Eli Lilly began 2026 expecting revenue of $80bn to $83bn. After its third quarter, it now expects $91bn to $92bn. Lilly’s sales reached $24.4bn in the three months to September, up 39%. Most of its large peers grew in single digits. Read together, pharma Q3 2026 earnings describe an industry whose fastest growth is concentrated in obesity medicines.
Three threads run through the results. Obesity drugs are driving the sharpest gains. Companies facing major patent expiries are spending through them rather than retrenching. Vaccines delivered mixed results, with GSK reporting a decline and Merck reporting growth. For every company covered here except Pfizer, the third quarter means calendar July to September 2026. Pfizer’s international subsidiaries closed their quarter on 23 August. Growth rates follow each company’s own reporting basis, which is labelled where it differs.
Why Are Lilly and Novo Raising 2026 Guidance?
Lilly reported third-quarter revenue of $24.4bn on 29 October, against $17.6bn a year earlier. US revenue rose 34% to $15.1bn. Revenue outside the US climbed 47% to $9.3bn. In both regions, volume growth outweighed lower realised prices. In the US, volume rose 41% while realised prices fell 7%.
Mounjaro generated $10.7bn worldwide, up 65%. Zepbound added $5.4bn, up 49%. The oral medicine Foundayo contributed $184m in the quarter and $281m so far this year.
The company lifted its full-year revenue guidance to $91bn to $92bn. Its previous range was $85bn to $87bn. No other company in pharma Q3 2026 earnings came close to Lilly’s growth rate. “Lilly had another strong quarter, exceeding our prior expectations,” said chair and chief executive David A. Ricks.
The Medicare GLP-1 Bridge is one source of new demand. According to Lilly’s third-quarter earnings presentation, more than 500,000 patients now access its obesity medicines through the programme. About 80% of them are new incretin starts. Monthly Bridge prescriptions for Lilly rose from 222,000 in July to 527,000 in September. The rules on who qualifies for the Medicare GLP-1 Bridge shape how far that demand can extend. The same presentation cites IQVIA prescription data for the four weeks to 25 September. On that measure, Lilly held 63.0% of US incretin prescriptions, against 36.6% for Novo Nordisk.
Novo Nordisk, the last company here to report, closed the pharma Q3 2026 earnings round on 4 November. Its third-quarter adjusted sales rose 4% at constant exchange rates (CER) to DKK 79.2bn. Adjusted operating profit rose 27% CER to DKK 31.7bn. The comparison was favourable, because the prior-year quarter carried DKK 9bn of transformation costs. On the earnings call, the company said US Operations grew 1% and International Operations grew 8%. Its full-year outlook for both measures is now a 2% decline to 2% growth at CER. The previous range was a 6% decline to flat. “We delivered a stronger-than-expected third quarter,” said president and chief executive Mike Doustdar.
The Wegovy pill generated DKK 5.4bn in the quarter, including DKK 4.2bn in the US. Novo Nordisk estimates the pill’s US new-to-brand market share at around 80%, across reimbursed, cash-pay and telehealth channels. Injectable Wegovy brought in DKK 20.4bn, although its US sales fell 13% CER. Ozempic generated DKK 29.7bn. Lower realised prices partly offset volume growth in US obesity sales. The company’s outlook assumes further US price pressure, amplified by its most-favoured-nation agreement with the US government. Doustdar said Novo Nordisk is preparing for a US launch of CagriSema in early 2027, subject to regulatory approval.
When Does Keytruda Lose Exclusivity?
Among the companies in pharma Q3 2026 earnings, Merck faces the most closely watched patent expiry. Its 2025 annual report on Form 10-K lists 2028 as the US expiry year for the Keytruda compound patent. The same filing gives 2031 for major EU markets and 2032 to 2033 for Japan. Merck adds that two further US patents in the family expire in 2029. It expects them to be litigated.
A second pressure comes from US price negotiation. Merck says it expects Keytruda to be selected in 2027 for government price setting, effective from 1 January 2029. It expects US Keytruda sales to decline materially after that point.
How Merck Is Preparing
Merck’s third-quarter worldwide sales rose 5% to $18.1bn, or 4% excluding foreign exchange. Combined sales of Keytruda and Keytruda Qlex reached $8.6bn, up 6%. Within that total, the subcutaneous Keytruda Qlex contributed $830m, while intravenous Keytruda fell 5% to $7.8bn. Merck said the timing of wholesaler purchases held back US sales. Its annual report lists a 2043 US patent expiry for Keytruda Qlex.
Winrevair, Merck’s pulmonary arterial hypertension treatment, grew 93% to $694m. Merck also narrowed its full-year sales guidance to $66.8bn to $67.3bn. That raised the bottom of its earlier $66.3bn to $67.3bn range.
Spending will stay high. On the earnings call, chief financial officer Caroline Litchfield said Merck sees 2027 “as another year of investment”, BioSpace reported. That investment will go behind its pipeline and new launches. The scale of that challenge sits within the wider patent cliff facing big pharma’s biologics.
Other Companies Managing Patent Cliffs
Patent pressure shaped several other sets of pharma Q3 2026 earnings. Novartis shows how quickly a blockbuster can fade. Its third-quarter net sales rose 4% in constant currencies (cc) to $14.5bn. Entresto, however, fell 38% cc to $1.2bn, which the company attributed to US generic competition. Kisqali grew 37% cc to $1.8bn and Leqvio grew 63% cc to $506m. Novartis also booked a $1.9bn partial impairment on del-desiran. It raised its core operating income guidance to between flat and low single-digit growth, from a low single-digit decline. Chief executive Vas Narasimhan said priority brands and launches “more than offset generic erosion”.
