Tirzepatide

Is it a coincidence the most valuable pharmaceutical company by market capitalization is also the one with the CEO rated highest by employees? Maybe not.Eli Lilly, which just became the first trillion-dollar pharmaceutical company, also holds another distinction: CEO David Ricks is ranked No. 1 among big pharma with regard to employee approval, according to reviews on Glassdoor.Employee approval of a CEO correlates with company performance, studies show, with top leaders boosting worker efficiency, improving recruitment and lifting customer perception.That certainly seems to be the case for Lilly, where 89% of roughly 6,100 reviewers on Glassdoor approve of the job Ricks is doing in the captains chair.Lillys financial performance matches that high approval rating thanks to blockbuster GLP-1 drugs Zepbound and Mounjaro, which together raked in more than $10 billion in the third quarter to top the pharmas sales charts. Lilly also raised full-year forecasts and touts a deep pipeline of closely watched research projects.With Ricks at the peak, how do other top pharma CEOs measure up?PharmaVoice searched the top 20 pharma companies by 2024 revenue on Glassdoor and sorted by the percentage of employees who approved of the current CEO. U.S.-based Merck & Co. and Germanys Merck KGaA were not included due to insufficient or unreliable Glassdoor data.Among the bottom-ranked CEOs, just over half of employees approved of the job they were doing, including Pfizers Albert Bourla at 52%, CSLs Paul McKenzie at 53% and Bayers Bill Anderson at 58%Bristol Myers Squibbs Chris Boerner and Takeda Pharmaceuticals Christophe Weber fared a little better, with 65% and 73% approval, respectively.The top-ranked CEOs, on the other hand, scored much higher, each with no fewer than 87% of employees approving of their performance. Heres a look at the top CEOs by approval rating.Eli LillyCEO: David RicksEmployee approval: 89%Recently named CEO of the year by Chief Executive magazine, David Ricks led Lilly to a string of wins this year, topped off with the tirzepatide franchise usurping Mercks Keytruda as the worlds best-selling drug and overtaking Novo Nordisk's Ozempic in the GLP-1 revenue race.Ricks, who also nabbed a spot on this years Time100 Health list, joined Novos CEO earlier this month to strike a deal with the White House to lower U.S. prices for GLP-1 drugs. Its part of a larger price-cutting and access strategy, which also includes a recent deal with Walmart to expand to direct-to-consumer pricing for Zepbound through LillyDirect, offering the drug for pick-up at the retail giants pharmacies.Looking to the future, Ricks says hes all-in on artificial intelligence. At least one or two AIs, are running during every meeting, according to the CEO. That enthusiasm is reflected across the whole of the company, with Lilly announcing plans to work with chip-maker Nvidia to build the most powerful supercomputer owned and operated by a pharmaceutical company that could power an “AI factory.Roche GroupCEO: Thomas SchineckerEmployee approval: 87%Thomas Schinecker started the year by taking over as president of the global pharma trade body, the International Federation of Pharmaceutical Manufacturers and Associations.Hes also remained an impactful leader at Roche, inking bigger-ticket deals like the $3.5 billion acquisition of 89bio and subsidiary Genentechs $2.1 billion pact with Orionis Biosciences to discover small-molecule glue medicines for cancer. Schinecker plans to keep up that business development clip, saying were not done during a third-quarter earnings call last month.Schinecker is rolling the dice elsewhere, too. Roche is betting big on its obesity pipeline, aiming to compete with Lilly and Novo, despite scrapping one of the early-stage assets from its $2.7 billion acquisition of Carmot Therapeutics.The company is also in talks with the U.S. government to lower drug costs, with Schinecker floating the possibility of selling prescriptions directly to consumers.Boehringer IngelheimCEO: Hubertus von BaumbachEmployee approval: 87%When Hubertus von Baumbach in 2015 took the reins of Boehringer Ingelheim, the largest private drugmaker in the world, he became the first CEO from the companys founding family in 25 years. Von Baumbach, a great-grandson of Boehringer Ingelheims founder, stepped into the role after serving as finance chief.In the decade since, von Baumbach has led the company in deals ranging from a multibillion-dollar business swap with Sanofi to an agreement with Google Quantum AI for R&D.Boehringer also scored two FDA approvals in the second half of 2025. Its Jascayd approval marked the first new idiopathic pulmonary fibrosis treatment in more than a decade, and the company entered the oncology market with the kinase inhibitor Hernexeos.In addition to the CEO role, von Baumbach was recently appointed as chairman of the companys shareholders committee.NovartisCEO: Vas NarasimhanEmployee approval: 87%Another Time100 Health honoree, Vas Narasimhan recently boasted of the companys firepower to ink big deals like a $12 billion acquisition of Avidity Biosciences announced