Eli Lilly raised its full-year revenue forecast to $85 billion to $87 billion and posted second-quarter adjusted earnings of $8.38 per share, nearly 40 percent above the $6.01 consensus, as Mounjaro and Zepbound sales continued to outrun price erosion. The beat matters because it confirms the GLP-1 franchise can absorb cash-pay discounts and international reimbursement cuts without breaking stride.

The numbers that matter

Revenue came in at $22.97 billion against a $20.73 billion estimate. Mounjaro worldwide sales jumped 91 percent to $9.94 billion, with U.S. revenue of $4.8 billion versus a $4.44 billion expectation and international sales up 172 percent. Zepbound U.S. revenue rose 44 percent year over year to $4.93 billion, topping the $4.69 billion estimate. The newly approved obesity pill Foundayo contributed $98 million in its first full quarter, slightly below the $103 million FactSet consensus. GAAP net income was $7.10 billion, or $7.94 per share, including $3.03 per share in acquisition-related charges. A year earlier the company earned $5.66 billion, or $6.29 per share.

Volume up price down

U.S. revenue climbed 33 percent to $14.4 billion on a 37 percent volume increase, partially offset by lower realized prices on Mounjaro and Zepbound. Outside the U.S. the dynamic was more extreme: revenue surged 80 percent to $8.6 billion on a 113 percent volume jump that was partly erased by a 36 percent price decline, driven largely by Mounjaro's inclusion in China's state-run insurance program for Type 2 diabetes. The company said it raised underlying full-year profit guidance by $2.78 per share at the midpoint, then subtracted the $3.03 per share deal charge to arrive at an adjusted range of $35.50 to $36.50, versus the prior $35.50 to $37.

The M&A offset

Lilly is recycling the GLP-1 windfall into a historic acquisition spree. A psychedelics drugmaker was acquired in July and three vaccine makers were announced in May. The $3.03 per share charge this quarter reflects the accounting cost of those deals. Adjusted guidance excludes the charge; GAAP guidance does not. The distinction matters for anyone modeling the P&L.

What to watch

CEO Dave Ricks told investors in April he expects lower prices to accelerate U.S. volumes and projects global GLP-1 patients rising from roughly 20 million at the end of 2025 to 30 million by year-end 2026. Medicare's expanded coverage takes effect next year. Novo Nordisk's rival oral GLP-1 is already on the market. The volume-price trade-off is the story to track.