Top 10 Pharmaceutical Companies in USA 2026

Five years ago, it was all about COVID vaccines. In 2026, the story is GLP-1 weight-loss drugs, cancer immunotherapy and a wave of patent expiries.

Look at the numbers. Eli Lilly’s sales jumped 45% to $65.2 billion in 2025, and its two obesity and diabetes brands, Mounjaro and Zepbound, brought in about $36.5 billion between them. Johnson & Johnson still takes the crown, with $94.2 billion in 2025 sales and a 2026 outlook of about $101.2 billion. Others went the other way. Pfizer’s revenue slipped 2% as COVID sales faded, and AbbVie’s Humira sales roughly halved once biosimilars hit the market.

So which pharmaceutical companies in USA are the biggest right now? We ranked US-headquartered drugmakers by total revenue for fiscal 2025, taken from each company’s full-year results and annual 10-K filing. All figures are in US dollars. We then added each company’s latest reported quarter: the second quarter of 2026 for most, and the third quarter for J&J, which reported on October 13, 2026. Plenty of foreign drugmakers have big US businesses, such as Novartis, Roche, AstraZeneca and Novo Nordisk, but they aren’t ranked here. This guide looks at the top 10 pharmaceutical companies in USA for 2026.

Also Read: Top 10 Pharmaceutical Companies in UAE 2026

Why the US Pharmaceutical Industry Matters in 2026

The largest pharmaceutical companies in the US make many of the medicines used around the world. Four trends shaped this year’s ranking.

Obesity Drugs Have Rewritten the Leaderboard

Lilly took off on the back of GLP-1 drugs. Tirzepatide, sold as Mounjaro and Zepbound, made up 56% of Lilly’s 2025 revenue. Pfizer and Amgen now have obesity drugs of their own in late-stage trials.

Patent Cliffs Are Forcing Change

As older drugs lose patent protection, sales drop. Bristol Myers Squibb’s legacy portfolio fell 15% in 2025, and Humira declined 49.5% at AbbVie. The companies that rank well are the ones that built replacement products early.

Dealmaking Fills the Pipeline

Big US drugmakers keep buying growth. J&J acquired Intra-Cellular Therapies for $14.6 billion in 2025, Pfizer finished its acquisition of Metsera in November 2025, and Merck completed the roughly $9.2 billion Cidara acquisition in 2026.

New Formats Make Treatment Easier

How drugs are given is changing too. Merck now offers Keytruda as an under-the-skin injection, Gilead’s HIV prevention drug Yeztugo needs only two doses a year, and Lilly’s Foundayo is a once-daily weight-loss pill.

Top 10 Pharmaceutical Companies in USA at a Glance

Top 10 Pharmaceutical Companies in USA (2026)

Below you’ll find each company, ranked by fiscal 2025 total revenue, with its latest reported numbers.

1. Johnson & Johnson

Founded in 1886, Johnson & Johnson is still headquartered in New Brunswick, New Jersey, and is the largest US-based drugmaker on this list by revenue. It had about 138,200 employees in 2025. Sales came in at $94.2 billion in 2025, with Innovative Medicine contributing $60.4 billion and MedTech $33.8 billion. Since separating its consumer products business, Kenvue, in 2023, J&J has been a pharmaceutical and medtech company.

The cancer drug Darzalex made $14.4 billion in 2025, and Tremfya made $5.2 billion. In April 2025, J&J bought Intra-Cellular Therapies for $14.6 billion to expand in neuroscience. In the third quarter of 2026, sales rose 5.9% to $25.4 billion and Innovative Medicine grew 7.7%. J&J raised its 2026 sales outlook to about $101.2 billion at the midpoint. It also recently won FDA approval for IMAAVY, and the FDA authorized its OTTAVA robotic surgical system.

Key Pharmaceutical Strengths
✔ Oncology leader with Darzalex
✔ Immunology brands including Tremfya
✔ Neuroscience medicines from Intra-Cellular
✔ MedTech, including surgical robotics

Best for: Scale and breadth across medicines and medical devices.

