Pharma's giants, new and old, tell more tales than their numbers show

From perennial giants Johnson & Johnson, Pfizer and Novartis to long-lost buyout targets Wyeth and Schering-Plough to the newest names at the top of revenue rankings, the numbers tell only a bit of the story.

It takes some mighty big forces to shift the enormous drugmakers that, like boulders in a stream, help define the course of the pharma industry. The last 10 years of upheaval have shifted them, all right—but some moved far more than others, and there's a story behind all of them.

The biggest Big Pharmas back in 2007 are still the biggest today. Johnson & Johnson has $72 billion in revenue now, $61 billion back then; Pfizer, $53 billion, up from $48 billion; Roche, $50 billion, up from $38 billion; Novartis, $49 billion, up from $38 billion.

But among the top 15 pharma companies ranked by 2016 revenue, several weren’t even close to that stature in 2007. Gilead Sciences, for one, took a flying leap into the top echelon thanks to its blockbuster hepatitis C drugs Sovaldi and Harvoni. Back in 2007, Gilead was largely an HIV drugmaker, and it posted a record year—$4.2 billion in revenue. Last year? Almost $31 billion, about seven times as much.

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After Gilead reported those results in early 2008, the Los Angeles Times declared that treating HIV was finally profitable, something Gilead had believed as some other drugmakers shied away. "A lot of companies were scared off because of all the political and assumed financial pressure" around HIV drugs, Gilead Chief Executive John Martin told the newspaper.

Since then, Gilead has caught plenty of fire for its HIV drug pricing—and hep C pricing, for that matter—but along the way its drugs have treated millions of patients, and its HIV revenue grown to almost $13 billion. And now, Gilead is, like its new peers on the revenue side, under pressure to make a deal to put its overall revenue back on a growth track.

Then there’s Bristol-Myers Squibb, whose revenue these days stands just about where it did in 2007. The company reported $19 billion in revenue that year and in 2016. Underneath those numbers, almost everything has changed.

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It started shrinking, deliberately; its 2009 split-off of the nutrition business Mead-Johnson—in a deal worth $7.3 billion—was one of the asset sales that fueled “string-of-pearls” deals far far smaller. Back then, Bristol-Myers had big ambitions in diabetes, with drugs like Onglyza and Farxiga in its pipeline. It teamed up with AstraZeneca in the field, jointly bought Amylin for $7 billion in 2012, and then, in 2014, decided to ditch the business completely. (Some thought the idea was nuts; “Most pharma businesses don’t get rid of pharma businesses,” then-CFO Charlie Bancroft told Fortune in 2014.)

Ten years ago, Bristol-Myers depended on blood thinner Plavix for the lion’s share of its revenue—$4.76 billion—along with antipsychotic drug Abilify ($1.66 billion) and blood pressure drugs Avapro and Avalide ($1.2 billion). All of those drugs have since dwindled in the face of generic competition.

Orencia, an immunology med, had just launched back then; now, it’s a $2.26 billion product. Sprycel, a leukemia drug, was brand-new then, too, and last year it brought in $1.82 billion.

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But arguably the biggest change for Bristol-Myers was its move into immuno-oncology with the 2009 buyout of Medarex. That deal yielded ipilimumab, aka melanoma med Yervoy, and nivolumab, now known as blockbuster PD-1 therapy Opdivo. In 2007, the two companies were partners, and, ironically enough, some trial data had analysts at Bear Stearns and BMO Capital Markets speculating that Yervoy wouldn’t win FDA approval.

Something that’s close to the same? Eliquis. That’s an anticoagulant, rather than a blood thinner like Plavix, and it’s shared with Pfizer, not Sanofi, but it’s almost as lucrative at $3.34 billion in 2016 sales.

A couple of glaringly obvious changes since we ranked drugmakers by 2007 revenue: One, Pfizer bought Wyeth in 2009, pulling its name off the rankings ever since. Wyeth brought in $22 billion that year to Pfizer’s $48 billion. Though the wisdom of that deal has been debated ever since—it’s a case study in some business schools—Pfizer has the Wyeth buy to thank for one very important product: Prevnar, its pneumococcal vaccine and current top seller with $5.72 billion in 2016 revenue. Not to mention the immunology med Enbrel and Effexor, the antidepressant that was a big earner for the company till it went off patent.

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Two, Merck merged with Schering-Plough, the maker of allergy giant Claritin and Merck’s partner in developing cholesterol meds Zetia and Vytorin, which only now are facing generic competition. Schering put up $13 billion in 2007, to Merck’s $24 billion. Merck has since offloaded some of Schering’s portfolio, including the Claritin, Coppertone and Dr. Scholl’s consumer brands it sold to Bayer HealthCare in 2014.

Of course, there’s a tale to tell with each revenue tally above. Novartis’ current numbers include Alcon, picked up in a now-oft-lamented 2010 deal, and GlaxoSmithKline’s oncology meds by virtue of their 2014 asset swap. Likewise, GSK now sells Novartis’ vaccines, runs a consumer joint venture with that company and, separately, ViiV Healthcare, an HIV-fighting venture with Shionogi. Abbott, one of the top companies on our 2007 list, spun off AbbVie, which is now among the top 15 by 2016 revenue. 

And those stories continue, with more deals, more patent losses, more new product launches, more trial data, all of them with the potential to add to or subtract from the numbers recorded for 2016. In 2027, will this lineup have changed much? Check back in 10 years to find out.