Top 10 pharmaceutical companies by revenue in 2024
Six of the top 20 drugmakers had double-digit increases in 2024, compared to just two in 2023. Five others saw a revenue bump of between 7% and 9%, compared to two reaching those figures in 2023.
For the second year in a row, Eli Lilly (32%) and Novo Nordisk (26%) posted Big Pharma's largest year-over-year sales bumps, though their positions were flipped from 2023 when Novo (31%) topped Lilly (20%).
Expect the same form in 2025 as Lilly—boosted by sales of its diabetes and obesity drugs Moujaro and Zepbound—projects its sales to fall between $58 billion and $61 billion. At the midpoint of the projection, it would be a 32% increase, matching the sales boom it saw last year. Meanwhile, Novo—which also has been powered by sales of its diabetes and obesity treatments—is projecting sales to increase by a range of between 16% and 24%.
As for their places in the industry rankings, Lilly’s success has allowed it to jump from No. 15 in the revenue rankings in 2020 to No. 9 last year, with sales over that period increasing from $24.5 billion to $45 billion. Novo, meanwhile, has made a similar surge, jumping from No. 17 in 2022 to No. 11 last year as sales over the period jumped from 177 billion Danish kroner ($25 billion) to 290 billion Danish kroner ($42.1 billion).
Top of the rankings
For the second straight year, there was no change at the top as No. 1 Johnson & Johnson, No. 2 Roche, No. 3 Merck, No. 4 Pfizer and No. 5 AbbVie each held their positions. Each company delivered modest revenue increases in 2024 of between 3% and 7%.Getting back to growth was significant for Pfizer and Roche as they were coming off sales decreases of 41% and 7%, respectively, in 2023, largely due to declining sales of COVID-19 products. Last year was a course correction of sorts for the companies as they returned to their pre-pandemic growth trajectories.
AbbVie’s 4% increase was noteworthy as well. It came after the company saw a 6% revenue decline in 2023 as autoimmune superstar Humira faced generic competition in the U.S. The Illinois-based company has come full circle, with next-gen treatments Skyrizi and Rinvoq primed to provide growth over the next decade. In its fourth-quarter earnings presentation, AbbVie estimated combined sales of the Humira follow-ons would reach $31 billion in 2027.
The No. 1 rank for J&J was the 12th time in the last 13 years that the New Jersey powerhouse has finished on top. J&J’s lone year not in the top spot came in 2022, when Pfizer set an industry record by generating more than $100 billion in sales, with more than $56 billion coming from revenue from its COVID products.
Slides in the rankings
Sanofi and GSK
were the only companies in the top 20 that fell by at least two slots in the
rankings. Sanofi dropped from No. 6 in 2023 to No. 10 last year because of a
reorganization in which it is separating from its consumer health business. In
its financial reports, the company is accounting for the spinoff as if it has
happened, even though the sell-off has yet to be completed. Aside from the
effects of the divestment, Sanofi’s pharma products accomplished a 9% sales
increase in 2024.Despite consecutive years with a 3% revenue increase, GSK has dropped from No. 10 to No. 12 in the rankings as it has been surpassed by Lilly and Novo. Holding back the British company were plummeting (PDF) sales of respiratory syncytial virus (RSV) vaccine Arexvy after the Centers for Disease Control and Prevention narrowed its guidance on who should receive RSV shots.
Falling out of the rankings was Viatris, which was No. 20 in 2023 and has seen three straight years of revenue declines, including a 4% drop in 2024.
Crashing the rankings for the first time and replacing Viatris is CSL. The Australian plasma specialist has had nine straight years of growth, boosted by acquisitions including an $11.7 billion buyout of Vifor Pharma in 2021.
Other big gainers in 2024
Other companies that had significant turnarounds from 2023 to 2024 were Germany’s Merck KGaA, which went from a 5% revenue decline to a 2% gain; Merck, which had a 7% revenue increase compared to a 1% gain in 2023; Gilead Sciences, which was up 6% after sales were flat in 2023; and Bristol Myers Squibb, which saw a 7% bump after a 2% decline in 2023.
While Bayer was the only company with a year-over-year revenue decline, be it minuscule at 0.4%, it was a significant improvement over its 5% drop in 2023.