2. Eli Lilly

Eli Lilly and Company was started in 1876 by Eli Lilly, a pharmaceutical chemist and Union Army veteran. It’s based in Indianapolis, Indiana, and had about 50,000 employees in 2025. Revenue grew 45% to $65.2 billion in 2025, up from $45.0 billion in 2024. Mounjaro brought in $23.0 billion and Zepbound $13.5 billion.

In November 2025, Lilly became the first healthcare company to reach a $1 trillion market value. In April 2026, the FDA approved Foundayo (orforglipron), its once-daily oral obesity pill. Second-quarter 2026 revenue grew 48% to $23.0 billion, and Lilly raised its 2026 revenue guidance to $85-$87 billion. It reports third-quarter results on October 29, 2026.

Key Pharmaceutical Strengths
✔ Tirzepatide franchise (Mounjaro, Zepbound)
✔ Oral obesity treatment with Foundayo
✔ Diabetes care heritage going back to insulin
✔ Oncology, including Jaypirca

Best for: Leadership in diabetes and obesity medicine.

3. Merck

Merck & Co. was set up in 1891 as the American arm of Germany’s Merck and became independent in 1917. It’s headquartered in Rahway, New Jersey, has about 75,000 employees and is known as MSD outside the United States and Canada. Worldwide sales were $65.0 billion in 2025, up 1%. Keytruda alone accounted for $31.7 billion.

Merck is working to depend less on Keytruda. It closed its Verona Pharma deal in October 2025 and completed the roughly $9.2 billion Cidara acquisition in 2026. Winrevair, for pulmonary arterial hypertension, grew 75% to $588 million in Q2 2026, a quarter in which total sales rose 5% to $16.6 billion. Gardasil sales fell 39% in 2025, which is worth watching. Merck reports Q3 results on October 29, 2026.

Key Pharmaceutical Strengths
✔ Keytruda and subcutaneous Keytruda Qlex
✔ Vaccines, including Gardasil
✔ Winrevair for pulmonary arterial hypertension
✔ New pipeline assets from the Verona and Cidara deals

Best for: Cancer immunotherapy and vaccines.

4. Pfizer

Pfizer was founded in 1849 in New York by Charles Pfizer and Charles F. Erhart. Its headquarters is The Spiral at Hudson Yards in Manhattan, and it had about 75,000 employees in 2025. Revenue fell 2% to $62.6 billion in 2025, but excluding Paxlovid and Comirnaty, it grew 6% operationally.

Pfizer bought Seagen for $43 billion in December 2023 to strengthen its cancer business and completed its Metsera acquisition in November 2025 to move into obesity. It plans 10 Phase 3 trials in 2026 for berobenatide, a once-a-month GLP-1 treatment. Q2 2026 revenue rose 3% to $15.0 billion, with Eliquis bringing in $2.4 billion and Padcev up 23%. Pfizer raised its 2026 revenue range to $60.5-$62.5 billion and reports Q3 results on November 3, 2026.

Key Pharmaceutical Strengths
✔ Cardiovascular drugs Eliquis and Vyndaqel
✔ Vaccines, including Prevnar
✔ Oncology from the Seagen acquisition
✔ Obesity pipeline led by berobenatide

Best for: Broad portfolio across medicines and vaccines.

5. AbbVie

AbbVie was spun off from Abbott Laboratories and became a public company in January 2013. It’s based in North Chicago, Illinois, and had 57,000 employees in 2025. Net revenues rose 8.6% to $61.2 billion in 2025, even though Humira dropped to $4.5 billion.

AbbVie’s Humira replacements are doing their job. In 2025, Skyrizi made $17.6 billion and Rinvoq $8.3 billion. The roughly $63 billion Allergan deal, announced in 2019, brought in Botox. In 2024, AbbVie bought ImmunoGen for $10.1 billion and Cerevel for $8.7 billion, and it has proposed acquiring Apogee Therapeutics. Q2 2026 net revenues grew 10.2% to $17.0 billion, with Skyrizi and Rinvoq each up more than 24%.

