The numbers are stark. In its second week on the market, Eli Lilly’s new oral obesity pill Foundayo generated just 3,707 prescriptions. By comparison, Novo Nordisk’s oral Wegovy racked up 18,410 in the same window. That gap has rattled investors, sending the stock down roughly 22% from its January peak and about 18% year-to-date.
Yet Lilly is urging calm. The company argues that weekly prescription data, compiled by IQVIA and analyzed by RBC Capital Markets, offer an incomplete snapshot. RBC analyst Trung Huynh agrees, noting that Foundayo’s true commercial trajectory won’t become clear until weeks eight through twelve. Some investors had initially baked in up to $5 billion in Foundayo revenue for 2026; those estimates have now been slashed to a range of $1.3 billion to $1.5 billion—achievable if roughly 300,000 prescriptions are written by year-end.
The Core Business Holds Steady
While Foundayo’s debut has dominated headlines, Lilly’s GLP-1 franchise remains robust. Mounjaro posted roughly 758,400 total prescriptions in the week ending April 17. The company commands about 59% of new GLP-1 prescriptions, while Zepbound dominates the branded obesity market with nearly 70% of new scripts.
For 2025, total revenue surged 45% to $65.2 billion. Management has guided for $80 billion to $83 billion in 2026 revenue—roughly 25% growth—despite acknowledging that pricing pressures will shave off low- to mid-double-digit percentage points from growth. Non-GAAP earnings per share are expected to land between $33.50 and $35.00, up from $24.21 in 2025.
Wall Street is bracing for a strong first-quarter print on Wednesday, April 30. Analysts expect earnings per share of $7.55, more than double the $3.34 reported a year earlier, on revenue of $17.6 billion. Of the 30 analysts covering the stock, 23 rate it a strong buy.
A Buying Spree in Full Swing
Even as Foundayo struggles to gain traction, Lilly has been on an acquisition tear. On April 27, the company agreed to acquire the remaining majority stake in Ajax Therapeutics for up to $2.3 billion. Ajax is developing AJ1-11095, an oral therapy for myelofibrosis, a rare blood cancer. The drug targets JAK2, a signaling protein implicated in several blood malignancies.
That deal follows a flurry of activity. Less than a month earlier, Lilly announced the $7.8 billion acquisition of Centessa Pharmaceuticals, which focuses on sleep-disorder treatments like narcolepsy. In March, it closed the $1.2 billion purchase of Ventyx Biosciences, a developer of oral anti-inflammatory drugs. February brought a $2.4 billion deal with Orna Therapeutics.
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The aggressive pace of dealmaking raises a key question for investors: how will Lilly balance its acquisition appetite with margin discipline, especially as pricing pressure mounts in the GLP-1 market?
Oncology Pipeline Shows Promise
Beyond the weight-loss arena, Lilly’s oncology pipeline is generating positive data. The company recently reported Phase 3 results for Jaypirca (pirtobrutinib) in relapsed or refractory chronic lymphocytic leukemia. The study met its primary endpoint with a statistically significant improvement in progression-free survival—the fourth positive Phase 3 readout for the drug.
Morningstar has raised its fair value estimate for Lilly to $870, up from $770, citing strong 2025 results. The research firm projects 27% revenue growth in 2026, followed by 20% in 2027. But it maintains a high uncertainty rating, pointing to variables around insurance coverage, pricing dynamics, and the complexity of managing multiple simultaneous product launches.
What Wednesday’s Numbers Will Reveal
When Lilly reports first-quarter results on Wednesday, the focus will be on two fronts: how management recalibrates expectations for Foundayo, and whether the company can sustain its acquisition momentum without sacrificing margins. Morningstar has already penciled in $1.7 billion in Foundayo revenue for this year, with international sales expected to surpass U.S. revenue by 2027.
Lilly’s oral pill holds a manufacturing advantage over Novo Nordisk’s Wegovy, and the company still has patent protection on Mounjaro and Zepbound through at least 2036. Those products already accounted for 56% of total revenue in 2025, and that share could climb above 60% this year.
For now, the market is waiting to see whether Foundayo’s slow start is a temporary stumble or a sign of deeper headwinds. Wednesday’s earnings call will offer the first real opportunity for Lilly to make its case.
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