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Mounjaro ($22.96B), Ozempic ($20.01B), and Eliquis ($14.44B) led the cardiometabolic market in FY2025. Demand for incretin-based therapies, expansion across approved indications, broader access, and continued adoption of cardiorenal therapies shaped the year, while generic competition and pricing pressure weighed on several established brands.
Together, the 20 products generated approximately $141.0B in FY2025. The six incretin-based products (Mounjaro, Ozempic, Zepbound, Wegovy, Trulicity, and Rybelsus) accounted for approximately $76.7B, or about 54% of the total. The list also spans anticoagulant, SGLT2, lipid-management, heart-failure, renal, insulin-combination, and pulmonary arterial hypertension therapies. Products are ranked in descending order of FY2025 product revenue, with FY2024 revenue and reported year-over-year growth shown for comparison. Financial values are in USD and rounded for readability.
The fastest risers were Winrevair (+251%), Zepbound (+174.9%), Kerendia (+102%), and Mounjaro (+99%). The steepest declines hit Xarelto (-24.03%) and Trulicity (-19%), while Entresto slipped 1% after US generic entry.
20. Xultophy
Non-Proprietary Name: Insulin degludec/liraglutide
Company: Novo Nordisk
First Approved: EU (2014), US (2016)
FY2025 Revenue: $0.72B
FY2024 Revenue: $0.62B
YoY Growth: +15.7%
Xultophy (insulin degludec/liraglutide) is a once-daily fixed-ratio combination of a long-acting basal insulin and a GLP-1 receptor agonist, indicated to improve glycemic control in adults with type 2 diabetes inadequately controlled on basal insulin or liraglutide.
Xultophy generated $0.72B in FY2025, compared with $0.62B in FY2024; reported YoY growth was 15.7%. The fixed-ratio combination brings basal insulin and GLP-1 receptor agonism together in a single daily injection for adults who require treatment intensification.
In November 2026, the FDA required class-wide safety labeling updates for GLP-1 receptor agonists, including Xultophy, over the potential risk of non-arteritic anterior ischemic optic neuropathy (NAION), a rare serious eye condition.
19. Kerendia
Non-Proprietary Name: Finerenone
Company: Bayer
First Approved: US (2021), EU (2022)
FY2025 Revenue: $0.97B
FY2024 Revenue: $0.48B
YoY Growth: +102%
Kerendia (finerenone) is a nonsteroidal, selective mineralocorticoid receptor antagonist indicated to reduce the risk of sustained eGFR decline, end-stage kidney disease, cardiovascular death, non-fatal myocardial infarction, and hospitalization for heart failure in adults with chronic kidney disease associated with type 2 diabetes.
Kerendia generated $0.97B in FY2025, compared with $0.48B in FY2024; reported YoY growth was 102%. Growth reflects increasing adoption in patients with chronic kidney disease associated with type 2 diabetes and its role in cardiorenal risk management.
Bayer reported that the US FDA accepted its supplemental new drug application (sNDA) for Kerendia in chronic kidney disease without diabetes.
18. Leqvio
Non-Proprietary Name: Inclisiran
Company: Novartis
First Approved: US (2021), EU (2020)
FY2025 Revenue: $1.19B
FY2024 Revenue: $0.75B
YoY Growth: +58.9%
Leqvio (inclisiran) is a small interfering RNA (siRNA) therapy that lowers LDL cholesterol by targeting hepatic PCSK9 production. It is used as an adjunct to diet and exercise, including alongside maximally tolerated statin therapy, in adults with primary hypercholesterolemia or mixed dyslipidemia.
Leqvio generated $1.19B in FY2025, compared with $0.75B in FY2024; reported YoY growth was 58.9%. Growth reflects increasing adoption of twice-yearly maintenance dosing and broader use in patients requiring additional LDL-C reduction.
Novartis reported Phase IV V-DIFFERENCE trial findings on Leqvio (inclisiran) for hypercholesterolemia.
17. Winrevair
Non-Proprietary Name: Sotatercept-csrk
Company: Merck & Co.
First Approved: US (2024), EU (2024)
FY2025 Revenue: $1.44B
FY2024 Revenue: $0.41B
YoY Growth: +251%
Winrevair (sotatercept-csrk) is an activin signaling inhibitor approved for adults with pulmonary arterial hypertension (PAH, WHO Group 1) to improve exercise capacity and WHO functional class and to reduce the risk of clinical worsening events, including hospitalization, lung transplantation, and death.
