type 2 diabetes and expects approval by year-end.

Recently, Foundayo (for weight-loss indication) has been launched in the United Arab Emirates, received approval for weight-loss use in Saudi Arabia, and gained approval for both type 2 diabetes and weight-loss indications in Mexico. Additionally, regulatory reviews for Foundayo’s marketing applications are currently underway in more than 40 countries globally. A key focus over the coming quarters will be Foundayo’s international market expansion...

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