Eli Lilly has reported $12.73bn in Q1 2025 revenue, a 45% increase from the prior year, driven largely by demand for its diabetes and obesity drugs, Mounjaro (tirzepatide) and Zepbound (tirzepatide), respectively.
But the announcement was quickly overshadowed by news from rival Novo Nordisk, which disclosed that CVS Caremark – the largest US pharmacy benefit manager (PBM) – will make its weight loss drug Wegovy (semaglutide) the preferred glucagon-like receptor 1 agonist (GLP-1RA) treatment on its template formularies starting 1 July.
CVS’s decision is expected to expand access to Novo’s weight-loss therapy, whilst limiting coverage for Lilly’s Zepbound, potentially complicating the rollout of one of Lilly’s fastest-growing products. CVS said the change aims to offer members “a more affordable price”.
Lilly’s stock fell 6% when markets opened following the announcement on 1 May, despite its strong revenue performance. Zepbound brought in $2.31bn during the quarter, up from $517m a year ago. Meanwhile, Novo shares rose 3.6% after the CVS news.
Lilly’s CEO David Ricks downplayed the impact of the CVS decision to investors during the company’s earnings call. “We’re not surprised that this kind of thing was announced,” Ricks said. “Most of the growth in the category is happening with our medicine…We’re not interested at all in one of the deals of reducing access and choice for doctors and patients. We want to expand it.”
Ricks suggested the impact of the CVS deal may be limited, referencing the relatively low opt-in rates from employers using template formularies. “We’ll work through it. Our job will be to continue to drive [the] share and preference for our brand,” Ricks added.
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By GlobalDataAccording to GlobalData analyst Costanza Alciati, the competitive dynamic between Wegovy and Zepbound comes down to pricing: “Wegovy and Zepbound have similar efficacy and tolerability profiles, which means that the cost is the main determinant when it comes to competitiveness,” she said, noting that physicians tend to prescribe the more affordable option due to the high prices of GLP-1RA therapies.
Alciati also pointed to regulatory and pricing pressures from US authorities as a key factor influencing these coverage deals. “Novo Nordisk and Eli Lilly have received a lot of pressure, especially from the US government, to reduce obesity drugs prices, thus these deals with pharmacies and healthcare authorities are a way to offer discounts to patients and gain some competitive edge over each others.”
Still, she noted that Eli Lilly may be playing the long game. “It may be that Eli Lilly is not concerned as it has strong candidates in the pipeline,” she said. Among them are its oral GLP-1RA drug orforglipron and retatrutide, which have shown strong clinical results, while Novo’s once-promising CagriSema underperformed in recent trials.
Last month, Lilly shared positive data from the Phase III trial of orforglipron. The drugmaker expects to file for the drug’s approval in obesity by the end of 2025 and type 2 diabetes in 2026. If it gains market approval, GlobalData projects sales of orforglipron to reach $11.8bn in 2030.
GlobalData is the parent company of Pharmaceutical Technology.
Lilly reaffirmed its full-year 2025 revenue guidance of $58bn to $61bn, which does not yet reflect proposed tariffs on pharmaceutical imports.
