Eli Lilly beats on earnings even as weight loss, diabetes drug sales fall short

Eli Lilly on Thursday reported mixed results for the fourth quarter, even as demand for its blockbuster weight loss drug Zepbound and diabetes treatment Mounjaro soared.

The company’s quarterly earnings topped Wall Street estimates, but sales fell just short as Mounjaro saw lower realized prices. Zepbound and Mounjaro have now underperformed expectations for two straight quarters, with the company previously pointing to issues around inventory decreases among wholesalers.

The pharmaceutical giant also issued fiscal 2025 profit guidance of $22.05 to $23.55 per share, which is in line with what analysts were expecting. Eli Lilly reiterated its fiscal 2025 sales guidance of $58 billion to $61 billion, noting that it expects to launch Mounjaro in new international markets throughout the year.

Eli Lilly expects to see “a continuation of basically the total prescription growth that we have seen in 2024” for incretin drugs such as Zepbound and Mounjaro, “so that’s what we built in our 2025 guidance for the market,” the company’s CFO Lucas Montarce said during an earnings call on Thursday.

Shares of Eli Lilly rose more than 4% on Thursday.

The figures were consistent with the preliminary results Eli Lilly shared in January, which disappointed investors. Eli Lilly had slashed its 2024 revenue guidance, as it said demand for its weight loss and diabetes drugs would not meet its lofty expectations.

Notably, Eli Lilly said it plans to report late-stage data on its next-generation obesity drug retatrutide later this year, a few months earlier than expected. Retatrutide works differently from any of the treatments on the market, mimicking three different hunger-regulating hormones: GLP-1, GIP and glucagon.

Here’s what Eli Lilly reported for the fourth quarter compared with what Wall Street was expecting, based on a survey of analysts by LSEG: 

• Earnings per share: $5.32 adjusted vs. $4.95 expected
• Revenue: $13.53 billion vs. $13.57 billion expected

The company posted fourth-quarter revenue of $13.53 billion, up 45% from the same period a year ago. 

The pharmaceutical giant booked net income of $4.41 billion, or $4.88 per share, for the fourth quarter. That compares with a profit of $2.19 billion, or $2.42 a share, a year earlier. 

Excluding one-time items associated with the value of intangible assets and other adjustments, Eli Lilly posted earnings of $5.32 per share for the fourth quarter of 2024.

Mounjaro posted $3.53 billion in revenue for the fourth quarter, up 60% from the year-earlier period. Analysts had expected the drug to book $3.62 billion in sales for the quarter, according to StreetAccount.  

Eli Lilly said the increase reflects strong demand and increased supply of Mounjaro, but was partially offset by lower realized prices due to “favorable changes” in the fourth quarter of 2023 to estimates for rebates and discounts. 

Meanwhile, the results cap Zepbound’s first full year on the U.S. market. The weekly injection raked in $1.91 billion in sales for the fourth quarter, which is below the $1.98 billion that analysts expected, according to StreetAccount. 

Montarce said Zepbound became the market leader in the obesity market in the fourth quarter, as measured by new prescriptions.

But demand in the U.S. has still far outpaced supply for Eli Lilly’s incretin drugs, such as Zepbound and Mounjaro, over the last year. Both treatments mimic certain gut hormones to tamp down a person’s appetite and regulate their blood sugar.

The popularity of those injectable drugs has forced both Eli Lilly and its rival Novo Nordisk to invest billions to ramp up manufacturing capacity for their treatments. The efforts appear to be paying off: The Food and Drug Administration in December reaffirmed its decision to declare the U.S. shortage of tirzepatide — the active ingredient in Zepbound and Mounjaro — over.