15. Bristol-Myers Squibb

When Bristol-Myers unveiled its 17% revenue growth for 2016 in January, its also cut its 2017 earnings guidance.

15. Bristol-Myers Squibb
Headquarters: New York City
2016 revenues: $19.427 billion
2015 revenues: $16.56 billion

By the numbers, Bristol-Myers Squibb had the kind of year that its Big Pharma rivals would have liked. Fueled by some recent launches—including the immuno-oncology blockbuster Opdivo—the company grew sales by a whopping 17%. That’s not easy to do when your baseline is more than $16 billion.

And the numbers don’t lie. Bristol-Myers managed to weather its first full year without U.S. revenue from Abilify and Erbitux, whose commercial rights went back to BMS partner Otsuka in mid-2015. Competition for antivirals Baraclude, Reyataz and Sustiva all took $100 million-plus bites out of those meds; BMS handled that, too.

 Why? A few meds chipped in low-end, double-digit growth: the anti-inflammatory Orencia, up 20% to $2.265 billion, and the leukemia treatment Sprycel, up 13% to  $1.824 billion. Empliciti, a brand-new multiple myeloma med, jumped from $3 million to $150 million.

But two other meds stole the show. Opdivo, the immuno-oncology therapy, zoomed to $3.774 billion after pulling in $942 million in 2015. And Eliquis, an anticoagulant partnered with Pfizer, took an 80% leap to $3.343 billion—results would have wowed a crowd if they weren’t outshone by Opdivo.

And therein lies the problem for Bristol-Myers. Opdivo isn’t expected to take such a big leap in 2017, partly because it fell short in an important lung cancer trial that could have opened up a big new market—previously untreated patients—and cement its position as leader in the I/O market. The news of Opdivo’s failure in that trial, known as Checkmate-026, sent Bristol-Myers’ shares reeling. The company lost more than $35 billion off its market cap.

With that new indication sidelined, Opdivo stands to lose share in second-line lung cancer, too, some analysts say, as Merck & Co.’s Keytruda becomes a more formidable competitor.

Opdivo also won’t zoom into early lung cancer with companion drug Yervoy by its side. After the Opdivo trial failure news hit in August, Bristol-Myers announced in early January 2017 that it wouldn’t try to win accelerated approval for that combo.

Bristol-Myers is still plugging away with Opdivo in indications beyond lung cancer. It won a head and neck cancer approval in late 2016, for instance, And BMS is confident that the drug can succeed in combination cancer trials; it has multiple development partnerships testing multiple cocktails in multiple cancers, including one struck in February with Exelexis for a test in first-line kidney cancer.

Still, for now, Opdivo’s fortunes aren’t as sure as they once were. When Bristol-Myers unveiled its 17% revenue growth for 2016 in January, its also cut its 2017 earnings guidance. It’s looking for sales growth in the low-single digits and earnings per share of $2.70 to $2.90, down from $2.85-$3.05. Its shares plummeted again, to $46.82, though they’ve since recovered to $57.26 as of press time.

Now, the company faces pressure from activist investors, one of which pushed BMS to add three directors to its board. The second is Carl Icahn, who has a history of pushing deals and concessions in the biopharma industry. That, in turn, has market-watchers gossiping about a potential megamerger pairing Bristol-Myers with a fellow Big Pharma or even, perhaps, a Big Biotech.

Clearly 2016 was a roller-coaster ride for Bristol-Myers, with a sickening drop in late summer. But at least it had a nice upward ride before the fall.

15. Bristol-Myers Squibb