Eli Lilly and Co on Tuesday cut its annual profit forecast for the third time, as a stronger dollar piled more pressure on the drugmaker struggling with lower insulin prices and generic competition for its cancer drug.

The company’s shares fell nearly 4% in premarket trading as the forecast cut overshadowed strong performance by its newly approved diabetes drug.

Eli Lilly now expects adjusted full-year earnings of $7.70 to $7.85 per share, compared to its prior forecast of $7.90 to $8.05.

The drugmaker also trimmed its full-year revenue forecast to a range of $28.5 billion and $29 billion, from its previous expectation of $28.8 billion and $29.3 billion, citing an additional $300 million hit from the dollar since August.

Multinational companies such as Abbott Laboratories and Johnson & Johnson have been hit by the dollar’s strength against a basket of currencies.

Lilly flagged a total impact of about $1 billion from the strong dollar for the full year.

The company posted better-than-expected results for the third quarter, as demand for its recently approved diabetes drug, Mounjaro, helped counter declining sales of its diabetes and cancer treatments.

Third-quarter sales of the diabetes drug was $187.3 million, with more than half coming from the United States.