Lilly raises guidance to $92 billion and hits a record close, while Novo Nordisk bets November on CagriSema
Lilly just priced its clinical lead at 31 times earnings while Novo Nordisk trades at 12x, and Novo's November congress calendar is the last scheduled chance to argue back before retatrutide's FDA filing closes the record.
Vincent Jiang · 3 min read
Two drugmakers, one verdict scheduled for November
Eli Lilly+3.15% — Eli Lilly, up 3.15 percent today closed at a record $1,373.70 on October 29, up 6.63%, after raising its 2026 revenue forecast to $91–92 billion, roughly $10 billion above the range it set in February 4. Novo Nordisk+2.14% — Novo Nordisk, up 2.14 percent today, the Danish rival it dethroned in obesity medicine, spent the same week buying back its own stock: DKK 11.19 billion of a DKK 15 billion program completed through October 23 5. The two moves answer different questions. Lilly's raise answers whether demand is real. Novo's buyback answers nothing about demand at all.
The money has already moved
Lilly's third-quarter revenue rose 39% to $24.4 billion, with Mounjaro and Zepbound clearing $16 billion combined 2. The catch sits in the footnotes: about $2 billion of 2026 revenue is one-time milestones and rebate adjustments that will not recur, which makes the Street's 2027 estimate near $103 billion a demand for about 15% growth on a cleaner base 24. The climb to get here was not a step, it was a staircase.
Lilly's revenue has climbed every quarter for more than two years
Data
| Revenue ($B) | |
|---|---|
| Q2 '24 | 11.3 |
| Q3 '24 | 11.44 |
| Q4 '24 | 13.53 |
| Q1 '25 | 12.73 |
| Q2 '25 | 15.56 |
| Q3 '25 | 17.6 |
| Q4 '25 | 19.29 |
| Q1 '26 | 19.8 |
| Q2 '26 | 22.97 |
| Q3 '26 | 24.4 |
Novo's revenue went sideways while Lilly's more than doubled
- Lilly ($B)
- Novo Nordisk ($B)
Data
| Lilly ($B) | Novo Nordisk ($B) | |
|---|---|---|
| Q2 '24 | $11.3B | $9.78B |
| Q3 '24 | $11.44B | $10.52B |
| Q4 '24 | $13.53B | $11.95B |
| Q1 '25 | $12.73B | $11.33B |
| Q2 '25 | $15.56B | $12.08B |
| Q3 '25 | $17.6B | $11.79B |
| Q4 '25 | $19.29B | $12.44B |
| Q1 '26 | $22.97B | $14.85B |
| Q2 '26 | $24.4B | $11.98B |
The clinical bar Novo must clear
On October 28, Lilly reported that retatrutide cut blood sugar by 2.2% versus 1.8% for Ozempic, and produced up to 20.9% weight loss against 9.4%, in a phase 3 head-to-head across nearly 1,300 patients 3. Lilly plans to file for FDA approval in the first quarter of 2027, so these are the last public data before the dossier closes 3.
Novo's reply comes on a calendar it set itself: twelve semaglutide and efruxifermin abstracts at The Liver Meeting, November 5–9 in Denver, then 26 abstracts at ObesityWeek, November 14–17, including CagriSema and the Wegovy tablet 5.
Twice the weight loss, three times the dropouts
Data
| Value | |
|---|---|
| Retatrutide 12 mg | 20.9 |
| Retatrutide 9 mg | 19.5 |
| Ozempic 2 mg | 9.4 |
The lead has a price, and so does the discount
Retatrutide's edge is not free. On the top dose, 7.9% of patients quit over side effects versus 2.7% on Ozempic, with diarrhea the widest gap 3.
The bull case for Novo is a different arithmetic: the stock has fallen more than 60% cumulatively and trades at about 12x forward earnings against roughly 31x for Lilly on the same drug class 46. One camp reads the efficacy gap as permanent. The other notes the market itself is widening: more than 500,000 fills through Medicare's Bridge program since July, and about 80% of those patients were new to incretin therapy, demand that lifts both houses 12.
What decides it
Novo's quarterly report and the two November congresses either support the comeback or bury it. The tell is whether Novo's own figures show the sector's demand reaching its business, or whether Lilly's tailwind stays a competitor's story. J.P. Morgan−1.74% — J.P. Morgan, down 1.74 percent today still holds at DKK 275, a wait, not a verdict 5. When the abstracts land, count the endpoints, not the slide count.
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