Top 10 Drugs by Worldwide Sales in 2025: Final Results and the 2026 Outlook
Originally published June 2025 · Updated August 24, 2026 with final full-year 2025 results reported in company 10-Ks, 20-Fs, and Q4 earnings releases
Quick Answer
Merck's Keytruda stayed the world's best-selling drug in 2025 at $31.68 billion, but the bigger story was tirzepatide: Eli Lilly's Mounjaro ($22.97B) and Zepbound ($13.54B) combined for $36.5 billion, overtaking Novo Nordisk's Ozempic-and-Wegovy semaglutide franchise (roughly $31.8B) for the first time. Counting both BMS's and Pfizer's booked shares, Eliquis jumped to #3 at $22.4 billion. The top 10 drugs together generated $188.1 billion in 2025, up 21.5% from 2024. Wegovy narrowly fell out of the top 10, edged out by the Jardiance family.
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The Final 2025 Ranking
Every full-year 2025 figure below comes from the companies' own 10-K, 20-F, or fourth-quarter earnings disclosures — not analyst projections. Together, the top 10 generated $188.136 billion in 2025, up 21.5% from $154.888 billion in 2024, according to Genetic Engineering & Biotechnology News's (GEN) industry-standard annual tally.
| Rank | Drug | Company | 2025 Sales | YoY Change |
|---|---|---|---|---|
| 1 | Keytruda / Keytruda Qlex | Merck & Co. | $31.68B | +7.5% |
| 2 | Mounjaro | Eli Lilly | $22.97B | +99.0% |
| 3 | Eliquis | BMS & Pfizer | $22.40B | +8.2% |
| 4 | Ozempic | Novo Nordisk | $19.61B | +5.6% |
| 5 | Dupixent | Sanofi & Regeneron | $18.12B | +20.2% |
| 6 | Skyrizi | AbbVie | $17.56B | +49.9% |
| 7 | Darzalex / Faspro | Johnson & Johnson | $14.35B | +23.0% |
| 8 | Biktarvy | Gilead Sciences | $14.33B | +6.8% |
| 9 | Jardiance family | Boehringer Ingelheim & Eli Lilly | $13.56B | +4.5% |
| 10 | Zepbound | Eli Lilly | $13.54B | +174.9% |
Sources: Merck 10-K/Q4 2025 earnings release; Eli Lilly Q4 2025 earnings release; Bristol Myers Squibb and Pfizer 2025 10-Ks; Novo Nordisk 2025 Annual Report (Form 20-F); Sanofi and Regeneron FY2025 results; AbbVie Q4/FY2025 earnings release; Genmab/J&J Darzalex net sales announcement; Gilead Q4/FY2025 earnings release; Boehringer Ingelheim/Eli Lilly disclosures — as compiled in GEN's Top 10 Best-Selling Drugs 2026 A-List (published July 9, 2026).
2025 Worldwide Sales by Drug ($ billions)
Chart: One Day Advisor. Data: company FY2025 filings, as tabulated above.
Highlights and Market Trends
Keytruda held on, but growth is slowing. Merck's pembrolizumab franchise — now reported as a single figure that combines the original intravenous Keytruda with the newer subcutaneous Keytruda Qlex® — grew 7.5% to $31.68 billion, roughly half of Merck's total $65.0 billion in worldwide sales. That's a smaller percentage gain than the 18% jump Keytruda posted in 2024, a sign that a drug approved for more than 40 indications is starting to mature even before its 2028 patent cliff.
Tirzepatide had the biggest year of any drug on this list. Eli Lilly's twin GLP-1/GIP products very nearly doubled and nearly tripled, respectively: Mounjaro grew 99.0% to $22.97 billion and Zepbound grew 174.9% to $13.54 billion. Combined, the tirzepatide franchise added more than $20 billion in a single year — a growth rate no other blockbuster on this list came close to matching.
Eliquis' jump to #3 is a reporting-convention story as much as a sales story. Because Bristol Myers Squibb and Pfizer co-promote apixaban and each books its own share of revenue, GEN's industry-standard tally counts both companies' recognized sales ($14.443B + $7.961B) for a combined $22.40 billion. Trackers that count only BMS's booked figure place Eliquis lower, around $14.4 billion. Both numbers are correct; they're just answering different questions. See the methodology section below.
