Eli Lilly reports Zepbound revenue up 49% to $5.35 billion in third quarter

Eli Lilly said on 29 October that Zepbound revenue rose 49% to $5.35 billion in the third quarter. It listed expanded US coverage for obesity care among the drivers [11]. That is the first hard number on what Medicare's $50 obesity-drug benefit does to demand.

Patients see the difference in cash. They pay a flat $50 a month, not $299 to $699 for the Zepbound KwikPen bought out of pocket [1][11].

For Eli Lilly and Novo Nordisk, the rule decides how fast newly eligible seniors start treatment. Eli Lilly is capturing most of them so far [7]. Nobody can say yet whether the coverage survives past 31 December 2027 [1]. Mounjaro shares Zepbound's active ingredient and is approved for type 2 diabetes. It brought in $10.72 billion, up 65% [11]. The two drugs made up about two-thirds of Eli Lilly's quarterly revenue [11]. Total revenue reached $24.4 billion, up 39%. Eli Lilly raised its full-year forecast to $91 billion to $92 billion from $85 billion to $87 billion [11]. Foundayo, its oral GLP-1, added $184 million [11].

Overall sales volume rose 53%, while the prices Eli Lilly actually collected fell 15% [11]. Volume up 53% against a 15% price decline is the plainest signal in the report [11].

What the Bridge program actually covers

Federal law barred Medicare from paying for drugs prescribed solely for weight loss. The program needed a workaround [1][5]. The Bridge program runs from 1 July 2026 to 31 December 2027 [3][4]. Enrollees need Part D and a body mass index of 35 or higher. They can also qualify at 27 or higher with a condition such as prediabetes or heart disease [3][5]. The $50 copay does not rise with the dose, unlike cash prices [3]. Approval does not go through the patient's own Part D insurer. Doctors submit prior authorization to a central system run by CMS contractor Humana. Medicare handles claims and pays pharmacies [3][5].

Physicians have warned the process may be cumbersome. Some expect demand to strain clinics and pharmacies [1].

700,000 new seniors, seven in ten on Eli Lilly

Dave Ricks, Eli Lilly's chief executive, told CNBC that about 700,000 new seniors have started GLP-1 drugs since coverage began in July. Roughly seven in 10 of them are on Eli Lilly medicines [7]. One-third of new patients on oral GLP-1s use Foundayo, he said [7].

The eligible pool is far larger. KFF put the number of Medicare beneficiaries with obesity or overweight at about 13.7 million, based on 2020 data [5]. Novo Nordisk and Eli Lilly estimate that 15 million to 20 million older adults qualify [1]. Medicare had more than 69 million beneficiaries as of late June. So 13.7 million is roughly a fifth of the program [1][5]. Neither company reports patient counts. Sales cannot be read as headcount: revenue depends on dose, rebates and months of supply [11].

How the program got here

CMS had planned something broader. BALANCE would have had the agency negotiate directly with manufacturers for state Medicaid offices and Part D plans [2].

CVS Health declined to take part. On UnitedHealth's 21 April earnings call, Bobby Hunter, chief of government programs, cited "notable challenges and outstanding questions" [2][4]. CMS postponed BALANCE indefinitely and extended the Bridge instead [2][4]. Truist Securities put up to about $500 million in peak Zepbound Medicare Part D sales at risk from CVS Health's exit [2]. That would reach around $3.3 billion if every pharmacy benefit manager opted out [2]. Eli Lilly shares closed nearly 2% lower. Novo Nordisk fell 4% [2].

What happens after 2027

The Bridge program expires on 31 December 2027 unless the administration extends or replaces it. Permanent coverage would need a change in federal law [1]. "It's good news that Medicare is rolling out this program, but it is temporary," Juliette Cubanski, director of the Program on Medicare Policy at KFF, said [1].

Private coverage is heading the other way. A Mercer survey published on 11 June found about 6% of large employers will drop GLP-1 weight-loss coverage in 2026. Another 5% will drop it in 2027 [5].