All but four of the world's top-20 drugmakers achieved growth in 2025 led by Eli Lilly, which was up 45%. No other top-20 company increased its sales by more than 10%.
Boosted by a 45% increase in sales in 2025, Eli Lilly has jumped six notches in the annual top-20 revenue ranking, becoming the third-largest company in the biopharma industry. The Indianapolis drugmaker increased its sales from $45 billion in 2024 to $65.2 billion last year, catapulting past Bristol Myers Squibb, Novartis, AstraZeneca, AbbVie, Pfizer and Merck in the rankings.Accounting for nearly all of Lilly’s $20.2 billion increase in sales in 2025 were its diabetes and obesity drugs Mounjaro and Zepbound. In 2025, the duo generated combined sales of $36.5 billion, which were up from $16.5 billion in 2024. The tirzepatide treatments accounted for 56% of Lilly’s revenue in 2025, up from 37% in 2024. In this decade, Lilly has leaped from No. 15 in the rankings in 2020 to its current spot at No. 3.Fueled by its own diabetes and obesity products, Novo Nordisk had been on a similar trajectory earlier in the decade, jumping from No. 17 in the rankings in 2020 to No. 11 in 2024. Novo more than doubled its revenue during that period, but the momentum of the Danish company has stalled, as it remained at No. 11 last year after a 6% increase in sales. It was the first year this decade that Novo did not achieve a double-digit sales increase. Novo is likely to go in the opposite direction in 2026 as it is projecting a decline in sales of between 5% and 13%. CEO Mike Doustdar blamed “unprecedented pricing pressures” for his company's anticipated sales slide, also citing “intensifying competition” and the most favored nation (MFN) pricing deal the company struck with the Trump administration last fall. The year also featured a figurative passing of the torch from Novo to Lilly, as its semaglutide duo, Ozempic and Wegovy, racked up combined sales of $31 billion, failing for the first time to top the combined sales of Mounjaro and Zepbound. At the top of the rankings again in 2025 was Johnson & Johnson with sales of $94.2 billion. J&J has held the top spot every year since 2012, except for 2022, when Pfizer jumped to No. 1, becoming the first drugmaker in history to exceed the $100 billion mark. That leap was largely due to combined sales of $56.7 billion for its COVID products, Comirnaty and Paxlovid.J&J has a chance to top the century mark this year as it is projecting sales to come in at between $99.5 billion and $101.08 billion. Since spinning off its consumer health unit, Kenvue, in 2023, J&J has seen its revenue increase at a higher rate each year, reaching 6% last year. Aside from Lilly’s rise, there were few changes in the top-20 rankings in 2025. Bristol Myers Squibb, which was one of four companies in the top 20 which had a revenue decline in 2025, dropped two notches to No. 10. The company cited declining sales of its legacy drugs, which were down 16%. Those products include blood cancer blockbusters Revlimid and Pomalyst. Moving up a notch to No. 9 and surpassing BMS was Sanofi, which had a 10% increase in sales. The French company ranked No. 6 in 2023 before it sold off its consumer health unit, Opella, and dropped to No. 10 in 2024. Like J&J, Sanofi has seen an uptick in growth since divesting.Another company that saw revenue decline in 2025 and dropped one notch was Takeda, which moved to No. 15. Moving up a rung to No. 14 was Boehringer Ingelheim, which saw a 4% increase in sales.There were no new companies in the top 20 this year. At the bottom of the rankings, CSL, with $15.4 billion in revenue in 2025, remained ahead of Regeneron ($14.3 billion) and Viatris ($14.3 billion), with Japanese drugmakers Astellas ($13.8 billion) and Daiichi Sankyo ($13.7 billion) also close behind.