Key Pharmaceutical Strengths
✔ Immunology leader with Skyrizi and Rinvoq
✔ Aesthetics, including Botox
✔ Neuroscience pipeline from Cerevel
✔ Oncology, including Elahere from ImmunoGen

Best for: Immunology and chronic inflammatory disease.

6. Bristol Myers Squibb

Bristol Myers Squibb was founded in 1887, is headquartered in Princeton, New Jersey, and employed 32,500 people in 2025. Revenue stayed flat at $48.2 billion in 2025. Its growth portfolio rose 17% to $26.4 billion, while the legacy portfolio fell 15% to $21.8 billion as Revlimid and Pomalyst faced generic competition.

BMS bought Celgene for $74 billion in 2019 and Karuna Therapeutics for $14 billion in 2024. The Karuna deal brought Cobenfy, approved in September 2024 as a new type of schizophrenia treatment. Q2 2026 revenue rose 6% to $13.0 billion. Eliquis was up 22% at $4.5 billion, and Camzyos rose 60%. BMS raised its 2026 revenue guidance to about $49-$50 billion and reports Q3 results on October 29, 2026.

Key Pharmaceutical Strengths
✔ Eliquis in cardiovascular care
✔ Opdivo in cancer immunotherapy
✔ Camzyos in cardiology
✔ Cobenfy in neuroscience

Best for: Oncology, cardiovascular and neuroscience medicines.

7. Amgen

Amgen started on April 8, 1980, as Applied Molecular Genetics. It’s headquartered in Thousand Oaks, California, and operates in about 100 countries. Total revenues rose 10% to $36.8 billion in 2025.

Its $27.8 billion Horizon Therapeutics deal in October 2023 added rare disease drugs. In 2025, Repatha grew 36% to $3.0 billion, Evenity rose 34% to $2.1 billion and Tezspire climbed 52% to $1.5 billion. Q2 2026 revenues were up 10% at $10.1 billion, and Amgen raised its 2026 revenue guidance to $38.2-$39.4 billion. Its weight-loss candidate, MariTide, is in Phase 3 trials known as MARITIME.

Key Pharmaceutical Strengths
✔ Cardiovascular drug Repatha
✔ Bone health with Prolia and Evenity
✔ Tezspire and rare disease medicines from Horizon
✔ Obesity pipeline led by MariTide

Best for: Biotech-driven medicines for chronic disease.

8. Gilead Sciences

Gilead Sciences was founded in 1987 by Michael L. Riordan. It’s headquartered in Foster City, California, and had 17,000 employees in 2025. Total revenues rose 2% to $29.4 billion in 2025. HIV drugs made up $20.8 billion of that, and Biktarvy alone brought in $14.3 billion.

In June 2025, the FDA approved Yeztugo (lenacapavir), the first twice-yearly injection for HIV pre-exposure prophylaxis (PrEP) in the US. In Q2 2026, Gilead’s PrEP sales topped $1 billion in a quarter for the first time. Total revenue that quarter was $7.6 billion, and Yeztugo made $232 million. Gilead expects about $1 billion in Yeztugo sales in 2026. Its 2017 purchase of Kite Pharma also gave it a cell therapy business.

Key Pharmaceutical Strengths
✔ HIV treatment with Biktarvy
✔ HIV prevention with Descovy and Yeztugo
✔ Cell therapy through Kite
✔ COVID-19 antiviral Veklury

Best for: HIV treatment and prevention.

9. Regeneron

Regeneron Pharmaceuticals was founded in 1988 by Leonard Schleifer and George Yancopoulos and is based in Tarrytown, New York. It had 15,410 employees in 2025. Total revenues were $14.34 billion in 2025, just ahead of Viatris.

Its biggest drug is Dupixent, developed with Sanofi, which records the drug’s sales. Dupixent made $17.8 billion globally in 2025. In Q2 2026, Regeneron’s revenues rose 17% to $4.3 billion. Dupixent hit a record $6.0 billion, EYLEA HD rose 52% to $596 million and Libtayo grew 30% to $489 million. In April 2026, Dupixent was approved by the FDA for chronic spontaneous urticaria in children aged 2 to 11.