Editor's note: For the purpose of this ranking, company revenues outside of the health sciences arena were excluded. Examples include Bayer's crop science sales and Merck KGaA's electronics business. For companies reporting in foreign currencies, conversion to U.S. dollars is based on the annual average exchange rate.1. Johnson & Johnson
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| For 2025, Johnson & Johnson projects overall sales growth of roughly 4% to $92 billion. Johnson & Johnson |
- 2024 revenue: $88.8 billion
- 2023 revenue: $85.2 billion
- Change: +4%
- Headquarters: New Brunswick, New Jersey
Through these developments—and even more now in the wake of them—the company has remained focused on its innovative drug business. Thanks to new approvals and future label expansions, the company has projected that its innovative medicines business can deliver annual growth of 5% to 7% from 2025 to 2030.
Of J&J’s $88.8 billion in global sales last year, its innovative medicines group delivered annual sales of nearly $57 billion. Its medtech division, meanwhile, pulled down nearly $32 billion. Both groups delivered sales growth of 4% to 5% compared with 2023.
Related: The top 10 drugs losing US exclusivity in 2025
For 2025, J&J projects overall sales growth of roughly 4% to $92 billion. To get there, the company expects to fight “headwinds associated with U.S. biosimilar entries for Stelara,” CEO Joaquin Duato told analysts on an earnings call in January. California's Amgen launched the Stelara biosimilar onslaught at the start of the year, and, since then, several other copycats have entered the market. More are on the way, so J&J is bracing for sales of its megablockbuster immunology medicine to continue to decline. Last year, Stelara’s sales declined by 4.6% to about $10.4 billion.
In addition to the Stelara biosim pressure, the company is anticipating some challenges from a Medicare Part D redesign in the U.S. and macroeconomic factors in China, Duato informed analysts during the January earnings call.
On the flip side, J&J says it has 10 or more medicines that could generate more than $5 billion in peak-year sales. This list includes multiple myeloma drugs Talvey, Tecvayli and investigational oral medicine icotrokinra. Another 15 assets—or more—could generate between $1 billion and $5 billion at peak, including depression spray Spravato.
In all, J&J expects to deliver 70 new products or label expansions (or the associated regulatory filings for these expansions) by 2030, according to its Enterprise Business Review presentation (PDF) in 202
“I cannot think of any other company that would be able to deliver growth through the first year of losing exclusivity of a multibillion-dollar product,” Duato said on January’s call. “We are able to achieve these results because of the diversification of our business, the strength of our commercial assets, as well as the breadth of our pipeline, with additional launches in 2025, including Tremfya in [inflammatory bowel disease], Rybrevant and Lazcluze in lung cancer, and Varipulse and the Dual Energy Thermocool Smarttouch SF catheter in electrophysiology.”
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| Last year, Roche's sales grew 3% to about 60.5 billion Swiss francs, including 46.2 billion Swiss francs from the pharma division. trabantos/Getty Images |
2. Roche
2024 revenue: 60.5 billion Swiss francs ($65.3 billion)2023 revenue: 58.7 billion Swiss francs ($65.3 billion)
Change: +3%
Headquarters: Basel, Switzerland
Roche made several headlines in 2024, although not all were positive developments.
If one were to name 2024’s star pharmaceutical products beyond the GLP-1s, Roche’s eye injection Vabysmo would likely be on the list. First approved by the FDA in January 2022 as a competitor to Bayer and Regeneron’s Eylea, Vabysmo already reached 3.86 billion Swiss francs (about $4.5 billion) of sales in 2024.
The VEGFxAng-2 bispecific antibody became even more competitive last year by offering a more convenient single-dose prefilled syringe option.
The rise of Vabysmo pushed the checkpoint inhibitor Tecentriq off Roche’s top three medicines list by sales.
Then, a few months later, Roche said the closely watched Skyscraper-01 trial of its TIGIT antibody tiragolumab failed to show an overall survival benefit when combined with Tecentriq in first-line PD-L1-high non-small cell lung cancer, despite an earlier positive signal.
Given the importance of the indication, the trial failure pushed the entire TIGIT idea—once billed as the potential next big immune checkpoint target after PD-1/L1—ever closer to its graveyard. Bristol Myers Squibb, Merck & Co. and, most recently, BeiGene, have all ditched TIGIT, although Roche still has a few ongoing phase 3 trials that are fully enrolled.
Also in cancer immunotherapy, Roche last year struck a $1.5 billion deal to purchase its then-partner Poseida Therapeutics, giving the cell therapy field a much-needed injection of confidence. The deal brought to Roche an allogeneic cell therapy platform, which includes a gene editing tool that allows for the delivery of multiple CARs in a single step.
