The Pharmaceutical Giants Behind Common Medicines

One molecule made roughly $36.5 billion last year. Tirzepatide, sold as Mounjaro for diabetes and Zepbound for weight loss, now generates more annual revenue than Bristol Myers Squibb or Sanofi make as entire companies.

That single fact explains the biggest reshuffle the drug industry has seen in a generation. The pharmaceutical giants behind common medicines changed order in 2025. Eli Lilly dethroned Merck. Novo Nordisk lost its US obesity crown to its own rival's molecule. Merck's Keytruda is still the best-selling drug on Earth, and its patent dies in 2028.

We pulled the FY2025 earnings, the top-selling drug rankings, and the patent calendars. Here is who actually makes the medicines in your cabinet.

The Pharma Reshuffle

For decades the ranking of the world's largest drugmakers moved slowly. Then GLP-1 drugs happened. Eli Lilly and Company finished FY2025 as the world's top-earning pharma company by revenue at $65.2 billion, edging Merck & Co. at $65.0 billion by roughly $169 million. One year earlier Lilly was not even close.

The shift matters because it was not gradual. Lilly's revenue jumped 44.7% in a single year, a gain of about $20.1 billion, almost entirely on the back of two injectable pens. Merck grew 1.3% over the same period.

A caveat worth noting: rankings depend on what you count. Nature Reviews Drug Discovery ranks Lilly first on prescription drug sales ($60.8 billion), while J&J retains the overall revenue crown if you include its full business. Our database tracks the pharma-focused ranking, and by that measure Lilly is number one.

Eli Lilly: The GLP-1 King

Eli Lilly (NYSE: LLY) is the story of the decade in pharma. The Indianapolis company posted $24.5 billion in revenue in 2020. It posted $65.2 billion in 2025, nearly tripling in five years.

The engine is tirzepatide, a dual GLP-1 and GIP receptor agonist. Mounjaro nearly doubled to $23.0 billion (+99% year over year). Zepbound, launched only in late 2023, nearly tripled to $13.5 billion (+175%). Combined, that is $36.5 billion from one molecule.

The guidance tells you where this goes next. Lilly projects $80 to $83 billion in revenue for 2026, and analysts expect tirzepatide's global sales to surpass $45 billion this year. The company also just won FDA approval for an oral GLP-1, which could expand the market again by removing the needle.

Novo Nordisk: The GLP-1 Pioneer

Novo Nordisk (NYSE: NVO, Copenhagen: NOVO-B) invented this market. The Danish company still leads it by volume, with a 59.6% branded volume market share in the global GLP-1 obesity market. Its GLP-1 value share in type 2 diabetes is 45.8%.

The 2025 numbers were strong on paper. Sales hit DKK 309.1 billion (about $44 billion), up 10% at constant exchange rates. Ozempic reached DKK 127.1 billion, roughly $19 billion. Wegovy grew 36% to DKK 79 billion, about $12 billion.

But the momentum flipped. Zepbound overtook Wegovy in US weekly prescriptions in early 2025, and Novo's 2026 outlook calls for adjusted sales to fall 5 to 13% at constant rates. The reasons: Most Favoured Nations pricing pressure in the US, semaglutide patent expiry in some international markets, and Lilly's manufacturing scale. New CEO Maziar Mike Doustdar, who took over in August 2025, is betting on the newly launched Wegovy pill to win back patients.

Merck: The Keytruda Dependency

Merck & Co. (NYSE: MRK) earned $65.0 billion in FY2025, essentially flat, but it owns the single biggest product in the industry. Keytruda, the cancer immunotherapy pembrolizumab, grew 7.5% to $31.7 billion and kept its spot as the number one drug brand in the world.

That is also the problem. Keytruda's US patent protection ends in 2028. When it goes, the largest patent cliff in pharma history opens underneath Merck's flagship. The company is racing to diversify through acquisitions and a subcutaneous formulation of Keytruda designed to soften the biosimilar hit, but replacing a $31 billion product is not something any pipeline does quietly.

Pfizer: The Patent Cliff

Pfizer (NYSE: PFE) reported $62.6 billion in FY2025, down 1.7%, and faces the steepest loss-of-exclusivity wave in the industry between 2026 and 2030. Eliquis (co-marketed with Bristol Myers Squibb), Ibrance, Xtandi, and Xeljanz together represent more than $20 billion in annual revenue facing generic entry.

Pfizer is also a strange hybrid. It is an innovator bleeding exclusivity, and it is one of the biggest generic and biosimilar manufacturers itself. The COVID franchise that made it famous has normalized: Comirnaty still generates about $4.4 billion and Paxlovid about $2.4 billion, respectable numbers but a fraction of the pandemic peak. The Seagen acquisition is its bet that oncology fills the gap.

AbbVie: The Humira Transition

AbbVie (NYSE: ABBV) posted $61.2 billion in FY2025, up 8.6%, and pulled off what Merck is about to attempt. Humira, once the best-selling drug in the world, went off patent and AbbVie replaced it without collapsing.

The replacements are already blockbusters. Skyrizi reached $17.6 billion (+49.9%) and Rinvoq hit $8.3 billion (+39.1%). Immunology is one of the few large therapeutic categories still expanding fast, up 20.6%, and AbbVie owns more of it than anyone. The transition took years and billions in R&D, which is the part of the story investors sometimes forget.

Johnson & Johnson: The Diversified Giant

Johnson & Johnson (NYSE: JNJ) booked about $60.4 billion in Innovative Medicine revenue in FY2025 after spinning off its consumer health unit Kenvue in 2023. Inside that number is the same pattern as AbbVie's: old giant fading, new giants rising.

