Risankizumab-RZAA

Seven of the biopharma industry's top 25 companies saw their revenue decrease in the first quarter of 2025, all from the U.S. The declines came after revenues boomed in the fourth quarter of 2024. After a fourth quarter in which revenue boomed throughout the biopharma industry, there were reversals for several drugmakers in the first three months of 2025. The companies that took the biggest hits were in the U.S., where there is already considerable angst in the industry over the tariff threats and drug price-slashing aspirations of President Donald Trump, along with the unsettling prospects of having a pharma adversary, Robert F. Kennedy Jr., heading up the Department of Health and Human Services.Among the top 25 revenue companies in the industry in the first quarter, there were seven that saw year-over-year sales declines, all from the U.S. Viatris took the biggest hit at 11%, followed by Pfizer (-8%), Organon (-7%), Bristol Myers Squibb (-6%), Regeneron (-4%), Merck (-2%) and Gilead (-0.3%).Additionally, only two of the top 25 companies in the industry—Daiichi Sankyo (6%) and Novartis (0.6%)—had sequential revenue increases in the first quarter, though analysts warn that fourth quarter sales can skew positively, with drugmakers often expecting a sequential slide.While many factors are at play with the political landscape that could have depressed sales in the first quarter, most companies that saw first-quarter declines cited non-macroeconomic reasons for their results.The decline for Viatris, for example, was not a surprise. Its annual revenue has decreased each year since 2021 as the Pittsburgh-based company has executed a series of selloffs. But it still was Viatris’ largest quarterly sales decrease—on a percentage basis—since the company was formed in 2020 with the merger of generics specialists Mylan and Upjohn.The drop-off for Pfizer can be chalked up (PDF) to a decline in sales for COVID-19 antiviral Paxlovid, which plummeted from $2 billion in the first quarter of 2024 to $491 million in the first quarter of 2025. In recent years, revenue for the company has varied dramatically based on the demand for its COVID products. For example, last year in the first quarter, Pfizer delivered a 19% year-over-year decrease. Two quarters later, sales were up 32%.Another factor in the sales slide for Pfizer—as well as that for BMS—was a premature decline in the sales for Eliquis. The megablockbuster blood thinner, which is shared by the New York City drugmakers, is set for a Medicare price reduction next year under the Inflation Reduction Act (IRA). But it is already facing market headwinds, as its sales fell by 4% in the first quarter.In its earnings release, Pfizer explained that the decline was driven primarily by a “lower net price in the U.S., including the impact of higher manufacturer discounts resulting from the IRA Medicare Part D Redesign.”The 6% decrease in the first quarter for BMS came after the company reported increases of between 5% and 9% in each of the four quarters in 2024. Also tied to the decline for BMS were plummeting sales of aging blood cancer drugs Revlimid, Pomalyst and Imnovid.The sales shortfall for Regeneron, which came after the company posted double-digit increases in each of the previous three quarters, highlighted the continuing struggles of eye disease treatment Eylea and Eylea HD, which saw a combined 16% year-over-year sales free fall from $2.25 billion to $1.90 billion.Regeneron cited a host of issues, including “competitive pressures,” which is a reference to Roche’ surging Vabysmo. Launched in 2022, the drug has robbed Eylea of its dominance of the market—especially in the U.S.Regeneron also said sales were affected in the period by an 11% sequential decrease in “physician unit demand,” in addition to lower net selling prices and lower wholesaler inventory levels. Additionally, the company warned of continuing headwinds affecting Eylea sales this year.The sales drop for Merck came after increases in the previous seven quarters, thanks largely to juggernaut cancer treatment Keytruda. But in Q1, a YOY increase in Keytruda sales from $6.9 billion to $7.2 billion could not compensate for a free fall in Gardasil sales, from $2.2 billion to $1.3 billion, as the company continues to navigate demand declines in China.“We see significant risk to the Gardasil franchise, as China woes continue,” Leerink Partners analyst Daina Graybosch, Ph.D., said in a note to investors.There are even signs of a slowdown for Keytruda, which had its first sequential sales decline since the first quarter of 2020—and the drop was significant, from $7.8 billion in the fourth quarter of 2024 to $7.2 billion in the most recent earnings period.No shortfall for surging Lilly While many other American companies navigated various hurdles in the first quarter, there was nothing to slow the roll of Eli Lilly. Fueled by still-growing demand for its diabetes and obesity drugs, Lilly saw sales increase by 45%, which was more than twice that of any other company among the 25 that generated the most revenue in the industry in the period.It was the second straight quarter in which Lilly achieved a 45% YOY increase in sales and the eighth quarter in a row that Lilly pulled off a quarterly increase of at least 20%. Much of the run can be attributed to booming sales of diabetes drug Mounjaro and its obesity follow-on Zepbound. In the first quarter, the duo rolled up combined sales of $6.1 billion.Lilly has seized the momentum in the market from Novo Nordisk, which recently decided to start a CEO search and move on from its longtime leader Lars Fruergaard Jørgensen. In contrast, in the first quarter, Novo had a 19% sales increase. It was the first time since the fourth quarter of 2021 that Novo’s quarterly sales boost came up short of 20%. Combined sales of Novo’s diabetes drug Ozempic and obesity follow-on Wegovy still exceeded those of Lilly’s corresponding drugs, coming in at $7.5 billion in the quarter. But the gap is quickly shrinking. Expect Novo’s headwinds to continue throughout this year. In its first quarter report, the Danish company slashed its annual revenue projection from a window of 16% to 24% to one of 13% to 21%. At the midpoint of its 2025 revenue projection, Lilly expects a sales increase of 41%.Other gainers in Q1 In addition to Lilly and Novo, there were four other companies that accomplished double-digit revenue gains in the first quarter, including Japanese companies Daiichi Sankyo (+21%) and Astellas (11%). Both drugmakers are enjoying sales growth as a result of successful Big Pharma-partnered cancer medicines.The other two double-digit gainers—Novartis (+12%) and Sanofi (+11%)—are growing after executing sell-offs to become pure-play innovators. Among its divestments, Novartis spun off its generics and biosimilars unit Sandoz, while Sanofi recently sold a controlling stake in the consumer health business Opella. Also of note among the other companies that saw revenue increases in the period was Amgen’s 9% figure, which was its first true quarterly growth measure since completing the $27.8 billion acquisition of Horizon Therapeutics in October 2023.  AbbVie’s 8% boost was its largest quarterly increase since the third quarter of 2021, indicating that the company has compensated for the loss of patent protection for powerhouse Humira with its pair of next-gen immunology treatments Skyrizi and Rinvoq. The quarterly increases for AstraZeneca (+7%) and Vertex (+3%) came after both companies had double-digit annual growth in 2024. On the flip side, the gains for Biogen (+6%) and Bayer (+4%) come after both companies saw saw their revenues slide in 2024.