Eli Lilly & Co Earnings - Q4 2025 Analysis & Highlights
Eli Lilly and Company delivered exceptional financial performance in 2025 driven by robust growth in its incretin portfolio (Mounjaro and Zepbound), successful pipeline advancement with positive Phase 3 data across multiple therapeutic areas, significant manufacturing expansion, and strategic pricing actions to expand patient access, while guiding for continued strong growth in 2026 with revenue expected between $80-83 billion despite anticipated pricing headwinds.
Key Financial Results
Full year 2025 revenue reached $65.2 billion, representing 45% year-over-year growth compared to 2024.
Earnings per share grew 86% to $24.21 for the full year 2025.
Q4 2025 revenue grew 43% compared to Q4 2024, driven by key products.
Gross margin as a percentage of revenue was 83.2% in Q4 2025, consistent with Q4 2024.
Non-GAAP performance margin was 47.2% in Q4, an increase of 4.2 percentage points compared to Q4 2024.
Q4 2025 earnings per share was $7.54, inclusive of $0.52 of acquired IPR&D charges, compared to $5.32 in Q4 2024.
The company distributed $1.3 billion in dividends and $1.5 billion in share repurchases during 2025.
Business Segment Results
Key products contributed over $13 billion to revenue in Q4 and grew 91% compared to Q4 2024.
Kisunla (neuroscience) became the US market leader in amyloid-targeting therapy space with more than 50% share of total prescriptions, with Q4 revenue of $109 million.
Ebglyss (immunology) delivered solid performance in atopic dermatitis, with US total prescriptions increasing 25% compared to Q3 2025.
Omvoh (immunology) continued uptake with global revenue increasing 55% compared to Q4 2024.
Jaypirca (oncology) posted strong sales performance with global sales growing 30% compared to Q4 2024, and recently received an expanded US indication.
Verzenio (oncology) global sales increased 3%, driven by volume growth outside the US, and remains the market leader in early breast cancer indication.
US Zepbound revenue more than doubled compared to Q4 2024, with nearly 70% share of new prescriptions in the branded obesity market.
Zepbound vials represented approximately one-third of total Zepbound prescriptions and nearly 50% of new Zepbound prescriptions in Q4.
US Mounjaro expanded market leadership in type 2 diabetes incretin market, exiting the quarter with over 55% of new prescriptions.
International Mounjaro delivered strong results with $3.3 billion in Q4 revenue, and Lilly became the incretin share of market leader outside the US.
US incretin analog market continued robust growth with total prescriptions increasing by 33% compared to Q4 2024.
Capital Allocation
The company distributed $1.3 billion in dividends during 2025.
Share repurchases totaled $1.5 billion in 2025.
Since 2020, Lilly has committed over $55 billion to manufacturing expansion, described as the largest manufacturing build out in company history.
The company announced plans to build multiple new manufacturing sites in the US and Europe.
Manufacturing capacity was increased with new sites beginning production in Wisconsin and North Carolina.
Industry Trends and Dynamics
The US incretin analog market demonstrated robust growth 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 market growth in the quarters and years to come.
The oral GLP-1 market is expanding the addressable market, with oral semaglutide launch validating belief that a substantial number of people with overweight and obesity have been waiting for an oral option.
The company helped over 70 million people around the world in 2025.
The LillyDirect direct-to-patient platform increased to over 1 million patients in 2025.
Competitive Landscape
Zepbound continues to be the market leader in the branded obesity market with nearly 70% share of new prescriptions.
Kisunla recently became the US market leader in the amyloid-targeting therapy space with more than 50% share of total prescriptions.
Mounjaro expanded market leadership in the type 2 diabetes incretin market with over 55% of new prescriptions.
Verzenio remains the market leader in its early breast cancer indication, though overall market penetration has reached a plateau as reflected in US trends.
Management noted that oral semaglutide launch validates the belief that there is a substantial number of people with overweight and obesity waiting for an oral option, suggesting market expansion rather than cannibalization.
The company expects orforglipron to launch for chronic weight management in the US during Q2 2026 and believes the launch will be market expansive and bring new people to therapy for obesity.
Macroeconomic Environment
The company noted that price is expected to be a drag on growth in the low to mid-teens in 2026.
Three factors will impact US price: 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 China National Reimbursement Drug List for type 2 diabetes.
Management expects new states will add coverage for people with Medicaid in 2027, though there will be a reduction in Medicaid access in 2026 due to key states like California removing obesity coverage.
Growth Opportunities and Strategies
The company launched new medicines including Inluriyo, secured new indications for Omvoh and Jaypirca, and completed international rollouts of both Mounjaro and Kisunla.