Immunology had a breakout year. AbbVie's Skyrizi jumped nearly 50% to $17.56 billion as it continues to backfill the revenue AbbVie lost when Humira went off-patent. Dupixent grew 20.2% to $18.12 billion, and Darzalex grew 23.0% to $14.35 billion. All three now generate more in a single year than Humira did at its 2022 peak.
A new entrant, and a notable dropout. The Jardiance family (empagliflozin, plus its fixed-dose combinations Glyxambi, Synjardy, and Trijardy XR) cracked the top 10 for the first time at $13.56 billion, a diabetes/heart-failure/chronic-kidney-disease franchise that had quietly grown into blockbuster territory. It bumped Novo Nordisk's Wegovy out of the top 10 — not because Wegovy shrank, but because everything else around it grew faster.
Drug-by-Drug Profiles
1. Keytruda / Keytruda Qlex (pembrolizumab) — Merck & Co.
2025 sales: $31.68 billion (+7.5%) | Category: Oncology, PD-1 checkpoint inhibitor
Keytruda remains the best-selling drug in the world for a third straight year, now approved across more than 40 oncology indications including melanoma, non-small cell lung cancer, head and neck cancer, renal cell carcinoma, classical Hodgkin lymphoma, bladder cancer, triple-negative breast cancer, and several gastrointestinal and gynecologic cancers. Growth is increasingly coming from earlier-stage, pre-metastatic use (particularly resectable non-small cell lung cancer) rather than from new approvals alone.
The bigger operational story in 2025 was the U.S. launch of Keytruda Qlex, a subcutaneous formulation co-formulated with Alteogen's hyaluronidase technology that cuts infusion time from roughly 30 minutes to a few minutes. Qlex contributed a modest $40 million in its first partial quarter (Q4 2025) but scaled to $128 million by Q1 2026, and Merck is counting on it to defend prescriber and patient loyalty as pembrolizumab's core U.S. patent exclusivity is set to lapse in 2028. Merck has said it expects Keytruda to keep growing through the loss-of-exclusivity date, with 2028 peak sales estimated near $35 billion before biosimilar competition begins eroding the franchise, similar to what happened to AbbVie's Humira after 2023.
2. Mounjaro (tirzepatide) — Eli Lilly
2025 sales: $22.97 billion (+99.0%) | Category: Type 2 diabetes, dual GIP/GLP-1 receptor agonist
Mounjaro is the diabetes-indicated twin of Lilly's tirzepatide molecule (Zepbound is the obesity-indicated version). It nearly doubled in a single year on the back of expanded U.S. manufacturing capacity that finally caught up with demand, and it ended 2025 as the U.S. market-share leader among type 2 diabetes incretin therapies, with roughly 48% total prescription share. In early 2026, Mounjaro's label was expanded to pediatric patients 10 and older with type 2 diabetes, and by Q1 2026 the combined tirzepatide franchise had briefly overtaken Keytruda as the single best-selling drug by quarter.
3. Eliquis (apixaban) — Bristol Myers Squibb & Pfizer
2025 sales: $22.40 billion combined ($14.44B BMS + $7.96B Pfizer), +8.2% | Category: Anticoagulant, factor Xa inhibitor
Eliquis is the elder statesman of this list, approved since 2012 for stroke prevention in atrial fibrillation and for treating and preventing venous thromboembolism. Sales growth in the high single digits, more than a decade after launch, reflects both an aging population and continued share gains against warfarin and other direct oral anticoagulants. The drug's core U.S. compound patent expires in November 2026, but litigation settlements block generic entry until April 1, 2028 — giving BMS and Pfizer roughly 16 more months of exclusivity than the underlying patent alone would suggest.
4. Ozempic (semaglutide) — Novo Nordisk
2025 sales: $19.61 billion / DKK 127.089 billion (+5.6%) | Category: Type 2 diabetes, GLP-1 receptor agonist
Ozempic is still the single best-selling type 2 diabetes drug on Earth, but its growth rate has fallen sharply from the near-90% jumps Novo posted in 2023. Novo has pointed to intensifying U.S. price competition, the rise of compounded semaglutide, and share losses to Lilly's tirzepatide franchise as the main headwinds. Novo Nordisk guided for a sales decline of 5–13% in 2026 — a striking reversal for a company that spent three years as Europe's most valuable by market cap.
