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LivestreamMenuThe United States remains the largest and most lucrative pharmaceutical market in the world. But at this stage of Eli Lilly’s crucial obesity-drug business, the greenest pastures are currently overseas. Indianopolis-based Lilly’s blistering GLP-1 growth internationally offers investors another reason to stick with a stock that’s already advanced almost 170% in the past three years — easily outperforming both a basket of drug stocks and the broader market over that stretch. Sales of GLP-1s outside the U.S. more than tripled in 2025 and again in the first quarter of 2026. In the larger, more established domestic market, Lilly’s GLP-1 sales rose 96% last year and 69% in the first three months of this year. “There’s a lot of people who feel, you know what, ‘This is a played-out story,” Jim Cramer said on CNBC, alluding to the fact obesity drugs went mainstream in the U.S. about four years ago and Lilly’s stock has been such a winner since then. “There’s so much of the world that isn’t using it yet.” On Wall Street, there’s a proven recipe for steady stock gains: consistently beat consensus estimates each quarter, prompting analysts and investors to raise their projections for future quarters. This makes the stock look more attractive than it was before the earnings report, inviting more buyers into the shares. Lilly’s overseas business has become the essential ingredient in that beat-and-raise cycle, representing the main source of upside versus analysts’ revenue expectations in recent quarterly results. That dynamic is likely to remain at play when Lilly delivers second-quarter results early next month, analysts say. In notes this week, JPMorgan and RBC Capital Markets both called out international strength while raising their respective price targets. JPMorgan went to $1,400 per share from $1,300. RBC went to $1,500 from $1,250. Both firms have buy ratings on the stock. “I think it’s going to hold again for the quarter,” said Cantor Fitzgerald analyst Carter Gould, who also has a buy on Lilly shares. He raised his price target this week to $1,350 from $1,230. “We [model] not a heroic beat, but a meaningful beat for the quarter. Certainly, if they exceed that, I think you’re going to see full-year numbers come up more meaningfully.” Lilly is scheduled to report second-quarter earnings before the opening bell on Aug. 5. LLY 1Y mountain Eli Lilly’s stock performance over the past 12 months. In addition to further growth potential, the primary reason why Lilly’s international GLP-1 business has become such an important focus for investors ahead of earnings is rooted in the challenges of forecasting it, compared to the U.S. business. In the U.S., analysts and investors lean on third-party data providers to track prescription trends and other demand signals to model revenue estimates. That kind of data is tougher to come by in important overseas growth markets like Brazil and China. As a result of these visibility challenges, Gould said that analysts are more conservative in their estimates. “That’s where you’ve seen more surprises on the prints. The variance between U.S. results versus consensus tends to be much smaller.” Morgan Stanley concurred, writing in a late June note: “We continue to see a meaningful medium-to-long-term [overseas] opportunity for LLY’s obesity franchise … but acknowledge that quarterly forecasting internationally remains inherently less precise than in the U.S.” Analysts expect $4.8 billion in international GLP-1 sales in the second quarter. To be sure, Lilly’s performance in the U.S. remains critical to the company’s overall results, and material cracks at home would be cause for concern. In the first quarter, Lilly’s GLP-1 revenue in the U.S. was $8.37 billion, covering both diabetes and obesity, while international sales were $4.46 billion. The combined total of $12.8 billion is nearly two-thirds of Lilly’s revenue, reflecting the centrality of GLP-1s to Lilly’s financials and its stock. “”There’s a lot of people who feel, you know what, ‘This is a played-out story. There’s so much of the world that isn’t using it yet.” Jim Cramer While Lilly’s growth is primarily coming from one class of drug, the international strength shows it’s not happening in only a single market. Lilly’s leading GLP-1 is tirzepatide. In most international markets, the weekly injectable drug shares the brand name Mounjaro for both diabetes and weight loss. In the U.S., it’s marketed as Mounjaro for diabetes and Zepbound for obesity. Mounjaro was approved by U.S. regulators in 2022, while the obesity clearance came in late 2023. Chief rival Novo Nordisk of Denmark, which makes Ozempic for diabetes and Wegovy for obesity, beat Lilly to both markets. The active ingredient in the Novo drugs is semaglutide, which is different from Lilly’s tirzepatide. The common thread between them is that they both mimic a naturally occurring gut hormone — appropriately called glucagon-like peptide-1 (GLP-1) — involved in regulating appetite and blood-sugar control. The added benefit of tirzepatide is that it also mimics a second gut hormone — called glucose-dependent insulinotropic polypeptide (GIP) — making it dual-action, which studies have shown to be more effective in promoting weight loss and insulin sensitivity. Neither company could keep up with booming demand in the first couple of years of the GLP-1 craze, leading to severe supply shortages that capped their growth, primarily in the U.S. Lilly did roughly $330 million in overseas GLP-1 sales in 2023, compared with roughly $5 billion in the U.S. The following year, international GLP-1 sales jumped to $2.6 billion — though that still represented only 15% of the company’s 2024 total. Last year, that percentage grew to 25%, before increasing to roughly 35% in the first three months of 2026. The revenue growth has coincided with Lilly’s entrance into more markets. On Lilly’s first-quarter earnings call in late April, the company said Mounjaro was fully launched in more than 55 countries. Rewind to a year earlier, and that number was over 40. Important launches in 2025 