New York, Feb 4, 2026, 16:42 EST — After-hours
Eli Lilly (LLY) shares surged roughly 10.4% to $1,107.12 in after-hours trading Wednesday following a robust fourth-quarter report and a 2026 profit forecast that topped Wall Street estimates. During the regular session, the stock fluctuated between $995.88 and $1,114, with around 7.1 million shares changing hands.
The rally comes amid growing price pressure in the obesity-drug sector, beyond just demand issues. Novo Nordisk flagged “unprecedented” pricing pressures hitting in 2026, warning sales and profits could drop by up to 13%, which sent its shares tumbling. Its CFO highlighted a faster move toward patients paying out of pocket and rising rebate demands from insurers—those rebates being discounts returned to insurers and pharmacy intermediaries. 1
Lilly says it can weather the pricing squeeze by leaning on higher volumes, as more patients pay out of pocket in a growing “cash-pay” market instead of relying on insurance. Ken Custer, head of cardiometabolic health, called early demand for Novo’s oral Wegovy “very encouraging,” seeing it as proof many patients have been waiting for a pill option. That’s as Lilly gets ready to launch its own oral obesity drug, orforglipron. CFO Lucas Montarce warned investors that price will likely be a “drag” on growth. Meanwhile, BMO Capital Markets analyst Evan Seigerman noted the update shows the pressures facing Lilly and Novo aren’t the same. 2
Lilly reported Q4 revenue up 43% to $19.292 billion, with non-GAAP earnings at $7.54 per share. The adjusted earnings exclude certain charges and amortization. Sales from Mounjaro hit $7.409 billion, while Zepbound brought in $4.261 billion for the quarter, according to the company. Looking ahead, Lilly projects 2026 revenue between $80 billion and $83 billion, with non-GAAP earnings per share ranging from $33.50 to $35.00. 3
Leerink Partners analyst David Risinger noted the revenue came in roughly 7% above consensus, while earnings topped estimates by about 9%, despite growing investor concerns over obesity drug pricing. He highlighted the stronger 2026 forecasts as the main catalyst behind the stock’s rally. 4
Executives repeatedly circled back to the same dilemma: lower prices versus higher volumes. CEO David Ricks described orforglipron as “a bit of a wild card” when it comes to near- and mid-term forecasts, adding he struggled to find any comparison for how many patients are paying out of pocket for a prescription drug. On that same call, Cantor Fitzgerald analyst Carter Gould called Lilly’s results “the standout print” and noted the 2026 guidance showed more confidence than many on the Street had anticipated. 5
The risk still centers on price drops—and their speed. Lilly’s shares tumbled roughly 4% Tuesday as investors offloaded obesity-related stocks following Novo’s guidance. Analysts pointed out that U.S. prices for GLP-1 drugs from Lilly and Novo are slipping amid rising competition, prompting some to cut forecasts for the obesity-drug market’s long-term potential. 6
Attention now shifts to Washington and the FDA. Investors are watching closely to see how much pricing pressure Lilly will face under its agreement with the Trump administration, which covers Medicare, Medicaid, and cash-paying customers. Also in focus is an expected U.S. decision in April on orforglipron. Lilly plans to launch the drug in the U.S. during the second quarter if it gets the green light. 7
