Oct 29, 2026 earnings call — Incretin-driven revenue and pipeline progress
Company raised full-year revenue guidance to between $91 and $92 billion on strong incretin and other product growth.
Revenue $24.4B (est $22.6B) · EPS $7.48 (est $5.71) · Next-quarter revenue outlook $91.0B–$92.0B
Key quotes
"As part of the Medicare GLP-1 bridge program, we expanded access to obesity medicines in The US for approximately 20 million seniors."
"We added to our pipeline through business development this quarter, acquiring AtaiBeckley and Merida Biosciences."
"We broke ground on 2 new manufacturing facilities, a $6.5 billion facility in Houston, Texas and a $5 billion facility in Richmond, Virginia."
Analyst Q&A 16
Why guidance changed
Q (Christopher Schott · JPMorgan): He asked why revenue guidance rose about $10 billion and whether growth reflects US vs international, cash pay vs commercial, or a larger long-term market.
A: Management did not give details in this exchange. They handed the question to Lucas to answer the guidance and incretin outlook.
"To talk a bit about guidance and our outlook for incretins in the future, we will go to Lucas." — Michael Czapar
Tirzepatide persistency data
Q (Geoffrey Meacham · Citi): He asked what data exist on tirzepatide persistency in obesity and whether oral products (Foundayo, retatrutide) will show different real-world adherence next year.
A: Management deferred to Ilya to discuss persistency and expectations for orals versus injectables.
"Thanks, Jeff. To talk about tirzepatide persistency and obesity and thoughts on the pipeline looking in the future, we will go to Ilya." — Michael Czapar
Real-world adherence for Zepbound
Q (Ilya Yuffa · Citi): He wanted data on persistency for tirzepatide (Zepbound) and whether orals will have different adherence than weekly injectables.
A: They said Zepbound persistency in covered patients is similar to their chronic standard (about 16 to 18 months) and self-pay persistence is close to covered. They expect orals to have lower adherence than weekly injectables, and noted Bridge's low out-of-pocket helps adherence.
Trailblazer-3 and early diagnosis
Q (Seamus Fernandez · Guggenheim): He asked about the chances Trailblazer-3 will succeed and how novel tau blood biomarkers might change Alzheimer’s treatment and market size.
A: They said Kisunla growth reflects its convenience and treat-to-clear potential. New blood biomarkers like P-tau217 enable earlier diagnosis, possibly in primary care, and Trailblazer-3 could expand treatment into earlier, cognitively unimpaired stages where treating earlier may have greater cognitive benefit.
"As we look at Trailblazer-3, which is our study looking at prevention in cognitively unimpaired people, looking at prevention of early symptomatic Alzheimer's disease, these biomarkers will certainly also enable early diagnosis for people that have risk concerns about their cognition before loss of their cognition." — Michael Czapar
Next multibillion growth area
Q (Evan Seigerman · BMO): He asked which therapeutic area after incretins could be Lilly’s next multibillion-dollar growth pillar and if M&A shows neuroscience or immunology are higher priorities.
A: They said they are excited about oncology, neuroscience, and immunology. Oncology has many late-stage programs; neuroscience has large unmet need and recent deals; immunology has crowded but promising targets and acquisitions aimed at breakthrough efficacy.
"I would say that we are excited about all 3 of our other therapeutic areas, which are immunology, neuroscience, and oncology." — Daniel Skovronsky
Medicare Bridge split and switches
Q (Berenberg): She asked about the split between injectable and pill use in the Medicare Bridge program, and what share are treatment-naive versus patients switching from other channels.
A: Management said they would have Ilya address the Bridge split and naive versus switches.
"Thank you, Kerry. I will go to Ilya to talk a bit about Bridge, the injectable versus pill split, as well as naive versus switches." — Michael Czapar
Bridge: injectables, market share, naives
Q (Ilya Yuffa · Berenberg): She asked whether most Medicare demand is injectable, how that compares to other segments, and what proportion in Bridge are treatment-naive versus switches.
A: They said Bridge performed very well: about 75% of Bridge patients choose injectables, 7 out of 10 choose a Lilly medicine, and about 80% of people treated under Bridge are treatment-naive, driving expanded access.
