Pharma 50: The 50 best-selling drugs of FY2025

The pharmaceutical landscape in Fiscal Year 2025 was defined by a monumental shift at the very apex of the industry’s sales leaderboard, even as established specialty franchises continued their robust expansion. While Merck’s oncology powerhouse, Keytruda, steadfastly held its position as the No. 1 brand, the true headline battle unfolded at the molecular level, where Eli Lilly’s tirzepatide and Novo Nordisk’s semaglutide collectively surpassed Keytruda’s formidable sales. This reshuffle signals a profound transformation driven by the explosive growth of GLP-1 agonists, particularly in the diabetes and weight management sectors, challenging traditional market hierarchies. Beyond this top-tier contest, the FY2025 sales figures reveal an industry where scaled specialty franchises are not merely plateauing but actively compounding growth. Drugs like Skyrizi, Rinvoq, Dupixent, Darzalex, Tremfya, and Kisqali all posted meaningful gains, underscoring the enduring vitality of targeted therapies. Immunologicals, in particular, emerged as one of the few large therapeutic categories still experiencing significant expansion, registering an impressive 20.6% growth even as the overall pharmaceutical pipeline saw a contraction during the same fiscal year. This comprehensive ranking, meticulously compiled from primary corporate filings, details the top-selling drugs reported by the Pharma 50 companies in FY2025, with currency conversions applied where necessary to provide a unified financial perspective.

The Ascendancy of GLP-1 Agonists: A Market Reshaping Force

The most striking narrative of FY2025 is undoubtedly the unprecedented rise of GLP-1 receptor agonists, epitomized by Eli Lilly’s tirzepatide (marketed as Mounjaro for diabetes and Zepbound for weight loss) and Novo Nordisk’s semaglutide (Ozempic for diabetes, Wegovy for weight loss, and Rybelsus as an oral formulation). These molecules have not just gained market share; they have fundamentally reshaped expectations for drug growth and therapeutic impact.

Eli Lilly’s tirzepatide, a dual GIP and GLP-1 receptor agonist, demonstrated astonishing growth. Mounjaro, primarily indicated for type 2 diabetes, recorded sales of $22,965 million in FY2025, marking a staggering 99.0% year-over-year increase from $11,540 million in FY2024. Its sibling, Zepbound, specifically approved for chronic weight management, accelerated even faster, reaching $13,542 million from $4,926 million, an astonishing 174.9% growth. Combined, tirzepatide’s sales totaled $36,507 million, making it the highest-grossing molecule in FY2025, a testament to its broad utility and high demand.

Novo Nordisk’s semaglutide also showcased robust performance. Ozempic, for type 2 diabetes, posted sales of $19,206 million, a solid 5.6% increase. Wegovy, its weight management counterpart, surged to $11,955 million, up 35.9% from $8,796 million. Even the oral formulation, Rybelsus, despite a slight decline to $3,339 million, contributed significantly to the semaglutide franchise. Collectively, semaglutide’s various formulations generated over $34.5 billion, firmly establishing it as the second-highest-grossing molecule.

The combined sales of tirzepatide and semaglutide alone underscore a pivotal shift. Their aggregate performance of over $71 billion effectively surpassed Keytruda’s $31.68 billion, signifying a new era where metabolic diseases and weight management are not only recognized as critical public health challenges but also as incredibly lucrative therapeutic areas. This rapid ascent reflects the profound unmet need for effective treatments for these conditions and the strong clinical efficacy demonstrated by these agents. Pharmaceutical executives from Lilly and Novo Nordisk are undoubtedly prioritizing scaling up production, expanding clinical indications, and defending their market positions through strategic pricing and continued innovation, as the global demand for these drugs shows no signs of abating. The success of these drugs is also driving significant investment into related research, including next-generation obesity and metabolic disorder treatments, signaling a sustained focus on this burgeoning therapeutic category.

Keytruda’s Enduring Dominance in Oncology

Despite the groundbreaking surge of GLP-1 agonists, Merck’s Keytruda (pembrolizumab) maintained its formidable position as the top-selling brand in FY2025, underscoring its unparalleled impact in oncology. With sales reaching $31,680 million, a healthy 7.5% increase from $29,482 million in FY2024, Keytruda continues to be the bedrock of Merck’s pharmaceutical portfolio.

Keytruda, a programmed death receptor-1 (PD-1) blocking antibody, has revolutionized cancer treatment across a multitude of indications. Its broad utility spans non-small cell lung cancer, melanoma, head and neck squamous cell carcinoma, renal cell carcinoma, classical Hodgkin lymphoma, and various other solid tumors, often as a first-line treatment or in combination therapies. This extensive label expansion and its demonstrated efficacy in improving patient outcomes have solidified its market leadership.

