Despite the largest U.S. pharmacy benefit manager (PBM) knocking Zepbound off its formulary this summer, sales of Lilly’s dual-action obesity med continue to impress, thanks in no small part to the company’s direct-to-consumer sales channel LillyDirect.
In the third quarter, sales of Zepbound (tirzepatide) reached nearly $3.6 billion, growing a staggering 185% year over year and besting consensus sales expectations by more than $500 million, analysts at Citi Research wrote in a note to clients Thursday.
Compared to its performance in the second quarter, the obesity med’s sequential growth of 6% was more muted but still “fundamentally impressive,” the Citi team wrote.
Worth noting, CVS Caremark—the biggest PBM in the U.S.—announced in May that it would make Novo Nordisk’s rival drug Wegovy (semaglutide) the preferred obesity GLP-1 on its formulary. The move was expected to boost access to Wegovy in the U.S.—albeit likely at the expense of that for Lilly’s Zepbound.
In the three months following the formulary switch, which took effect July 1, the exclusion did take a bite out of Zepbound’s sales growth, but the impact overall was “limited in our view,” the Citi analysts said.
Zepbound’s 185% sales growth over 2025’s third quarter was undeniably noteworthy “and underscores [the] increasing importance of LillyDirect,” the analysts added, referring to the channel through which Lilly sells certain medicines at a discount to people paying out of pocket.
Zepbound’s robust sales showing came amid a “strong quarter across the board” for Lilly, the Citi analysts said, noting that the continued success of Lilly’s incretins franchise bodes well for the expected launch of its oral GLP-1 asset orfoglipron sometime next year.
Zepbound’s sister medicine in diabetes, Mounjaro, also bested Wall Street’s sales expectations with revenues of $6.5 billion for the quarter. The drug grew 109% compared to the third quarter of 2024 and delivered sales roughly $1 billion ahead of both Citi and consensus projections.
To put things in perspective, tirzepatide's collective sales are now charting above those of Merck's megablockbuster cancer medicine Keytruda, which previously captured the industry's sales crown in 2023. Collectively, Lilly’s Zepbound and Mounjaro brands delivered global sales of $10.1 billion in 2025’s third quarter, eclipsing Keytruda’s performance in the period at $8.1 billion.
During the second quarter of 2025, Lilly's two brands generated roughly $8.6 billion combined versus $8 billion for Keytruda. The growing space between the meds' sales as the year progresses shows the rapid upward trajectory of the Lilly meds.
The Indianapolis drugmaker’s third chief growth driver, breast cancer med Verzenio, continued to move up the sales ladder, too, although certainly not at the pace of its incretin cousins in diabetes and obesity—and below the threshold the Citi team had forecast.
During the most recent quarter, Verzenio grew sales 7% to $1.47 billion, about $100 million off from Citi’s estimate and $75 million below Wall Street’s for the period.
Separately, Lilly noted in an earnings presentation Thursday that it’s no longer pursuing development of Verzenio, also known as abemaciclib, in a late-stage “[metastatic breast cancer] sequencing” indication.
The purpose of that program was to "answer a scientific question" around the potential benefit of CDK4/6 inhibition after treatment with the drug class, of which Verzenio is a member, a Lilly spokesperson explained in an emailed statement.
"PostMONARCH was a statistically positive trial and can help inform [healthcare professional] treatment decisions," the spokesperson said. "However at this time, we do not anticipate submission for any label updates."
Lilly’s overall sales for the period climbed 54% year-over-year to $17.6 billion, which the company itself attributed in large part to Mounjaro and Zepbound.
In light of its performance in the quarter, Lilly is bumping its guidance up for the full year and now expects to stick a 2025 sales landing in the vicinity of $63 billion to $63.5 billion. The company had previously forecast full-year sales between $60 billion and $62 billion.
Editor's note: This story was updated with a comment from Eli Lilly on its Verzenio development plans.