Eli Lilly beat Q2 consensus with revenue up 48% to $22.974 billion, lifted 2026 guidance to $85-$87 billion, and posted 91% Mounjaro growth, while trimming high-end EPS guidance on $2.8 billion in acquisition charges. Novo Nordisk's semaglutide franchise grew by low single digits, Krystal Biotech…
Eli Lilly and Company NYSE: LLY closed the review week up 6.3%, with shares rising from $1,115.68 on August 4 to a Thursday peak of $1,192.28 before profit-taking pulled the stock to $1,185.71 at Friday's close. The 6.9% rise from August 4 to Thursday came after second-quarter results that beat analyst estimates on both lines: revenue rose 48% year over year to $22.974 billion, and net income rose 25% to $7.095 billion.
The company raised its 2026 GAAP revenue guidance to $85 billion to $87 billion, a 2.4% to 3.7% increase over its prior range of $82 billion to $85 billion, and lifted the midpoint from $85.5 billion to $86 billion. The incretin franchise powered the quarter: Mounjaro total revenue grew 91% to $9.943 billion, and Zepbound revenue grew 46% to $4.928 billion.
The same week split the rest of the sector. Krystal Biotech Nasdaq: KRYS shares fell 11% after Vyjuvek revenue came in slightly below consensus. Emergent BioSolutions NYSE: EBS shares tumbled about 30% on Thursday as the company announced a roughly 93-position restructuring. Iovance Biotherapeutics Nasdaq: IOVA shares surged 43% on record quarterly revenue. The divergence tracks where commercial momentum now sits across peptide, gene, and cell therapies.
Lilly's second-quarter earnings per share came in at $7.94, up 26% from $6.29 in the year-ago quarter, on revenue of $22.974 billion versus $15.558 billion. Net income was $7.095 billion, up 25% from $5.661 billion. By the consensus figures Leerink Partners maintains, Lilly beat by 25% on EPS and by 11% on revenue.
David Risinger, Senior Managing Director and Senior Research Analyst at Leerink Partners, said: "LLY significantly exceeded 2Q consensus expectations, and the income statement shows the tremendous operating leverage as sales upside drives much higher margins and profits."
The guidance picture was more nuanced than the headline raise. Lilly raised its 2026 EPS forecast by 7% to $33.87 to $36.20, but trimmed the high end by 1.4% to $36.50 from $37.00, leaving the low end unchanged at $35.50. The trim reflects $2.8 billion, or $3.03 per share, in acquired in-process research and development IPR&D charges taken in the quarter. Those charges came from two acquisitions completed in Q2: Orna Therapeutics, a circular RNA therapy developer acquired for $2.4 billion, and Ajax Therapeutics, a JAK2 inhibitor developer acquired for up to $2.3 billion. The Ajax figure is a maximum, so the final consideration may be lower. Under US GAAP, the fair value of in-process R&D with no alternative future use is expensed at close, which is why the revenue guidance rose while the reported earnings ceiling fell.
Leerink raised its 12-month price target for Lilly to $1,232 to $1,309, a 6% increase, based on a 25x multiple of its revised estimate of 2027 adjusted EPS of $49.28 to $52.34.
David A. Ricks, Chairman and CEO of Eli Lilly, tied the quarter to the pipeline: "With our next-generation weight-loss medicine retatrutide and its complete clinical data package in hand, new manufacturing capacity coming online... Lilly's future, after 150 years, has never been brighter."
That manufacturing capacity is measurable. Since 2020, Lilly has announced US projects totaling $55 billion. The build-out serves two purposes: meeting the scale demands of injectable incretins, and shifting production onshore to avoid tariffs imposed by the Trump administration on imported drugs.
Mounjaro tirzepatide , Lilly's drug for adult type 2 diabetes, brought in $9.943 billion in the quarter, up 91% from $5.199 billion a year earlier. US sales were $4.791 billion, about 10% above consensus; ex-US sales were $5.162 billion, about 14% above consensus. Zepbound , the same molecule marketed for obesity and available as a KwikPen pre-filled injection version, grew 46% to $4.928 billion from $3.381 billion in the same period of the prior year.
The growth contrast with Novo Nordisk NYSE ADR: NVO is stark. Ozempic , Novo's type 2 diabetes product built on semaglutide , posted Q2 sales of DKK 31.375 billion, or $4.851 billion, up 5% year over year. Injectable Wegovy posted DKK 19.484 billion, or $3.013 billion, up 1%. Oral Wegovy, which reached the US market on January 5, contributed DKK 3.218 billion, about $498 million. Mounjaro's quarterly sales alone, at $9.943 billion, exceeded the combined reported sales of all three semaglutide brands.
The pharmacologic distinction matters here. Tirzepatide is a dual agonist at the GLP-1 and GIP receptors; semaglutide is a GLP-1 receptor agonist. Both are sometimes loosely described as GLP-1 inhibitors, but the molecules activate incretin signaling rather than block it, and their receptor coverage differs. The Q2 numbers are a market-level signal that dual agonism retains a commercial edge in this cycle, and they set a high bar for retatrutide , Lilly's Phase III candidate that targets GLP-1, GIP, and glucagon receptors.
The demand environment for the class is partly policy-driven. Medicare's GLP-1 Bridge Program caps participant cost at a fixed $50 monthly copay and is scheduled to end December 31, 2027. The program's existence, and its expiration date, are now inputs into every forecasting model for the franchise, and the scheduled end creates a demand cliff that payers and manufacturers will have to negotiate before then.
The FDA approved Foundayo orforglipron , an oral small-molecule GLP-1 receptor agonist for obesity, on April 1. In its first quarter on the market, the drug generated $98 million in sales, about $3 million below the consensus forecasts Jefferies cites.
