The Pharma Top 10: Highest Revenue Drugs of 2025 (Official Sales Data & Analysis) | Top selling pharmaceutical drugs | iPharmaCenter
- Badari Andukuri
- Feb 11
- 7 min read
TOP PHARMACEUTICALS BY REVENUES IN 2025
COLLATED FROM THE REVENUES OF COMPANY WEBSITES
Rank | Brand | Revenues |
1 | Keytruda | $ 31.7 billion |
2 | Mounjaro | $ 23.0 billion |
3 | Ozempic | $ 20 billion |
4 | Dupixent | $ 18.5 billion |
5 | Skyrizi | $ 17.6 billion |
6 | Darzalex | $ 14.5 billion |
7 | Eliquis | $ 14.4 billion |
8 | Biktarvy | $ 14.3 billion |
9 | Zepbound | $ 13.5 billion |
10 | Wegovy | $ 12.5 billion |
Keytruda (pembrolizumab)
Mechanism of action
Keytruda, from Merck, is a humanized monoclonal antibody targeting the programmed cell death‑1 (PD‑1) receptor on T cells. By blocking PD‑1 from binding its ligands PD‑L1 and PD‑L2, it releases inhibitory “brakes” on cytotoxic T cells, enhancing antitumor immune responses across a wide range of solid tumors and hematologic malignancies.
Indications
Clinically, Keytruda is approved in multiple settings including metastatic and adjuvant melanoma, non‑small cell lung cancer, urothelial carcinoma, head and neck squamous cell carcinoma, cervical cancer, triple‑negative breast cancer, endometrial carcinoma and MSI‑high or mismatch‑repair–deficient tumors, among others, reflecting its broad tissue‑agnostic and tumor‑specific indications.
What is driving Keytruda's growth
In 2025, growth has been propelled in part by increased use in tumors that predominantly affect women, such as specific cervical, breast and endometrial cancers, as well as uptake of Keytruda in combination with enfortumab vedotin in first‑line, locally advanced or metastatic urothelial cancer.
What is after Keytruda?
Keytruda’s loss of exclusivity, beginning around 2028 in the US, is rapidly approaching and is expected to trigger mounting biosimilar competition and pricing pressure. In anticipation of this patent cliff, Merck is actively reshaping its portfolio, highlighting a broad late‑stage pipeline, oncology partnerships, and business development to ensure growth is no longer overly dependent on Keytruda.
Winrevair, Ohtuvayre, enlicitide decanoate, MK‑1406, Enflonsia, tulisokibart, sacituzumab tirumotecan and ifinatamab deruxtecan are among the priority programs the company is advancing to sustain and diversify long‑term revenue beyond Keytruda.
Mounjaro (tirzepatide)
Mechanism of action
Mounjaro, developed by Eli Lilly, is a once‑weekly injectable dual agonist of the glucose‑dependent insulinotropic polypeptide (GIP) and glucagon‑like peptide‑1 (GLP‑1) receptors. By simultaneously activating both incretin pathways, tirzepatide enhances glucose‑dependent insulin secretion, suppresses glucagon, slows gastric emptying and reduces appetite, leading to substantial improvements in glycemic control and body weight in adults with type 2 diabetes.
Indications
Mounjaro is indicated as an adjunct to diet and exercise for adults with type 2 diabetes, and real‑world adoption has been rapid; by Q3 2025 it had achieved U.S. incretin analog class leadership with roughly mid‑40% total prescription share and more than 50% new‑to‑brand share, alongside exceptionally strong international revenue growth versus the prior quarter.
How big is Mounjaro?
