As multinational pharmaceutical companies released their 2025 performance reports, a new competitive landscape in the global industry has become clear. Johnson & Johnson led the revenue ranking with total global revenue of $94.193 billion, driven by its two core segments: Innovative Medicine, which brought in $60.401 billion (up 6%), and MedTech, which contributed $33.792 billion (up 6.1%). Eli Lilly achieved full-year revenue of $65.179 billion, representing a high growth rate of 44%, making it the fastest-growing major pharmaceutical firm. Other leading companies, including Sanofi, Novartis, AstraZeneca, and AbbVie, also maintained upward revenue trends, collectively supporting the steady development of the global pharmaceutical sector.
Beneath the growth figures, many multinational firms face increasing pressure from the "patent cliff," prompting accelerated strategic adjustments. A series of measures, including pipeline optimization, organizational streamlining, and personnel changes, are being actively implemented, with strategic plans now moving into the execution phase. For instance, Sanofi's board appointed Belén Garijo as the new CEO, effective after the Annual General Meeting on April 29, 2026. It is reported that Garijo will drive the company's strategy with greater rigor, with her primary task being to enhance the productivity, governance, and innovation capabilities of the R&D department. Separately, Merck & Co. announced a restructuring of its pharmaceutical business, dividing its Human Health unit into two new segments: Oncology and Specialty, Pharma & Infectious Diseases. This reorganization aims to maintain Merck's leadership in oncology while focusing on launching an increasingly broad and diverse range of new products. To support the new Human Health structure, Jannie Oosthuizen was appointed Executive Vice President and President of Merck's International business and Oncology operations.
Looking ahead to 2026, the divergence in growth trajectories within the global pharmaceutical industry is expected to continue. A research report from Guosen Securities indicated that among the 16 companies it tracked, only Eli Lilly provided double-digit revenue growth guidance for 2026. Novo Nordisk expects revenue to decline by 13% to 5% due to market competition and pricing pressures. Bristol-Myers Squibb anticipates a low to mid-single-digit revenue decline as several key products face patent expirations. Revenue growth guidance for the other 13 companies largely falls within the single-digit range.
The contest for the title of global "Drug King" remains a focal point in the industry, and 2025 saw a change in leadership. In 2024, Merck's Keytruda secured the top spot for the second time with sales of $29.482 billion. In 2025, Keytruda sales reached $31.68 billion, a 7% year-on-year increase, but it ultimately relinquished the crown amid competition from GLP-1 class drugs. Eli Lilly's tirzepatide emerged as the new "Drug King" in 2025, generating a total of $36.5 billion in revenue. Sales of Mounjaro reached $22.965 billion, up 99% year-on-year, while sales of Zepbound reached $13.542 billion, surging 175%. Novo Nordisk's semaglutide followed closely behind, with the "blockbuster product" achieving sales of $36.1 billion, an increase of over 10% year-on-year. Sales of the injectable diabetes drug Ozempic were 127.089 billion Danish kroner (approximately $20.105 billion), while the weight-loss injection Wegovy brought in 79.106 billion Danish kroner (approximately $12.515 billion). Sales of the oral diabetes tablet Rybelsus were 22.093 billion Danish kroner (approximately $3.495 billion).
A pharmaceutical analyst from a securities firm pointed out that the GLP-1 market for weight loss and diabetes is now dominated by Novo Nordisk and Eli Lilly, but competition is intensifying. On one hand, GLP-1 drugs have demonstrated significant efficacy in areas like blood sugar control and weight loss, leading to rapid market expansion. As more companies enter the field, competition is becoming fiercer. On the other hand, the core patent for semaglutide is set to expire in March 2026, which will allow domestic generic drug manufacturers to enter the market en masse, posing a risk of market share erosion for the originator companies. The GLP-1 field has now entered a new phase of intense competition. According to the医药魔方Nextpharma database, there are 88 small-molecule GLP-1 drugs in development globally, with six already in Phase III clinical trials, including Eli Lilly's orforglipron and Hengrui Pharmaceuticals' HRS-7535. Chinese pharmaceutical companies are accelerating their布局 in GLP-1 generics and improved new drugs, indicating that global GLP-1 market competition will enter a more diversified stage.
