🏦 Lilly tops $1T market cap again after Q4 GLP-1 beat

Eli Lilly’s Q4 2025 sales hit $19.3B (+43% YoY) vs. $17.9B expected, powered by tirzepatide demand (Mounjaro $7.4B, +110%; Zepbound $4.3B, +123%), sending shares up >10% and pushing it back above a $1T market cap.

Why It Matters To Oncology

• GLP-1 cash flow can subsidize risk-taking in oncology discovery and late-stage development, even as pricing headwinds loom across specialty pharma.

• Lilly’s oncology franchise remains material but slower-growth vs. incretins: Verzenio posted $1.6B in Q4 (+3%) and Jaypirca $148M (+30%).

• Breast Cancer pipeline signal: newly approved oral SERD Inluriyo contributed $14M post-U.S. launch, an early read on commercial ramp amid a crowded endocrine landscape.

• Portfolio discipline also showed up in R&D: Lilly removed three programs, including Phase I radiopharmaceutical [Ac-225]-PSMA-62 (LY4181530) in PSMA+ prostate cancer.

The Financials

• Q4 revenue: $19.3B (+43% YoY) vs. $17.9B consensus.

• Q4 net income: $6.6B vs. $4.4B prior year.

• Full-year 2025 revenue: $65.1B (+45%).

• 2026 guidance: revenue $80B–$83B; EPS $33.50–$35 (vs. Street ~ $77.6B revenue, $32.47 EPS).

What They're Saying

• CEO Dave Ricks: Lilly Direct engagement rose by >1M patients in 2025; Zepbound self-pay vials now represent ~1/3 of new obesity-med starts on any brand.

• Cantor’s Carter Gould called the outlook “assertive,” arguing it should ease concerns about whether incretin market expansion can offset pricing pressure.

• Competitive contrast: Novo Nordisk guided 2026 sales and operating profit down 5%–13% (constant currency), versus expectations for a smaller contraction.

What's Next

• Watch for how Lilly allocates incremental GLP-1-driven cash toward oncology BD, platform build (e.g., targeted radiopharma), and lifecycle work vs. share repurchases.

• Track early adoption dynamics for Inluriyo in Breast Cancer and whether it can differentiate on tolerability, sequencing, and combination strategies.

• Expect continued pipeline pruning as Lilly prioritizes programs with clearer biomarkers, manufacturability, and commercial path—especially in crowded solid-tumor spaces.

• Monitor GLP-1 pricing and access trends, as payer pressure could indirectly shape oncology investment pace across big pharma.