5. Dupixent (dupilumab) — Sanofi & Regeneron
2025 sales: $18.12 billion / €15.714 billion (+20.2%) | Category: Immunology, IL-4/IL-13 pathway inhibitor
Dupixent now accounts for 36% of Sanofi's total net sales, having grown into new indications almost every year since its 2017 launch: atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyps, eosinophilic esophagitis, prurigo nodularis, chronic spontaneous urticaria, and — the newest driver of 2025 growth — chronic obstructive pulmonary disease (COPD). Sanofi and Regeneron split profits on the drug roughly evenly under their long-standing collaboration agreement.
6. Skyrizi (risankizumab) — AbbVie
2025 sales: $17.56 billion (+49.9%) | Category: Immunology, IL-23 inhibitor
Skyrizi is the centerpiece of AbbVie's post-Humira turnaround, approved for plaque psoriasis, psoriatic arthritis, Crohn's disease, and ulcerative colitis. Together with sister drug Rinvoq, it now generates more than the $30.4 billion AbbVie's entire immunology portfolio (including the fading Humira) produced in 2024. AbbVie has said it expects Skyrizi and Rinvoq combined to exceed $25 billion by the end of 2026.
7. Darzalex / Darzalex Faspro (daratumumab) — Johnson & Johnson
2025 sales: $14.35 billion (+23.0%) | Category: Oncology, anti-CD38 monoclonal antibody
Daratumumab is the standard of care in newly diagnosed and relapsed multiple myeloma, and its 23% growth was the fastest of any oncology drug on this list. J&J books and reports all Darzalex sales; Genmab, which discovered the antibody, receives royalties that totaled $2.443 billion in 2025 under its licensing agreement with J&J.
8. Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) — Gilead Sciences
2025 sales: $14.33 billion (+6.8%) | Category: HIV, integrase strand transfer inhibitor combination
Biktarvy is the most-prescribed HIV regimen in the United States, a single daily pill combining three antiretrovirals. Gilead's broader HIV portfolio, including the newly launched twice-yearly PrEP therapy Yeztugo, helped total product sales (excluding the COVID antiviral Veklury) grow 4% for the year, with Biktarvy remaining the clear anchor.
9. Jardiance family (empagliflozin) — Boehringer Ingelheim & Eli Lilly
2025 sales: $13.56 billion (+4.5%) | Category: Diabetes, cardiovascular and kidney disease, SGLT2 inhibitor
New to the top 10 this year, the Jardiance family includes Jardiance itself plus the fixed-dose combinations Glyxambi, Synjardy, and Trijardy XR. Originally approved for type 2 diabetes, empagliflozin has steadily expanded into heart failure (with and without reduced ejection fraction) and chronic kidney disease, giving it a durability that pure diabetes drugs from the prior SGLT2 generation didn't have.
10. Zepbound (tirzepatide) — Eli Lilly
2025 sales: $13.54 billion (+174.9%) | Category: Chronic weight management, dual GIP/GLP-1 receptor agonist
Zepbound posted the single largest percentage gain of any drug on this list, nearly tripling as U.S. supply constraints eased and the drug won a Phase 3 win in heart failure with preserved ejection fraction (HFpEF) in patients with obesity. Lilly and the Trump administration also reached an agreement in 2025 to expand government-backed access to obesity medicines for a broader swath of Americans, a policy shift that should keep volume growing into 2026 even as list prices face downward pressure.
The GLP-1 Story: Tirzepatide Overtakes Semaglutide
Four of the ten best-selling drugs of 2025 are incretin therapies for diabetes and obesity, and for the first time, Eli Lilly's tirzepatide molecule outsold Novo Nordisk's semaglutide molecule across the board:
| Franchise | Company | 2025 Combined Sales |
|---|---|---|
| Tirzepatide (Mounjaro + Zepbound) | Eli Lilly | ~$36.51B |
| Semaglutide (Ozempic + Wegovy) | Novo Nordisk | ~$31.82B |
Lilly's combined tirzepatide franchise made up 56% of the company's total 2025 revenue and helped push Lilly's total sales up 45% to $65.2 billion — roughly matching Merck's total company revenue for the year. Novo's semaglutide franchise still grew (Wegovy alone rose from around $8.4 billion in 2024 to roughly $12.2 billion in 2025), just not as fast as Lilly's. Novo has since brought a once-daily oral version of Wegovy to the U.S. market in an effort to close the gap in early 2026, while both companies race to launch next-generation oral incretins (Lilly's orforglipron and Novo's amycretin) that could reshape this rivalry again before the decade is out.
