In terms of revenue => CVS health ($373 billion), Walgreens Boots ($150 b), J&J ($88b), Sinopharm ($84b), Roche ($69b), Merck ($64b), Pfizer ($63b), Abbvie ($56b), Astrazenca($54b), Novartis ($51b).
Here below today's charts for quick context: by Market Cap and by Revenue =>
By Revenue:
By revenue, perhaps the above chart lists overall revenue. But if one were to look at just the revenue from pharma, following: (CVS and Walgreens being retailers)
What is interesting to note is that Eli Lilly, the largest company by market cap in pharma space does not figure in top 10 by pharma revenue.
Perhaps it is partly explained by 2024 Q4 revenue growth:
Lilly has delivered seven straight quarters with at least a 20% increase. Boosted by hefty sales of its diabetes and obesity drugs, Lilly posted an annual revenue increase of 32% in 2024,
The recent surge has been due to the tremendous growth Lilly has achieved due to its highly popular GLP-1 drugs, including Mounjaro (for diabetes) and Zepbound (for weight loss). Together, those two products generated $5.4 billion in sales for Eli Lilly last quarter, or 40% of the top line.
Lilly’s revenue increase in the quarter wasn’t just due to its GLP-1/GIP products, however. The company also said that sales of its non-incretin drugs jumped by 20% year over year and pointed to the performance of breast cancer therapy Verzenio and heart failure treatment Jardiance, which rang up quarterly figures of $1.6 billion and $1.2 billion, respectively.
Since announcing in January at the J.P. Morgan Healthcare Conference that it expects revenue to increase 32% in 2025, Lilly has seen its market cap increase from $745 billion to $844 billion, which is more than twice the value of any other company in the industry.Much of the investor enthusiasm surrounds the prospects of Lilly’s obesity treatments in a market that is still growing.
Eli Lilly also faces formidable competitio n from Novo Nordisk, the maker of rival GLP-1 drugs Ozempic and Wegovy. In addition, companies like Hims & Hers Health sell so-called compounded cheaper versions of these drugs which contain semaglutide, the active ingredient in GLP-1 medications. The U.S. Food and Drug Administration does not test these compounded drugs but allows them to be sold due to continued supply shortages of the FDA-approved brand-name versions.
Following chart from Visual Capitalist shows the key companies by market cap in each region - North Am, Europe and Asia Pac.
The Pharmaceutical Context - From Europe:
Thanks to advances in science and technology, the research-based pharmaceutical industry is entering an exciting new era in medicines development. Research methods are evolving and we have many promising prospects on the horizon, with groundbreaking cell and gene therapies being increasingly available*. The innovative pharmaceutical industry is driven by, and drives, medical progress. It aims to turn fundamental research into innovative treatments that are widely available and accessible to patients.Already, the industry has contributed to significant improvements in patient well-being. Today’s European citizens can expect to live up to 30 years longer than they did a century ago. Some major steps in biopharmaceutical research, complemented by many smaller steps, have allowed for reductions in mortality, for instance from HIV/AIDS-related causes and several cancers. High blood pressure and cardiovascular diseases can be controlled with antihypertensive and cholesterol-lowering medicines; knee or hip replacements prevent patients from immobility; and some cancers can be controlled – or even cured – with the help of new targeted treatments. European citizens can expect not only to live longer, but to live better quality lives. Yet major hurdles remain, including Alzheimer’s, Multiple Sclerosis, many cancers, and rare diseases.
Following is an interesting chart on new medicines:
The global pharma market is $1.3 trillion. For context, global wheat market is ~$200b annually.
The following chart shows the spend on R&D in pharma. Against the global market size of Euro 1.28 trillion, ~Euro 145 billion was invested in Research by the largest markets - US, Europe, Japan and China.
"All new medicines introduced into the market are the result of lengthy, costly and risky research and
development (R&D) conducted by pharmaceutical companies: "
(Following from European context)
"On average, only one to two of every 10,000 substances synthesised in laboratories will successfully pass all stages of development required to become a marketable medicine."
"The cost of researching and developing a new chemical or biological entity is estimated at € 3,130 million ($ 3,296 million in year 2022 dollars)"
$3.2 billion for a new chemical entity.
Medicines in development around the world:
On average, researchers identify one promising compound among 5,000–10,000 screened. Researchers then extensively test the compound to ensure its efficacy and safety, a process that can take 10 to 15 years for both a medicine and a vaccine. In 2020, 53 new medicines were launched, while currently more than 9,000 compounds are at different stages of development globally.
Given the nature of the industry, Pharma is one of the highest R&D industries globally:
The price structure reflects some of this R&D spend. Following is indicative from Europe:
Pharma is one part of the overall healthcare system. Following is how it breaks down for Europe. Medicines constitute 17.3% of overall healthcare cost. Remaining being hospitals and outpatient care.
Over time, with development, medicines can help generate overall healthcare savings.
A good healthcare govt spend/sytem is an important priority or pillar for a country's basic development. The amount of govt spend also reflects in a patient's OOP spend. In countries with lower General Govt Health Expenditure, the patients have to bear higher share of OOP.
Of the indicative industry size of $1.3 trillion, ~ half is exports.
Following is a quick snapshot around the world:
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