Lilly notes that ex‑U.S. revenue for the company rose 43%, largely propelled by Mounjaro, and that international Mounjaro revenue grew 10% versus Q3 2025. Mounjaro is now the share‑of‑market (SOM) leader among U.S. type 2 diabetes incretin analogs, with around 48% total prescription (TRx) SOM and 55% new‑to‑brand prescription (NBRx) SOM at the end of Q4 2025, and its label has been expanded to include pediatric patients 10 years and older with type 2 diabetes in the U.S., further broadening its commercial reach
Ozempic (semaglutide)
Mechanism of action
Ozempic, from Novo Nordisk, contains semaglutide, a long‑acting GLP‑1 receptor agonist administered once weekly for adults with type 2 diabetes. By mimicking endogenous GLP‑1, semaglutide increases glucose‑dependent insulin secretion, decreases glucagon release and modestly delays gastric emptying, thereby improving fasting and post‑prandial glycemic control while also reducing appetite and caloric intake.
Indications
Ozempic is approved primarily for glycemic management in type 2 diabetes, with additional cardiovascular risk‑reduction indications in certain high‑risk patients, and has become a cornerstone of modern incretin‑based therapy as demand for agents that address both glucose and weight continues to surge.
Dupixent (dupilumab)
Mechanism of action
Dupixent, co‑developed by Sanofi and Regeneron, is a fully human monoclonal antibody that targets the interleukin‑4 receptor alpha (IL‑4Rα) subunit, thereby inhibiting signaling of both IL‑4 and IL‑13, key drivers of type 2 inflammation.
Indications
It is approved across a broad spectrum of type 2 inflammatory diseases, including moderate‑to‑severe atopic dermatitis (adults and children from 6 months of age), moderate‑to‑severe asthma, chronic rhinosinusitis with nasal polyps, eosinophilic esophagitis and prurigo nodularis, with additional late‑stage programs in chronic spontaneous urticaria, chronic obstructive pulmonary disease and bullous pemphigoid.
By 2025, more than 1.3 million patients were on therapy globally, and new launches in COPD, chronic spontaneous urticaria and bullous pemphigoid, as well as positive data in allergic fungal rhinosinusitis and expanding pediatric programs, are sustaining strong, multi‑indication growth.
Skyrizi (risankizumab)
Mechanism of action
Skyrizi, marketed by AbbVie (and in some regions with Boehringer Ingelheim), is a humanized monoclonal antibody that selectively targets the p19 subunit of interleukin‑23 (IL‑23). By blocking IL‑23 signaling, Skyrizi down‑regulates downstream Th17‑driven inflammatory pathways implicated in psoriasis, psoriatic arthritis and inflammatory bowel disease.
Indications
The drug is approved for adults with moderate‑to‑severe plaque psoriasis, active psoriatic arthritis and Crohn’s disease, with additional ulcerative colitis and related IBD programs expanding its footprint, supporting revenue growth that has approached roughly 60% year‑on‑year as it anchors AbbVie’s next‑generation immunology portfolio.
Eliquis (apixaban)
Mechanism of action
Eliquis, jointly developed by Bristol Myers Squibb and Pfizer, is an oral, direct factor Xa inhibitor used as an anticoagulant. By selectively inhibiting factor Xa, apixaban reduces thrombin generation and fibrin clot formation without requiring routine coagulation monitoring, which differentiates it from traditional vitamin K antagonists.
Indications
Eliquis is indicated to reduce the risk of stroke and systemic embolism in patients with non‑valvular atrial fibrillation, for treatment and secondary prevention of deep vein thrombosis and pulmonary embolism, and for thromboprophylaxis after hip or knee replacement surgery, and it remains one of the world’s highest‑selling cardiovascular drugs despite intensifying competition from other direct oral anticoagulants and generic erosion concerns.
Darzalex (daratumumab)
Mechanism of action
Darzalex, from Johnson & Johnson (Janssen), is a human IgG1κ monoclonal antibody that targets CD38, a cell‑surface glycoprotein highly expressed on multiple myeloma cells. Binding to CD38 induces tumor cell death via multiple immune‑mediated mechanisms, including complement‑dependent cytotoxicity, antibody‑dependent cell‑mediated cytotoxicity and apoptosis, while also modulating the surrounding immune microenvironment.