The Poseida buy also strengthened Roche’s flourishing hematology portfolio. Its hemophilia drug Hemlibra grew sales by 12% at constant exchange rates, reaching 4.5 billion Swiss francs last year. Diffuse large B-cell lymphoma (DLBCL) antibody-drug conjugate Polivy crossed the blockbuster threshold with 1.1 billion Swiss francs in 2024. Its two CD19xCD3 bispecifics, Columvi and Lunsumio, are anticipated to receive an FDA decision and a phase 3 readout, respectively, in second-line DLBCL this year.
Overall, Roche has successfully navigated the scary losses of exclusivity of its former top-selling cancer drugs—Avastin, Herceptin and Rituxan. In 2024, group sales went up 3% to about 60.5 billion Swiss francs, including 46.2 billion Swiss francs from the pharma division, which ginned up 4% year-over-year growth.Roche also bought a portfolio of CDK inhibitors from China’s Regor Pharmaceuticals last year for $850 million upfront. What’s more, two important phase 3 trials of the company’s oral SERD, giredestrant, could read out this year.
For 2025, Roche projects group sales to rise in the mid-single-digit range, with Vabysmo still expected to be a major growth driver despite the launch of an Eylea biosimilar. |
| In 2024, Merck generated global sales of $64.2 billion, a 7% increase from the prior year. Merck & Co. |
3 . Merck
2024 revenue: $64.2 billion2023 revenue: $60.1 billion
Change: +7%
Headquarters: Rahway, New Jersey
Even as Merck sets a course to navigate the eventual downfall of PD-1 king Keytruda, the company is contending with uncertain vaccine demand in China. That issue, rather than the Keytruda situation, has hit the company particularly hard in recent months.
During its fourth-quarter earnings report in February, Merck said it was halting Gardasil shipments to China as the company and its local distribution partner, Zhifei, had been experiencing lower-than-expected demand in the key market. The company further pulled its $11 billion long-term sales target for the HPV shot, its second-biggest product by revenue behind Keytruda.
All told, Gardasil sales fell 3% last year to $8.6 billion.
On the flip side, sales of Merck's megablockbuster checkpoint inhibitor Keytruda climbed 18% last year to $29.48 billion.
While Merck has long enjoyed the booming success of Keytruda, including securing a 40th U.S. indication last year, the drug's trajectory will eventually change. And it’s not just generics waiting around the corner: In a recent securities filing, Merck said it expects the U.S. government to select Keytruda for Inflation Reduction Act (IRA) "government price setting" in 2026. After a two-year process, the new negotiated prices for Medicare would take effect at the start of 2028.
“As a result, U.S. sales of Keytruda will decline after that time," the company explained in its annual report.
Merck halts Gardasil shipments to China, withdraws $11B sales target as demand nosedives Besides the IRA process, Merck lists 2028 as the expiration of Keytruda’s “key patent protection.” Together, Keytruda and Gardasil were responsible for roughly 59% of Merck’s annual sales in 2024. With both products facing future uncertainties, Merck execs have been busy figuring out the company’s growth path for the years to come. On Merck’s fourth-quarter earnings conference call, CEO Robert Davis said the company has been “very focused from a business development perspective, with nearly $40 billion invested in the last 3.5 years across really a diverse set of assets that have built out the pipeline.” Some of the company’s business development deals over the last few years include its $11.5 billion purchase of Acceleron and its $10.8 billion buyout of Prometheus Biosciences. More recently, Merck last year struck a deal worth up to $3 billion to scoop up ophthalmology-focused EyeBio.
After Merck’s Acceleron buyout, one drug getting a significant amount of attention at the New Jersey drug giant is Winrevair. The pulmonary arterial hypertension therapy scored its initial FDA nod in 2024 and is carrying blockbuster expectations.
Going forward, business development deals worth up to $15 billion are in the company’s “sweet spot,” Davis added on the February conference call. The company is eyeing a range of investigational and commercial opportunities, he said.
In 2024, Merck generated global sales of $64.2 billion, a 7% increase from the prior year. The company has set a somewhat cautious tone for 2025, expecting its sales this year to land between $64.1 billion and $65.5 billion. Even at the high end of the range, the growth rate would be just 2%.
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| Pfizer bounced back after COVID-related fluctuations sent sales spiraling in 2023. Pfizer |
4. Pfizer
- 2024 revenue: $63.6 billion
- 2023 revenue: $59.6 billion
- Change: +7%
- Headquarters: New York City
The
past few years for Pfizer have reflected both high highs and low lows
as the company’s COVID-19 products reacted to inconsistent demand. The
company seems to have emerged from the choppy waters on solid ground as
it ended 2024 with a clutch of new products sweetening its revenue pot.
