11. AstraZeneca

Patent expiries continued to undermine AstraZeneca's efforts to get traction on its aggressive goal to build revenues.

11. AstraZeneca
Headquarters: London
2016 revenues: $23.00 billion
2015 revenues: $24.71 billion

AstraZeneca has been beaten up by patent expiries lately, and 2016 was no exception. After the company’s last-ditch attempt to block copies of cholesterol blockbuster Crestor—a move that failed thanks to a federal judge, who denied AZ’s bid for a restraining order—copycats hit the market, putting a dent in the British drugmaker’s top line.

All told, revenues sank by 7%, or 5% in constant exchange rates. And execs are predicting a low- to mid-single digit decline for 2017, too.

AZ’s respiratory meds headed south, too, with the unit slipping 3% to $4.75 billion. The company attributed the poor performance on U.S. pricing pressure to Symbicort, whose peers—including GlaxoSmithKline’s Advair—have been feeling similar effects. That may continue down the line, with GlaxoSmithKline offering up 20% discounts on Advair to payers to soften the blow it will take when generics of that behemoth med finally hit. Eventually, “respiratory market prices will sharply come down,” and “impact will extend to other major products,” Bernstein analyst Ronny Gal recently wrote to clients.

There were some 2016 highlights, though, the British drugmaker stressed. In emerging markets, it posted 6% growth for the year, taking its total haul there to $5.79 billion. Those figures got a big boost from sales in China, which swelled by 10% to hit $2.64 billion.

AZ’s diabetes business also grew by 11%, though SGLT2 med Farxiga did most of the work in that department; in Q4, DPP-4 Onglyza crashed by 22%, while GLP-1 Bydureon slid by 8%. It should be getting some help this year though with the recent FDA approval of Qtern, a marriage of Farxiga and Onglyza that'll get a chance to take a crack at competing Eli Lilly and Boehringer Ingelheim combo Glyxambi.

New oncology products provided another bright spot, though, with lung cancer-fighter Tagrisso netting $423 million in its first year on the market. When it comes to cancer, though, all eyes are on AZ’s immuno-oncology prospect durvalumab and whether the company’s PD-L1/CTLA4 combo approach can prevail over chemo combos in lung cancer.

If it can? AZ just might find itself snagging the No. 2 spot in the non-small cell lung cancer race behind Merck, whose powerhouse Keytruda has a solid lead. The British drugmaker has the chance to displace Bristol-Myers Squibb, whose well-documented recent struggles have the M&A rumor mill abuzz. 

11. AstraZeneca