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Exclusive Article
Lilly's Double-Beat Widens the GLP-1 Gap—And a New Pill Could Make It PermanentSubmitted by Nathan Reiff. Publication Date: 5/1/2026. 
Key Points
- Eli Lilly reported impressive Q1 2026 results, including a $2-billion revenue beat over analyst predictions and 156% year-over-year EPS improvement.
- Significant boosts to full-year guidance and news of Foundayo's approval could also help to generate momentum for LLY shares.
- Novo Nordisk faces an uphill battle at the same time, as the threat of generic versions of Ozempic looms.
- Special Report: The Biggest IPO Ever: Claim Your Stake Today
The $63-billion GLP-1 agonist market is forecast to triple over the next decade, so it's no surprise that pharmaceutical companies of all sizes are scrambling to get in on the action. For now, the market is still dominated by two names: Eli Lilly and Co. (NYSE: LLY) and Novo Nordisk A/S (NYSE: NVO). Between the two, Novo Nordisk may have the more recognizable brands in the GLP-1 space, as it makes both Ozempic and Wegovy.
However, Eli Lilly's latest earnings suggest it could cement a dominant position that would make it even tougher for competitors in this fast-growing market. Eli Lilly delivered a Q1 2026 trifecta—an earnings beat, raised full-year guidance, and early-April FDA approval of Foundayo, the first oral GLP-1 with no food or water restrictions—widening its lead over Novo Nordisk just as the race for a convenient weight-loss pill heats up. Digging Into Lilly's Q1 2026 ResultsStrictly on the numbers, Eli Lilly's Q1 2026 results were strong. Revenue rose an impressive 56% year over year, driven largely by $12.8 billion in combined sales of its two main GLP-1 products, Mounjaro and Zepbound. Total revenue of nearly $20 billion came in about $2 billion above consensus. On the bottom line, Lilly reported $8.55 in earnings per share (EPS), a 156% increase from a year earlier and $1.58 above analyst expectations. The biggest development beyond the financials is the FDA approval of Foundayo, the first oral GLP-1 agonist for obesity that can be taken at any time of day with no food or water restrictions. Many current oral GLP-1 medications require dosing at specific times or waiting before eating, so Foundayo represents a meaningful step forward in convenience and flexibility. Early uptake appears encouraging: the initial install base of roughly the first 20,000 patients is gaining traction. As Lilly continues rolling out Foundayo, that convenience could make it the GLP-1 of choice for many patients. There’s more to the momentum than a single product. Management raised full-year 2026 revenue guidance by $2 billion at both the low and high ends (previously $80 billion to $83 billion; now $82 billion to $85 billion). EPS guidance also increased by $2 at both ends, to a range of $35.50 to $37 for the year. Novo Nordisk's Uphill BattleAfter Lilly's strong report, investors will be watching Novo Nordisk's Q1 2026 earnings closely. The Danish firm is working on an oral version of Ozempic and seeking pediatric approvals, which would expand its addressable market. It is also running early trials for LX9851, a non-incretin obesity drug that could serve as an alternative to GLP-1 therapies. One of Novo Nordisk's major risks is the prospect of generics. Canada recently approved a generic version of Ozempic, which could put pressure on Novo's pricing power. Notably, the FDA has proposed excluding certain active ingredients in Novo's products from the mass compounding list, which would make it more difficult for other companies to create copycats and help protect its core GLP-1 portfolio. Analysts are mixed on Novo's outlook. Only four of 23 analysts rate NVO shares a Buy, although the stock has roughly 50% upside based on a consensus price target of $65.56. By contrast, Wall Street is more optimistic about Eli Lilly: 25 of 30 analysts rate LLY a Buy or equivalent, even though the consensus upside for LLY is lower at about 25%. As Foundayo continues to enter the market, investors will be watching whether updated price targets indicate more room for growth. |
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