Key Pharmaceutical Strengths
✔ Dupixent for allergic and inflammatory disease
✔ EYLEA HD for retinal disease
✔ Libtayo in oncology
✔ Praluent and Kevzara

Best for: Science-led antibody medicines.

10. Viatris

Viatris was formed on November 16, 2020, when Mylan merged with Upjohn, a legacy division of Pfizer. It’s based in Canonsburg, Pennsylvania, near Pittsburgh, and had about 32,000 employees in 2024. Revenues fell 3% to $14.30 billion in 2025.

Viatris sells generic drugs and well-known brands such as Lipitor, Viagra and Xanax. Q2 2026 revenues rose 5% to $3.76 billion, and it raised its 2026 revenue guidance to $14.55-$14.95 billion. In July 2026, the FDA approved its once-weekly birth control patch, Gwyn Lo, and a fast-acting form of meloxicam for acute pain has an FDA decision date of December 27, 2026.

Key Pharmaceutical Strengths
✔ Generic medicines at global scale
✔ Established brands such as Lipitor and Viagra
✔ Women’s health products
✔ Complex generics and injectables

Best for: Affordable generics and established brands.

How to Choose the Right Pharmaceutical Partner in the USA

Whether you’re selling to these companies, investing in them, looking for a job or buying from them, here’s what to weigh.

Check the FDA Track Record

Look at recent FDA approvals and new indications. A steady flow of them, like Lilly’s Foundayo or Regeneron’s new Dupixent uses, shows a pipeline that turns research into products.

Look at Revenue Concentration

Many of these companies lean on one or two blockbuster drugs. Keytruda was nearly half of Merck’s 2025 sales, and tirzepatide was 56% of Lilly’s revenue. Concentration isn’t bad in itself, but it matters when patents run out.

Read the Latest Guidance

Companies update their full-year guidance when they report quarterly results, and that tells you where management thinks the business is heading. J&J, Lilly, Merck, Pfizer, BMS, Amgen and Viatris all raised their 2026 revenue outlooks this year.

Match the Therapeutic Focus

Know what each company does best. AbbVie leads in immunology, Gilead in HIV, Amgen in bone and heart health, and Viatris in generics.

Review Dealmaking and Pipeline Depth

Acquisitions show where a company expects future growth. Merck’s Cidara deal, Pfizer’s Metsera deal and J&J’s Intra-Cellular purchase show where each one is placing its bets.

Frequently Asked Questions About Pharmaceutical Companies in USA

Which is the largest pharmaceutical company in the USA?

By 2025 revenue, Johnson & Johnson is the largest, with $94.2 billion, though that includes its MedTech business. By market value, Eli Lilly stands out: in November 2025, it became the first healthcare company to reach $1 trillion.

Which US pharma company is growing the fastest?

Among the companies in this ranking, Eli Lilly grew fastest in 2025, with revenue up 45%. Its Q2 2026 revenue rose another 48%.

Why aren’t Novartis, Roche or Novo Nordisk on this list?

This ranking covers only companies headquartered in the United States. Those firms are based in Switzerland and Denmark, even though they sell heavily in the US.

Which is the best pharmaceutical company to work for or partner with?

There’s no single best choice for everyone. It depends on what you’re looking for, so compare the disease areas each company focuses on, its recent results and its pipeline before deciding.

Conclusion

The top pharmaceutical companies in USA for 2026 are being reshaped by obesity drugs, patent expiries and big acquisitions. J&J is still the biggest, Lilly is growing fastest, and Merck, Pfizer and AbbVie are all working to replace aging blockbusters.

Third-quarter earnings season is under way. Lilly, Merck and BMS report on October 29, and Pfizer follows on November 3, so some of these numbers will move soon. For now, these 10 companies remain the backbone of American medicine.

Related Reading:

• Top 10 Healthcare Companies in USA 2026
• Top 10 Biotech Companies in USA 2026
• Top 10 Healthcare Companies in the UK 2026