in October, thanks to Novartis free cash flow approaching $20 billion a year. He also said Novartis wont step away from the M&A table in the quest for the next great asset.Avidity marked Novartis largest deal since Narasimhan took the helm as CEO in 2018. Still, the company faced criticism for the acquisition, with investors raising questions about the effectiveness of the biotechs antibody-oligonucleotide conjugates.Novartis also faces pressure to strike deals with the White House to lower drug prices, similar to those brokered by Pfizer, Lilly, AstraZeneca and Novo. However, while Narasimhan acknowledged the drugmaker is engaged in ongoing talks with the Trump administration, he said such deals dont get to the root of the problem.I think the pharma industrys view is that the proposed negotiations or proposed actions are not going to address the underlying issues here, he said during a recent earnings call.AstraZenecaCEO: Pascal SoriotEmployee approval: 87%After Pascal Soriot struck a deal with the White House to lower drug prices and avoid tariffs, Reuters called the AstraZeneca CEO something of a Trump whisperer who went on a charm offensive to reach the agreement, including meeting at a royal banquet in the U.K., where the company is based.Just a week after Trump won the 2024 election, AstraZeneca said it would invest $3.5 billion in R&D and manufacturing in the U.S. Then in July, the company said it would pour an additional $50 billion into the U.S. by 2030.Todays announcement underpins our belief in Americas innovation in biopharmaceuticals and our commitment to the millions of patients who need our medicines in America and globally, Soriot said in a statement.Soriots dealings with the U.S. are in stark contrast to how its approaching affairs in its home country, saying that if the U.K.s NHS doesnt spend more on new drugs, and if things continue to deteriorate the way they do, the nation could someday only be able to afford cheap generics. 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Major vaccine makers reported significant declines in U.S. sales and demand in the third quarter. Anti-vaccine sentiment is alive and well, especially in the U.S. And it was evident in recent weeks as drugmakers revealed their third-quarter earnings, replete with declining vaccine sales.Pfizer’s numbers (PDF) were particularly indicative of the erosion in demand for immunizations in the U.S. While sales of its Prevnar franchise of pneumococcal vaccines were up 18% year over year outside of the U.S., they were down 12% in the U.S. The same was true of COVID shot Comirnaty, which saw a 9% sales increase internationally and a 25% decline domestically.Meanwhile, sales of Pfizer’s new respiratory syncytial virus (RSV) vaccine Abrysvo were up 81% outside of the U.S. and down 34% in the U.S., with CEO Albert Bourla, Ph.D., saying the company was “experiencing the headwind of a more difficult-to-activate population as we enter the third season of RSV.”Sanofi, for its part, sustained an 8% year-over-year decline in its vaccine revenues, with Chief Financial Officer François Roger noting a “negative buzz” around the jabs. In the company's earnings announcement, CEO Paul Hudson attributed the shortfall to “increased price competition and lower vaccination rate.”GSK managed to squeak out a 2% overall increase in vaccine revenue despite a 15% decline of sales in the U.S., which the company chalked up largely to plummeting demand for its shingles jab Shingrix.As for Merck, which has been hindered for more than a year by declining demand in China for its HPV shot Gardasil, sales of each of its vaccines were down in the third quarter except for Capvaxive, which CFO Caroline Litchfield said is off to a “very strong launch.” The shot, which is the first designed specifically to prevent pneumococcal disease in adults, has generated sales of $530 million in its first four quarters on the market. The third-quarter results were even more grim for companies that specialize in vaccines and depend largely on U.S. sales. Moderna sustained a 45% year-over-year decrease in revenue during the quarter as its RSV shot mResvia drummed up sales of just $2 million and its COVID vaccine Spikevax pulled in $971 million, which was down from $1.8 billion during the same period last year. With the result, Moderna reduced the top end of its 2025 guidance from $2.2 billion to $2 billion.Another company that has been impacted by declining demand for vaccines has been CSL. Last month, the Australian drugmaker backtracked on its plan to spin out its vaccine division, CSL Seqirus, because of the “heightened volatility in the current U.S. influenza vaccine market,” Chairman Brian McNamee explained. He added that the timing of the transaction would “not fully capture Seqirus’ value potential.”Citing insurance claims data, CSL’s leaders said they expect this season's flu vaccination rates in the U.S. to decline by 12% overall and by 14% for people ages 65 and older compared with last year.  