15 Pharma Firms in 2026 Fortune 500; Eli Lilly Jumps to 224th as Tirzepatide Tops Global Drug Sales
The 2026 Fortune Global 500 lists 15 pharmaceutical companies, unchanged from 2025 but with reshuffled rankings. Eli Lilly posted the largest leap, rising 112 spots to 224th, with revenue surging 44.7% to $65.179 billion and profit soaring 94.9% to $20.64 billion. Its GLP-1 drug tirzepatide generated $36.507 billion in sales, surpassing Novo Nordisk's semaglutide ($36.1 billion) to become the world's best-selling medicine. Novo Nordisk also gained 35 places, and both companies led profit margins among pharma peers.
The 2026 Fortune Global 500 list has been released, with 15 pharmaceutical companies making the cut. The roster of companies is identical to the previous year, but rankings have shifted significantly. The listed pharma firms include Johnson & Johnson, Roche, Eli Lilly, Merck & Co. , Pfizer, AbbVie, AstraZeneca, Novartis, Sanofi, Bayer, Bristol-Myers Squibb, Novo Nordisk, GlaxoSmithKline, Amgen, and Guangzhou Pharmaceutical Group.
Among them, nine companies improved their rankings compared with 2025. Eli Lilly posted the biggest gain, jumping from 336th in 2025 to 224th in 2026, a rise of 112 places. Lilly returned to the Fortune Global 500 in 2024 and has continued to climb. In the 2025 list, Lilly ranked 11th among pharma companies; in 2026 it rose to third, behind only Johnson & Johnson and Roche.
Merck & Co. slipped from third place in 2025 to fourth in 2026. The company's 2025 revenue grew only 1.3% to $65.011 billion, pressured by slowing growth in its cancer drug Keytruda and falling sales of its HPV vaccine.
Eli Lilly reported 2025 revenue of $65.179 billion, up 44.7% year over year, and profit of $20.64 billion, up 94.9%. Its GLP-1 dual-target drug tirzepatide achieved full-year 2025 sales of $36.507 billion, surpassing Novo Nordisk's semaglutide, which posted $36.1 billion in the same period, making tirzepatide the world's top-selling drug by revenue. The diabetes indication, Mounjaro, generated $22.965 billion in sales, up 99% year over year, while the weight-loss indication, Zepbound, brought in $13.542 billion, up 175%.
Novo Nordisk rose 35 places in the 2026 Fortune Global 500 versus 2025, the second-largest ranking gain among pharma companies. By profit margin, Novo Nordisk led the sector at 33.1%, followed by Eli Lilly at 31.7%. The two companies are locked in fierce competition in the GLP-1 weight-loss drug market. Global GLP-1 research and development has entered the 'second half,' with pharmaceutical companies advancing next-generation innovative weight-loss therapies around oral small molecules, ultra-long-acting formulations, multi-target agonists, and fat reduction without muscle loss.
Why this event matters
The event has a measured impact on 2 industrys. The strongest current signal is mixed for Pharmaceuticals, with intensity 80/100 and 90% confidence over a medium term horizon.
Pharmaceuticals
- Direction
- mixed
- Intensity
- 80
- Confidence
- 90%
- Horizon
- Medium term
Biotechnology
- Direction
- positive
- Intensity
- 70
- Confidence
- 85%
- Horizon
- Medium term
Impact figures are analytical estimates that combine direction, intensity, confidence and event importance. They are not investment advice.