Eli Lilly hits a record high one week before the quarter that tests Ricks's volume bet
Lilly reports Q3 on October 29, the first quarter containing the $50-copay Medicare Bridge, with the stock at a record high and guidance implying a sharp growth slowdown for the second half.
Richard Tang · 2 min read
Eli Lilly−1.32% — Eli Lilly, down 1.32 percent today closed at an all-time high of $1,311.21 on October 20, and reports third-quarter results on October 29, the first quarter with the Medicare GLP-1 Bridge inside the numbers 1. The print has to answer one question David Ricks set up in January: prices fell first, and now volume has to show up 2.
What Ricks promised, and what it costs
The terms are the bet. Medicare pays no more than $50 a month for Zepbound under the Bridge, which began July 1 and runs only to December 31, 2027; in return Lilly took three years of tariff relief and freedom from future pricing mandates 2. Ricks said in September that roughly 700,000 seniors had started GLP-1 treatment since July, about 70% of them on Lilly medicines 2. That is a management snapshot, not revenue.
The realized price shows what it costs: worldwide price fell 13% in each of the first two quarters, and about 9% in the US once rebate adjustments are stripped out 2.
Revenue grew every quarter but guidance implies a slower second half
Data
| Revenue | |
|---|---|
| Q3 '24 | $11.4B |
| Q4 '24 | $13.5B |
| Q1 '25 | $12.7B |
| Q2 '25 | $15.6B |
| Q3 '25 | $17.6B |
| Q4 '25 | $19.3B |
| Q1 '26 | $19.8B |
| Q2 '26 | $23B |
The guidance math is where the bet gets hard
Lilly has raised 2026 guidance three times to $85-87 billion, but with $42.77 billion banked in the first half that leaves about $21.1-22.1 billion a quarter for the second half, below the $22.97 billion just reported, and growth of roughly 14-20% against 43-56% in each of the last three quarters 2. A fourth raise on October 29 would say the Bridge volume is arriving faster than the range assumes; a miss against that pace says price is still outrunning prescriptions 2.
Two overhangs sit against the record price
Paying 41 times trailing earnings, against 23 for the S&P 500, already assumes the ramp works 3. The same filing that showed the two-drug dependence, Mounjaro and Zepbound near two-thirds of revenue, also disclosed generic applications filed against both before certain patents expire 23.
And the Bridge itself has a cliff: it ends in late 2027, and whether Zepbound then earns a place on standard Part D formularies depends on data the program has not yet produced, as its own participants suspect 4. Lilly's pipeline hedges the demand side: eloralintide plus tirzepatide delivered up to 23.3% average weight loss at 48 weeks and enters Phase 3 before year end, which keeps the moat deep even if prices keep falling 5.
The judgment
The mechanism is real, prescriptions are replacing price, and the first hop of Ricks's bet has landed. The unproven hop is durability, volume that outlasts a two-year program. Wait for the October 29 numbers to price it.
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