Winrevair generated $1.44B in FY2025, compared with $0.41B in FY2024; YoY growth was 251%. Growth reflected continued launch uptake in PAH following its March 2024 approval, alongside an October 2025 US label update that added data from the Phase III ZENITH trial in advanced PAH.
In September 2026, the US FDA approved a label update for Winrevair to include data from the Phase III HYPERION trial, in which adding Winrevair to background therapy reduced the risk of clinical worsening events by 76% versus placebo in adults diagnosed with PAH within the prior 12 months.
16. Tresiba
Non-Proprietary Name: Insulin degludec
Company: Novo Nordisk
First Approved: EU (2013), US (2015)
FY2025 Revenue: $1.89B
FY2024 Revenue: $1.38B
YoY Growth: +37.2%
Tresiba (insulin degludec) is an ultra-long-acting basal insulin approved to improve glycemic control in patients aged 1 year and older with diabetes mellitus.
Tresiba generated $1.89B in FY2025, compared with $1.38B in FY2024; reported YoY growth was 37.2%. The brand grew against a 4% decline in Novo Nordisk’s total insulin sales, which reached $8.2B in 2025.
In August 2026, Novo Nordisk’s once-weekly basal insulin icodec became available in the US for adults with type 2 diabetes, adding a new option to the company’s basal insulin portfolio.
15. NovoLog/NovoRapid
Non-Proprietary Name: Insulin aspart
Company: Novo Nordisk
First Approved: EU (1999), US (2000)
FY2025 Revenue: $2.48B
FY2024 Revenue: $2.32B
YoY Growth: +6.8%
NovoLog/NovoRapid (insulin aspart) is a rapid-acting mealtime insulin approved to improve glycemic control in adults and children with diabetes mellitus.
NovoLog/NovoRapid generated $2.48B in FY2025, compared with $2.32B in FY2024; reported YoY growth was 6.8%. In Q4 2025, NovoLog sales fell 24% while Fiasp, Novo Nordisk’s faster-acting insulin aspart, grew 154%.
In January 2026, the Medicare negotiated price for NovoLog/Fiasp took effect under the US Drug Price Negotiation Program.
14. Januvia/Janumet
Non-Proprietary Name: Sitagliptin; Sitagliptin/metformin
Company: Merck & Co.
First Approved: US (2006), EU (2007)
FY2025 Revenue: $2.54B
FY2024 Revenue: $2.26B
YoY Growth: +12%
Januvia/Janumet (sitagliptin; sitagliptin/metformin) are dipeptidyl peptidase-4 (DPP-4) inhibitor-based treatments approved as adjuncts to diet and exercise to improve glycemic control in adults with type 2 diabetes.
Januvia/Janumet generated $2.54B in FY2025, compared with $2.26B in FY2024; reported YoY growth was 12%. Growth was driven primarily by higher US net pricing amid an overall decline in the DPP-4 inhibitor market, partially offset by lower demand in China and other international markets due to generic competition.
Par Health launched the first and only generic version of Janumet XR (sitagliptin and metformin HCl extended-release) tablets in the US.
13. Xarelto
Non-Proprietary Name: Rivaroxaban
Company: Bayer & Johnson & Johnson
First Approved: EU (2008), US (2011)
FY2025 Revenue: $2.75B
FY2024 Revenue: $3.62B
YoY Decline: -24.03%
Xarelto (rivaroxaban) is a direct oral factor Xa inhibitor approved to reduce the risk of stroke and systemic embolism in nonvalvular atrial fibrillation, treat and reduce the recurrence of DVT and PE, prevent DVT after hip or knee replacement surgery, reduce the risk of major cardiovascular events in coronary or peripheral artery disease (with aspirin), and treat VTE in pediatric patients.
Xarelto generated $2.75B in FY2025, compared with $3.62B in FY2024; reported YoY decline was-24.03%. Bayer’s sales outside the US fell 33% to €2.34B, led by generic pressure in Europe and Japan.
Sunshine Biopharma announced Canadian approval for a generic version of rivaroxaban, adding to generic competition for Xarelto.
12. Repatha
Non-Proprietary Name: Evolocumab
Company: Amgen
First Approved: EU (2015), US (2015)
FY2025 Revenue: $3.01B
FY2024 Revenue: $2.22B
YoY Growth: +36%
Repatha (evolocumab) is a PCSK9 inhibitor monoclonal antibody approved to reduce the risk of major adverse cardiovascular events in adults at increased cardiovascular risk due to uncontrolled LDL-C or with established cardiovascular disease, and as an adjunct to diet and other LDL-C-lowering therapies in adults and pediatric patients with primary hyperlipidemia, including heterozygous and homozygous familial hypercholesterolemia.