included Mexico and Brazil, which have been a major source of overseas demand. It entered China in a limited capacity in late 2024. Gould, the Cantor analyst, said Lilly deliberately waited to launch Mounjaro in more international markets before they had shored up its supply. Lilly has spent billions adding to its injectable GLP-1 manufacturing capacity. “It’s tough to argue with the results,” Gould said. Novo has also brought its obesity drugs into more countries as supply has improved, launching Wegovy in 35 new countries last year. That’s more than triple the number of new countries entered in 2024, according to the company. On Novo’s February earnings call, an executive said the company continues to see GLP-1 growth outside the U.S., where “a large unmet need remains and penetration rates are low.” If 2025 was the year that Lilly finished bringing Mounjaro to most developed countries, this year is about getting more patients onto the drug and increasing its share of the market. Lilly had 53% of the international GLP-1 market, according to its April earnings report, and a 60% share in the U.S. “While LLY has already captured 50%+ share of the ex-US market, the product’s ramp remains in its early stages and we see a continued runway for outperformance for the product with global penetration rates still in the single digits,” JPMorgan wrote in a note to clients Tuesday. One concern that investors have around the maturing GLP-1 market is declining prices, both in the U.S. and overseas markets like China. Lilly CEO David Ricks has said that as prices fall, Lilly has seen prescription volumes increase to offset the impact — partially due to the amount of people paying out of pocket versus drugs for other conditions that have higher insurance coverage. “I think investors can think about this category perhaps unlike other pharmaceutical categories in the past,” Ricks said in April. About 75% of ex-U.S. patients pay for the drug with cash, according to Ricks. The remaining quarter is covered by health insurance reimbursement in their respective countries. In the U.S., Ricks said a “meaningful portion” of patients pay for the drugs out of pocket, though he didn’t offer a specific figure. In India, Lilly has to contend with cheaper generic competition after Novo’s flagship injectable GLP-1 lost patent protection in March of this year . While Lilly hasn’t pointed to India as a major growth driver for Mounjaro, the company said in April that, based on early data, the arrival of generics “seems like it’s really stimulating the growth in the overall obesity market, and that includes our product.” Novo’s patent for semaglutide has also expired in Canada . It is protected in the U.S. until 2032, according to Novo’s 2025 annual report . Lilly’s Mounjaro and Zepbound won’t face patent issues for quite some time, with major markets including the U.S. protected until at least 2036 . Lilly and Novo are racing to bring next-generation GLP-1s to the market, starting with daily pill alternatives to their injectables. Both debuted weight-loss pills this year — Novo’s oral Wegovy debuted in the U.S. in January, while Lilly’s Foundayo received approval from the Food and Drug Administration on April 1 and started shipping soon thereafter. The oral GLP-1s are easier to manufacture and ship due to a lack of refrigeration requirements, unlike their injectable counterparts. For that reason, Lilly believes its weight-loss pill can play “an outsized role internationally,” Ricks said at the JPMorgan Healthcare Conference in January. He specifically referenced middle-income countries such as India, China, Indonesia and Brazil. “I’m pleased to say we’ve submitted this medicine in nearly all those markets already. So, we expect a rapid rollout late 2026, early 2027,” Ricks said. Gould said he’s modeling about $100 million worth of international Foundayo sales for Lilly this year, before that ramps “over the course of ’27 and probably even more meaningfully into ’28.” The United Arab Emirates is one country outside the U.S. where Foundayo has already been approved . According to FactSet, Wall Street expects total Foundayo revenue of $980 million in 2026. Lilly also has multiple injectable next-generation obesity treatments, including a triple-acting retatrutide which clinical trials have shown to generate more weight loss than Mounjaro and Zepbound. Retatrutide has earned the nickname “triple G” because it targets a third hormone in glucagon (in addition to GLP-1 and GIP). The company expects to submit the triple-G drug for FDA approval later this year. Eloralintide, another experimental weight-loss therapy, entered a late-stage clinical trial this year. It’s also being studied as a combination therapy combined with the active ingredient in Mounjaro and Zepbound because it targets a different hormone, called amylin, involved in appetite regulation. The hope is that the pairing would lead to better tolerability. “It’s like a 1A and 1B discussion when you think about U.S. versus ex-U.S., and that’s not going to change as you think about the next wave of the Lilly pipeline. Not just with Foundayo, but if you think about retatrutide and also their amylin assets over the course of ’27 and ’28,” Gould said. “Those could also be meaningful contributors outside the United States, as well as inside it.” (Jim Cramer’s Charitable Trust is long LLY. See here for a full list of the stocks.) As a subscriber to the CNBC Investing Club with Jim Cramer, you will receive a trade alert before Jim makes a trade. Jim waits 45 minutes after sending a trade alert before buying or selling a stock in his charitable trust’s portfolio. If Jim has talked about a stock on CNBC TV, he waits 72 hours after issuing the trade alert before executing the trade. THE ABOVE INVESTING CLUB INFORMATION IS SUBJECT TO OUR TERMS AND CONDITIONS AND PRIVACY POLICY , TOGETHER WITH OUR DISCLAIMER . NO FIDUCIARY OBLIGATION OR DUTY EXISTS, OR IS CREATED, BY VIRTUE OF YOUR RECEIPT OF ANY INFORMATION PROVIDED IN CONNECTION WITH THE INVESTING CLUB. NO SPECIFIC OUTCOME OR PROFIT IS GUARANTEED.Read More
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