Darzalex, the multiple myeloma drug, grew 23% to $14.4 billion. Tremfya grew 40.5% to $5.2 billion. Meanwhile Stelara fell 41.3% to $6.1 billion as biosimilars arrived. J&J's pharma engine is now oncology and immunology, with medtech carrying a second $33.8 billion business alongside it.

The Top 10 Drugs of 2025

The product ranking tells the ownership story in one table. The top 10 drugs generated $198.4 billion in global sales in 2025, about 16.3% of the entire pharmaceutical market, and GLP-1 medicines now occupy four of the ten slots.

Source: Drug Discovery and Development, Pharma 50, FY2025.

The Ownership Comparison

Figures from company FY2025 filings and Drug Discovery and Development rankings.

Every name on that list is publicly traded. None of them are family controlled in any meaningful sense. The ownership of your medicine cabinet sits with index funds, pension plans, and whichever molecule wins the next patent race.

The Patent Cliff Calendar

The thread connecting nearly every company on this list is loss of exclusivity. Pharma revenue is built on temporary monopolies, and the expiries are scheduled years in advance.

Here is the sequence playing out now. Humira fell to biosimilars in 2023 and AbbVie had to rebuild around Skyrizi. Stelara followed, dragging J&J's immunology franchise down 41% in a single year. Eliquis, Ibrance, Xtandi, and Xeljanz start hitting generics between 2026 and 2030, which is Pfizer's $20 billion problem. Semaglutide's patent expires in some international markets in 2026, part of why Novo Nordisk guided negative growth. And in 2028, Keytruda loses protection, the largest single-product cliff the industry has ever faced.

This is why the GLP-1 race mattered so much. The companies that secured a next-generation growth driver before their cliffs arrived, Lilly with tirzepatide and AbbVie with Skyrizi, look prescient. The ones that are still looking, Merck and Pfizer, are the ones buying pipeline assets at premium prices.

What This Means for Brand Ownership

The pharmaceutical giants behind common medicines are in the middle of a once-in-a-decade reshuffle. Eli Lilly is number one on GLP-1 momentum. Novo Nordisk still holds the volume lead but is losing the growth race. Merck holds the biggest single product and the biggest patent risk. Pfizer is a cliff in progress. AbbVie already survived its cliff and came out bigger.

For consumers, the practical takeaway is simple: brand names like Ozempic, Keytruda, and Humira are products, not companies. The companies behind them are trillion-dollar-scale public entities whose strategies are driven by patent calendars and pipeline math. For a related view, see our breakdown of Pfizer vs Johnson & Johnson's brand portfolios, why big pharma keeps buying smaller drug brands, or our pharmaceutical brand ownership complete guide.

Frequently Asked Questions

What is the best-selling drug in the world? Keytruda, Merck's cancer immunotherapy, was the top-selling drug globally in 2025 at $31.7 billion. Mounjaro is closing fast at $23.0 billion after growing 99% in one year.

Who is the largest pharmaceutical company? By FY2025 revenue, Eli Lilly at $65.2 billion, edging Merck ($65.0 billion) by roughly $169 million. Rankings vary if you count only prescription drugs or total company revenue.

What are GLP-1 drugs? GLP-1 receptor agonists mimic a gut hormone to regulate blood sugar and appetite. The class includes Novo Nordisk's semaglutide (Ozempic, Wegovy) and Eli Lilly's tirzepatide (Mounjaro, Zepbound), and they now fill four of the top ten drug spots worldwide.

When does Keytruda lose patent protection? Keytruda's key US patents expire in 2028, opening what analysts call the largest patent cliff in pharmaceutical history. Merck is investing heavily in diversification and a subcutaneous version before biosimilars arrive.

Is Pfizer going out of business? No. Pfizer earned $62.6 billion in 2025 and remains the third-largest drugmaker, but it faces more than $20 billion of revenue exposed to generic competition between 2026 and 2030 across Eliquis, Ibrance, Xtandi, and Xeljanz.

The Bottom Line

The pharma leaderboard was rewritten in twelve months. Lilly took the crown on $36.5 billion of tirzepatide, Novo kept the volume lead while losing the prescription war, and Merck's number one product now has a two-year fuse. The next reshuffle starts when Keytruda's patent dies in 2028.

Want to see who owns the medicines you take? Check Ozempic, Mounjaro, or Keytruda in our database.

Explore Related Brands

• Ozempic - Semaglutide diabetes drug owned by Novo Nordisk
• Mounjaro - Tirzepatide diabetes drug owned by Eli Lilly
• Zepbound - Tirzepatide obesity drug owned by Eli Lilly
• Keytruda - Cancer immunotherapy owned by Merck
• Eliquis - Blood thinner co-marketed by Bristol Myers Squibb and Pfizer
• Dupixent - Immunology drug co-owned by Sanofi and Regeneron

Browse all healthcare and pharmaceutical brands →

Sources

1. Drug Discovery and Development. "Pharma 50: The 50 Best-Selling Drugs of FY2025." 2026 2. Drug Discovery and Development. "Lilly Is Now the Top Pharma Company by Revenue." March 25, 2026 3. Eli Lilly and Company. "Q4 and Full Year 2025 Financial Results." investor.lilly.com 4. Novo Nordisk. "Annual Report 2025: Financial Performance." annualreport.novonordisk.com 5. Nature Reviews Drug Discovery. "Top Companies and Drugs by Sales in 2025." 2026 6. TechTarget. "GLP-1 Therapies Set to Top Global Drug Sales in 2026." 2026

All brand ownership data verified through WhoBrands.com's research methodology. Last updated: November 6, 2026.