Repatha generated $3.01B in FY2025, compared with $2.22B in FY2024; reported YoY growth was 36%. Growth reflected strong volume demand, alongside the August 2025 FDA label broadening and the November 2025 VESALIUS-CV results showing a 25% reduction in major adverse cardiovascular events.
In August 2026, the European Commission approved an expanded Repatha indication based on VESALIUS-CV, and Amgen reported at ESC Congress 2026 that Repatha reduced the risk of all-cause death by 20% in high-risk adults without a prior heart attack or stroke.
11. Rybelsus
Non-Proprietary Name: Semaglutide (oral)
Company: Novo Nordisk
First Approved: US (2019), EU (2020)
FY2025 Revenue: $3.48B
FY2024 Revenue: $3.25B
YoY Growth: +6.9%
Rybelsus (oral semaglutide) is a GLP-1 receptor agonist tablet approved to improve glycemic control in adults with type 2 diabetes and to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes at high cardiovascular risk.
Rybelsus generated $3.48B in FY2025, compared with $3.25B in FY2024; reported YoY growth was 6.9%. Growth in International Operations was offset by lower sales in the US.
In February 2026, the US FDA approved Ozempic as the proprietary name for the reformulated oral semaglutide tablets (1.5 mg, 4 mg, and 9 mg), which became available in the US on May 4, 2026; Rybelsus continues to be marketed outside the US.
10. Trulicity
Non-Proprietary Name: Dulaglutide
Company: Eli Lilly
First Approved: US (2014), EU (2014)
FY2025 Revenue: $4.27B
FY2024 Revenue: $5.25B
YoY Decline: -19%
Trulicity (dulaglutide) is a once-weekly GLP-1 receptor agonist approved to improve glycemic control in adults and pediatric patients aged 10 years and older with type 2 diabetes and to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes who have established cardiovascular disease or multiple cardiovascular risk factors.
Trulicity generated $4.27B in FY2025, compared with $5.25B in FY2024; reported YoY decline was -19%. Sales were hurt by competitive dynamics, including patient switches to Mounjaro and lower realized prices.
In January 2026, CMS selected Trulicity among the drugs for the third cycle of Medicare drug price negotiations.
9. Vyndaqel Family
Non-Proprietary Name: Tafamidis
Company: Pfizer
First Approved: EU (2011), US (2019)
FY2025 Revenue: $6.38B
FY2024 Revenue: $5.45B
YoY Growth: +17%
Vyndaqel Family (tafamidis) is a transthyretin stabilizer approved for the treatment of wild-type or hereditary transthyretin-mediated amyloidosis with cardiomyopathy (ATTR-CM) in adults, reducing cardiovascular mortality and cardiovascular-related hospitalization. Vyndaqel is also approved in several countries for transthyretin amyloid polyneuropathy (ATTR-PN).
Vyndaqel Family generated $6.38B in FY2025, compared with $5.45B in FY2024; reported YoY growth was 17%. Growth was primarily driven by strong demand and continued patient diagnosis, particularly in the US and developed international markets, alongside improved US patient affordability. This was partially offset by lower US net pricing from higher manufacturer discounts under the Medicare Part D redesign and new lower-priced payer contracts.
In April 2026, Pfizer reached settlement agreements with three generic manufacturers over Vyndamax patent litigation, extending the effective US patent expiry to June 1, 2031, subject to other litigation.
8. Entresto
Non-Proprietary Name: Sacubitril/valsartan
Company: Novartis
First Approved: US (2015), EU (2015)
FY2025 Revenue: $7.74B
FY2024 Revenue: $7.82B
YoY Decline: -1%
Entresto (sacubitril/valsartan) is an angiotensin receptor-neprilysin inhibitor (ARNI) approved for adult and pediatric heart failure, including reducing the risk of cardiovascular death and hospitalization for heart failure in adults and treating heart failure due to systemic left ventricular systolic dysfunction in pediatric patients.
Entresto generated $7.74B in FY2025, compared with $7.82B in FY2024; reported YoY decline was -1%. Sales declined primarily because of generic competition in the US, which began in the third quarter of 2025, while continued growth in ex-US markets, where Entresto is also approved for hypertension in China and Japan, partially offset the decline.
