Guidance raises are the cleanest read on management confidence in the back-half trajectory of a launch. The 2026 Q1 cycle produced an unusually concentrated cluster across the peptide therapeutics ecosystem.
Covered here: Eli Lilly's April 30 raise on the back of an $8.66B Mounjaro quarter and a $4.16B Zepbound run, lifting 2026 revenue guidance to $82-85B; Novo Nordisk's May 6 tightening of full-year guidance from a 5-13% sales-and-operating-profit decline to a 4-12% decline as the Wegovy pill posted ~$354M Q1 sales nearly double consensus; and Hims & Hers' May 11 Q1 print raising full-year 2026 guidance to $2.8-3.0B revenue and $275-350M Adjusted EBITDA on the pivot from compounded semaglutide to branded Novo Nordisk supply. Each raise reflects a different bet on the same underlying market — Lilly leaning on Mounjaro/Zepbound volume, Novo on Wegovy pill share, Hims on branded distribution access.
Stories here cover the print, the model implications, and the analyst reactions. See #q1-2026, #eli-lilly, and #novo-nordisk.
Novo Nordisk Q1 management commentary delivered alongside the ECO 2026 data updates confirmed that the Wegovy pill (oral semaglutide 25 mg) will launch in select international markets in the second half of 2026 with European approval expected before year-end. The international rollout follows the January 5 US launch that delivered DKK 2.26B (~$354M) in Q1 sales — nearly double the DKK 1.16B analyst consensus — on roughly 1.3 million Q1 prescriptions and >2M cumulative US prescriptions. Wegovy now holds 65% of all new US GLP-1 prescriptions; Novo tightened its full-year guidance to a 4-12% sales decline (from 5-13%). The international expansion is the inflection point for Novo's competitive positioning vs Lilly's Foundayo and the next-generation Mounjaro/Zepbound franchise.
Hims & Hers reported Q1 2026 after market close May 11: revenue $608.1M (+4% YoY vs $586M prior year), missing the $616.9M consensus; subscribers up 9% to 2.6M; net loss of $92.1M ($0.41/share) vs $49.5M net income in Q1 2025. Gross margin compressed from 73% to 65% on the strategic pivot away from compounded semaglutide toward branded Novo Nordisk Wegovy/Ozempic supply (live since March 26). Q1 closed March 31 — meaningful Wegovy revenue contribution lands in Q2. Full-year 2026 guidance was raised: revenue to $2.8-3.0B and Adjusted EBITDA to $275-350M. The company is keeping limited compounded GLP-1 access alive alongside branded supply, threading the FDA April 30 503B bulks-list proposal.
Novo Nordisk reported Q1 2026 results May 6: net sales of DKK 96.82B (+24% YoY) and operating profit of DKK 59.62B (+54%). The Wegovy pill drove the print with DKK 2.26B (~$354M) in Q1 sales — almost double the DKK 1.16B analyst consensus — on roughly 1.3 million Q1 prescriptions and more than 2 million cumulative US prescriptions since the January 5 launch. Injectable Wegovy sales rose 12% YoY to DKK 18.2B. Ozempic sales fell 8% YoY but came in above expectations. The company tightened full-year guidance to a 4–12% sales-and-operating-profit decline at constant exchange rates, narrower than the prior 5–13% range. NVO US-listed shares rose roughly 6% on the print.
Eli Lilly reported Q1 2026 worldwide revenue of $19.8 billion, up 56% year over year on 65% volume growth partially offset by a 13% price decline. Mounjaro hit $8.66 billion globally (+125%), Zepbound delivered $4.16 billion in U.S. sales (+80%), and reported Q1 EPS jumped 170% to $8.26. Lilly raised 2026 revenue guidance by $2 billion at each end to $82–85 billion and lifted non-GAAP EPS guidance to $35.50–$37.00. The release also recapped five positive Phase 3 readouts, six new Phase 3 starts, and the closings of the Orna, Centessa, Colonia, and Ajax acquisitions in the quarter.