According to its third-quarter results release, Bristol Myers Squibb grew revenue 7% to $13.1bn. Its Growth Portfolio rose 12% to $7.7bn. In the Legacy Portfolio, Eliquis grew 25% to $4.69bn, while Revlimid fell 47% to $303m. BMS raised revenue guidance to between $49.75bn and $50.25bn, from $49.0bn to $50.0bn. At the same time, it cut non-GAAP earnings per share guidance to $6.35 to $6.55, from $6.75 to $7.00. About $1.6bn of acquired in-process research and development (IPRD) charges drove that cut, mainly from new licence agreements. BMS’s quarterly filing lists a $600m upfront payment to Hengrui and a $500m anniversary payment to BioNTech among them.
Biogen grew revenue 11% to $2.8bn, or 10% at constant currency. Products acquired with Apellis, which closed in May, added $243m with no prior-year comparison. Multiple sclerosis revenue fell 13% to $919m. Acquired and newer products offset that decline. Eisai-reported in-market sales of Leqembi rose 67% to $202m, and Skyclarys grew 34% to $178m. “Our third quarter results demonstrate that Biogen has returned to growth,” said Christopher A. Viehbacher, president and chief executive.
Why Are GSK Vaccine Sales Falling?
GSK’s third-quarter turnover rose 4% at actual exchange rates to £8.89bn, or 5% at CER. Its vaccines business moved the other way. According to its third-quarter results filing, vaccines turnover fell 2% CER to £2.58bn.
The company gave product-specific reasons. Shingrix fell 5% CER to £780m on lower sales in its International region, primarily China. US pricing and inventory build partly offset that fall. Arexvy, the respiratory syncytial virus vaccine, fell 24% CER to £195m. GSK cited lower market demand and a comparison with US returns provision adjustments in the third quarter of 2025. Influenza vaccines declined because of US competitive pressure and delayed deliveries.
Specialty Medicines carried the group instead, rising 15% CER to £3.88bn. GSK reaffirmed that it expects 2026 turnover growth in the upper half of a 3% to 5% CER range. “GSK has delivered another strong quarter,” said chief executive Luke Miels.
The weakness was not uniform across the sector. Merck’s Gardasil sales rose 14% to $2.0bn. Merck attributed the increase mainly to favourable US public-sector purchasing patterns, with higher net pricing also contributing. At AstraZeneca, FluMist grew 20% to $146m, while Beyfortus slipped 2% CER to $233m. On the reasons the companies gave, vaccine pressure in pharma Q3 2026 earnings was product specific rather than sector wide.
Oncology and Specialty Brands Carry Large-Cap Growth
Outside obesity, oncology produced some of the strongest large-cap growth. AstraZeneca reported third-quarter revenue of $16.2bn on 30 October, up 7% at both actual rates and CER. Oncology revenue reached $7.77bn, up 17% CER. The company reconfirmed guidance for mid to high single-digit revenue growth in 2026. “In the first nine months we saw strong commercial momentum,” said chief executive Pascal Soriot.
Roche reported nine-month group sales of CHF 46.5bn on 22 October, up 6% CER. Third-quarter sales grew 7% CER, or 8% in Swiss francs. Its nine-month results release shows the five leading growth drivers rising 12% CER to CHF 16.8bn. Those brands are Xolair, Hemlibra, Ocrevus, Phesgo and Vabysmo. Roche confirmed its outlook for mid single-digit sales growth at CER.
How Pfizer’s Results Fit the Three Threads
Pfizer’s results, reported on 3 November, touch all three threads of pharma Q3 2026 earnings. Third-quarter revenue was flat operationally at $16.6bn. Excluding Comirnaty and Paxlovid, revenue grew 7% operationally. Both COVID-19 products fell operationally: Paxlovid by 63% to $449m and Comirnaty by 29% to $808m. The Prevnar family fell 10% to $1.56bn, with Pfizer citing lower US vaccination rates and adult market share erosion. Pfizer raised its full-year revenue guidance to $62bn to $64bn, from $60.5bn to $62.5bn. That guidance includes about $1.1bn of expected revenue impact from generic and biosimilar competition. Chair and chief executive Albert Bourla told analysts that Pfizer plans to advance 10 Phase 3 obesity trials in 2026. He said it is working towards the first of several potential approvals for its GLP-1 candidate, berobenatide, in 2028.
What Do Pharma Q3 2026 Earnings Mean for 2027?
Three conclusions stand out from the pharma Q3 2026 earnings round. First, obesity growth is concentrated. Lilly holds almost two thirds of US incretin prescriptions on IQVIA data cited by Lilly. Its revenue guidance has risen by about $10bn at the midpoint since February. The oral segment looks different, with Novo Nordisk’s own estimate putting its pill ahead on new prescriptions.
Second, companies facing patent cliffs are investing rather than retrenching. Merck expects 2027 to be another year of investment. BMS absorbed about $1.6bn of acquired IPRD charges in a single quarter. Novartis is leaning on launches, and Biogen on launches and acquired products, to replace mature franchises.
Third, vaccine businesses face demand risk at product level. GSK’s RSV and China shingles sales weakened, while Merck’s HPV vaccine grew on US purchasing patterns. The two UK-headquartered companies in this group show the wider split. AstraZeneca’s oncology revenue grew 17% CER, while GSK’s vaccines fell 2% CER.
These trends will frame the fourth-quarter and full-year reporting season in February.