Lilly generated positive clinical data in more than 25 Phase 3 trials, including registrational trials supporting two new incretins: orforglipron and retatrutide.
The company submitted orforglipron for obesity in the US and in more than 40 countries globally.
14 new Phase 3 programs were started over the past few months, including eloralintide and brenipatide.
The company has one of the largest clinical stage pipelines in company history.
39 business development transactions were executed across all therapeutic areas, adding multiple clinical stage assets through transactions including Scorpion, Verve, SiteOne, Adverum, and the upcoming acquisition of Ventyx.
Lilly continues investing in artificial intelligence to discover and develop new medicines, including a new collaboration with NVIDIA to open a co-innovation AI lab.
The company exceeded its goal to produce 1.8 times the number of incretin doses in the second half of 2025 compared to the second half of 2024.
An agreement with the US government provides access to obesity medicines to millions of Americans with insurance through Medicare and Medicaid at $50 per month out-of-pocket.
Zepbound self-pay vials now make up one-third of new patient starts who start on any brand of obesity medication.
The company is exploring combination therapies with incretins and immunology treatments, with the TOGETHER-PsA trial showing a 64% relative increase in the proportion of patients achieving a 50% reduction in psoriatic arthritis symptoms when tirzepatide was added to ixekizumab.
Orforglipron demonstrated positive results in the ATTAIN-MAINTAIN trial, helping people maintain weight loss achieved on injectable therapies.
Retatrutide showed strong efficacy with participants taking the 12 milligram dose losing an average of 29% of their body weight at 68 weeks, and reduced WOMAC pain scores by an average of 4.5 points, representing a 76% reduction in pain.
The company is exploring orforglipron Phase 3 cardiovascular outcomes trials and Phase 3 for treatment of peripheral artery disease.
Pirtobrutinib received full FDA approval for expanded indication for treatment of adults with relapsed or refractory CLL/SLL who have previously been treated with a covalent BTK inhibitor.
The company is advancing sofetabart mipitecan, a next-generation antibody drug conjugate targeting folate receptor alpha, into Phase 3 testing for women with platinum-resistant ovarian cancer.
Lilly is exploring incretins to treat substance use disorders and psychiatric conditions, with Phase 3 program of BRENIPATIDE in alcohol use disorder already underway.
The company is studying donanemab in people with normal cognition but a positive blood test for Alzheimer's disease in the TRAILBLAZER-ALZ 3 trial, with primary completion projected for 2027.
Management is pursuing combination therapies across immunology, oncology, and neuroscience, including studies of ixekizumab and tirzepatide in psoriasis and mirikizumab and tirzepatide in Crohn's disease and ulcerative colitis.
Pipeline and R&D Progress
The company achieved positive outcomes for nearly all R&D key events in 2025, described as a rare set of results in this industry.
36 active Phase 3 programs are in the pipeline, with plans to initiate even more new programs in 2026.
Eloralintide achieved up to 20.1% weight loss with excellent tolerability, with only one incidence of vomiting out of more than 50 patients in the 3-9 milligram titration group.
The company is exploring combination therapies with GIP plus GLP-1 plus amylin, described as a very physiological construct of three nutrient-stimulated hormones.
EMBER-4, an 8,000-patient adjuvant breast cancer trial, is fully enrolled and will be the next Phase 3 readout of an oral SERD for patients with early breast cancer.
The company expects to readout six additional Phase 3 trials for retatrutide in 2026, including the remainder of the core registration package.
Sofetabart mipitecan received Breakthrough Therapy designation from FDA.
The company is initiating Phase 3 programs for TERSOLISIB, a mutant-selective PI3-kinase alpha inhibitor, and VEPUGRATINIB, an FGFR3 inhibitor.
Financial Guidance and Outlook
2026 revenue guidance is between $80 billion and $83 billion, with the midpoint representing an increase of 25% compared to 2025.
The company expects to deliver industry-leading volume growth 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 in 2026.
Non-GAAP performance margin is expected to be between 46% and 47.5% in 2026.
Gross margin is expected to be relatively stable to slightly down compared to Q4 2025 as favorable product mix and increased productivity are offset by price and new facilities coming online.
R&D expenses are expected to scale up in 2026 consistent with the company's strategy to invest in innovation.
Marketing, selling and administrative expenses are expected to grow as the company invests to support new launches across therapeutic areas.
Earnings per share is expected to be between $33.50 and $35, setting up another year of strong top line and bottom line growth.
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.
Within revenue, Ebglyss, Jaypirca, Inluriyo, Kisunla, and Omvoh are expected to contribute to growth, whereas late lifecycle products like Trulicity, Taltz, and Verzenio are expected to be flat or decline.
The company expects Zepbound to be launched in a multi-use KwikPen device in the US within the next few weeks.
