Eli Lilly (LLY) Q3 2026 Earnings: Mounjaro Grows Abroad, Foundayo Lags Scripts

Eli Lilly (LLY) third-quarter 2026 earnings showed patient volume growing faster than prices fell in both the US and international markets. The company reported results for the quarter ended September 30, 2026 on October 29, 2026 through its 10-Q, earnings release and earnings call. Revenue was $24.397 billion, up 39%, with volume adding 53 percentage points and price subtracting 15 points [1].

The prior view of Lilly rested on four questions: whether US volume could offset price cuts, whether ex-US Mounjaro could hold up through the seasonally weak third quarter, whether prescriptions for oral Foundayo could turn into revenue, and whether margins would fall in the second half. US revenue grew 34%, and US price fell 10% excluding an adjustment to rebate estimates, so volume still clearly outran price [2]. More than 500,000 people have filled a Lilly prescription through the Medicare GLP-1 Bridge program since July, and about 80% of Bridge patients are new to incretin therapy [3][4]. Ex-US Mounjaro kept growing in the seasonal low; Foundayo prescriptions rose but revenue lagged.

Margins also held up better than the August guidance implied. The non-GAAP performance margin was 54.2%, and it stays near 52% after removing about $900 million of one-time revenue benefits [5][6]. Lilly raised full-year revenue guidance to $91 billion to $92 billion and performance margin guidance to 52% to 52.5% [7]. The limits are also clear. Management said growth in government insurance channels in 2027 will shift the mix toward lower net prices [8]. Operating cash flow covers investment in manufacturing capacity, but this year's large acquisitions have raised borrowing.

Lilly is an Indianapolis-based drugmaker whose products are sold in about 90 countries [9]. In the US, most of its medicines reach pharmacies and hospitals through wholesalers, and prices are set through rebates and discounts negotiated with insurers, pharmacy benefit managers and government programs [10]. Tirzepatide drives revenue: in the quarter, the diabetes drug Mounjaro brought in $10.723 billion and the obesity drug Zepbound $5.352 billion [11].

Ex-US Mounjaro hit a record in a seasonally weak quarter

Ex-US Mounjaro revenue kept rising, and the feared seasonal decline did not happen. Revenue outside the US was $5.725 billion, above $5.152 billion in the second quarter and up 93% from $2.965 billion a year earlier [12][13]. Lilly attributed the growth to volume and said lower prices came mainly from adding Mounjaro to China's National Reimbursement Drug List [14].

Price pressure eased while market share rose. The price drag on revenue outside the US narrowed from 36 percentage points in the second quarter to 29 points, and volume added 76 points [1][15]. Management said Lilly's share of the international incretin market rose nearly 4 percentage points from the second quarter to about 58% [16]. China revenue was $947 million, compared with $560 million a year earlier [17].

These results show international uptake is still expanding. Ex-US Mounjaro was about 23% of company revenue in the quarter and added about $2.76 billion year over year. Competition still has to be tested: generics have launched in India, Brazil and Canada, and management said Lilly has held its share there but gave no figures [18].

Foundayo prescriptions rose faster than revenue

Foundayo revenue did not keep pace with prescriptions. Third-quarter Foundayo revenue was $184 million worldwide, about 1.9 times the second quarter's $98 million and short of doubling [11][19]. New Foundayo patients doubled from the second quarter, and Foundayo's share of new US prescriptions for oral obesity drugs approached 40% [20][21].

The dose mix explains most of the gap. Management said only about 25% of patients have reached a maintenance dose, so most remain on lower-priced starting doses [22]. In the Bridge program, about 75% of patients chose an injectable therapy [23]. Lilly did not split Foundayo revenue between the US and other markets this quarter, and the second-quarter base included $31 million from the launch in the United Arab Emirates [19], so the US growth multiple is unknown.

Foundayo was about 0.8% of revenue in the quarter, so its effect on profit is small, but it is Lilly's main new product for 2027. The company expects a US regulatory decision on the type 2 diabetes indication in the fourth quarter and has launched in four markets outside the US [20].