In January 2026, the Medicare negotiated price for Entresto took effect under the US Drug Price Negotiation Program.
7. Farxiga
Non-Proprietary Name: Dapagliflozin
Company: AstraZeneca
First Approved: EU (2012), US (2014)
FY2025 Revenue: $8.40B
FY2024 Revenue: $7.65B
YoY Growth: +9%
Farxiga/Forxiga (dapagliflozin) is a sodium-glucose cotransporter 2 (SGLT2) inhibitor approved for type 2 diabetes mellitus, heart failure, and chronic kidney disease.
Farxiga generated $8.40B in FY2025, compared with $7.65B in FY2024; reported YoY growth was 9% at constant exchange rates (CER). Growth was supported by continued demand across its diabetes, heart-failure, and chronic-kidney-disease indications, which have significantly broadened its addressable patient population.
In April 2026, the US FDA approved the first generic versions of dapagliflozin (Farxiga) for certain type 2 diabetes indications.
6. Jardiance
Non-Proprietary Name: Empagliflozin
Company: Boehringer Ingelheim & Eli Lilly
First Approved: EU (2014), US (2014)
FY2025 Revenue: $10.33B
FY2024 Revenue: $8.72B
YoY Growth: +18.5%
Jardiance (empagliflozin) is an SGLT2 inhibitor used across type 2 diabetes, heart failure, and chronic kidney disease. Its US approvals include improving glycemic control in adults and children aged 10 years and older with type 2 diabetes, reducing cardiovascular death in adults with type 2 diabetes and established cardiovascular disease, reducing cardiovascular death and heart-failure hospitalization in adults with heart failure, and reducing kidney and cardiovascular risks in adults with chronic kidney disease at risk of progression.
Jardiance generated $10.33B in FY2025, compared with $8.72B in FY2024; reported YoY growth was 18.5% in USD. Growth was supported by continued demand across its diabetes and heart-failure uses, with the broader heart-failure and chronic-kidney-disease populations expanding its commercial reach.
In January 2026, the Medicare negotiated price for Jardiance took effect under the US Drug Price Negotiation Program.
5. Wegovy
Non-Proprietary Name: Semaglutide
Company: Novo Nordisk
First Approved: US (2021), EU (2022)
FY2025 Revenue: $12.46B
FY2024 Revenue: $8.12B
YoY Growth: +53.3%
Wegovy (semaglutide) is a GLP-1 receptor agonist approved for chronic weight management in adults and adolescents aged 12 years and older with obesity (or overweight with a weight-related condition), to reduce the risk of major adverse cardiovascular events in adults with established cardiovascular disease and obesity or overweight, and for noncirrhotic MASH with moderate to advanced liver fibrosis in adults.
Wegovy generated $12.46B in FY2025, compared with $8.12B in FY2024; reported YoY growth was 53.3%. Growth was driven by continued uptake in the US and International Operations, supported by launches in 35 new countries during 2025.
In March 2026, the US FDA approved Wegovy HD (semaglutide 7.2 mg) for chronic weight management in adults with obesity or overweight, based on the STEP UP program, which showed a mean weight loss of 20.7% at 72 weeks.
4. Zepbound
Non-Proprietary Name: Tirzepatide
Company: Eli Lilly
First Approved: US (2023); EU (marketed as Mounjaro, 2022)
FY2025 Revenue: $13.54B
FY2024 Revenue: $4.92B
YoY Growth: +174.9%
Zepbound (tirzepatide) is a dual GIP and GLP-1 receptor agonist approved for chronic weight management in adults with obesity or overweight with weight-related comorbidities and for moderate-to-severe obstructive sleep apnea in adults with obesity.
Zepbound generated $13.54B in FY2025, compared with $4.92B in FY2024; reported YoY growth was 174.9%. Growth was driven by increased demand, with Zepbound holding nearly 70% of new prescriptions in the US branded obesity market in Q4 2025, partially offset by lower realized prices.
In February 2026, the US FDA approved a label expansion for Zepbound to include the four-dose KwikPen, delivering a full month of treatment in one device.
