Merck CEO Kenneth Frazier

6. Merck & Co. ($MRK)
2014 revenue: $42.237 billion
2013 revenue: $44.033 billion

For a couple of years after Merck & Co. merged with partner Schering-Plough in 2009 in a $41.1 billion deal, the muscled-up company saw strong revenue growth. Sales jumped to $48 billion in 2011 compared to its own revenues of only $27.4 billion in 2009. But Merck has watched sales melt away every year since, hitting $42.2 billion last year, down 12% from that peak. Pharma sales were off 4% to $36.042 billion, and next year's revenues are forecast to be down yet again.

The slide started when the New Jersey-based company lost patent protection for asthma drug Singulair in 2012. The $3 billion-plus a year blockbuster saw its sales free fall a breathtaking 90% in four weeks. Merck's troubles were exacerbated by R&D failures of some of the drugs that were supposed to come to the rescue. That all led to the massive cost and job cutting it has been doing, a restructuring that has targeted 8,500 positions--and $2.5 billion in savings--by the end of this year.

Merck CEO Kenneth Frazier has been executing on a plan to reverse the revenue slide by slimming the company down and narrowing its focus to vaccines, immunology, emerging markets, diabetes drugs and hospital acute care. Toward that end, he sold off Merck's consumer health unit last year to Bayer for $14.2 billion, then made a couple of M&A moves he thinks he can build on.

The drugmaker agreed last year to shell out $9.5 billion for Cubist, a specialist in hospital acute care. The company also added to its hep C program with a $3.8 billion deal to buy Idenix Pharmaceuticals and then accelerated that program. Idenix has three hep C drugs in development that analysts said should help Merck's treatment better compete against Gilead Sciences' ($GILD) Sovaldi and Harvoni, which have been tearing up the market. But with Gilead's treatments and Viekira Pak, a hep C cocktail from AbbVie ($ABBV) now on the market, Merck's treatment is starting to look like an also-ran. In fact, the FDA recently canceled the "breakthrough" designation for Merck's hep C treatment, as well as one from Bristol-Myers Squibb ($BMY), because there are now treatments available.

On the oncology side, Merck's sales have been helped by its first-in-class, highly promising cancer treatment Keytruda, which turned in $50 million in sales in the fourth quarter after being approved in September. Keytruda is one of 6 drugs Merck got approvals for last year, including approvals in December for insomnia treatment Belsomra and Zerbaxa, a Cubist product approved to treat hospital-acquired infections. With some of the 6 launching this year, Merck may be getting to the point where the tide will turn on its ebbing revenue picture.

-- Eric Palmer (email | Twitter

For more:
Special Reports: Pharma's top 10 M&A deals of 2014 - Bayer/Merck | Top 10 pharma companies by employees - Merck | Top 10 best-selling cancer drugs of 2013 | Merck - The top 10 largest pharma layoffs in 2013
Merck losing 'breakthrough' tag for hep C treatment but earnings hit the mark
Merck CEO Frazier credits Keytruda success to slim-down strategy
Merck poised for early Keytruda launch in lung cancer
Merck adds heft to hospital biz with $9.5B Cubist buyout
Merck's Singulair sales free-fall 90% in 4 weeks