Novo Nordisk vs Eli Lilly: The Better Buy Before Earnings

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

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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