5. Sanofi

Sanofi Pasteur HQ
Sanofi pledges a return to growth in 2018. (Sanofi/Vincent Moncorgé)

2017 revenue: $40.91 billion (€36.20 billion)
2016 revenue: $38.52 billion (€34.71 billion)
Headquarters: Paris, France

Sanofi’s 2017 top line was flat. Its dealmaking news, practically nil. But truth is, a lot happened at Sanofi last year—some good, some not so good and some we can’t yet judge.

The French drugmaker rolled out two brand-new drugs last year, Dupixent and Kevzara, both of them in partnership with Regeneron. Dupixent, a first-in-class eczema drug, was pegged as one of the most anticipated launches of the year, with peak sales estimates of $4 billion or more.

It launched a new fast-acting insulin, Admelog, to complement its newest basal insulin, Toujeo. Its relatively new multiple sclerosis drug, Aubagio, continued to grab market share from its fellow oral meds, and it now has a clear runway for sales till March 2023 under a newly crafted settlement with all 20 generics makers looking to copy the med.

And it started reaping sales with a flu shot it acquired along with Protein Science, Flublok, that’s not produced using eggs. That’s a feature increasingly seen as an advantage, given questions about the efficacy of shots produced the old-fashioned way.

RELATED: Sanofi and Regeneron's Dupixent scores a potential sales boost as AbbVie candidate threatens

Genzyme, the company’s specialty drugs business—including its rare disease therapies—burgeoned by more than 14%, and its MS franchise provided most of the fuel at almost 21% growth to €1.98 billion. Meanwhile, longtime Genzyme chief David Meeker left in June, passing the baton to Bill Sibold. And the whole portfolio in China together delivered double-digit growth.

Those are some of the highlights. One of the lowlights: Its diabetes franchise, expected to take a dive, did just that with an 11% sales decline overall, excluding foreign exchange. In the U.S., that decline was precipitous—22.8% to €3.13 billion.

Outside of the numbers, controversy hit Sanofi’s vaccines business, which happened to be its fastest-growing of the year. First, critics took aim at Sanofi’s collaboration with the U.S. Army on a Zika vaccine, and some lawmakers demanded guarantees that any eventual shot—years away, and far from a sure thing, of course—would be reasonably priced. Unwilling to talk price on a vaccine long before it entered large-scale testing, the company drew more fire and then dropped the deal completely.

Then, late in the year, Sanofi rolled out long-term data from its dengue vaccine testing, showing that it could trigger more serious dengue infections if administered to people who’d never before been exposed to the virus. The company said it would change the labeling on the vaccine to advise against using the shot in people unlikely to have been exposed.

The disclosure sparked a firestorm in the Philippines, still ongoing, and the WHO recently said the vaccine shouldn’t be given without testing for prior infection—but such a test doesn’t yet exist.

RELATED: Sanofi's Dengvaxia needs a dengue diagnostic, stat, thanks to WHO

While all that was brewing, investors were pressuring Sanofi for M&A; coming off of two failures to make deals in 2016 and early 2017, market watchers were ready for a buyout signed, sealed and delivered. No such luck—they had to wait till early 2018 for that, when Sanofi snapped up Biogen’s newbie spinoff Bioverativ and the nanobody-focused biotech Ablynx within days of each other.

What Sanofi did do in 2017, deal-wise, was put its European generics business on the block; it’s now in exclusive talks with Advent International for a proposed €1.9 billion ($2.35 billion) deal.

Those two rapid-fire deals in 2018 came along with CEO Olivier Brandicourt’s pledge that 2018 will mark a return to growth for the drugmaker. He sees Bioverativ—which will add to sales this year—adding a blood disorders franchise to its Genzyme business. Ablynx, of course, is a longer-term proposition. The new launches are expected to gain more traction, particularly Dupixent. And earnings per share are expected to grow by 2% to 5%.

5. Sanofi