Eli Lilly & Co.: Framing the Mounjaro OUS ramp through 2026

Research evidence excerpt

Eli Lilly & Co.: Framing the Mounjaro OUS ramp through 2026

IdeaMIn late April LLY reported another strong quarter for Mounjaro OUS in 1Q26,

with revenue increasing to $4.4bn from $3.3bn in 4Q25 (LINK). Mgmt noted that

LLY remains the international incretin market-share leader, with ~53% share

internationally vs. ~60% in the U.S., and expects continued strong y/y growth with

“some” sequential growth as recent market-share gains begin to stabilize. The

current Mounjaro OUS mix is ~75% weight management (largely cash-pay) and 25%

T2D (primarily reimbursed). Management also highlighted encouraging recent

trends in India, where the launch of generic semaglutide has expanded category

awareness and driven a “halo effect,” with Mounjaro reportedly growing ~10%

despite generic competition. In China, Mounjaro was added to the NRDL effective

January 1, creating a near-term pricing headwind but potentially supporting stronger

volume growth later in 2026 (LINK). In China, the launch of generic semaglutide

appears delayed into next year for the T2D indication (with obesity potentially

following even later given that most companies are sequencing obesity

development after diabetes), based on disclosures from Jiuyuan Gene’s 2025

financial report and Livzon Pharma Group, whose semaglutide approval process is

currently suspended due to implications related to the China-Switzerland Free

Trade Agreement (LINK).

For our analysis we first analyzed Novo’s OUS GLP-1 franchise as a baseline,

particularly given Ozempic (for T2D), Wegovy (for obesity), and Rybelsus (oral GLP-1

for T2D) were initially the primary products available across international markets.

NOVO's GLP-1 franchise continued to grow through 2025, driven primarily by

Wegovy in obesity and Ozempic in T2D ( Exhibit 2 ).