Just Missed the Cut (#11–15)
Drugs ranked 11th through 15th generated between roughly $8.4 billion and $12.2 billion in 2025:
- Wegovy® (semaglutide) — Novo Nordisk. ~$12.2 billion. The GLP-1 obesity drug that opened this entire category, dropped from the top 10 for the first time.
- Opdivo® / Opdivo Qvantig™ (nivolumab) — Bristol Myers Squibb (Ono Pharmaceutical in Japan, South Korea, and Taiwan). Keytruda's chief PD-1 rival.
- Trikafta® (elexacaftor/tezacaftor/ivacaftor and ivacaftor) — Vertex Pharmaceuticals, marketed outside the U.S. as Kaftrio®. The cystic fibrosis modulator with no direct competitor.
- Ocrevus® (ocrelizumab) — Roche/Genentech. The dominant B-cell therapy for both relapsing and primary progressive multiple sclerosis.
- Farxiga® / Forxiga® (dapagliflozin) — AstraZeneca. Jardiance's main SGLT2-inhibitor competitor across diabetes, heart failure, and kidney disease.
Three drugs that ranked in the top 15 a year earlier fell further down the list in 2025: Regeneron/Bayer's Eylea/Eylea HD dropped to #17 amid biosimilar aflibercept competition; Merck's Gardasil/Gardasil 9 fell to #27 after Merck halted shipments to China over declining demand; and AbbVie's Humira — the world's top-selling drug for most of the 2010s — is now #32, effectively priced out of the blockbuster tier by biosimilars.
Patent Cliffs to Watch
Roughly $190 billion of annual revenue concentrated in ten products is, by definition, concentrated risk. A few dates worth flagging for anyone tracking this list going forward:
- Keytruda — 2028. Merck's core U.S. compound patent exclusivity lapses in 2028, with two additional formulation patents the company believes can extend protection into 2029. Keytruda Qlex is Merck's bet on retaining prescribers through a more convenient subcutaneous option before biosimilar pembrolizumab arrives.
- Eliquis — April 2028 (U.S.). The core compound patent expires in November 2026, but litigation settlements with generic manufacturers delay U.S. commercial launch until April 1, 2028. European generic entry begins on a faster timeline, starting in parts of the EU in 2026.
- Semaglutide — 2026 in several ex-U.S. markets. Novo Nordisk's semaglutide molecule is losing exclusivity in Canada, Brazil, and China in 2026, well ahead of its U.S. and EU expiration later this decade — part of why Novo's 2026 guidance calls for a sales decline rather than growth.
- Humira as the cautionary tale. AbbVie's adalimumab fell from the top-selling drug in the world to #32 in roughly three years once U.S. biosimilars launched in 2023 — the fastest and steepest drop of any blockbuster in this category's recent history, and the reason every company on this list is investing heavily in next-generation follow-ons before their own cliffs arrive.
2026 So Far: An Early Look
Early 2026 results suggest this ranking is already shifting:
- In Q1 2026, Lilly's combined Mounjaro-and-Zepbound tirzepatide franchise displaced Keytruda as the single best-selling drug by quarter for the first time, even as Keytruda itself posted a strong 12% year-over-year gain to $8.03 billion.
- Skyrizi kept accelerating, hitting $5.5 billion in a single quarter (Q2 2026), up 24% on an operational basis, and remains AbbVie's largest product.
- Novo Nordisk guided for a full-year 2026 sales decline of 5–13% at constant exchange rates — its first annual guidance for a contraction in over a decade — citing U.S. pricing pressure and compounded-semaglutide competition, even as the newly launched oral Wegovy pill shows encouraging early uptake.
- Merck guided FY2026 revenue of $65.5–$67.0 billion, roughly flat with 2025, while absorbing a one-time charge related to its Cidara Therapeutics acquisition and continuing to prepare for Keytruda's 2028 patent cliff.
We'll update this article again once full-year 2026 results are reported by the companies in the first weeks of 2027.
