Pegozafermin

iStock, Anant_Kasetsinsombut 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. Patents How J&J Kept Growing Amid the Erosion of Cornerstone Drug Stelara The company cut back in areas while investing in internal and external opportunities to offset the loss of exclusivity on a product that until recently accounted for 20% of innovative medicine sales. October 22, 2025 · 5 min read · Nick Paul Taylor Read more 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 . Earnings ‘We’re Not Done’: Roche Plans To Sustain Dealmaking Pace After 89bio Roche has already signed several high-ticket deals this year, including the $3.5 billion acquisition of 89bio and Genentech’s $2.1 billion molecular glue pact with Orionis Biosciences. October 23, 2025 · 2 min read · Tristan Manalac Read more 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 . Obesity Lilly’s Weight Loss Trio Could Top $100B in Revenue Thanks to Oral Option If Eli Lilly’s obesity pill orforglipron is approved and priced around $200 per month, analysts at Truist predict patients will flock to it. November 19, 2025 · 1 min read · Annalee Armstrong Read more 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.” Earnings Keytruda Hangs On to Best Seller Crown as GLP-1s Gain Ground Merck’s Keytruda will soon lose exclusivity, just as weight-loss giants Eli Lilly and Novo Nordisk press in with their blockbuster GLP-1s. March 4, 2026 · 9 min read · Tristan Manalac Read more 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. .responsive-container { display: flex; flex-wrap: wrap; border: 1px solid #ededed; font-family: Helvetica, Arial, Sans-Serif; padding: 20px 20px 10px 20px; } .column-left { flex: 1; max-width: 45%; padding: 20px 20px 10px 20px; } .column-right { flex: 2; padding: 20px 20px 10px 20px; } @media (max-width: 768px) { .column-left, .column-right { max-width: 100%; flex: 100%; padding: 10px 0; } } Subscribe to BioPharm Executive! 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iStock, Volodymyr Kryshtal After last year’s ‘stampede’ for FGF21 assets, the focus for the metabolic dysfunction-associated steatohepatitis space has shifted toward differentiated approaches, such as THR-β agonists and combination treatments, that seek to mirror the commercial success of Madrigal’s Rezdiffra. Before Madrigal’s Rezdiffra, the quest for a cure for metabolic dysfunction-associated steatohepatitis was a veritable graveyard for drug developers. However, the 2024 approval of that first drug for the inflammatory liver disease demonstrated to the pharma industry that the feat was possible. Not only that, but Madrigal proved it could be lucrative. In November 2025, the company announced in its third-quarter financial update that Rezdiffra had generated revenues of $287 million, just six quarters after its launch. Altogether, the product has amassed $817 million in revenue for its maker. This commercial success has not gone unnoticed, with three Big Pharma acquisitions in the MASH space in 2025, all worth billions of dollars. GSK began the rush in May by acquiring the investigational FGF21 analog efimosfermin alfa from Boston Pharmaceuticals for $1.2 billion upfront. Then, in September, Roche snapped up 89bio and another FGF21 analog pegozafermin for around $3.5 billion. Novo Nordisk followed weeks later with a $5.2 billion deal for Akero Therapeutics . The spate of acquisitions—all focused on FGF21 analogs—was centered on the success of Akero Therapeutics’ efruxifermin, which, in January 2025, showed positive long-term data in a mid-stage trial. “I think that really set off the stampede because there were very few FGF21 assets in development,” Edward Nash, managing director at Canaccord Genuity, told BioSpace . “This caused a big pharma reaction of, ‘Wait a minute, we need one of those too because we have a metabolic franchise and we need to be able to compete, especially given the data seen to date in the FGF21 space.’” This, alongside the approval of Novo Nordisk’s GLP-1 weight-loss blockbuster Wegovy for MASH, has led to the market opening up, and now, more companies want in, Nash said. All of this activity means the overall MASH landscape has changed significantly in the past year . With the key FGF21 developers off the market, there is an increased focus on the other assets in the field’s late-stage pipeline. Here are four candidates, each with differentiated mechanisms of action, that Big Pharma companies could have in their sights in 2026. Policy FDA Approves Madrigal’s Rezdiffra as First MASH Therapy Madrigal Pharmaceuticals’ Rezdiffra (resmetirom) is the first-ever approved therapy for metabolic dysfunction-associated steatohepatitis—a decision experts say could signal a sea change in treatment of the disease. March 14, 2024 · 6 min read · Jill Neimark Inventiva Homes In On Potential Next Oral MASH Drug Inventiva’s upcoming Phase III readout for pan-PPAR agonist lanifibranor is “the biggest event in the MASH space” this year, according to Nash. “It’s been a long trial, and it’s been long-awaited by the Street,” he said. “Depending on the data, [Inventiva] could definitely become another takeover candidate.” The French biotech is now solely focused on lanifibranor after halving its workforce and stopping all preclinical research not related to the drug to help fund its development in February 2025. This singular focus will help push the drug through its Phase III trial, with Inventiva poised to publish topline results from the NATiV3 trial in the second half of 2026. With these data