Eli Lilly Faces a Crossroads: Foundayo’s Tepid Debut Overshadows Soaring GLP-1 Sales

Eli Lilly's Q1 earnings show strong Mounjaro and Zepbound sales, but focus shifts to Foundayo's modest launch. Stock down 20% YTD as CEO bets on volume via price cuts.

Eli Lilly reports first-quarter earnings today, and for the first time in years, the market’s attention is trained on something other than the blockbuster sales of Zepbound and Mounjaro. The spotlight has shifted to Foundayo, the company’s newly launched oral weight-loss drug, and early prescription data suggests a launch that is far from explosive.

Analyst David Risinger of Leerink Partners has flagged the initial uptake as modest, a characterization that has already weighed on the stock. The drug only hit the market in the second quarter, meaning its revenue has yet to appear in the earnings report. But investors are already pricing in the disappointment, particularly with Novo Nordisk having secured a three-month head start in the US with its own Wegovy pill.

The underlying business, however, remains formidable. Analysts project worldwide sales of roughly $7 billion for Mounjaro in the first quarter, with Zepbound adding another $4 billion. That would put total revenue growth at nearly 37% year-over-year. Yet the stock has failed to reflect this operational strength. Trading at around $737, shares have fallen more than 20% since the start of 2026 and dropped over 7% in the past month alone, trailing the broader pharmaceutical sector.

The company is navigating a strategic pivot. CEO Dave Ricks has chosen to prioritize volume over pricing, cutting costs for GLP-1 drugs under a new agreement with the US government. Starting in April, Medicare patients will pay no more than $50 per month for Zepbound and Foundayo, while Lilly receives tariff relief for three years in return. Ricks is betting that lower prices will dramatically boost prescription volumes, targeting 30 million GLP-1 patients globally by the end of 2026 — an increase of 10 million from the prior year.

That strategy will be tested when Lilly reaffirms its full-year guidance. The company is targeting 2026 revenue between $80 billion and $83 billion, a roughly 25% jump from last year’s $65.2 billion. But the pace of growth is already slowing: the first quarter’s expected 36.8% increase, while impressive, marks a deceleration from the 45.2% growth recorded in the same period a year ago. The fourth quarter of 2025 was particularly strong, with revenue of $19.3 billion and growth of 42.6%.

Earnings per share have also been a bright spot. Adjusted EPS for 2025 came in at $24.21, up 86%. In the most recent quarter, Lilly delivered $7.54 per share, beating the consensus estimate of $6.91 by 9.1%. That track record of outperformance — three of the last four quarters have beaten expectations — sets a high bar for today’s report.

Beyond the earnings numbers, the company is making aggressive moves in oncology. On Monday, Lilly announced plans to acquire Ajax Therapeutics for up to $2.3 billion in cash, including upfront and milestone payments. Ajax is developing AJ1-11095, a next-generation oral JAK2 inhibitor that targets a signaling protein involved in certain blood cancers through a novel mechanism. Early clinical efficacy data are expected by the end of 2026.

The Ajax deal marks the third oncology acquisition in just three weeks, following offers for CrossBridge Bio and Kelonia Therapeutics. The pattern is unmistakable: Lilly is methodically building out its cancer pipeline, even as its weight-loss franchise dominates headlines.

Management will face tough questions during the analyst call at 4 p.m. Central European Time. Investors want clarity on production capacity for GLP-1 drugs, the sustainability of margins amid heavy capital spending, and the potential impact of tariffs on the pharmaceutical industry. With a market capitalization of roughly $783 billion, Lilly has plenty to prove.

The stock has missed the recent pharma rally — peers gained an average of 10.8% over the past 30 days, while Lilly lost 1.5%. If the company can beat expectations again and reaffirm its full-year outlook, that gap could close quickly. A miss on earnings or weak margin guidance, however, would widen the divide further, leaving Foundayo’s slow start as more than just a temporary concern.