Foundayo launch and titration
Q (Asad Haider · Goldman Sachs): He asked how Foundayo's US and international launches are progressing versus oral Wegovy, and about titration where lower doses made up about 75%–80% of TRx recently and where that might go.
A: They said Foundayo launched in 4 non-US markets and orals are expanding the market with many new patients. In the US they reported over half a million TRx in the quarter, rising consumer awareness, and maintenance dose progression with about 25% at a maintenance dose, which is higher than Wegovy.
"orals are truly expanding the market, and we see a huge amount of patients actually being new to incretins." — Patrik Jonsson (PRESIDENT)
Why guidance surprises occur
Q (Steve Scala · TD Cowen): He asked why Lilly's guidance has often been a poor predictor and whether surprises come from units, pricing, or conservative guidance posture.
A: They said the main surprises came from novel, hard-to-predict events this year—Bridge uptake and international consumer purchasing—which turned out positive. They prefer conservative, reliable guidance while the category is experiencing unprecedented expansion, and expect predictability to improve over time.
"Let's remember, like, we are in the middle of the largest new category expansion in the history of the pharmaceutical industry." — David A. Ricks (CEO·CHAIR)
Long-acting incretin programs
Q (Terence Flynn · Morgan Stanley): He asked whether Lilly will present clinical data on their longer-acting incretin programs at R&D Day and what development stage those programs are in.
A: They said they have multiple competing long-acting platforms in the clinic and are evaluating which technology and molecule properties perform best; they will review the clinical data and choose which efforts to advance to Phase 3.
2027 coverage and pricing mix
Q (Kenneth Custer · RBC): He asked about 2027 trends in GLP-1 coverage among large US employers, whether US channel mix could change and cause pricing pressure next year.
A: They said some employers are opting out, but commercial access should remain relatively stable through 2027. The main access growth will come from Medicare and Medicaid, shifting mix toward lower net price segments, while commercial pricing is expected to be modest and disciplined.
Ex-US pricing and cash pay market
Q (Jefferies): He asked if ex-US pricing could be more stable than expected and how net price per patient may evolve US versus international, plus size of middle-income cash-pay international markets.
A: They said they use disciplined pricing OUS and see providers, consumers, and payers willing to pay for differentiated products. Out-of-pocket willingness exists internationally and there is large long-term opportunity outside the US, with ongoing efforts to secure type 2 reimbursement.
EMBER-4 interim and effect size
Q (Akash Tewari · Evercore): He asked about the odds of early stoppage for EMBER-4 and how effect size might compare to Lidera given a more real-world setting with CDK4/6 use.
A: They said they have not discussed interim analyses and expect EMBER-4 to read out in 2027. The study is designed in a more real-world setting with CDK4/6 use, which could make results more clinically relevant; they would not comment on anticipated effect sizes now.
Bridge program longevity with admin
Q (Umer Raffat · Cantor): He asked whether Lilly has confidence the Bridge pilot will be extended or adopted into Part D and not disrupted at the end of the pilot.
A: They said they are optimistic expansion will occur because early uptake is strong, use is appropriate, and independent analysis shows cost savings; CMS may do its own analysis, and shifting into Part D with carriers is a likely path for continued access.
How patients choose obesity drugs
Q (UBS): He asked how a consumer-driven market will shape choice among Lilly’s obesity portfolio (retatrutide, amylin, others) as options and prices change.
A: They said the obesity problem is huge and a portfolio approach is needed. Each molecule has unique roles: Foundayo as an on-ramp/maintenance, tirzepatide as a cornerstone, retatrutide for high and simple dosing and certain subpopulations, and amylin offering different tolerability—patients will choose what works and stay on Lilly medicines.
BD strategy and risk appetite
Q (Michael Yee · Berenberg): She asked how Lilly is balancing risk and reward in M&A and licensing, what areas they still want to add, and how they keep deal standards high.
A: They said they can take calculated early-stage risks because current revenues allow long-term planning. They pursue early clinical-stage deals with enough derisking to create value, have a rigorous, disciplined process, and will continue adding high-quality science across therapeutic areas.