expected, “lanifibranor could potentially be the next oral therapy approved for the treatment of patients with MASH,” CEO Frederic Cren said in a statement in April 2025. Lanifibranor is an oral small molecule that activates three peroxisome proliferator-activated receptor (PPAR) isoforms. Through the activation of these isoforms, Inventiva aims to address the key drivers of the disease, including inducing anti-fibrotic, anti-inflammatory and beneficial metabolic changes. In the NATIVE Phase IIb trial , reported in June 2020, lanifibranor achieved statistically significant MASH resolution and fibrosis improvement, with 42% of patients who received a 1200 mg dose seeing fibrosis improvement vs. 24% of placebo comparators after 24 weeks. The path to this year’s Phase III readout has not been straightforward for Inventiva. In February 2024 , the company voluntarily suspended screening and enrollment of patients in NATiV3 after a patient exhibited severely elevated aminotransferase levels. Now, Inventiva expects the results from NATiV3, if positive, to form the basis for a submission for regulatory approval. Viking Still Up For Grabs Viking Therapeutics has long attracted significant interest from Big Pharma. With pipeline assets that target both obesity and MASH, analysts have marked the biotech as one likely to draw suitors. For MASH, the company is developing VK2809, an oral thyroid hormone receptor-beta (THR-β) agonist. In the Phase IIb VOYAGE trial , VK2809 demonstrated a 37%-55% mean reduction in liver fat, with up to 75% of patients reaching MASH resolution without fibrosis worsening, according to data released in November 2024. In addition to these outcomes, the drug also demonstrated lipid-lowering effects and minimal side effects, Brian Lian, CEO of Viking, told BioSpace in an email. The overall body of evidence for VK2809 makes it “highly competitive” against both marketed products and drug candidates for MASH, he added. While Lian has previously stated that Viking would be open to partnering on the asset and confirmed that the company is still exploring partnering opportunities—he previously said that having a partner is not mandatory in order to bring the product to the market. Earnings MASH, Metsera Deals Send Analysts Marauding to Viking Viking Therapeutics CEO Brian Lian is watching the growth of interest in MASH and obesity but prepared to go it alone. October 23, 2025 · 6 min read · Annalee Armstrong Altimmune Open to Partnering Pemvidutide But Could Go It Alone Altimmune’s pemvidutide stands apart from others in the MASH pipeline due to its ability to preserve lean muscle mass, as well as ensuring MASH resolution and weight loss, a company spokesperson told BioSpace in an email. Pemvidutide is a weekly injectable GLP-1/glucagon dual receptor agonist that last month received the FDA’s Breakthrough Therapy Designation for MASH. This follows the November release of Phase IIb data from Altimmune’s IMPACT study, which showed that 52% of patients achieved MASH resolution without worsening of fibrosis, as well as improvements to liver fat content and weight loss. Altimmune is in a similar position to Viking, as both companies have the data to progress their drugs into Phase III, but may not begin those trials until they can find a partner, Nash said. “These two companies are all in on obesity, and that treatment area is already a big enough nut to crack,” he added. “To try to do that and run a MASH trial at the same time, I think you’re going to get a lot more bang for your buck if your molecule is differentiated in obesity.” The Altimmune spokesperson countered this, however, saying that independently bringing the asset forward in MASH is a “legitimate path forward.” However, they also noted that Altimmune remains open to any opportunity “that adds value, including partnerships.” Sagimet Looks to Combo FASN Inhibitor For Optimum Effect Like pemvidutide, Sagimet Biosciences’ denifanstat, an oral, once-daily fatty acid synthase (FASN) inhibitor that blocks the production of new fat in the liver, holds FDA Breakthrough Therapy Designation in MASH. Unlike Altimmune, however, Sagimet is not considering pursuing a Phase III trial alone, according to Nash. Instead, the California-based company is looking to cement its drug as a validated part of a combination therapy. In line with this, Sagimet released data in December from a Phase I trial that featured denifanstat paired with Rezdiffra, the current market leader. The trial showed that the combination was well-tolerated, and Sagimet plans to advance denifanstat into Phase II efficacy trials for MASH patients with F4 fibrosis. The combined treatment could boost fibrosis reduction more than Rezdiffra alone, Nash said. This type of combination approach is likely to be the future of MASH treatments because the disease is multifactorial, he added, with the main two targets being liver fat and fibrosis. So far, the marketed drugs— Rezdiffra and Wegovy—and the investigational pipeline have not proven outstanding at hitting both of these targets, making a combination treatment approach logical, Nash said. It seems the same could be true for the companies themselves, with partnering and M&A the likeliest outcome for the smaller players in the MASH landscape. “It’s hard to be successful as a standalone company,” Nash said. “There’s usually only one company when that happens, like Madrigal. I think we’re going to have one, maybe two biotechs, that can do it—after that, it’s going to be Big Pharma taking them in and developing them.”