As pharma navigates issues ranging from the US Inflation Reduction Act to new EU pharmaceutical legislation, and the impact of global unrest on supply chains, the industry is experiencing other shifts as reflected in Pharma Exec’s 2024 Top 50 Companies. Based on 2023 drug revenue performance from global drug makers, the ranking reveals the effects of the end of the COVID-19 vaccine boom, the challenging patent cliffs certain Big Pharmas are coming up against, and the rewards of reaching blockbuster status.
1. Johnson & Johnson
2022 position: 3
Rx Sales: USD 53.463 billion
R&D Spend: USD 14.805 billion
Dethroning Pfizer at the top of the list following its post-COVID-19 vaccine downturn is Johnson & Johnson, which jumped up from third place on the back of a couple of the industry’s top selling drugs, the immunosuppressant Stelara, which went off-patent last year but is not yet facing biosimilar competition, and its monoclonal antibody Darzalex, which rose 39.7 percent in sales. J&J has also been building its medtech arm and last year acquired Shockwave Medical for USD 13.1 billion.
2. AbbVie
2022 position: 2
Rx Sales: USD 52.734 billion
R&D Spend: USD 7.029 billion
The New Jersey-based company has held on to its second place position despite the loss of US exclusivity for its blockbuster Humira which caused its sales to drop by 32.2 percent. AbbVie, which named a new CEO in 2023, and has remained in second place thanks to sales of Skyrizi, which grew by 50.3 percent, and Rinvoq, that saw sales growth of 57.4 percent.
3. Novartis
2022 position: 4
Rx Sales: USD 52.473 billion
R&D Spend: USD 8.600 billion
The Swiss company’s efforts to focus exclusively on innovation after having spun off its generics division Sandoz, have paid off, bringing it up one spot in the ranking from last year. Up 4.8 percent, Novartis’s top-selling drugs Entresto Cosentyx SC and Promacta have accounted for much of its performance.
4. Merck & Co
2022 position: 5
Rx Sales: USD 50.846 billion
R&D Spend: USD 29.711 billion (including its USD 5.5 billion collaboration with Daiichi Sankyo and USD 11.4 billion in acquisitions)
Merck & Co also moved up a notch with an overall rise in Rx sales of 2.5 percent, but a 19.5 percent increase for its Keytruda therapy, which is now approved for 17 types of cancer and has become the world’s largest selling drug. The US-headquartered drug manufacturer has also made some major deals, strengthening its pipeline in immunology with Prometheus Biosciences and acquiring the bone marrow diseases specialist Imago BioSciences.
5. Roche
2022 position: 6
Rx Sales: USD 49.1103 billion
R&D Spend: USD 14.743 billion
The Swiss giant Roche also got bumped up from its position in last year’s classification with an increase of 2.5 percent. Top-selling medicines were multiple sclerosis therapy Ocrevus, haemophilia A med Hellibra and breast cancer treatment Perjeta. In 2023, the company enhanced its pipeline with the acquisition of the IBS treatment Telavant from Roivant and weight-loss biotech Carmot.
6. Pfizer
2022 position: 1
Rx Sales: USD 48.218 billion
R&D Spend: USD 10.679 billion
After two straight years at the head of the list thanks to its COVID-19 vaccine and therapies, Pfizer drops into sixth place with its prescription drug revenues falling by 47.2 percent in 2023. While the mRNA vaccine Comirnaty plunged 70.3 percent from its peak the previous year, the antiviral Paxlovid, after generating USD 18.93 billion in 2022, also took a dive. But Pfizer is looking to bounce back with its oncology portfolio, having acquired Seagen for USD 43 billion, the company says it is aiming for at least eight blockbuster cancer drugs by 2030.
7. Bristol Myers Squibb
2022 position: 7
Rx Sales: USD 44.398 billion
R&D Spend: USD 9.112 billion
While New York-based Bristol Myers Squibb has maintained its spot, its Rx revenue was down 2.2 percent in 2023. Top sellers for BMS were Eliquis, Opdivo and Revlimid while the company entered into multiple transactions at the end of the year to enhance its portfolio and pipeline, including with neurological specialist Karuna Therapeutics.
8. AstraZeneca
2022 position: 8
Rx Sales: USD 43.790 billion
R&D Spend: USD 10.267 billion
UK-based heavyweight AstraZeneca celebrated its 25th anniversary in 2023 and retained its 8th place ranking with a rise in Rx Sales of 1.8 percent with its biggest sellers being Farxiga, Tagrisso and Imfinzi. Another milestone for the company last year was the launch of its digital health solutions provider Evinova and the acquisition the vaccine company Icosavax and the cell therapy specialist Gracell Biotechnologies.
9. Sanofi
2022 position: 9
Rx Sales: USD 40.805 billion
R&D Spend: USD 7.278 billion
France’s Sanofi holds on to the 9th place position with its drug sales rising by 1.1 percent. The company has been undergoing a pipeline overhaul, redirecting its resources to areas like immunology, and claims that it has 12 potential blockbusters working their way through late-stage development.
10. GSK
2022 position: 10
Rx Sales: USD 33.443 billion
R&D Spend: USD 6.573 billion
Although its drug sales were down by 3.9 percent, the British firm GSK has maintained its position at number 10. After spinning off its consumer healthcare arm and weathering its failed COVID-19 attempts, GSK has excelled in vaccines with its biggest seller Shingrix generating some USD 4.4 billion. Last year also saw the launch of its Arexvy vaccine for Respiratory Syncytial Virus (RSV), the world’s first approved RSV vaccine.
