Recently, the "report cards" of multinational pharmaceutical companies in 2024 have been released one after another. Overall, the leading multinational pharmaceutical companies have shown major trends such as revenue growth, significant volume growth of innovative products, and accelerated development of precise mergers and acquisitions. As one of the important pharmaceutical markets in the world, the Chinese market remains the focus of competition among major pharmaceutical companies.

"Drug King" Competition

According to the performance announced by multinational pharmaceutical companies, Johnson & Johnson ranked first with a total revenue of US$88.821 billion, and Roche, Merck, and Pfizer ranked second, third, and fourth with revenues of more than US$60 billion, respectively. AbbVie, AstraZeneca, and Novartis followed closely behind, with revenues exceeding US$50 billion. Bristol-Myers Squibb (BMS), Eli Lilly, Sanofi, Novo Nordisk, and GlaxoSmithKline all had revenues of more than US$40 billion.

In the competition among multinational pharmaceutical companies, annual sales of tens of billions of dollars are usually the threshold for a single product to enter the global blockbuster drug list. This year's "king of medicine" competition is equally fierce.

The rapid growth of semaglutide gives the drug plenty of room for imagination. Novo Nordisk's semaglutide series of products (including Ozempic, Rybelsus and Wegovy) achieved remarkable results in 2024 and lived up to expectations. Novo Nordisk's 2024 performance report shows that the total sales of the drug reached US$29.296 billion, a year-on-year increase of 38.43%, accounting for 69.5% of Novo Nordisk's total revenue. Among them, the year-on-year increase of 86% for semaglutide injection for weight loss was even more impressive.

Despite this, the title of "king of medicine" was still "taken away" by K drug with a slight advantage.

Since its first appearance in 2014, Merck's K drug (Keytruda, pembrolizumab) has become a shining star in the global pharmaceutical market. After ten years of market baptism and scientific verification, K drug has repeatedly set new highs in sales performance.

According to Merck's 2024 performance report, the drug generated revenue of US$29.482 billion at a growth rate of 18%, accounting for about 46% of Merck's total annual revenue. The drug has been approved for about 40 indications worldwide, and its dominant position in the field of tumor treatment is solid. Data shows that the cumulative sales of the drug in the ten years since its launch have reached US$131 billion.

Sanofi's Dupixent's performance in 2024 is also worth paying attention to. The drug is the first biological targeted agent in the field of chronic obstructive pulmonary disease. In 2024, its annual sales reached a new high of 13.072 billion euros (about US$14.179 billion), a year-on-year increase of 23.1%, becoming the best-selling autoimmune product at present.

Although Pfizer achieved a total revenue of US$63.627 billion (a year-on-year increase of 7%) in 2024 and failed to make it into the top three in the world, the company's pharmaceutical business achieved a revenue of US$62.6 billion, becoming the "world's largest pharmaceutical revenue in 2024".

Pfizer digested the "new crown cliff" in one year and returned to the growth track. New crown prevention and treatment drugs still contributed more than US$11 billion in sales to Pfizer. In addition, the anticoagulant drugs jointly developed by Pfizer and BMS had sales of US$13.3 billion in 2024, and Pfizer received US$7.366 billion in revenue.

Despite maintaining its position as the world's largest pharmaceutical giant, Pfizer's lack of innovation has not changed. The company's multiple products are facing patent cliffs, which has also seriously affected the company's performance in the capital market. Its market value is far lower than that of other leading multinational pharmaceutical companies.

Among the TOP 10 multinational pharmaceutical companies, Eli Lilly has the fastest year-on-year revenue growth in 2024.

According to Eli Lilly's 2024 performance report, the company achieved revenue of US$45.043 billion, a year-on-year increase of 32%; and achieved net profit of US$10.59 billion, a year-on-year increase of 102%. The cardiovascular metabolism sector is Eli Lilly's core business. In 2024, the sector achieved revenue of US$29.521 billion, accounting for 66% of revenue, mainly due to the rapid increase in the volume of telportin.

China Opportunities

As the world's second largest pharmaceutical market, the impact of China's operating conditions on the performance of large multinational pharmaceutical companies is self-evident.

AstraZeneca achieved a double-digit growth of 11% in China in 2024, and ranked first in the performance competition of multinational pharmaceutical companies in China with revenue of US$6.413 billion (accounting for 12% of its global market share). AstraZeneca said that the growth momentum in China came from the PARP inhibitor Lynparza, which was included in the medical insurance in 2024 for ovarian cancer indications. The emerging markets corresponding to the drug achieved revenue of US$655 million, a year-on-year increase of 30%, and China should be the main driving force.

In 2024, AstraZeneca increased its investment in China and announced that it would build a new small molecule innovative drug factory in Wuxi. In addition, the project to build an inhalation aerosol production and supply base in Qingdao announced in 2023 is also progressing steadily.

As Novartis' second largest market in the world, China performed particularly well in 2024, with annual sales of US$3.9 billion, a year-on-year increase of 21%, far exceeding the global average growth rate. Novartis' highly anticipated nuclear medicine Pluvicto achieved revenue of US$1.392 billion in 2024, a 42% increase. In 2024, Novartis submitted an application for the listing of Pluvicto in China, and officially launched the construction of the first nuclear medicine production base in China in July of the same year, with an investment of approximately 600 million yuan, which is expected to be completed and put into production by the end of 2026.

Sanofi's revenue in the Chinese market in 2024 was 2.666 billion euros (approximately US$2.892 billion), with a slight decline in growth (-0.5%). In December 2024, the company spent 1 billion euros to establish a new manufacturing base in Beijing, which is Sanofi's largest single investment in China. The plant aims to enhance the end-to-end production and pharmaceutical capabilities of insulin in China, focusing on serving the insulin medication needs of local Chinese diabetic patients.

Merck's revenue in China in 2024 was US$5.394 billion (accounting for 9.4% of its global pharmaceutical business), a decrease of nearly 20%, making it the multinational pharmaceutical company with the largest decline in performance in China. The company's quadrivalent/nine-valent HPV vaccine Gardasil saw a significant decline in revenue in the Chinese market in the fourth quarter of 2024. In addition, due to generic competition, Merck's supply of gliptin and sitagliptin metformin in the Chinese market has also decreased.

Merck said that the Chinese market provides an important long-term opportunity for Gardasil, and the company will continue to be committed to and fully prepared to maximize this long-term potential.

According to industry reports, more than one-third of the candidate molecules introduced by large pharmaceutical companies from external authorization in 2024 came from China. Industry insiders believe that as the world's second largest pharmaceutical market, how multinational pharmaceutical companies "discover valuable pipelines in China and realize value outside of China" in the future will be an extreme test of their vision and courage. The Chinese market is also expected to become one of the decisive strongholds for each company.

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