A significant change to Pfizer’s 2024 revenue
was new earnings from its $43 billion Seagen buyout, which wrapped up
at the end of 2023 and added four established oncology drugs and a major
pipeline upgrade. In reporting its 2024 revenue, the company opted to
retroactively add sales from the Seagen medicines to its 2023 bottom
line, reflecting a more accurate growth rate in comparing the two years.
With
Seagen’s products and the $3.4 billion they earned included, the New
York-based drugmaker's revenues had a 7% growth spurt. Taking out sales
from COVID-19 antiviral Paxlovid and BioNTech-partnered vaccine
Comirnaty, that figure jumps to a 12% sales increase.
It’s a welcome return to growth for Pfizer after COVID products in 2023 prompted an overall revenue decline of more than 40%. The company now finds itself firmly back on track, with revenue volatility “largely in the past” as COVID-related uncertainties have “diminished,” Pfizer declared in its earnings presentation (PDF).
In 2024,
however, those uncertainties played out largely in Pfizer’s favor with
surprise revenue boosts for Comirnaty and Paxlovid. Both pulled around
$5 billion in sales, which was down for Comirnaty compared to 2023 but a
boost on Paxlovid’s end. Usage of the antiviral is in line with
COVID-19 burden and the ebb and flow of infection rates, the company
pointed out, demonstrating the “sustainability” of the two-product COVID
portfolio.
As for the company’s other vaccines,
respiratory syncytial virus vaccine Abrysvo was negatively impacted by
narrowed vaccine recommendations from the Centers for Disease Control
and Prevention. The agency flipped on its previous recommendation for
all adults aged 60 and older to instead recommend the vaccine for people
75 years and older and those aged 60 to 74 with a higher risk of severe
disease. A decline in vaccination rates due to the shrunken U.S. market
played a part in Abrysvo sales falling 62% during 2024’s fourth
quarter, Pfizer said, although the shot picked up $890 million in yearly
sales.
Meanwhile, Pfizer’s long-dominant pneumococcal vaccine franchise, Prevnar, saw relatively flat sales over the year but could face trouble on the horizon with Merck and its 21-serotype Capvaxive eager to edge in on Prevnar’s turf.
For 2025, the company is forecasting revenue of between $61 billion and $64 billion. It also expects to deliver overall net cost savings of about $4.5 billion by the end of 2025 thanks to the significant “cost realignment” drive it’s been running, which, along with the Seagen products, should help a return to “predictable growth,” Edward Jones healthcare analyst John Boylan pointed out in a note to clients earlier this year.
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| AbbVie's fast-growing immunology duo Skyrizi and Rinvoq is more than making up for the company's sinking Humira sales. AbbVie |
5. AbbVie
- 2024 revenue: $56.3 billion
- 2023 revenue: $54.3 billion
- Change: +4%
- Headquarters: North Chicago
AbbVie’s
return to top-line sales growth the year following top-selling
immunology drug Humira’s high profile loss of exclusivity is one for the
books. 2024 marked AbbVie’s first year after Humira, which was once the
world’s bestselling drug and taking in around $21 billion in peak
annual sales, dived off the patent cliff in 2023. Competing biosimilars
quickly edged in on Humira’s market share, leaving Humira’s sales
tanking to $14.4 billion as AbbVie reported a full-year sales decline
for the first time in its company history in 2023. It was a spiral that
could have toppled other companies, but AbbVie ultimately came out on
top thanks to its powerhouse immunology duo—and Humira
follow-ups—Skyrizi and Rinvoq.
Together, Skyrizi and
Rinvoq pulled in upward of $17 billion in 2024 sales, more than making
up for Humira’s 37.6% sales dip to $8.9 billion with both Skyrizi and
Rinvoq each achieving individual sales growth of more than 50%.The
drugs, which both first hit the market in 2019, were central to AbbVie’s
plan for success in its post-Humira operations. Still, it took the pair
a few quarters to pick up enough steam to live up to Humira’s sales
dominance. After creeping up behind Humira in sales for several
quarters, Skyrizi finally eclipsed its predecessor in October,
officially snatching the top sales crown with its $3.2 billion quarterly
haul. Skyrizi holds biologic share leadership in approximately 30
countries and boasts a “best-in-class profile” that presents a “very
high bar” for rivals, AbbVie's chief commercial officer Jeffrey Stewart
said on a company earnings call. Skyrizi added a key ulcerative colitis
indication to its belt in June, which, together with its prior Crohn’s
disease nod, allows the drug to treat both forms of inflammatory bowel
disease (IBD). Rinvoq, too holds indications for both forms of IBD.
