Wall Street is betting about $11.3 billion on Eli Lilly's GLP-1 drugs this quarter. Eli Lilly is due to report first-quarter results before the bell Thursday, with analysts expecting $6.66 in adjusted earnings per share and about $17.62 billion in revenue. Forecasts hinge on Mounjaro and Zepbound, which are projected to bring roughly $7.26 billion and $4.04 billion worldwide, respectively. Foundayo, Lilly's newly approved oral obesity pill, launched after the quarter and won't appear in the results, but executives will face heavy questions about its early rollout. Investors will also watch guidance after Lilly flagged pricing headwinds tied to a federal drug pricing deal and lower cash-pay prices at home.

Street estimates and the headline numbers

The market expects a strong quarter. Analysts surveyed by LSEG put adjusted EPS at $6.66. They see revenue near $17.62 billion.

Those figures reflect continued demand for GLP-1 medicines. Mounjaro and Zepbound are the main drivers. StreetAccount estimates show Mounjaro at about $7.26 billion in worldwide sales. They project roughly $3.87 billion of that came from the U.S.

Zepbound will probably bring in about $4.04 billion globally, with nearly $3.98 billion from U.S. Sales, according to StreetAccount.

Those two products together account for a large chunk of the revenue Wall Street is pricing into Lilly's quarter.

Product mix and what's missing

Foundayo's launch matters, but not for Q1 figures. The pill rolled out in the second quarter.

That means Foundayo sales won't appear in the results Lilly files Thursday.

Still, the company's decision to push an oral GLP-1 into the market shapes investor expectations. Executives will be asked how the new product is tracking versus rivals. Novo Nordisk's Wegovy had a three-month U.S. Lead, and analysts want to know whether Foundayo can close the gap.

Leerink Partners analyst David Risinger told clients that early prescription data show a modest start for Foundayo. He used the word "modest" to describe initial uptake.

The comment suggests Lilly may face questions about prescription momentum and distribution ahead of any revenue contribution.

Pricing pressure, policy and guidance

Lilly has flagged both upside and downside forces. The company said it expects to gain from Foundayo's launch and from Medicare coverage of obesity drugs coming online later in the year. Those developments are potential growth levers.

At the same time, Lilly warned of pricing pressure. The company pointed to a drug pricing deal with President Donald Trump and falling cash-pay prices for Zepbound as factors that could trim revenue per prescription. Management has made clear that mixes of volume and price will both move the top line.

Mastheads

Dave Ricks, Eli Lilly chief executive officer, said he expects lower prices to accelerate U.S. Prescription volumes. He also estimated that global GLP-1 use would rise from about 20 million patients at the end of last year to 30 million by the end of 2026. Those comments give investors an explicit view on how management thinks volume and pricing will interact.

Who benefits and who bears the pressure

Drugmakers with GLP-1 franchises are the immediate winners from robust demand. Lilly holds majority share in that market, according to the company narrative and the sales estimates Wall Street uses. High share means Lilly should capture a large slice of growth even as prices adjust.

Patients could see lower cash prices for some treatments, the company acknowledged. Payers will also play a role. Medicare coverage of obesity drugs is set to change the economics for older patients later this year, which could widen use but also alter reimbursement dynamics.

For investors, the balance matters. Higher volumes can partly offset price concessions. But the impact on margins depends on how much price falls and how quickly new prescriptions grow. Lilly told investors it expects both forces this year.

Expect the call to zero in on three items. First, management commentary on Foundayo's rollout.

Executives will need to explain distribution, patient uptake and provider demand. Those are operational details investors want to hear even if the drug's revenue impact isn't yet visible.

Second, guidance or color on pricing. Lilly has already warned of pressure linked to a federal pricing agreement and to lower cash-pay prices. Investors will try to quantify how much those forces shaved margins in the quarter and how management expects them to evolve.

Third, volume trends for Mounjaro and Zepbound. Wall Street models large sales for both drugs.

Any signs that prescriptions are accelerating would support current estimates. Conversely, a slowdown would force analysts to cut forecasts.

The GLP-1 class has reshaped the sector. Multiple products now compete for obesity and diabetes patients. Novo Nordisk's Wegovy is the closest comparator in obesity. Its early U.S. Lead is part of why investors will ask about Foundayo's ability to gain share.

Competition also affects pricing. Greater supply and new product formats can push prices down. Lilly itself warned that lower cash-pay prices are already a factor in the U.S. Such moves change the calculus for revenue growth soon.

Investors will look at how Lilly balances market share gains with price concessions. That trade-off is central to whether revenue growth translates to profit growth.

StreetAccount and LSEG estimates provide the starting points for sell-side models. Analysts use those figures to build guidance scenarios. If Lilly beats on EPS or revenue, models that assume slower Foundayo uptake may be revised upward.

Conversely, if Lilly flags tougher-than-expected pricing pressure, analysts could cut near-term revenue forecasts. Cuts would focus on the U.S., where cash-pay pricing and the company's deal with the administration are most likely to hit top-line numbers.

Either way, the interplay between volume and price will drive revisions. Management commentary about prescription trends and payer behavior will thus move estimates more than raw quarterly sales in some cases.

The quarter should show how resilient Lilly's GLP-1 franchise is to price moves. Mounjaro and Zepbound are big enough that small percentage swings matter. Analysts expect both to deliver multi-billion dollar sales in the period.

Foundayo is a forward-looking variable. It won't help Thursday's numbers. But executives will still need to explain how the pill's launch fits into Lilly's broader strategy and what early demand looks like.

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Dave Ricks, Eli Lilly chief executive officer, said he expects global GLP-1 use to rise to about 30 million patients by the end of 2026.

This article was created with AI assistance.