Who runs pharma now
The eight biggest drugmakers of 2020, ranked again today. Eli Lilly went from last of the eight to first.
At the end of 2020 these were the eight most valuable drugmakers in the world: Johnson & Johnson, Roche, Novartis, Merck, Pfizer, AbbVie, Novo Nordisk and Eli Lilly - in that order. Lilly was the smallest of them, worth about $162B.
Rank them again today and Lilly is first, at roughly $1.06 trillion. It is the first pharmaceutical company ever worth that much. Pfizer went the other way: about $205B at the end of 2020, about $153B now, last of the eight.
Most of Lilly's move is one molecule. Tirzepatide, sold as Mounjaro for diabetes and Zepbound for weight loss, brought in $14.9B in the second quarter of 2026 alone. Total company revenue that quarter was $23.0B, up 48% - and that was with realised prices 13% LOWER than a year earlier. Volume grew 60%, which more than covered the price cuts.
Two notes on the chart. Both columns are the same eight companies measured the same way, so it shows how they moved against each other - it is not today's top eight. AstraZeneca (about $250B) and Amgen (about $222B) are now bigger than Novo and Pfizer, but neither was in the 2020 group. And in 2020 Novo and Lilly were roughly 1% apart for seventh and eighth, close enough to have moved with the day.
