While Johnson & Johnson retains the top revenue rank across the major pharma companies, Eli Lilly last year established itself as the clear leader in the obesity market, in the process capturing investors’ attention and enthusiasm.
2025 was Lilly’s year.
While the company wasn’t able to topple any record-holders—Merck’s Keytruda technically remains the top selling drug and Johnson & Johnson holds the overall sales crown—the giant from Indiana has been the year’s biggest buzz-maker.
In November, Lilly became the first pharma company to enter the trillion-dollar club, joining the tech-dominated pantheon of companies such as NVIDIA, Apple, Microsoft and Alphabet with a market cap over $1 trillion. Pharma’s second-largest company is J&J, which as of writing has a market cap of $585 billion—far behind Lilly. J&J does more than just pharma, with a robust medtech section that contributes heavily to earnings.
While Lilly has consistently been a strong performer, its rise in 2025 was no doubt driven by strong execution in the cardiometabolic space, particularly for the obesity and diabetes drug tirzepatide. In a recent interview, CEO David Ricks claimed that Lilly captures 70% to 75% of new patients starting their GLP-1 journeys—“almost three-to-one” versus its main competitor Novo Nordisk.
That’s not to say other pharmas didn’t have a strong 2025. J&J and Pfizer stand out, for instance, for keeping earnings afloat despite persistent headwinds—be it an impending patent cliff, a continued post-pandemic slide or the antagonistic rhetoric of a high-ranking health official. Others, still, have chosen to focus their efforts on building out their pipelines, paving the path for sustainable growth into the future.
Here, BioSpace reviews the top five pharma companies in terms of revenue, looking at what’s behind their strong market performance in 2025 and how they plan to maintain their momentum moving forward.
J&J Keeps Crown Despite Stelara Loss of Exclusivity
2025 Revenue: $94.19 billion
YoY Growth: 6%
With money flowing in from both the pharma and medtech industries, Johnson & Johnson is consistently among the top-earning drugmakers—and 2025 was no different.
With $94.19 billion in sales, J&J holds a comfortable lead over its Big Pharma peers (Roche is the closest challenger, more than $10 billion behind), despite the biosimilar erosion that immunology blockbuster Stelara endured in 2025. The product lost key market protections early last year and saw sales nosedive 41% from 2024.
J&J was well-prepared, however. In recent years, the pharma started cutting back on spending in some areas, such as infectious diseases and vaccines, and diverted these resources into immunology. The result is that newer products, including Tremfya and Simponi, have helped soften the blow of the Stelara cliff. Last year, these drugs surged nearly 40% and 22% year-on-year, respectively.
Meanwhile, J&J’s cancer division continues to be the cornerstone of the pharma’s business. In 2025, oncology accounted for more than a quarter of the company’s revenue, bringing in $25.4 billion—almost 21% growth from the previous year. The myeloma drug Darzalex was the pharma’s top-selling product last year, with $14.35 billion in earnings.
Medtech contributed $33.8 billion to J&J’s topline in 2025.
Roche Maintains Second-Place as Dealmaking Ramps Up
2025 Revenue: $79.48 billion
YoY Growth: 7%
Also racking up revenue from two industries—pharma and diagnostics—is Roche, which kept its second-place spot from the 2024 ranking. The group brought in CHF 61.516 billion ($79.48 billion) last year, representing 7% year-on-year growth.
Ocrevus, a monoclonal antibody indicated for multiple sclerosis, continued to be Roche’s top-selling product, making CHF 7.01 billion ($9 billion) in 2025, a 9% increase. The hemophilia A therapy Hemlibra likewise had a strong year, growing 11% to hit CHF 4.754 billion ($6.12 billion) in sales. Beyond these products, Roche attributed its revenue growth to the asthma drug Xolair, which surged 32% year-on-year to hit sales of CHF 3.075 billion ($4.78 billion).
Beyond its commercial performance, 2025 turned out to be a big dealmaking year for Roche. In September, the group acquired 89bio for $3.5 billion, obtaining its late-stage FGF21 analog pegozafermin for the treatment of metabolic dysfunction-associated steatohepatitis.
Roche in March 2025 also dropped $1.65 billion upfront—and promised up to $3.6 billion more in milestones—to partner with Zealand Pharma on its long-acting amylin analog petrelintide for obesity.
In October that year, during the pharma’s third quarter earnings call, CEO Thomas Schinecker said that despite these hefty investments, Roche “is not done with BD.” The company has made good on that promise, with hundreds of millions poured into back-to-back cancer deals, as well as an RNA interference alliance.
Eli Lilly Skyrockets To Third on Back of Obesity Rush
2025 Revenue: $65.179 billion
YoY Growth: 45%
With a 45% increase in revenue from the year prior, Eli Lilly is by far 2025’s fastest-growing pharma, jumping six spots to land in third place on this list. The Indianapolis powerhouse’s 2025 sales hit $65.18 billion.
