The Q1 2026 earnings cycle reset the GLP-1 commercial picture. Eli Lilly's April 30 print delivered $19.8 billion in revenue (+56% YoY) on Mounjaro at $8.66B (+125%) and Zepbound at $4.16B (+80%), with full-year guidance raised to $82–85 billion. Pfizer beat consensus with $14.45B revenue on April 29 and reaffirmed 2026 guidance plus 20+ obesity trials including 10 Phase 3 of PF'3944. Roche's April 23 call confirmed ENITH 1 and ENITH 2 Phase 3 enicepatide trials initiated and projected $9B obesity peak sales. Boehringer-Zealand reported the survodutide SYNCHRONIZE-1 Phase 3 topline (16.6% weight loss at 76 weeks) on April 28.
The Q1 cycle culminates with Novo Nordisk reporting May 6 and Hims & Hers reporting May 11. Investors are watching Novo's Wegovy pill 721,000 Q1 prescription momentum against the February guidance of a 5–13% sales/operating-profit decline at constant exchange rates, and Hims's testosterone-and-peptide pivot heading into the July PCAC meeting.
Stories here cover earnings beats, pipeline disclosures, and the analyst reactions that follow them. See #eli-lilly, #novo-nordisk, and #roche.
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.
Bloomberg reported May 6 that Eli Lilly's Mounjaro displaced Merck's Keytruda as the world's best-selling pharmaceutical in Q1 2026 — $8.66B Mounjaro Q1 sales vs Keytruda's $7.9B Q1 sales. The Mounjaro+Zepbound combined tirzepatide platform generated $36.5B in 2025, outpacing Keytruda's $31.6B. Keytruda had held the #1 ranking since Q1 2023, when it displaced AbbVie's Humira. The shift is the first time a peptide therapeutic has taken the top spot since the historical run of insulin biosimilars. The narrative also frames Lilly's $4.5B Lebanon Indiana manufacturing recommitment and the broader $21B Indiana capital plan as the supply-chain answer to demand at that scale.
Tonix Pharmaceuticals reported Q1 2026 May 11 with $6.9M total net product revenue and a $40.2M net loss. TONMYA (cyclobenzaprine HCl sublingual tablet for fibromyalgia) generated $3.7M in its first full commercial quarter on 5,400 prescriptions filled and 2,145 prescribing HCPs. The peptide-relevant pipeline continues to anchor on TNX-1900, an intranasal potentiated oxytocin candidate now in four Phase 2 investigator-initiated studies at Mass General Hospital and the University of Virginia: binge-eating disorder, adolescent obesity, bone health in autism spectrum disorder, and arginine vasopressin deficiency. The portfolio represents one of the few clinical-stage neuropeptide programs outside the GLP-1 axis, with potential applications across psychiatric, metabolic, and rare endocrine indications.
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.
Rhythm Pharmaceuticals reported Q1 2026 results May 5: setmelanotide (IMCIVREE) net product revenue of $60.1M, up from $37.7M a year earlier ($36.9M US, $23.2M ex-US), driven by 150+ new US start forms in acquired hypothalamic obesity following the FDA approval and the EU Marketing Authorization for the same indication; Japan's PMDA accepted the NDA for review. The MC4R-agonist peptide is the only commercial therapy for hypothalamic obesity. Offsetting the topline beat: the Phase 3 EMANATE trial in genetically caused MC4R-pathway diseases failed its primary endpoint in all four independent substudies, narrowing the indication-expansion runway. Net loss was $56.7M; cash $340.6M for 24+ months runway.
Hims & Hers reports Q1 2026 after market close May 11, with consensus revenue at $616-619M and EPS at roughly 3-4 cents — a 90% YoY decline. The investor question is whether the legitimate Wegovy/Ozempic distribution channel from the Novo Nordisk partnership (signed April 2026) can offset the wind-down of the compounded semaglutide business. Novo's branded products were not on the platform until March 26, with Q1 books closing March 31 — meaningful Wegovy revenue contribution likely lands in Q2. Subscriber count above 2.5M and ~82% three-month retention remain the standing benchmarks. The April 30 FDA proposal to remove semaglutide, tirzepatide, and liraglutide from the 503B bulks list raises the medium-term bar for any compounding-driven model.
Crinetics Pharmaceuticals reported Q1 2026 results May 7 — total revenue $10.7M (vs $8.5M consensus, +25.7% beat), Palsonify (paltusotine) net product revenue $10.3M in its first full commercial quarter (up from $5.4M in Q4 2025), 263 unique prescribers (up from 125 at year-end), 232 new patient enrollment forms in the quarter, and approximately 70% of patients reimbursed with payer coverage above 60% (target above 75% by Q3). Cash, equivalents, and investments closed at $1.3B. R&D rose 17.6% to $100.1M to fund Phase 3 paltusotine in carcinoid syndrome plus atumelnant Phase 3 programs in congenital adrenal hyperplasia and Cushing's syndrome. Shares rose 4.3% in after-hours trading.