Merck’s strategic approach to Keytruda involves continuous investment in clinical trials to explore new indications, combination therapies, and adjuvant settings, ensuring its relevance in an increasingly competitive immuno-oncology landscape. While the looming threat of biosimilar entry remains a long-term consideration, Keytruda’s robust growth in FY2025 indicates that its patent exclusivity and established clinical profile will continue to drive significant revenue for the foreseeable future. The company’s focus on maximizing the lifecycle of Keytruda through innovative formulations and expanded uses will be crucial in maintaining its top brand status amidst the dynamic market shifts.

The Resilient Growth of Specialty Franchises

Beyond the top two molecular contenders, the FY2025 data vividly illustrates the continued compounding growth of scaled specialty franchises. This segment of the market, characterized by high-value, often biologics-based therapies for complex conditions, continues to defy expectations of plateauing sales.

Immunologicals emerged as a standout, with the therapeutic bucket growing by an impressive 20.6%. This category addresses a wide range of autoimmune and inflammatory conditions, driven by ongoing innovation and a deeper understanding of disease mechanisms. Leading this charge were:

Pharma 50: The 50 best-selling drugs of FY2025

Dupixent (Sanofi/Regeneron): This blockbuster for atopic dermatitis, asthma, and chronic rhinosinusitis with nasal polyps, achieved sales of $17,736 million, up 20.2% from $14,754 million. Its broad applicability and strong efficacy continue to drive its expansion.
Skyrizi (AbbVie): For psoriasis, psoriatic arthritis, and Crohn’s disease, Skyrizi demonstrated phenomenal growth, reaching $17,562 million, a nearly 50% increase (49.9%) from $11,718 million. Its strong clinical profile and patient preference are key drivers.
Rinvoq (AbbVie): Another AbbVie asset, Rinvoq, a JAK inhibitor for rheumatoid arthritis, psoriatic arthritis, atopic dermatitis, and ulcerative colitis, grew by 39.1% to $8,304 million from $5,971 million.
Tremfya (J&J): This IL-23 inhibitor for plaque psoriasis and psoriatic arthritis, saw a significant 40.5% jump in sales, reaching $5,155 million.
Cosentyx (Novartis): An IL-17A inhibitor for psoriasis, psoriatic arthritis, and ankylosing spondylitis, Cosentyx grew by 8.6% to $6,668 million.
Kesimpta (Novartis): For relapsing multiple sclerosis, Kesimpta’s sales surged by 37.3% to $4,426 million.

In oncology, targeted therapies also showed robust performance:

Darzalex (J&J): For multiple myeloma, Darzalex achieved $14,351 million, up 23.0% from $11,670 million, benefiting from expanded indications and combination therapies.
Kisqali (Novartis): This CDK4/6 inhibitor for breast cancer experienced a remarkable 57.7% growth, reaching $4,783 million from $3,033 million, highlighting its increasing adoption in the treatment paradigm.
Imfinzi (AstraZeneca): An immunotherapy for various cancers, including lung and bladder cancer, grew by 28.5% to $6,063 million.
Verzenio (Eli Lilly): Another CDK4/6 inhibitor for breast cancer, Verzenio posted a solid 7.8% gain, reaching $5,723 million.

Other notable specialty drugs maintaining strong growth include:

Eliquis (BMS/Pfizer): The anticoagulant continued its upward trajectory, reaching $14,443 million, an 8.3% increase.
Biktarvy (Gilead Sciences): A leading HIV regimen, Biktarvy maintained consistent growth at 6.7%, with sales of $14,300 million.
Vyndaqel family (Pfizer): For transthyretin amyloidosis, sales climbed by 17.0% to $6,380 million, demonstrating the value of therapies for rare diseases.

The sustained growth in these specialty areas reflects several factors: the ongoing identification of specific patient populations with high unmet needs, the development of highly effective and targeted therapies, and the ability of pharmaceutical companies to command premium pricing for innovative treatments that significantly improve quality of life and survival outcomes. This trend suggests that despite broader pipeline contractions, targeted innovation in areas like immunology and oncology remains a cornerstone of pharmaceutical success.

Winners and Losers: Significant Shifts and Declines

While FY2025 celebrated numerous successes, it also marked significant declines for several once-dominant drugs, illustrating the dynamic and often unforgiving nature of the pharmaceutical market. These shifts were primarily driven by factors such as loss of patent exclusivity, increasing competition from biosimilars, and the waning demand for pandemic-related products.