Behind the company’s blockbuster year is the tirzepatide franchise. The drug, a dual agonist of the GLP-1 and GIP receptors, is marketed as Mounjaro for type 1 diabetes and Zepbound for weight loss. Mounjaro nearly doubled sales in 2025 to $22.97 billion, while Zepbound surged 175% year-on-year to make $13.54 billion.
Despite being a late entrant to the GLP-1 game—tirzepatide was first approved as Mounjaro in May 2022, while Novo Nordisk’s Ozempic was cleared in January 2020—Lilly has cleanly overtaken its competitor with a rapid ramp-up in sales that outpaced even Merck’s long-time cancer blockbuster Keytruda.
Also helping boost tirzepatide’s case are studies that show the drug to have better weight-loss and glucose control profiles than Novo’s semaglutide.
The future continues to look bright for Lilly’s business, as the lead over Novo extends in the obesity space. While the Danish competitor brought a weight-loss pill to the market first—the FDA signed off on an oral formulation of Wegovy late last year—Lilly’s own tablet, a GLP-1 analog called orforglipron, is close behind, with an FDA target action date of April 10.
Orforglipron also appears to have an efficacy edge over oral semaglutide, with the Phase 3 ACHIEVE-3 study demonstrating that Lilly’s pill elicited better sugar control and greater weight reduction.
Merck Slows Down, Focuses on Pipeline as Keytruda’s Cliff Approaches
2025 Revenue: $65.01 billion
YoY Growth: 1%
During Merck’s full-year 2025 earnings call, an analyst at TD Cowen pressed the pharma on its relatively slow growth last year: “Is this what we should expect from Merck going forward, a company that grows modestly in good times and is significantly pressured in less good times?”
Merck in 2025 was bogged down substantially by a slowdown in vaccine sales. Its HPV vaccine Gardasil made $5.23 billion globally last year—a 39% decrease from 2024. Pneumovax 23, the pneumococcal vaccine, cratered 37% year-on-year and brought in just $166 million in 2025.
Thankfully for Merck, the blockbuster PD-1 inhibitor Keytruda, which by now has become a cornerstone cancer therapy, continued its strong market performance, growing 7% to bring in $31.64 billion. Keytruda remains the industry’s top-selling drug, but it’s on a timer. Key protections for Keytruda are set to expire in 2028, after whichsales are expected to erode as biosimilars enter the market.
Merck has been preparing for this, however, and last year secured an FDA approval for Keytruda Qlex, a subcutaneous formulation of the cancer therapy, which the pharma—and analysts—say will help cushion Keytruda’s fall off the patent cliff. The under-the-skin injection made $40 million worldwide last year in its initial months.
The approval of Keytruda Qlex is part of why CEO Robert Davis pushed back against the TD Cowen comment during the pharma’s investor call. “I’m not sure I agree with your characterization,” Davis told the analyst, insisting that 2025’s modest growth was being taken “out of context.”
In particular, Davis pointed to the pharma’s strong push to expand its pipeline—an effort that may not immediately reflect on the topline, but will nevertheless help keep earnings high past Keytruda’s lifespan. In July 2025, the company scooped up Verona Pharma for $10 billion, gaining the commercial drug Ohtuvayre for chronic obstructive pulmonary disease. Then, in November, Merck paid $9.2 billion to acquire Cidara Therapeutics for a late-stage antiviral drug.
These deals have helped Merck build what Davis said is “probably the broadest and widest pipeline we’ve had in years.”
Pfizer Pivots Focus to Obesity as Sales Continue Slide
2025 Revenue: $62.579 billion
YoY Growth: -2%
Rounding out this list is Pfizer, which continues to struggle to regain its footing in a post-pandemic market. The pharma reported an overall 2% year-on-year sales slip to $62.6 billion, but taking its COVID-19 products—the antiviral Paxlovid and the vaccine Comirnaty—out of the equation reveals 6% operational growth.
Comirnaty nevertheless remains Pfizer’s best-selling product, making $2.27 billion worldwide. Close behind are the blood thinner Eliquis, which grew 8% year-on-year to bring in $2.02 billion, and the Prevnar family of conjugate vaccines, which racked up $1.71 billion in sales.
Notably, with vaccines accounting for much of earnings, Pfizer has been particularly exposed to policy headwinds in the U.S., driven by continued critical rhetoric and controversial vaccine policies from Health Secretary Robert F. Kennedy, Jr. So much so, in fact, that Pfizer CEO Albert Bourla felt the need to speak up about it at the World Economic Forum in January.
To return to growth, Pfizer is leaning heavily into the already-lucrative but increasingly competitive obesity market. The pharma previously tried to advance its own GLP-1 drug danuglipron, but was forced to pull the plug amid safety issues. Late last year, Pfizer won over Novo in a public bidding war for Metsera, ultimately paying $9.8 billion to acquire the biotech.
The pharma has since put more money into its weight-loss pipeline, including a potential $1.9 billion deal with China’s YaoPharma in December 2025 for an investigational GLP-1 drug, as well as a $495 million partnership with Sciwind Biosciences in February to license a GLP-1 injection called ecnoglutide, which is approved in China for diabetes.