Zealand Pharma reported Q1 2026 revenue of DKK 34M against DKK 8M a year earlier and the DKK 17M analyst consensus — a more-than-2× beat on the recognition of Roche's $700M (DKK 4.5B) milestone payment tied to petrelintide's advancement into Phase 3. The board authorized a share buyback of up to DKK 1.3B. Net operating expenses came in at DKK 573M (below the DKK 679M consensus), and the company reaffirmed petrelintide Phase 3 obesity initiation in H2 2026. Petrelintide is the long-acting amylin analog that posted ~10.7% mean weight loss with placebo-like tolerability in ZUPREME-1; the Roche partnership combines it with the GLP-1/GIP enicepatide (CT-388) in a fixed-dose Phase 2 starting mid-2026. Shares rose 8.4% to DKK 344.
Jefferies analysts pushed back May 6 against the otherwise-positive market reaction to Novo Nordisk's Q1, arguing that the change in full-year guidance (tightened from a 5–13% sales-and-operating-profit decline to a 4–12% decline) was unlikely to lift consensus forecasts and could even contract them: 'we suspect the fact that the company has not lifted the lower end of the guidance range more will be seen as a negative.' The framing matters because NVO US-listed shares had already risen ~6% on the print, and the price-war pressure on the GLP-1 class — with Wegovy pill running at $149/month for the 1.5 mg starter dose against intensifying Foundayo competition — leaves the lower-end risk path open through year-end.
Crinetics Pharmaceuticals reports Q1 2026 financial results after market close May 7, with a 4:30 p.m. ET conference call. Investors will be looking for first commercial color on Palsonify (paltusotine), the once-daily oral SST2 nonpeptide agonist that won European Commission approval April 27 for adult acromegaly across the 27 EU member states plus three EEA countries (Iceland, Liechtenstein, Norway). First launches are planned for Germany and Austria. Q1 commentary on CRN09682 — the first-in-class SSTR2 non-peptide drug conjugate currently in Phase 1/2 BRAVESST2 in metastatic neuroendocrine tumors — is also expected, with the program designed as a direct challenge to peptide-based PRRT including Lutathera and Perspective Therapeutics' alpha-PRRT.
Bicycle Therapeutics reported Q1 2026 financial results April 30 — net loss of $60.8M ($0.87 per share) on R&D of approximately $44M, with $559.5M in cash and equivalents at March 31 supporting a cash runway into 2030. The pipeline update reaffirmed that nuzefatide pevedotin (BT5528) Duravelo-2 dose-selection data in EphA2-positive solid tumors will be presented at the ASCO 2026 Rapid Oral Abstract Session on June 1, the Phase 2 nuzefatide pevedotin trial in recurrent pancreatic cancer enrolled its first patient in April, and the EphA2 gallium-68 PET imaging program continues to accumulate first-in-human data. Bicycle remains the leading bicyclic-peptide-platform pure-play in oncology.
Reuters reported May 5 that Novo Nordisk's Wegovy pill posted roughly 721,000 US prescriptions in Q1 per IQVIA, beating analyst expectations on volume but raising margin questions: about 450,000 of those scripts were for the cheapest 1.5 mg starter dose at $149/month. Lilly's Foundayo approval in early April closed Novo's window as the only oral obesity pill, and Wegovy injection prices have fallen rapidly amid intensifying competition. The Danish company's market value has shed more than $400 billion from its 2024 peak. Wednesday's Q1 print (May 6, 7:30 CEST) is the test: investors are watching whether Novo holds February's guidance of a 5–13% sales and operating-profit decline at constant exchange rates, and whether direct-to-consumer NovoCare and the WW Med+ + GoodRx channels can offset price pressure.
Hims & Hers reports Q1 2026 results May 11 after market close. Company guidance: $600–625M revenue (2–7% YoY) and $35–55M adjusted EBITDA (~7% margin), with Q1 carrying a roughly $65M timing impact from the weight-loss shift to 503A fulfillment. Outlook (ex-Eucalyptus) is $2.7–2.9B revenue and $300–375M EBITDA. Hims also launched Testosterone Rx+ — a once-daily pill for low-libido idiopathic hypogonadism — as a non-GLP-1 specialty addition, signaling the wider longevity and peptide play the company has telegraphed for 2026. The California peptide-manufacturing facility acquired in February 2025 sits as a post-PCAC option for producing reclassified Category 1 peptides if the July meeting clears the path.
Roche reported Q1 2026 sales up 6% at constant exchange rates and used the earnings call to re-anchor its obesity strategy. Executives project $9 billion in peak annual sales from the emerging breast cancer pill plus four obesity candidates. Lead asset petrelintide (licensed from Zealand Pharma, ZUPREME-1 Phase 2 showed up to 10.7% weight loss with placebo-like tolerability) is positioned at a differentiated patient segment. CEO Schinecker said Roche is not investing in the first generation of obesity drugs, but the next — with petrelintide and CT-388 (enicepatide) data headed for ADA 2026.