The duo’s showing in IBD prompted AbbVie to crank up its 2027 sales projection for the meds to a combined $31 billion, making for a $4 billion increase to its previous guidance. Out of that $4 billion, $2 billion goes to Skyrizi’s estimated sales in IBD and $500 million was added to Rinvoq’s in the same indication.
The company expects Skyrizi will bring in $20 billion in 2027 and Rinvoq’s sales will hit $11 billion. That $31 billion total is more than Humira, Skyrizi and Rinvoq together achieved in 2022 sales.
Outside of immunology, the company is working on priming another blockbuster after nabbing a long-awaited FDA approval for its Parkinson’s disease therapy Vyalev, a follow-up to its 2015 infusion pump Duopa. The drug could eventually achieve more than $2 billion in peak sales, analysts at Evercore ISI previously forecast.
2025, meanwhile, should see AbbVie grow its sales by mid-single-digit percentages, the company forecast. With no major losses of exclusivity in the near future, AbbVie is working with a “clear runway to growth for at least the next eight years,” CEO Rob Michael noted during the company’s fourth-quarter earnings call.
2024 was former Chief Operating Officer Michael’s first year at the helm after longtime chief Richard Gonzalez hung up the gloves after seeing Humira out. The company awarded Michael about $18.5 million in pay after he “achieved or exceeded” multiple goals over the year.
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| AstraZeneca’s stock price reached an all-time high last year. AstraZeneca |
6. AstraZeneca
- 2024 revenue: $54.1 billion
- 2023 revenue: $45.8 billion
- Change: +18%
- Headquarters: Cambridge, U.K.
By full-year numbers, AstraZeneca had one of the best 2024 among Big Pharma companies. Its 2024 revenue of $54.1 billion marked an impressive 18% increase year over year, fueled by the likes of SGLT2 inhibitor Farxiga, Sanofi-partnered respiratory syncytial virus prevention drug Beyfortus, blood cancer drug Calquence and Daiichi Sankyo-partnered antibody-drug conjugate Enhertu.
The British drugmaker’s stock price even reached an all-time high last year.
However, investigations into the company’s Chinese operations cast a shadow over AZ’s overall performance toward the end of the year. Chinese authorities have detained AZ’s then-China president, Leon Wang, and the probes are reportedly centered on the alleged illegal importation of Enhertu and the cancer immunotherapy Imjudo from Hong Kong to the mainland as well as improper collection of patient data.
After logging double-digit quarterly sales growth in China in the first nine months of 2024, AZ instead posted a 3% decrease at constant exchange rates in the country in the fourth quarter. Rather than the ongoing investigation, AZ attributed the decline to “year-end hospital ordering dynamics” of Tagrisso and Farxiga, plus lower demand for its respiratory medicines because of a mild infection season.
Despite China’s weak contribution, AZ’s overall four-quarter revenue still jumped 25% at constant exchange rates.
AZ’s biggest product, Farxiga, saw sales up an impressive 29% last year to reach $7.7 billion. The drug is, however, slated to take a mandatory price cut under the Inflation Reduction Act (IRA) in 2026.
The EGFR inhibitor king Tagrisso also managed a 13% sales growth to $6.6 billion with two new FDA approvals last year, one in combination with chemotherapy in first-line EGFR-mutated non-small cell lung cancer and the other for stage 3 EGFR lung cancer. But the drug is facing competition from Johnson & Johnson’s cocktail of Rybrevant and Lazcluze.
While locked in a fierce competition with BeiGene’s rival BTK inhibitor Brukinsa, Calquence was included in the second round of IRA price negotiations.
Following mixed phase 3 data and an FDA resubmission, AZ and Daiichi have in January 2025 won the FDA’s go-ahead for their second ADC, TROP2-directed Datroway, in HR-positive, HER2-negative breast cancer.
In a new approval in 2024, AZ’s Alexion picked up an FDA nod for the factor D inhibitor Voydeya as an add-on therapy to treat paroxysmal nocturnal hemoglobinuria patients with extravascular hemolysis.
On the dealmaking front, AZ last year inked a $2 billion buyout of radiopharmaceuticals specialist Fusion Pharmaceuticals. AZ also paid CSPC Pharma $100 million upfront for a preclinical candidate targeting lipoprotein (a), which has also attracted the interest of Eli Lilly and Merck & Co.
