Merck & Co. remains the “big dog” in the pharma industry in 2025, with roughly $64.17 billion in FY2024 revenue. It claimed the top position a year earlier. Drawing on continued Keytruda momentum, which continues its reign as the world’s best-selling drug with sales that rose 18% to $29.5 billion in 2024. In all, Keytruda accounts for about 46% of Merck’s sales. While Keytruda dominates, Gardasil/Gardasil 9 remains a significant contributor despite a 3% sales dip. It brought in $8.6 billion in 2024. Keytruda, however, faces a looming patent expiration in 2028. The company is actively working to broaden its pipeline.
Pfizer still in the second slot
Despite cratering COVID-19 demand that had catapulted it to the top of the ranks in FY2022 with more than $100 billion in revenue, Pfizer maintains its position in FY2024 as a close second with $63.63 billion in revenue for FY2024. The company is showing signs of stabilization after the sharp decline from its pandemic-driven peak, but its stock has still tumbled more than a quarter over the past five years.
Pfizer’s COVID portfolio, which once dominated its business, has seen sharp declines. Yet Pfizer’s diverse portfolio shows resilience with key non-COVID products like the anticoagulant Eliquis generating $7.4 billion, the Prevnar vaccine family bringing in $6.4 billion, and the Vyndaqel franchise had $5.5 billion in sales. Nevertheless, the company’s stock has struggled to recover from the post-pandemic revenue drop, trading at around $26.50 in early 2025, less than half its value at the peak during the COVID-19 pandemic.
Rounding out the top five
Established giants like Johnson & Johnson (pharma revenue of $57.07B), AbbVie ($56.33B), and AstraZeneca ($54.07B), round out the top five slots.
J&J has sustained momentum in oncology and immunology. Its top seller, the multiple myeloma treatment Darzalex, achieved $11.7 billion in 2024 sales, up 22%. Yet Stelara, a blockbuster immunology drug, saw a sales dip 4.6% to $10.4 billion.
Meanwhile, AbbVie is successfully navigating the patent expiry of its long-time blockbuster Humira. While Humira sales fell to $9.0 billion in 2024 owing to biosimilar competition, its newer immunology drugs Skyrizi and Rinvoq surged. Skyrizi became AbbVie’s top product with $11.7 billion in sales (a 50.9% YoY increase), and Rinvoq grew to $6.0 billion.
Meanwhile, AstraZeneca has successfully built out its product portfolio, especially in oncology and cardiovascular/metabolic diseases. Standout products include the SGLT2 inhibitor Farxiga/Forxiga, which led with $7.7 billion in sales (37% growth), and the cancer treatment Tagrisso, which generated $6.6 billion (a 27% increase from the previous year). Enhertu, recently winning broad approval in breast cancer, and Imfinzi ($4.72 billion in 2024) further bolster its oncology pipeline.
GLP-1s continue to revamp the sector
While tirzepatide’s unique properties have helped fuel Lilly’s growth, Novo Nordisk continues to maintain market dominance with nearly 55% of the total GLP-1 market share. Its diabetes medication Ozempic saw growth of 26% to $17.5 billion in 2024, with its U.S. patent protection secure until 2032, while Wegovy hit $8.4 billion, nearly doubling from 2023.
The market continues to evolve, with an expansion of clinical trials exploring new therapeutic applications. Tirzepatide won FDA approval for obstructive sleep apnea in late 2024 following successful Phase 3 trials (SURMOUNT-OSA) showing up to 63% reduction in apnea-hypopnea index. Beyond sleep apnea, both Lilly and Novo Nordisk are aggressively exploring neurological indications, with Novo running Phase 3 trials (EVOKE and EVOKE Plus) for semaglutide in early Alzheimer’s disease, expected to report results in late 2025. These trials follow promising Phase 2 data showing liraglutide slowed cognitive decline and reduced brain shrinkage in Alzheimer’s patients. Multiple Phase 2 trials have also shown improvements in motor activity for Parkinson’s disease patients treated with exenatide, liraglutide, and lixisenatide.
Meanwhile, if GLP-1 moves from injectables to oral therapies, the boom of the therapy class could extend even further.