The miss is small in absolute terms, but the launch profile matters for how investors read the oral channel. Akash Tewari, Equity Analyst at Jefferies, said: "While Foundayo's initial U.S. launch has been muted, we think investor focus will shift toward whether LLY's GLP-1/obesity franchise as a whole including Foundayo can beat expectations in '26."
The oral format is the strategic point. Injected peptide incretins require fill-finish capacity and patient training; an oral small molecule bypasses both. Orforglipron is a non-peptide small molecule, which is what allows it to survive the gastrointestinal environment and reach the circulation orally, whereas peptide agonists in this class are degraded in the gut and must be dosed by injection. That is why the $98 million figure, and the pace at which it grows, is watched as a proxy for whether the next generation of this class can escape the manufacturing constraints that have repeatedly limited supply. What the first quarter does not establish is durability. A single quarter of a launch, with sampling and early reimbursement still settling, is too short a window to separate a slow start from a structural ceiling. Second- and third-quarter sales trends will settle that question.
The commercial numbers rest on two of the most heavily studied peptide sequences in the Peptide Atlas registry:
The registry overlap is visible in shared indications. The Phase 4 trial of metabolic surgery for atrial fibrillation elimination NCT07027969 appears in both files, a sign of how far the incretin class has moved beyond glycemic control. The recruiting trials map the expansion. Semaglutide's file includes a Phase 2 study in stage 1 type 1 diabetes NCT07430332 , a Phase 2 trial pairing a GLP-1 agonist with the Shingrix vaccine to preserve beta cell function in recent-onset type 1 diabetes SHIELD-T1D, NCT07614412 , a Phase 4 study of pre-surgical optimization in endometrial cancer patients with obesity SHAPE-ENDO, NCT07462663 , and a Phase 4 trial in childhood obesity NCT06977438 . Tirzepatide's file includes a Phase 2 trial in cannabis use disorder NCT07468552 , a Phase 2 study in concurrent type 1 diabetes with overweight or obesity NCT06180616 , and a Phase 4 trial of tirzepatide after catheter ablation for atrial fibrillation in patients with obesity and heart failure with preserved ejection fraction NCT07630454 .
The indexed literature shows the same breadth, plus the safety signals that scale brings. Semaglutide has 197 indexed papers on file, tirzepatide 188. Recent semaglutide entries include a systematic review and meta-analysis of long-term safety and renal outcomes in non-diabetic obesity with chronic kidney disease or hypertension PMID 42340790 , the STRIDE trial in peripheral artery disease and diabetes PMID 41780559 , and a scoping review of retinal vascular event risk PMID 42348481 . Tirzepatide's file includes a real-world comparative effectiveness study against semaglutide for obesity PMID 42383938 and a multicenter real-world study in metabolic dysfunction-associated steatotic liver disease PMID 42397506 . Case reports, including starvation-type euglycemic ketoacidosis after unsupervised tirzepatide use PMID 42381258 , are a reminder that broad outpatient adoption increases the need for prescribing vigilance.
The breakdown fields on file capture only part of the registry totals, so the counts serve as directional evidence of development activity rather than a complete inventory. For the supply chain, the Peptide Atlas purity record is a reference point. Third-party laboratory tests on file show a highest observed purity of 99.979% for semaglutide across eight tests and 99.864% for tirzepatide across four tests. These are single highest observed values from independent tests, not batch certifications, so they function as verification benchmarks rather than guarantees of any commercial lot. In a market where branded injectables command premium pricing and compounding demand has expanded, those independent readings anchor quality expectations as manufacturing scales.
Krystal Biotech's weekly decline of 11% was a study in position, not demand. On July 31 the shares fell 7%, from $366.85 to $341.12, on profit-taking. On August 3 they dropped another 8% to $312.57. Thursday brought a 3% bounce to $322.69, and Friday a 1% rise to a close of $326.45. The move came despite bullish analyst notes on the underlying business.
Vyjuvek beremagene geperpavec-svdt, or B-VEC , Krystal's gene therapy for dystrophic epidermolysis bullosa DEB , posted Q2 net product revenue of $119.222 million, up 24% from $96.042 million in the year-ago quarter. That was 0.7% to 1.4% below the consensus range of $120.1 million to $120.9 million tracked by Jefferies. US sales were $91.6 million, European sales were $19.3 million, and Japan contributed $8.3 million. The shortfall was attributed to first-time German pricing accruals in the first full quarter, and the accounting may persist as a source of quarterly revenue volatility.
Roger Song, MD, Equity Analyst at Jefferies, said: "Despite a modest revenue miss driven primarily by German pricing accrual dynamics, underlying Vyjuvek demand remains robust across U.S. and ex-U.S."
The US operating metrics support the demand read. Vyjuvek held 730+ reimbursement approvals in the US as of Q2, an increase of 35 from the first quarter, and 640+ unique US prescribers have written for the therapy since its 2023 launch, with 70 new prescribers added in Q2. Jefferies estimates that 35 to 40 US patients have been added to treatment per quarter over the past year. At roughly 60% penetration of patients diagnosed with DEB in the US, the domestic base is…
Peptides referenced: Semaglutide, Tirzepatide, Retatrutide, Orforglipron, Glucagon, GLP-1.
Related reading: Meta-Analyses Question Long-Term Value of GLP-1 Weight-Loss Drugs, Gedeon Richter and Adalvo Expand Partnership to Tirzepatide Therapies, Tirzepatide tied to 32% lower MACE risk in real-world diabetes cohort, Coroner ties tirzepatide to law student's fatal arrhythmia.