For 2025, AZ doesn’t expect the same
level of growth it saw in 2024, instead projecting revenue to increase
by a high single-digit percentage at unchanged exchange rates. Part of
that is the result of pressure from the Medicare Part D redesign that
just went into effect this year, along with the U.S. loss of exclusivity
of blood thinner Brilinta. With several key readouts anticipated
throughout 2025, AZ believes it will have a good sense as to whether it
can reach the $80 billion-by-2030 revenue target CEO Pascal Soriot
outlined in 2024.
7. Novartis
- 2024 revenue: $50.3 billion
- 2023 revenue: $45.4 billion
- Change: +12%
- Headquarters: Basel, Switzerland
As a new corporate structure and business priorities set in, Novartis is focused on growth at a compound annual rate of 6% from 2023 to 2028, or 5% from 2024 to 2029, according to a plan unveiled in November.
The Swiss pharma was off to a good start. In 2024, the first full year that Novartis operated as a pure-play innovative medicines company without Sandoz, sales were up 12% in constant currencies (11% in U.S. dollars) from continuing operations, reaching $50.3 billion.
The company’s top four brands—heart medication Entresto, immunology treatment Cosentyx, multiple sclerosis drug Kesimpta and breast-cancer-targeted Kisqali—all contributed to the growth big time, with sales rising 30%, 23%, 49% and 46%, respectively.
In a key approval last year, Kisqali expanded into the adjuvant treatment of certain early-stage HR-positive, HER2-negative breast cancers. The new label gives Kisqali an edge over Eli Lilly’s Verzenio by covering patients who don’t have cancer cells in their lymph nodes.
By Novartis’ projection, the broad adjuvant nod could lift Kisqali to more than $8 billion in peak sales, versus the $3.2 billion the CDK4/6 inhibitor generated in 2024 mainly from metastatic disease use.
While potential significant growth still lies ahead for Kisqali, the good days of Entresto may be numbered, as Novartis expects the heart failure combo medication will lose U.S. market exclusivity in the coming months. Besides, even if no generics entered this year, Entresto is subject to a price cut under the Inflation Reduction Act beginning in 2026.
Despite the looming Entresto patent cliff, Novartis still expects 2025 sales to grow by mid- to high-single-digit percentages.
From the Medicare Part D reforms, Novartis expects a “modest headwind,” with the biggest impact to come from coverage for the catastrophic phase for Cosentyx and Kisqali in 2025, CEO Vas Narasimhan said during the company’s fourth-quarter earnings call. As to the policies’ potential impact on Novartis’ midterm performance as outlined above, Narasimhan said he’s “very comfortable” with Novartis’ modeling, which takes “appropriately conservative assumptions.”
In two other major expansions for Novartis last year, the FDA granted accelerated approvals to Scemblix in newly diagnosed chronic myeloid leukemia and Fabhalta in the kidney disease immunoglobulin A nephropathy. For both drugs, Novartis has outlined peak sales potential at above $3 billion.
Another potential multibillion-dollar asset, radioligand therapy Pluvicto, also delivered good news for Novartis. With a favorable final overall survival analysis last year from a phase 3 trial, the FDA has in March 2025 approved the PSMA-targeted therapy for metastatic castration-resistant prostate cancer before chemotherapy.
Novartis last year beefed up its radiopharmaceuticals capabilities with the $1 billion upfront acquisition of Mariana Oncology. While Pluvicto uses lutetium as the active substance, Mariana was focused on actinium.
The Swiss drugmaker also acquired gene therapy specialist Kate Therapeutics in a deal potentially worth $1.1 billion. The buyout was followed by a positive readout for an intrathecal formulation of Novartis’ spinal muscular atrophy gene therapy Zolgensma in older patients.
However, one Novartis acquisition last year immediately went into trouble. Just a few months after the $2.9 billion takeover of MorphoSys, Novartis pushed back its regulatory plan for the deal’s centerpiece, BET inhibitor pelabresib, in myelofibrosis after running into a safety signal that the company now hopes to shed more light on after longer follow-ups.
8. Bristol Myers Squibb
2024 revenue: $48.3 billion
2023 revenue: $45 billion
Change: +7%
Headquarters: Princeton, New Jersey
Last year ushered in better-than-expected revenue growth for Bristol Myers Squibb, following a 2023 in which revenues dropped 2% year over year. Going into 2024, the drugmaker was expecting annual growth only in the low single digits; investors were therefore pleasantly surprised when BMS ended up logging an increase of more than 7% for the year.