3. Eliquis
Non-Proprietary Name: Apixaban
Company: Bristol Myers Squibb & Pfizer
First Approved: EU (2011), US (2012)
FY2025 Revenue: $14.44B
FY2024 Revenue: $13.33B
YoY Growth: +8.3%
Eliquis (apixaban) is a direct oral factor Xa inhibitor used to reduce the risk of stroke and systemic embolism in adults with nonvalvular atrial fibrillation, prevent DVT following hip or knee replacement, treat DVT and pulmonary embolism (PE), reduce the risk of recurrent DVT/PE, and treat VTE and reduce recurrent VTE in pediatric patients from birth following initial anticoagulant treatment.
Eliquis generated $14.44B in FY2025, compared with $13.33B in FY2024; reported YoY growth was 8.3%. The increase was driven primarily by higher demand, with US revenue benefiting from continued market-share gains.
In April 2025, the FDA approved Eliquis Sprinkle (apixaban) oral suspension for the treatment of VTE and reduction in the risk of recurrent VTE in pediatric patients from birth and older, following at least five days of initial anticoagulant treatment.
2. Ozempic
Non-Proprietary Name: Semaglutide
Company: Novo Nordisk
First Approved: US (2017), EU (2018)
FY2025 Revenue: $20.01B
FY2024 Revenue: $16.80B
YoY Growth: +19.1%
Ozempic (semaglutide) is a once-weekly GLP-1 receptor agonist approved to improve glycemic control in adults with type 2 diabetes, to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease, and to reduce the risk of sustained eGFR decline, end-stage kidney disease, and cardiovascular death in adults with type 2 diabetes and chronic kidney disease.
Ozempic generated $20.01B in FY2025, compared with $16.80B in FY2024; reported YoY growth was 19.1%. Growth was driven by both the US and International Operations, with US sales positively impacted by gross-to-net adjustments and GLP-1 diabetes market growth, partially offset by market-share losses and lower realized prices.
In March 2026, Health Canada approved Ozempic to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease and/or chronic kidney disease.
1. Mounjaro
Non-Proprietary Name: TirzepatideCompany: Eli Lilly
First Approved: US (2022), EU (2022)
FY2025 Revenue: $22.96B
FY2024 Revenue: $11.54B
YoY Growth: +99%
Mounjaro (tirzepatide) is Eli Lilly’s dual GIP and GLP-1 receptor agonist, approved as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. Its rapid uptake has made it one of Lilly’s biggest growth drivers.
Mounjaro generated $22.96B in FY2025, compared with $11.54B in FY2024; reported YoY growth was 99%. Growth was driven primarily by strong demand and higher volume, including US market leadership with over 55% of new type 2 diabetes incretin prescriptions and rapid international expansion, partially offset by lower realized prices.
In August 2026, Mounjaro received US FDA approval to reduce the risk of major adverse cardiovascular events, including cardiovascular death, non-fatal heart attack, and non-fatal stroke, in adults with type 2 diabetes at high cardiovascular risk.
Sources:
Company Websites
Press Releases
Annual Filings and Earnings Presentations
Regulatory Agency Websites
Criteria:
The report is based on branded prescription product revenues for fiscal year 2025 and covers medicines approved for cardiometabolic conditions, including type 2 diabetes, obesity and chronic weight management, thrombosis and anticoagulation, heart failure, transthyretin amyloid cardiomyopathy, dyslipidemia, chronic kidney disease associated with type 2 diabetes, and pulmonary arterial hypertension.
Included: branded prescription therapeutics across modalities, including small molecules, peptides, monoclonal antibodies, siRNA therapies, and insulins. Products are ranked at the brand level; brands sharing an active ingredient are listed separately where marketed as distinct products. Product families or combinations are grouped where the source data reports combined revenue. For partner-marketed products, the revenue figure reported by the company in the dataset is used.
Excluded: generic, authorized generic, and biosimilar products; over-the-counter, nutritional, and supplement products; medical devices and diagnostics; vaccines; cell and gene therapies; compounded products; pipeline candidates and products without a full year of FY2025 sales; and medicines whose primary approved use lies outside the defined cardiometabolic scope.
Financial values are presented in USD and rounded to two decimal places where needed. For revenues originally reported in currencies other than USD, the exchange rate as of December 31, 2025 was used to convert FY2025 revenue into USD, while the exchange rate as of December 31, 2024 was used to convert FY2024 revenue into USD. Year-over-year growth is reproduced from company-reported figures, except for Winrevair, whose growth is calculated from the revenue figures shown, and may be based on reported or constant-exchange-rate (CER) methodology, as indicated. Reported growth rates are not recalculated, so small differences from the rounded revenue figures shown may arise from rounding and reporting basis.
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