The battle between obesity drug leaders is shaping everything on the pharmaceutical market this decade. In the revenue ranking, the most interesting question is how rivals Eli Lilly and Novo Nordisk positioned themselves.
With a 45% sales increase in 2025, Eli Lilly jumped six places in the annual top‑20 revenue ranking, becoming the third‑largest company in the biopharmaceutical industry. The company grew revenue from $45 billion in 2024 to $65.2 billion last year, overtaking giants such as Bristol Myers Squibb, Novartis, AstraZeneca, AbbVie, Pfizer and Merck. Lilly owes its growth to the success of its diabetes and obesity drugs Mounjaro and Zepbound. Their combined sales reached $36.5 billion in 2025, up from $16.5 billion in 2024. Tirzepatide accounted for 56% of Lilly’s revenue in 2025, compared with 37% in 2024.
At the start of the decade, its closest rival, Denmark’s Novo Nordisk, was moving just as fast. The company rocketed from 17th place in 2020 to 11th place in 2024, more than doubling its revenue over that period. But last year Novo slowed its momentum, remaining in 11th place with sales growth of just 6% to $31 billion. For the first time this decade, Novo Nordisk failed to achieve double‑digit sales growth. This year, the company expects sales to fall by 5‑13%. CEO Mike Doustdar blamed “increased competition” and a most‑favoured‑nation pricing deal the company struck with the Trump administration last autumn for the anticipated decline.
At the top of the 2025 ranking was again Johnson & Johnson, with sales of $94.2 billion. J&J has led the ranking since 2012. Only in 2022 was it briefly overtaken when Pfizer became the first drugmaker in history to exceed $100 billion in revenue – thanks to Covid, with $56.7 billion in sales of Comirnaty and Paxlovid.
Apart from Eli Lilly’s rise, there were no major changes in the top 20 in 2025. Bristol Myers Squibb, which had been in fourth place, saw revenue fall due to patent expirations on its old blockbuster blood cancer drugs Revlimid and Pomalyst. Sales of those drugs dropped 16%, and the company moved down to 10th place.
Japan’s Takeda also saw revenue decline in 2025, falling one notch to 15th place. Boehringer Ingelheim, by contrast, increased sales by 4% and moved up one place to 14th.
There are no new entrants in the top 20 this year. At the lower end of the ranking is Australia’s CSL with revenue of $15.4 billion in 2025. It outperformed Regeneron ($14.3 billion), Viatris ($14.3 billion), as well as Japanese drugmakers Astellas ($13.8 billion) and Daiichi Sankyo ($13.7 billion).