The upward drive came even as blockbuster leukemia med Sprycel tipped over the patent cliff. Global sales for the drug totaled just under $1.29 billion, marking a 33% year-over-year drop. BMS also registered decreases for sales of two other drugs that have lost exclusivity in recent years: blood cancer drug Revlimid and multiple solid tumors treatment Abraxane, which saw sales fall 5% and 13%, respectively.
While generic erosion of Revlimid in 2023 was credited with sending that year’s total revenues downward, in 2024, BMS saw demand for its growth portfolio and at least one member of its legacy drug family, anticoagulant med Eliquis, balance out the copycat competition.
Eliquis raked in a major $13.3 billion last year, up 9% from 2023, helping the legacy portfolio stay relatively flat year over year amid the losses from Revlimid, Sprycel and Abraxane. Sales in the growth portfolio, meanwhile, grew 17%, with four separate drugs earning more than $1 billion globally in 2024—Opdivo, Orencia, Yervoy and Reblozyl—and two others, Breyanzi and Camzyos, charting more than 100% growth throughout the year.
Heading into 2025, however, BMS is anticipating another contraction. The company forecast total revenues of approximately $45.5 billion for this year, which would represent a decrease of about 5.8%.
On a February conference call, while discussing the expected revenue drop—which came in about $1 billion short of consensus expectations—CEO Chris Boerner, Ph.D., noted: “We’re seeing the increased step-down on Revlimid.”
Elsewhere in 2025, the company will be continuing a multiyear cost-cutting plan that aims to save $2 billion by the end of 2027. Boerner said on the call that about half of the savings will be accomplished by the end of this year, and, while the restructuring is expected to include layoffs, the company did not specify how many jobs would be affected.
The latest cost-cutting effort begins as BMS works on wrapping up another initiative that it introduced in early 2024, aimed at slashing $1.5 billion in costs by the end of this year and including more than 2,000 total layoffs.
Both savings drives come as the pharma prepares for both Opdivo and Eliquis to lose exclusivity before the end of the decade, when they’re set to join Revlimid in seeing their sales plummet. Eliquis sales may take a further hit in 2026, when it becomes part of the first group of drugs to see their prices negotiated down under the Inflation Reduction Act.9. Eli Lilly
2024 revenue: $45 billion
2023 revenue: $34.1 billion
Change: +32%
Headquarters: Indianapolis
In the eternal struggle for obesity market dominance, Indianapolis’ Eli Lilly may be gaining an upper hand over its chief metabolic medicine rival Novo Nordisk.
Last year, Lilly recorded $45 billion in total sales, good for 32% growth over the roughly $34 billion it pocketed in 2023. In the fourth quarter alone, Lilly’s sales swelled 45% to $13.53 billion, which the company credited in no uncertain terms to the 60% revenue jump its Type 2 diabetes blockbuster Mounjaro enjoyed over the last three months of the year.
Meanwhile, Mounjaro’s GLP-1 sibling Zepbound—which is approved for obesity—grew sales roughly elevenfold in 2024’s fourth quarter, taking home $1.9 billion versus just $175 million during the quarter in 2023.
Those drugs’ performance likely “dispelled suspense” among both industry watchers and investors, analysts at Citi wrote in a note to clients earlier this year. The comments followed a third-quarter sales scare for Lilly last year, during which the company’s GLP-1 duo failed to meet Wall Street expectations. Some keeping tabs on the field speculated that the lackluster sales performance could be evidence that the larger GLP-1 market had started to plateau.
Lilly executives, for their part, have pointed to the uncertainties underpinning the burgeoning GLP-1 industry.
"The scale of this business and the way it's been growing, the consumer part of it, along with the stocking dynamics, it's just been a learning [experience] for us," Lilly CEO David Ricks said at the J.P. Morgan Healthcare Conference in January, reflecting on an unpopular sales guidance cut that the helmsman attributed to an overestimation of the pace of growth for Mounjaro and Zepbound.
In January, Lilly cut its sales guidance for 2024 to about $45 billion, representing a decline from the $45.4 billion to $46 billion the company had previously projected.
But, while Lilly may have fallen short of its own expectations toward the end of 2024, the fact remains that “it’s early days on a very, very large opportunity,” Ricks said of the GLP-1 situation on a recent conference call. Further, the company thinks its still far from reaching the edge of the demand curve for obesity, Ricks added.
