Text size Eli Lilly reported fourth-quarter earnings well ahead of analysts’ estimates. Daniel Acker/Bloomberg Eli Lilly stock was falling Thursday as sales in the pharmaceutical company’s diabetes drug Mounjaro, which is on track for regulatory approval to treat obesity, came up short. Fourth-quarter earnings, however, did crush estimates. Shares in Eli Lilly (ticker: LLY) fell 4.8% on Thursday, with the S&P 500 rising 0.9%, by comparison. The pharmaceutical group reported earnings per share of $2.09 in the fourth quarter on revenue of $7.3 billion. Analysts surveyed by FactSet had expected earnings of $1.78 a share on just more than $7.3 billion in revenue, so profit beat while sales were largely in line with estimates. “2023 is an inflection point for Lilly—a chance to expand our impact on patients and growth potential as an R&D-driven biopharma company,” David A. Ricks, the company’s chairman and CEO, said in a statement. “Over the course of this critical year, we hope to launch as many as four new medicines for challenging diseases, while advancing our next generation of molecules currently in Phase 3.” In focus were sales of Mounjaro, Eli Lilly’s tirzepatide obesity treatment. Optimism over Mounjaro, which is currently approved to treat type 2 diabetes, helped Eli Lilly stock outperform most of its peers last year and blow past the performance of the S&P 500. Mounjaro sales came in at $279 million in the fourth quarter, shy of the $319 million expected by analysts. Wall Street expects to see sales of the drug skyrocket next year, with a consensus estimate of revenue around $2.3 billion in 2023, when Eli Lilly aims to have Food and Drug Administration approval of a weight-loss version of the treatment. “Lilly demonstrated strong growth and achieved meaningful pipeline progress that included the launch for Mounjaro in type 2 diabetes,” Anat Ashkenazi, the group’s chief financial officer, said in a statement. “We expect to capitalize on this momentum and deliver midteen revenue growth for our core business in 2023 while remaining committed to investing in innovation, late-stage opportunities, manufacturing capacity, and our people.” Also in the spotlight was the company’s guidance for the year ahead. The stock tumbled in December after Eli Lilly said 2023 earnings would be around $8.10 to $8.30 a share, below Wall Street’s guidance for this year. But that figure was revised higher on Thursday to a range of $8.35 to $8.55—though still short of analysts’ prior forecasts. Eli Lilly’s 2023 revenue forecast was mostly in line with the market’s expectations, with sales in the range of $30.3 to $30.8 billion straddling analysts’ consensus of $30.5 billion. Write to Jack Denton at jack.denton@barrons.com