Eli Lilly and Co. (LLY) shares surged in premarket trading Wednesday after the pharmaceutical giant delivered a knockout fourth quarter, powered by relentless demand for its weight loss medications and backed by ambitious growth projections for the year ahead.

Earnings Breakdown

The Mounjaro maker reported fourth-quarter adjusted earnings of $7.54 per share, sailing past consensus expectations of $6.67. Revenue came in at $19.3 billion, well ahead of the $17.96 billion analysts had penciled in.

Sales jumped 43% compared to last year, driven primarily by a 46% surge in volume. The gains were partially offset by a 5% decline from lower realized prices, reflecting the pricing pressures that have become a recurring theme in the weight loss drug market.

Gross profit climbed 43% to $15.9 billion, with gross margin reaching 82.5%, up 0.3 percentage points. The margin improvement came courtesy of a favorable product mix and better production efficiency, though lower realized prices nibbled at those gains.

Weight Loss Drugs Steal the Show

The company's key products generated $13.8 billion in Q4 revenue, with Mounjaro and Zepbound leading the charge in what's become one of pharma's most competitive battlegrounds.

Mounjaro revenue exploded 110% to $7.4 billion. In the U.S., the diabetes drug pulled in $4.1 billion, up 57%, reflecting robust demand tempered by those pricing headwinds. International revenue hit $3.3 billion compared to just $899 million a year earlier, driven almost entirely by volume growth.

Zepbound, Eli Lilly's obesity-focused medication, saw U.S. revenue climb 122% to $4.2 billion. Again, strong demand was the primary driver, with lower realized prices acting as a partial brake.

Meanwhile, Verzenio, the company's breast cancer treatment, posted a more modest 3% revenue increase to $1.6 billion on volume growth.

Last Friday, Eli Lilly announced plans to invest more than $3.5 billion in a new manufacturing facility in Pennsylvania's Lehigh Valley. The site will produce injectable medicines and devices, including next-generation weight loss therapies. The facility will manufacture retatrutide, an investigational triple hormone receptor agonist targeting GIP, GLP-1, and glucagon pathways.

Looking Ahead

For fiscal 2026, Eli Lilly expects adjusted earnings between $33.50 and $35 per share, ahead of the consensus estimate of $33.23. More impressively, the obesity drug maker is projecting revenue of $80 billion to $83 billion, significantly surpassing Wall Street's $77.62 billion forecast.

Eli Lilly shares were up 8.85% at $1,092.23 during premarket trading Wednesday, approaching the stock's 52-week high of $1,133.95.