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UPDATE 3-Eli Lilly misses estimates for top-selling diabetes drug Trulicity, shares slip

shares slip@ (Adds details on quarter, comment from CFO)

April 30 (Reuters) - Eli Lilly and Co reported lower-than-expected sales for its top-selling diabetes drug Trulicity on Tuesday and said it expects further hits from price declines in the United States, sending its shares down 3 percent.

The company cited a number of challenges for the year including increased generic competition for drugs such as erectile dysfunction treatment Cialis and the global withdrawal of its cancer drug Lartruvo.

Under intensifying pressure from lawmakers to lower drug prices, Lilly agreed to offer a half-priced version of insulin injection Humalog earlier this year. The drugmaker is one of the three main global providers of insulin products.

Revenue was also hit by Lilly's programs that allow patients to try new drugs as insurance companies weigh coverage decisions, Chief Financial Officer Josh Smiley told Reuters.

Trulicity brought in $879.7 million in the first quarter, missing the average analyst estimate of $952 million, partly hurt by lower realized prices and changes in estimates to rebates and discounts in the United States.

Sales of psoriasis treatment Taltz, considered one of Lilly's growth drivers, came in at $252.5 million, also falling short of analysts' estimates.

"The results will ... lead to some pressure on Lilly shares today given the underperformance of Trulicity and Taltz," said Credit Suisse analyst Vamil Divan.

Sales of Cialis dropped 38 percent to $308.2 million as the drug continues to suffer from increased generic competition.

Lilly said it now expects 2019 revenue to come in between $22.0 billion and $22.5 billion, lower than its prior forecast of $25.1 billion to $25.6 billion. Analysts had expected $22.17 billion.

The forecast takes into account the recent completion of the spin-off of Lilly's animal health unit Elanco, Lilly said.

The company, however, raised its adjusted earnings forecast by 5 cents to a range of $5.60 to $5.70, beating the average analyst estimate of $5.63.

Net income more than tripled to $4.24 billion, or $4.31 per share, in the quarter ended March 31, as the company benefited from a $3.7 billion gain from its spin-off of animal health unit Elanco.

Excluding items, the company earned $1.33 per share, beating the average estimate of $1.31, according to IBES data from Refinitiv.

Revenue rose to $5.09 billion, but missed estimates of $5.13 billion. (Reporting by Saumya Sibi Joseph in Bengaluru and Julie Steenhuysen in Chicago; Editing by Shinjini Ganguli and Saumyadeb Chakrabarty)