Impact of Biosimilars and Patent Expiry:

Stelara (J&J): A long-standing blockbuster for inflammatory diseases, Stelara saw a drastic 41.3% decline, plummeting to $6,078 million from $10,361 million. This significant drop is largely attributable to the market entry of biosimilars, particularly in regions where patent protection had expired or was challenged.
Humira (AbbVie): Once the world’s best-selling drug, Humira continued its descent, falling by a staggering 49.5% to $4,540 million from $8,993 million. The robust entry of multiple adalimumab biosimilars in the U.S. market in 2023 and 2024 heavily impacted its sales, marking a pivotal moment in the biosimilar landscape.
Revlimid (BMS): Another former top seller for multiple myeloma, Revlimid experienced a substantial 48.9% decrease in sales, reaching $2,951 million from $5,773 million. Generic competition has severely eroded its market share.
Ibrance (Pfizer): This CDK4/6 inhibitor for breast cancer saw a 5.6% decline to $4,122 million, facing increased competition from newer entrants like Kisqali and Verzenio.
Imbruvica (AbbVie/J&J): For various blood cancers, Imbruvica declined by 14.3% to $2,869 million, facing competition from newer therapies and potential market saturation.
Sprycel (BMS): A leukemia treatment, Sprycel saw a precipitous 61.7% fall to $493 million, indicative of significant market pressures or loss of exclusivity.

Waning Pandemic-Era Demand:

Paxlovid (Pfizer): The oral antiviral for COVID-19 saw its sales drop by a sharp 58.7% to $2,362 million from $5,716 million. As the acute phase of the pandemic subsided and vaccination rates increased, demand for emergency COVID-19 treatments naturally decreased.
Comirnaty (Pfizer/BioNTech): The COVID-19 vaccine experienced an 18.4% reduction in sales, settling at $4,367 million. While still a significant contributor, the global vaccination drive shifted from initial widespread campaigns to booster shots and endemic management, leading to lower demand compared to peak pandemic years.

Other Notable Declines:

Gardasil (Merck): The HPV vaccine family saw a considerable 39.0% drop to $5,233 million from $8,583 million. While still a vital vaccine, market dynamics, potentially related to procurement cycles or regional demand fluctuations, contributed to this decline.
Entresto (Novartis): A heart failure medication, Entresto saw a slight decline of 0.9% to $7,748 million, suggesting market maturity or increased competition.

These declines highlight the cyclical nature of the pharmaceutical industry, where even once-dominant drugs eventually face headwinds from patent expiry, biosimilar competition, or evolving public health needs. Companies are constantly challenged to innovate and bring new products to market to offset these inevitable revenue losses.

Broader Industry Trends and Outlook

The FY2025 results paint a picture of a pharmaceutical industry in flux, characterized by distinct growth engines alongside areas of contraction. The overall pharma pipeline contracted in FY2025, suggesting that while specific therapeutic areas like GLP-1 agonists and immunologicals are thriving, the broader landscape of drug discovery and development faces challenges. This contraction could be attributed to several factors, including increased regulatory hurdles, higher R&D costs, and a greater focus on highly targeted therapies with smaller patient populations, leading to fewer but potentially more impactful approvals.

The industry’s strategic priorities are clearly shifting. Pharmaceutical companies are likely intensifying their focus on high-growth therapeutic areas, doubling down on R&D for next-generation GLP-1 agonists and advanced immunotherapies. Investments in artificial intelligence and machine learning for drug discovery and development are also becoming critical to improve efficiency and accelerate the pipeline. Furthermore, the strong performance of drugs like Jardiance (Boehringer/Lilly) in diabetes and cardiovascular outcomes ($9,932 million, up 4.8%) and Farxiga/Forxiga (AstraZeneca) in diabetes, heart failure, and chronic kidney disease ($8,492 million, up 10.0%) indicates a growing recognition of the interconnectedness of metabolic and cardiovascular health.

The data presented, built from primary corporate filings and carefully converted across currencies (e.g., DKK to USD at 6.617, EUR to USD at 0.886, CHF to USD at 0.831, GBP to USD at 0.759), provides a robust, fact-based snapshot of the pharmaceutical market’s financial health and strategic direction. The trends observed in FY2025—the meteoric rise of GLP-1s, the sustained strength of specialty franchises, and the impact of patent expirations—will undoubtedly shape investment decisions, R&D priorities, and competitive strategies for years to come. The industry is navigating a complex environment where unprecedented innovation in certain areas coexists with the imperative to manage the lifecycle of older, albeit successful, products, all while striving to meet evolving global health demands.