Indications
Darzalex (intravenous) and the subcutaneous formulation Darzalex Faspro are approved in numerous combinations and treatment lines for newly diagnosed and relapsed/refractory multiple myeloma, and continued strong share gains and overall market expansion have made it Johnson & Johnson’s best‑selling oncology medicine.
Biktarvy
Mechanism of action
Biktarvy combines three antiretrovirals—bictegravir, emtricitabine, and tenofovir alafenamide—that target different steps in the HIV‑1 replication cycle. Bictegravir is an integrase strand transfer inhibitor that blocks the HIV integrase enzyme, preventing viral DNA from integrating into the host cell genome, while emtricitabine and tenofovir alafenamide are nucleoside reverse transcriptase inhibitors that inhibit reverse transcriptase, stopping the virus from making new viral DNA. By simultaneously blocking reverse transcriptase and integrase, Biktarvy reduces the production of new virus particles, lowers viral load to undetectable levels in many patients, and allows CD4 cell counts to recover, strengthening immune function. It is formulated as a once‑daily, single‑tablet regimen designed as a complete treatment without the need for additional antiretroviral drugs.
Indications
Clinically, Biktarvy is indicated as a complete regimen for the treatment of HIV‑1 infection in adults and pediatric patients weighing at least 14 kg who either have no prior antiretroviral treatment history or are virologically suppressed on a stable regimen and wish to switch, provided there is no known or suspected resistance to its components.
Zepbound (tirzepatide)
Mechanism of action
Zepbound, also from Eli Lilly, contains the same active molecule as Mounjaro—tirzepatide, but is branded specifically for obesity and weight‑management indications. As a dual GIP and GLP‑1 receptor agonist, Zepbound reduces appetite, lowers caloric intake and improves glycemic parameters, producing substantial and sustained weight loss in adults with obesity or overweight plus weight‑related comorbidities, as well as in those with obesity and moderate‑to‑severe obstructive sleep apnea.
Indications
In the U.S. anti‑obesity market it rapidly achieved majority new‑to‑brand and total prescription share by Q3 2025, although plan design changes, such as CVS excluding Zepbound from certain template formularies, temporarily pressured total share even as new‑start demand rebounded once access pathways stabilized.
Wegovy (semaglutide)
Mechanism of action
Wegovy, also from Novo Nordisk, is a higher‑dose semaglutide formulation positioned for chronic weight management and cardiometabolic risk reduction rather than for glycemic control alone. As a GLP‑1 receptor agonist, it acts on appetite‑regulation centers in the brain, reduces hunger and facilitates lower energy intake, while also improving glycemic and cardiometabolic markers and, in specific high‑risk populations, reducing the risk of major adverse cardiovascular events.
Indications
Wegovy is indicated for adults and certain adolescents with obesity or overweight with weight‑related conditions and has also gained approval to reduce cardiovascular risk and to treat metabolic‑associated steatohepatitis in defined populations, with approximately tens of millions of Americans now having insurance coverage for the drug and fueling its explosive revenue growth.
Opdivo (nivolumab)
Mechanism of action
Opdivo, from Bristol Myers Squibb, is a fully human IgG4 monoclonal antibody that targets the PD‑1 immune checkpoint receptor, similar in class to pembrolizumab. By blocking interaction between PD‑1 and its ligands, Opdivo reinvigorates exhausted T cells and enhances antitumor immune activity, and it is used either alone or in combination (notably with ipilimumab and/or chemotherapy) across a wide range of solid tumors and hematologic cancers.
Indications
Key indications include melanoma, non‑small cell and small cell lung cancer, renal cell carcinoma, urothelial carcinoma, head and neck cancer, esophageal and gastric cancers, hepatocellular carcinoma and MSI‑high colorectal cancer, with around 95% of its revenue concentrated in major solid tumors such as NSCLC, RCC, melanoma and upper GI/bladder cancers and supported by new launches in MSI‑high colorectal cancer and expanding first‑line NSCLC usage.
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