Lilly's Double-Beat Widens the GLP-1 Gap—And a New Pill Could Make It Permanent

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.

The $63-billion GLP-1 agonist industry is forecast to triple in the coming decade, so it's no surprise that pharmaceuticals companies of all sizes are scrambling to get in on the action. For the time being, though, the market is still dominated by two names: Eli Lilly and Co. NYSE: LLY and Novo Nordisk A/S NYSE: NVO.

Between these, Novo Nordisk may have the more recognizable brands in the GLP-1 space, as it is the maker of both Ozempic and Wegovy.

However, Eli Lilly's recent earnings suggest that it could cement a dominant position that would make it even tougher for competitors in the fast-growing space.

Eli Lilly delivered a Q1 2026 trifecta—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 Results

Strictly on financials, Eli Lilly's Q1 2026 earnings results already shine. The company saw an impressive 56% year-over-year (YOY) boost to revenue, thanks in large part to $12.8 billion in combined sales of its two main GLP-1 agonists, Mounjaro and Zepbound. Total revenue of nearly $20 billion was about $2 billion above consensus estimates. On earnings, Lilly also thrived. The company reported $8.55 in earnings per share (EPS), 156% above last year's results in this area and a full $1.58 above analyst expectations.

In terms of overall business developments, the single biggest update from Lilly's latest report is that the FDA approved Foundayo as the first oral GLP-1 agonist for obesity that can be taken at any time of day and without any restrictions related to food or water. Current oral GLP-1 medications often require patients to take them at specific points of the day, or to wait certain amounts of time before eating after taking the medication.

Foundayo appears to be the latest advancement toward convenience and flexibility in the GLP-1 agonist space. While patients initially had to deal with injections and then moved to oral medications, Foundayo now goes a step further to reduce some of the inconveniences associated with preexisting options. As Eli Lilly continues to roll out the product, with early uptake among the first 20,000 or more patients picking up speed, Foundayo could easily become the GLP-1 agonist of choice.

There's more to Lilly's momentum than just its past results and its newest GLP-1, though: the company anticipates continued rapid growth, as reflected by significant increases in guidance. Management raised full-year 2026 revenue guidance by $2 billion at both the low and high ends of the range (previously the company guided for revenue of $80 billion to $83 billion; it now expects $82 billion to $85 billion). EPS guidance also got a $2 boost on both ends of the range, up to forecasts between $35.50 and $37 for the year.

Novo Nordisk's Uphill Battle

After Eli Lilly's strong earnings report and promising drug developments, investors will be watching Novo Nordisk carefully when it reports its own Q1 2026 earnings. The Danish firm is working toward its own oral version of Ozempic and is seeking approvals for pediatric use, which would significantly boost its addressable market. It is also in the midst of early trials for LX9851, a non-incretin obesity drug that would be a potential alternative to GLP-1s.

One of Novo Nordisk's biggest risks, however, is the potential for generics. Canada has recently approved a generic version of Ozempic, which could undermine Novo Nordisk's pricing power considerably.

Notably, there is an FDA proposal to exclude certain active ingredients in Novo's products from the mass compounding list. This means that it would become more difficult for companies to create copycats, protecting the firm's core GLP-1 products.

Despite the major success of Ozempic and Wegovy, analysts are mixed on Novo Nordisk going forward. Only four of 23 have rated NOV shares a Buy, although the stock has 50% upside potential based on a consensus price target of $65.56.

On the other hand, Wall Street is much more optimistic about Eli Lilly: 25 out of 30 ratings are a Buy or equivalent, despite the fact that upside potential for LLY is lower at about 25%. As Foundayo continues to enter the market, investors might watch to see if new price targets suggest more room for growth may be possible.