Lilly is No. 1 again Among the industry's largest companies, there was no surprise at the top of the growth rankings as Eli Lilly pulled off a whopping 54% increase. It was the fourth straight period in which the Indianapolis company delivered the highest sales bump among large biopharma companies. It also was the largest quarterly sales bump for a top-25 drugmaker since the COVID years.The performance is more evidence that Lilly has widened the gap on its rival in the diabetes and obesity market, Novo Nordisk. The Danish company had just a 5% revenue increase in the third quarter. Novo also saw a 2% quarter-to-quarter sales slide, which was its second straight period with a sequential revenue decline.Lilly’s boost was fueled by sales of its tirzepatide products, which exceeded $10 billion for the quarter. The figure included $6.5 billion sales for diabetes drug Mounjaro and $3.6 billion for obesity treatment Zepbound.The only time in history that a single drug has exceeded sales of $10 billion in a quarter came in the COVID years, when Pfizer and BioNTech’s Comirnaty passed the threshold in three straight periods, maxing out at $13.2 billion in the first quarter of 2022. On its current trajectory, sales of tirzepatide products figure to increase again in the coming periods. The scale-up has been remarkable this year, starting at $6.1 billion in the first quarter. In the second quarter, tirzepatide’s combined sales finally topped those of Novo’s semaglutide products, which was significant because Novo’s Ozempic was first to the market in 2017, compared to Mounjaro, which came along five years later.Tirzepatide also has supplanted Merck’s cancer treatment Keytruda as the current top-selling drug, a crown it has held since 2023. Through the first three quarters of the year, tirzepatide has generated sales of $24.8 billion compared to $23.2 billion for Keytruda. Big gainers in Q3 No company in the industry approached Lilly’s revenue bump in the quarter. The only other top-25 companies by sales that achieved a double-digit increase in the third quarter were the Japanese duo of Astellas (13%) and Daiichi Sankyo (12%), followed by Amgen (12%), AstraZeneca (11%) and Vertex (11%).Another company that thrived in the third quarter was AbbVie, with a 9% sales gain thanks in large part to Skyrizi, which the company is now projecting will achieve sales of $17.3 billion this year, up from $11.7 billion in 2024. The Illinois company also is back in the good graces of investors as it enjoyed a 25% increase in its market cap in the third quarter, according to a report from GlobalData.Johnson & Johnson, meanwhile, turned in a 7% sales increase, which was its largest quarterly boost since 2023. The showing is further evidence that J&J’s shedding of its consumer health unit has helped facilitate growth. Two of the catalysts for the performance were autoimmune star Tremfya, which grew sales 41% to $1.4 billion, and depression drug Spravato, which became a blockbuster last year and accomplished a 61% sales increase in the third quarter.Amgen’s double-digit increase (PDF) came on top of 9% increases in the first two quarters of this year as the company appears to be hitting its stride after its 2023 acquisition of Horizon Therapeutics. There were many plusses with Amgen, including its biosimilars, which were up 52% thanks largely to its Eylea knockoff, Pavblu. Its older medicines, like Prolia and Repatha—both on the market for more than a decade—had big surprise sales boosts in the third quarter. AbbVie, J&J and Amgen were among the group of drugmakers that bumped up their annual revenue projection after reporting third-quarter numbers. The only top-25 companies that reduced their annual revenue estimates were Takeda (PDF) and Merck, which dropped its projection by $300 million as Keytruda’s sales in the third quarter failed to meet expectations.Lilly increased (PDF) its guidance by more than $2 billion, while Bristol Myers Squibb bumped up (PDF) its estimate by $1.2 billion. Despite its U.S. vaccine sales struggles, GSK boosted (PDF) the top end of its 2025 revenue projection from an increase of 5% to 7%. Astellas and Daiichi each increased (PDF) their revenue projection by 100,000 million Japanese yen, which works out to about $650 million. U.S. rebound continued in Q3 Aside from the decline in vaccine sales, it was a strong quarter for biopharma overall as 21 of the world’s top 25 drugmakers achieved year-over-year revenue increases.It was another period of recovery following an unusual first quarter in which seven of the world’s top 25 companies saw falling sales, with each of the seven decliners based in the U.S. In the second quarter, the trend faded as four of the seven U.S. companies accomplished sales increases. Then, in the third quarter, Pfizer was the only U.S. company that sustained a revenue decrease.Of the non-U.S. companies that saw their sales decline in the third quarter, none were a surprise. Takeda had the largest sales falloff (PDF) among the industry’s top 25 companies at 8%, which matched its decline in the previous quarter. Meanwhile, Roche was down by 1% after a flat performance in the second quarter. Bayer was the other decliner (PDF), at 3%, following a trend that has been in place since 2023.