The latest ranking of the world's top 10 pharmaceutical companies has been officially released. Compared to 2023, the "stronger gets stronger" rule still dominates the industry landscape, with Johnson & Johnson, Roche, and Merck holding the top three positions in total revenue. Pfizer successfully reversed the decline caused by COVID-19 products, maintaining its fourth position. AstraZeneca, through expansion into emerging markets, saw its total revenue ranking rise to sixth, and its pharmaceutical business surpassed Roche to rank fifth, showing strong development momentum. Meanwhile, Eli Lilly demonstrated remarkable explosive growth with a 32% surge, entering the top ten.

Specifically, when ranked by pharmaceutical business revenue, the top 10 global pharmaceutical companies are Pfizer, Merck, Johnson & Johnson, AbbVie, AstraZeneca, Roche, Novartis, BMS, Eli Lilly, and Sanofi.

When ranked by total company revenue, the global top 10 pharmaceutical companies are Johnson & Johnson, Roche, Merck, Pfizer, AbbVie, AstraZeneca, Bayer, Novartis, BMS, and Eli Lilly.

The Top 10 Global Pharmaceutical Companies (Ranked by Pharmaceutical Business Revenue)

Notably, in the pharmaceutical business revenue top 10 list, six companies have a core product revenue share exceeding 40%. These blockbuster products, often worth billions, not only serve as the strongest engines driving performance growth for the major pharmaceutical giants but also significantly shape their strategic layouts.

Top 10 Global Pharmaceutical companies Best selling Drugs

Taking Merck as an example, its cancer drug Keytruda, with sales of $29.482 billion, retained the title of "king of drugs" while also supporting nearly half of Merck's revenue. In addition to Keytruda, the HPV and MMRV vaccines also contributed significantly, with the three blockbuster products together generating $40.55 billion in revenue, accounting for 70% of Merck's total revenue. To ensure sustainable growth, Merck is also investing in next-generation cancer products, including ADCs, bispecific antibodies, oncolytic viruses, and cancer vaccines.

However, relying on blockbuster products to create performance growth may lead to passive situations due to patent cliffs and the iteration of competing products. A prime example is the "king of drugs," Humira, which saw its performance rapidly decline in 2023 due to competition from biosimilars, causing AbbVie’s overall revenue to drop by 6.4%. Fortunately, AbbVie successfully transitioned to its new flagship product, Skyrizi, which achieved strong sales, helping the company maintain positive growth. In 2024, Skyrizi’s revenue surpassed the $10 billion mark, driving AbbVie’s overall growth alongside Rinvoq.

Johnson & Johnson's Stelara, after passing its peak period, faces similar challenges. But thanks to Darzalex, the company successfully maintained its growth momentum. This further proves that managing the product lifecycle of blockbuster drugs is crucial. When core products enter the maturity phase, companies need to introduce new "blockbusters" to fill the gap.

BMS is also a "blockbuster harvesting machine." Its drugs Eliquis, Opdivo, and Revlimid together generated $28.41 billion, accounting for nearly 60% of the company’s total revenue. As mature products face more significant "patent cliff" challenges, BMS is accelerating the development of a new and more diversified pipeline to ensure continued growth.

In the rapidly growing GLP-1 market, Novo Nordisk and Eli Lilly have reached new heights with their two super "blockbusters" – semaglutide ($29.296 billion) and tirzepatide ($16.466 billion). With the GLP-1 market now surpassing $50 billion, it has become one of the most valuable strategic fields, following PD-(L)1, attracting many pharmaceutical companies to accelerate their investments.

Sanofi also has a super "blockbuster" – Dupixent, the best-selling autoimmune product. Although Sanofi temporarily dropped out of the top ten total revenue ranking due to the spin-off of its consumer health business (Opella), this marks a critical transformation period for the company. By focusing on its core pharmaceutical business, Sanofi achieved an 11.3% growth in overall performance after becoming a purely pharmaceutical company. This strategy aligns with that of other pharmaceutical giants, such as Merck, Pfizer, GSK, Johnson & Johnson, and Novartis, which have spun off their consumer healthcare or generic drug businesses to focus more on their pharmaceutical operations.

Massive investments in R&D are also a key factor for pharmaceutical giants to maintain their leading position and product innovation. Except for Bayer, all other companies in the top 10 total revenue ranking spent over $10 billion on R&D, with Merck spending $17.938 billion, Johnson & Johnson $17.232 billion, Roche $14.852 billion, AstraZeneca $13.583 billion, AbbVie $12.791 billion, BMS $11.159 billion, Eli Lilly $10.991 billion, Pfizer $10.822 billion, and Novartis $10.022 billion.

Acquisitions are another common strategy among pharmaceutical giants to nurture and strengthen their leading products. However, according to data from the pharmaceutical database, global mergers and acquisitions in 2024 decreased by 60.76% compared to the previous year, with companies preferring smaller-scale acquisitions. The largest acquisition was Novo Nordisk’s $16.5 billion purchase of CDMO giant Catalent. With its ample cash flow from GLP-1 drugs in recent years, this acquisition will help Novo Nordisk further expand its GLP-1 production capacity.

Top 10 MNC Mergers and Acquisitions in 2024

In terms of transactions and collaborations, compared to 2023, major pharmaceutical giants have taken a relatively conservative approach, with no large deals like Merck’s $22 billion ADC agreement with Daiichi Sankyo. Instead, they have focused on smaller-scale strategic investments, such as Merck’s collaborations with Eisai and Hanmi Pharmaceuticals on PD-1/VEGF bispecific antibodies and oral small molecule GLP-1 drugs. Novartis, however, has been relatively active, securing six deals in the top 20 transactions, with the most notable being a $4.165 billion agreement with BOWAG Pharma to jointly develop several cardiovascular siRNA drugs.

The competitive landscape of the top 10 global pharmaceutical companies in 2024 continues the traditional logic of “the strong get stronger” while also showing new variables in the ever-evolving market. From the succession and layout of next-generation core products to the collective increase in R&D investment and the business restructuring under strategic focus, these actions reflect the pharmaceutical giants' firm determination to build sustainable competitive advantages. The prudent strategy in mergers and acquisitions also indicates careful consideration of the future market.

In 2025, the pharmaceutical industry will remain full of uncertainties, and it will be exciting to see how these industry leaders continue to shape the future of the sector and write their own legendary narratives.

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