Novo Nordisk (NYSE: NVO | NVO Price Prediction) and Eli Lilly (NYSE: LLY) both posted Q1 FY2026 results this spring, and the gap between them keeps widening.
Lilly delivered 55.55% revenue growth and raised guidance. Novo, meanwhile, is quietly restructuring after guiding to an adjusted sales decline of -4% to -12% at constant currency. Same drug class, very different quarters.
Foundayo Sprints. Wegovy Pill Defends.
Lilly’s Q1 was a blowout. Mounjaro rang up $8.66 billion (+125% YoY), and Zepbound added $4.16 billion (+80%). Volume climbed 65%, more than absorbing a 13% price drop. The centerpiece was Foundayo (orforglipron), the first approved GLP-1 pill with no food or water restrictions. That is a real manufacturing edge over injectable peptides.
Novo’s headline looked massive, $96.82 billion in revenue, but that number carried a $4.20 billion non-cash reversal of a US 340B provision. Strip that out and adjusted sales slipped 4% at constant exchange rates.
Ozempic fell to $27.83 billion (-8%). The bright spot: the Wegovy pill hit $2.26 billion in its first full quarter and reached over 1 million patients since its January launch. CEO Mike Doustdar called it “the most efficacious GLP-1 tablet” on the market. Impressive, but not enough to offset Ozempic and Rybelsus fatigue.
Expansion Mode vs. Damage Control
| Lens | Eli Lilly | Novo Nordisk |
| Core Bet | Tirzepatide plus oral orforglipron | Semaglutide franchise defense |
| 2026 Guidance | Raised to $82B-$85B | -4% to -12% CER |
| Pipeline Depth | Retatrutide, Kisunla, Ebglyss, Jaypirca | Wegovy HD, Zenagamtide (CagriSema shelved) |
| Leadership Tone | Offense | Restructuring |
Ricks used Q1 to announce four acquisitions (Orna, Centessa, Kelonia, Ajax). Doustdar, by contrast, is presiding over a company that already cut roughly 9,000 positions and pre-announced list price cuts of roughly 50% for Wegovy and 35% for Ozempic effective January 1, 2027.
That protects volume. It also caps 2027 cash flow. And CagriSema, once the marquee follow-on, missed its REDEFINE 4 primary endpoint and was terminated as a co-formulation.
The Next Test Is Lilly’s Q2 Earnings Report
Lilly reports Q2 on August 5. Prediction markets currently put a 70% probability on another earnings beat, with 96.4% odds Mounjaro clears $7.5 billion and 87% odds Zepbound tops $4 billion. I want to see whether Foundayo scripts scale fast enough to justify Lilly’s 53.02% one-year gain.
For Novo, keep an eye on the stock as Wegovy pill launches outside the US in H2 2026 and the Medicare Part D obesity pilot begins July 1, 2026.
Why Lilly Leads, While Novo Stays in the Mix
On momentum, Lilly is still the cleaner story. Volume is growing 65%, guidance keeps moving up, and Foundayo directly beat oral semaglutide in a head-to-head Phase 3 trial. The company setting the pricing floor arguably has a stronger position than the one reacting to it.
That said, Novo trades at a P/E near 12 with a 12.78% post-earnings recovery and a 3% dividend. For a turnaround investor patient enough to wait through the 2027 price reset, that setup is defensible. Avoiding both would only make sense if one doubted GLP-1 demand itself, which the numbers make hard to argue.
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