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 鈥 the largest US pharmacy benefit manager (PBM) 鈥 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鈥檚 decision is expected to expand access to Novo鈥檚 weight-loss therapy, whilst limiting coverage for Lilly鈥檚 Zepbound, potentially complicating the rollout of one of Lilly鈥檚 fastest-growing products. CVS said the change aims to offer members 鈥渁 more affordable price鈥.

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鈥檚 CEO David Ricks downplayed the impact of the CVS decision to investors during the company鈥檚 earnings call. 鈥淲e鈥檙e not surprised that this kind of thing was announced,鈥 Ricks said. 鈥淢ost of the growth in the category is happening with our medicine鈥e鈥檙e not interested at all in one of the deals of reducing access and choice for doctors and patients. We want to expand it.鈥

Ricks suggested the impact of the CVS deal may be limited, referencing the relatively low opt-in rates from employers using template formularies. 鈥淲e鈥檒l work through it. Our job will be to continue to drive [the] share and preference for our brand,鈥 Ricks added.

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According to GlobalData analyst Costanza Alciati, the competitive dynamic between Wegovy and Zepbound comes down to pricing: 鈥淲egovy and Zepbound have similar efficacy and tolerability profiles, which means that the cost is the main determinant when it comes to competitiveness,鈥 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. 鈥淣ovo 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.鈥

Still, she noted that Eli Lilly may be playing the long game. 鈥淚t may be that Eli Lilly is not concerned as it has strong candidates in the pipeline,鈥 she said. Among them are its oral GLP-1RA drug orforglipron and retatrutide, which have shown strong clinical results, while Novo鈥檚 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鈥檚 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 色界吧 Technology.

Lilly reaffirmed its full-year 2025 revenue guidance of $58bn to $61bn, which does not yet reflect proposed tariffs on pharmaceutical imports.