Furthermore, Pfizer recently announced results from the Phase IIb VESPER-3 study for its ultra-long-acting GLP-1 receptor agonist PF-3944 (MET-097i). PF-3944, developed by Metsera (acquired by Pfizer), is a first-in-class, fully biased, ultra-long-acting GLP-1 receptor agonist with the potential for once-monthly injection. The industry generally judges that competition in the GLP-1 arena will revolve around improving efficacy, dosing convenience, price accessibility, and expanding indications. Faced with increasingly fierce competition, Eli Lilly and Novo Nordisk are continuously deepening their moats to consolidate their market advantages.
As one of the world's most promising pharmaceutical markets, performance in China is a crucial support for the global results of multinational companies. According to disclosed financial reports, AstraZeneca maintained its position as the leader in China revenue among multinational pharma firms in 2025. During the reporting period, AstraZeneca achieved total revenue of $58.739 billion, an 8% year-on-year increase. China, its second-largest global market, contributed revenue of $6.654 billion, up 4% year-on-year, accounting for 11% of its global total. Behind this 4% growth lies the continuous optimization of AstraZeneca's business structure and strategic deepening in China. Public information shows that since 2023, AstraZeneca has entered into 15 licensing collaborations with 14 Chinese domestic innovative drug companies, covering cutting-edge areas like ADCs and cell therapies. Its AstraZeneca-CICC Healthcare Investment Fund has invested in 28 Chinese innovative companies, with assets under management of $550 million; 10 of these portfolio companies have entered into 17 global licensing deals with multinational pharmaceutical firms, totaling over $13.7 billion. On October 25, 2025, AstraZeneca officially opened its Global R&D Beijing Strategic Center, its second global strategic R&D center in China, further bolstering its commitment to China's pharmaceutical R&D innovation ecosystem. On January 29, 2026, AstraZeneca announced plans to invest over 100 billion RMB (approximately $15 billion) in China by 2030 to expand drug production and R&D布局, aiming to make China a core pivot for its global innovation and manufacturing.
In terms of growth rate, the top three multinational pharmaceutical companies by China revenue growth in 2025 were Eli Lilly, Roche, and Novartis. Roche was the only company besides Eli Lilly to achieve double-digit growth in China. According to Roche's financial report, its growth in China was primarily driven by three core products: the successful inclusion of Phesgo in the national reimbursement drug list; strong sales of Xofluza during the flu season; and steady growth from Vabysmo and Polivy. As the third-fastest-growing multinational in China for 2025, Novartis achieved steady growth through the launch of innovative drugs and localized布局. Notably, Pluvicto received approval for two late-stage prostate cancer indications in China in November 2025, becoming the country's first commercially available radioligand therapy. Alongside drug launches, Novartis is actively advancing its local production布局 in China. In December 2025, Novartis signed a commercial cooperation agreement with Atom High Tech to provide customized Pluvicto supply and solutions for medical institutions and patients, aiming to benefit more patients. Furthermore, Novartis has announced plans to establish a nuclear medicine production base in China to support the long-term supply of Pluvicto and other radiopharmaceuticals in the Chinese market.
It is worth noting that many multinational companies are continuously strengthening the strategic position of their China operations. For example, in December 2025, Boehringer Ingelheim announced that Dr. Ioannis Sapountzis would assume the role of Head of Greater China. To fully unlock China's potential, Boehringer Ingelheim will optimize its global regional market structure, making the Greater China region independent from the Human Pharma Emerging Markets region and reporting directly to the Global Head of Human Pharma Regions. From an industry perspective, as China's pharmaceutical market continues to open up and innovate, competition among multinationals in China will increasingly focus on innovation capability, localized布局, and collaborative empowerment. The advantages of leading companies will become more pronounced, while firms facing performance pressure must accelerate strategic adjustments and strengthen the competitiveness of their core products to gain a firm foothold in the increasingly competitive Chinese market.