Looking ahead, Lilly expects to reel in 2025 sales between $58 billion and $61 billion. Mounjaro and Zepbound will contribute greatly to that haul, naturally, but a suite of new drugs like cancer med Jaypirca, atopic dermatitis treatment Ebglyss, ulcerative colitis drug Omvoh and Alzheimer’s disease therapy Kisunla are also expected to pull their weight this year, Ricks said in early February.
Meanwhile, much like Novo, the continued success of Lilly’s GLP-1 franchise hinges on manufacturing capacity and the company’s ability to meet rampant demand.
To that end, Lilly recently revealed plans to build out four new production facilities in the U.S. beginning this year. The project, which is backed by a $27 billion investment, more than doubles what Lilly has earmarked for U.S. manufacturing since 2020 and will help expand domestic capacity for both active pharmaceutical ingredients and injectable drugs.10. Sanofi
2024 revenue: $41.1 billion euros ($44.46 billion)
2023 revenue: $37.8 billion euros ($40.1 billion)
Change: +9%
Headquarters: Paris
Although Sanofi slipped in Fierce Pharma’s 2024 rankings of the top pharma companies by sales, the change doesn't mark any tangible setback for the drugmaker.
In fact, the move down the ladder can easily be explained by the drugmaker’s planned sale of a controlling stake in its consumer health unit Opella, which, for all intents and purposes, was treated as though it’s a done deal in Sanofi’s 2024 financials.
For all of 2024, Sanofi logged sales of 41.08 billion euros ($44.46 billion), a step down from the roughly 43 billion euros it reported in 2023 but an 8.6% increase when accounting for the subtraction of consumer health sales last year.
Word of a planned consumer health sale by Sanofi began to materialize around September, when Bloomberg reported that the French pharma had received separated offers from equity firms PAI Partners and Clayton, Dubilier & Rice for the roughly 15 billion euro over-the-counter business.
Reports of mounting interest in the unit, dubbed Opella, followed an announcement by Sanofi in October 2023 that the company was reviewing multiple separation scenarios for the business, including a potential listing or sale.
Soon after the Bloomberg report, Sanofi confirmed last October that it had entered negotiations with Clayton, Dubilier & Rice to potentially sell a 50% controlling stake in Opella, which produces well-known brands like Allegra, Icy Hot, Gold Bond and Selsun Blue. Those talks became “exclusive” several weeks later and, as of February, Sanofi said it continues to expect to close the 50% stake sale with Clayton, Dubilier & Rice in 2025’s second quarter “at the earliest.”
Looking at Sanofi’s core 2024 performance, new launches paid off well for the company, making up 11% of the drugmaker’s total sales last year. That launch momentum was led by the company’s respiratory syncytial virus antibody for infants and young children Beyfortus, which delivered nearly 1.7 billion euros ($1.84 billion) for the entire year, followed up by hemophilia med Altuviiio, Pompe disease drug Nexviazyme and Rezurock for graft-versus-host disease.
Looking ahead, Sanofi is optimistic it can continue its growth trajectory in 2025, with the expectation that it’ll grow sales by a mid- to high-single-digit percentage over the year to come.
Meanwhile, with so many launches in the hopper, Sanofi has been continuously investing in its manufacturing network, too, with many of those investments piling up toward the end of 2024.
Following the opening of a half-billion-dollar modular plant for biologics and vaccines in September, Sanofi unveiled a production expansion in France and then touted the debut of a separate modular vaccine site in Singapore. Then, in December, Sanofi rolled out its largest investment in China to date when it revealed plans to build a 1 billion euro insulin “manufacturing base” in the country.Others (11 - 20):
11. Novo Nordisk: 2024 revenue = 290 billion Danish kroner (USD $42.1 billion)12. GSK: 2024 revenue = 31.4 billion pounds sterling (USD $40.1 billion)
13. Amgen: 2024 revenue = $33.4 billion
14. Takeda: 2024 revenue = 4.58 trillion Japanese yen (USD $30.9 billion)
15. Boehringer Ingelheim: 2024 revenue = 26.8 billion euros (USD $29.0 billion)
16. Gilead Sciences: 2024 revenue = $28.6 billion
17. Bayer: 2024 revenue = 24 billion euros (USD 26 billion)
18. Merck KGaA: 2024 revenue = 17.6 billion euros (USD 19.1 billion)
19. Teva Pharmaceuticals = 2024 revenue: $16.5 billion
20. CSL: 2024 revenue = $15.2 billion
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