Conclusion

The quarter strengthens the view that patient growth can offset price cuts, with growth in both the US and international markets driven by patient numbers. Profit conversion beat the level implied by August guidance, but about $900 million of one-time revenue will not repeat, and Lilly has now recognized all of its Jardiance sales milestones [5]. Operating cash flow remains ample, but debt raised for acquisitions should be tracked alongside profit. The next quarter will show whether margins hold the new guidance without one-time revenue, whether the underlying US price decline widens, and whether dose titration and a type 2 diabetes approval speed up Foundayo revenue.

Sources

[1] LLY Q3 2026 10-Q filed 2026-10-29 · Q3 2026 revenue bridge, https://www.sec.gov/Archives/edgar/data/59478/000005947826000108/lly-20260930.htm [2] LLY Q3 2026 earnings call 2026-10-29 · CFO prepared remarks on price/volume [3] LLY Q3 2026 earnings call 2026-10-29 · CEO remarks on Medicare GLP-1 Bridge [4] LLY Q3 2026 earnings call 2026-10-29 · Q&A on Bridge patient mix [5] LLY Q3 2026 8-K press release filed 2026-10-29 · Q3 2026 highlights, https://www.sec.gov/Archives/edgar/data/59478/000005947826000104/q326lillysalesandearningsp.htm [6] LLY Q3 2026 earnings call 2026-10-29 · CFO prepared remarks on Q3 results [7] LLY Q3 2026 8-K press release filed 2026-10-29 · 2026 financial guidance, https://www.sec.gov/Archives/edgar/data/59478/000005947826000104/q326lillysalesandearningsp.htm [8] LLY Q3 2026 earnings call 2026-10-29 · Q&A on 2027 access and channel mix [9] LLY 10-K filed 2026-02-12 · business overview, https://www.sec.gov/Archives/edgar/data/59478/000005947826000013/lly-20251231.htm [10] LLY 10-K filed 2026-02-12 · distribution, wholesalers and payment terms, https://www.sec.gov/Archives/edgar/data/59478/000005947826000013/lly-20251231.htm [11] LLY Q3 2026 8-K press release filed 2026-10-29 · Q3 2026 selected revenue highlights, https://www.sec.gov/Archives/edgar/data/59478/000005947826000104/q326lillysalesandearningsp.htm [12] LLY Q3 2026 10-Q filed 2026-10-29 · Q3 2026 revenue by product and region, https://www.sec.gov/Archives/edgar/data/59478/000005947826000108/lly-20260930.htm [13] LLY 10-Q filed 2026-08-05 · Q2 2026 revenue by product and region, https://www.sec.gov/Archives/edgar/data/59478/000005947826000081/lly-20260630.htm [14] LLY Q3 2026 10-Q filed 2026-10-29 · Q3 2026 Mounjaro and Zepbound commentary, https://www.sec.gov/Archives/edgar/data/59478/000005947826000108/lly-20260930.htm [15] LLY 10-Q filed 2026-08-05 · Q2 2026 revenue bridge, https://www.sec.gov/Archives/edgar/data/59478/000005947826000081/lly-20260630.htm [16] LLY Q3 2026 earnings call 2026-10-29 · CFO remarks on international incretins [17] LLY Q3 2026 10-Q filed 2026-10-29 · Q3 2026 revenue by geography, https://www.sec.gov/Archives/edgar/data/59478/000005947826000108/lly-20260930.htm [18] LLY Q3 2026 earnings call 2026-10-29 · Q&A on ex-US pricing [19] LLY Q2 2026 earnings call 2026-08-05 · market share and Foundayo revenue, https://investor.lilly.com/news-releases/news-release-details/lilly-reports-second-quarter-2026-financial-results-raises-full [20] LLY Q3 2026 earnings call 2026-10-29 · CFO remarks on Foundayo launch [21] LLY Q3 2026 earnings call 2026-10-29 · Q&A on Foundayo U.S. launch [22] LLY Q3 2026 earnings call 2026-10-29 · Q&A on Foundayo titration [23] LLY Q3 2026 earnings call 2026-10-29 · Q&A on Bridge injectable vs oral split