Methodology and Sources
Figures on this page are drawn directly from company 10-K, 20-F, and Q4/full-year earnings disclosures, cross-checked against GEN's Top 10 Best-Selling Drugs 2026 A-List, which uses a consistent, disclosed methodology across companies. Two conventions are worth understanding if you compare this list to others you may see:
- Co-marketed drugs are counted by combined recognized revenue. Eliquis (BMS + Pfizer) and Jardiance (Boehringer Ingelheim + Eli Lilly) are each sold by two companies that separately recognize revenue on their own share. This list adds both companies' figures together. Lists that track only one company's booked revenue will show these products lower in the ranking.
- Foreign-currency reporters are converted at each company's own average annual exchange rate. Novo Nordisk reports in Danish kroner and Sanofi in euros; the USD figures above reflect the conversions disclosed in their own filings and investor materials, which can differ slightly from other trackers' spot-rate conversions.
- Royalty-based products are counted by the marketer's reported net sales (e.g., Darzalex is J&J's reported figure; Genmab's separate royalty revenue is noted but not double-counted).
FAQ
What was the best-selling drug in the world in 2025?
Merck's Keytruda (pembrolizumab), including the newer subcutaneous Keytruda Qlex, with $31.68 billion in worldwide sales — a 7.5% increase over 2024.
Did Mounjaro or Ozempic sell more in 2025?
Mounjaro outsold Ozempic in 2025: $22.97 billion versus $19.61 billion. Including their sister obesity drugs, Lilly's combined tirzepatide franchise (Mounjaro + Zepbound, ~$36.5B) also outsold Novo Nordisk's combined semaglutide franchise (Ozempic + Wegovy, ~$31.8B) for the first time.
Why do some lists rank Eliquis lower than others?
Eliquis is co-marketed by Bristol Myers Squibb and Pfizer, and each books its own share of revenue. Counting both companies' shares together puts Eliquis at $22.4 billion (#3); counting only BMS's booked figure puts it closer to $14.4 billion. Both are accurate depending on what's being measured.
When does Keytruda lose patent protection?
Merck's core U.S. patent exclusivity on pembrolizumab is expected to lapse in 2028, though two additional formulation patents may extend certain protections into 2029.
Which drug fell out of the top 10 in 2025?
Novo Nordisk's Wegovy, which ranked #10 the prior year, fell to #11 (roughly $12.2 billion) as the Jardiance family (empagliflozin) grew into the top 10 for the first time.
How much did the top 10 best-selling drugs make combined in 2025?
$188.136 billion, up 21.5% from $154.888 billion in 2024, and more than double the $82.694 billion the top 10 generated in 2016.
Using This Data With AI Tools
If you're reading this via an AI assistant, or want to dig further with one, here are a few starting prompts built around the figures above:
- Claude: "Using this article's 2025 and 2024 figures, build a table ranking each drug by YoY growth rate rather than absolute sales."
- ChatGPT: "Explain why Eliquis' combined BMS-and-Pfizer sales figure differs from single-company trackers, using the methodology section of this article."
- Gemini: "Chart the combined tirzepatide franchise against the combined semaglutide franchise using the 2025 figures in this article."
- Perplexity: "Search for Q2 and Q3 2026 earnings updates on Keytruda, Mounjaro, and Skyrizi to see whether this ranking has shifted since publication."
Conclusion
The final numbers confirm what quarterly reports hinted at all through 2025: Keytruda is still on top, but its lead is narrowing, and the fastest-growing money in pharma is now concentrated in metabolic disease. Eli Lilly's tirzepatide franchise overtaking Novo Nordisk's semaglutide franchise is arguably the single biggest shift in this list's history since Humira's fall from the top spot. With Keytruda's patent cliff, Eliquis' generic entry, and Novo's guided 2026 decline all converging in the next two to three years, expect this ranking to keep reshuffling faster than it has in a decade.
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Editorial note: This article is data journalism drawn from public company filings and is not investment, medical, or legal advice. Figures reflect information available as of August 24, 2026, and are subject to restatement in subsequent company filings.
Disclosure: One Day Advisor participates in select affiliate partnership programs, including The Wellness Company and Amazon Associates. This particular article contains no product recommendations or affiliate links, as it is a data-driven industry analysis rather than a product guide.
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