An analysis by Bocom International pointed out that many multinational pharmaceutical companies face significant risk exposure from patent expirations, with some companies' exposure reaching as high as 70%. According to RBC Capital Markets, large pharmaceutical companies could see $400 billion in existing revenue lose exclusivity over the next decade, with approximately $180 billion of their free cash flow potentially being used to mitigate sales declines. Confronted with the looming "patent cliff," finding new growth drivers has become a common challenge for global multinationals. While announcing its 2025 results, Novartis noted it is facing the largest wave of patent expirations in its history, with sales of just three products – Entresto, Revolade, and Tasigna – in the US market expected to decline by $4 billion. To counter patent expiration risks and unearth new growth momentum, multinational companies have significantly increased their business development efforts in recent years. Mergers, acquisitions, and collaborative development to integrate high-quality innovative assets have become common industry strategies.
A Guosen Securities research report showed that transactions for innovative drug assets by multinational pharmaceutical firms hit a record high in 2025. The number of innovative drug deal cases for the year reached 142, comprising 36 M&A deals and 106 collaboration/development deals, both figures being the highest since 2015. The total deal value reached $264.5 billion, with M&A/collaboration deals valued at $106 billion and $158.4 billion respectively. The total deal value and collaboration value were the highest since 2015, while M&A value was second only to 2019 and 2023. This trend is likely to continue into 2026. Analysts at J.P. Morgan predicted at the end of 2025 that M&A activity would continue to heat up in 2026, especially after the resolution of several key policy uncertainties. Deals are expected to focus on late-stage, lower-risk assets, with more mid-sized transactions in the $5 billion to $15 billion range.
In the first quarter of 2026, BD transactions by multinational pharmaceutical companies have already shown signs of密集落地. On February 8, Innovent Biologics announced a strategic collaboration with Eli Lilly to jointly advance the global R&D of innovative drugs in oncology and immunology. The following day, Orna Therapeutics announced a definitive agreement to be acquired by Eli Lilly, which will fully acquire Orna to strengthen its布局 in cell and gene therapies. Later in the same month, GSK announced an agreement to acquire 35Pharma for $950 million in cash. 35Pharma's core pipeline asset is HS235, a drug targeting the activin receptor signaling pathway, a clinically validated target for pulmonary arterial hypertension treatment. On March 4, Sino Biopharmaceutical announced that its subsidiary, Chia Tai Tianqing, had entered into an exclusive licensing agreement with Sanofi for the global development, production, and commercialization of the JAK/ROCK inhibitor, rovatoltinib. Under the agreement, Sino Biopharmaceutical's subsidiary grants Sanofi an exclusive global license for rovatoltinib.
"The growing demand from multinational pharmaceutical companies for high-quality innovative assets not only provides important pathways for pipeline realization and value monetization for China's biotech firms but is also driving a global surge in BD and M&A activity in the biopharmaceutical sector," the aforementioned securities analyst emphasized. However, beneath this热潮 lies differentiation. For innovative drug companies to achieve sustainable development, they must still focus prudently on pipeline strategy, R&D capabilities, and clinical advancement, avoiding盲目跟风.
Currently, the competitive landscape of the global pharmaceutical industry is rapidly restructuring, with the strategic value of the Chinese market becoming increasingly prominent. On one hand, multinational companies are continuously increasing their investments in China. On the other hand, the innovative strength of Chinese pharmaceutical companies is steadily improving, with high-quality innovative assets gaining global recognition and becoming an indispensable force in the global pharmaceutical innovation ecosystem. This dynamic will promote the high-quality development of China's pharmaceutical industry and inject new vitality into the sustained growth of the global pharmaceutical sector.