Pharmaceuticals is one of the few industries where the average investor genuinely cannot predict which company will win year-to-year. A blockbuster drug approval can double a stock; a failed Phase 3 trial can cut it in half. But the ownership story underneath is much more boring than the headline volatility suggests — most major pharma companies have the same top three institutional shareholders, with a few exceptions where founding families, foundations, or strategic investors still play a role. Here’s the ten largest pharma companies in the world by 2025 revenue, and who actually holds the shares.
How we built this list
Ranking is by 2025 annual revenue (per each company’s most recent 10-K). Major shareholders come from each company’s DEF 14A proxy filing. Foundation-owned or family-controlled companies are highlighted because their ownership structure produces meaningfully different incentives than purely public-shareholder governance.
The Top 10
1. Johnson & Johnson — Vanguard ~9.5%, BlackRock ~7.6%, State Street ~5.0%
J&J (NYSE: JNJ) is the world’s largest healthcare conglomerate, though it spun off its consumer health division (Kenvue) in 2023 to focus on pharmaceuticals and medical devices. CEO Joaquin Duato leads the company. Passive institutional investors are dominant. Berkshire Hathaway sold its J&J position in 2020.
2. Pfizer — Vanguard ~9%, BlackRock ~7.6%, State Street ~4.5%
Pfizer (NYSE: PFE) had the largest single year in pharma history during the 2021 COVID vaccine launch, then saw revenue fall sharply through 2023–24 as vaccine demand normalized. CEO Albert Bourla has led the company since 2019. Major shareholders are passive index investors. The post-pandemic revenue cliff has been the central story of Pfizer’s last three years.
3. Roche — Roche-Hoffmann family ~10%, Novartis ~33% (non-voting bearer shares)
Roche of Switzerland is unique among major pharma companies: the founding Hoffmann-Oeri family (descendants of founder Fritz Hoffmann-La Roche) retains approximately 10% of voting shares and ~50% of bearer shares. Novartis holds approximately 33% of Roche’s non-voting bearer shares (a position taken in 2001 that Novartis has never sold). The Hoffmann family thus maintains effective control despite minority economic ownership.
4. Merck & Co. (US) — Vanguard ~9%, BlackRock ~7.5%, State Street ~5%
US Merck (known as MSD outside North America, to distinguish from German Merck KGaA) is the maker of Keytruda, the world’s top-selling cancer drug. CEO Robert Davis has led the company since 2021. Shareholder base is passive-institutional dominant. Berkshire Hathaway briefly held a position in 2020 but exited by 2022.
5. AbbVie — Vanguard ~9%, BlackRock ~7.5%, State Street ~4.5%
AbbVie (NYSE: ABBV) was spun off from Abbott Laboratories in 2013 and built around Humira, which lost US patent exclusivity in 2023. Replacement drugs Rinvoq and Skyrizi have driven post-Humira growth. CEO Richard Gonzalez retired in 2023; Robert Michael is current CEO. Index investors dominate.
6. Novartis — Public (Swiss-listed), Novartis Foundation, family trusts
Novartis (SIX: NOVN) is Swiss-headquartered and has a diverse shareholder base including the Novartis Foundation, the Sandoz Family Foundation, and passive institutional investors. The Sandoz family (descendants of the original Sandoz pharma family that merged with Ciba-Geigy to form Novartis) retains meaningful but non-controlling stakes.
7. AstraZeneca — Vanguard, BlackRock, broad institutional (UK-listed)
AstraZeneca (LSE: AZN) is UK-headquartered. The shareholder base is broadly institutional with Vanguard, BlackRock, and Capital Group as the largest holders. Pascal Soriot has been CEO since 2012. The company received unwanted takeover attention in 2014 when Pfizer pursued a $118 billion acquisition, which AstraZeneca’s board rejected.
8. Eli Lilly — Lilly Endowment (~10%), Vanguard ~7.5%, BlackRock ~6%
Eli Lilly (NYSE: LLY) became the world’s most valuable pharma company in 2024 on the back of Mounjaro/Zepbound (tirzepatide). The Lilly Endowment, a private foundation funded by descendants of founder Eli Lilly, remains one of the largest holders at approximately 10% of shares. CEO David Ricks has led the company since 2017.
9. Bristol-Myers Squibb — Vanguard ~8.5%, BlackRock ~7.5%, State Street ~4.8%
BMS (NYSE: BMY) acquired Celgene in 2019 for $74 billion, the largest pharma M&A deal at the time. The 2024 acquisition of Karuna Therapeutics added neuropsych assets. CEO Christopher Boerner took over in 2023. Shareholder base is passive-institutional.
10. Novo Nordisk — Novo Nordisk Foundation (~28% voting, ~77% economic via foundation)
Novo Nordisk of Denmark is the maker of Ozempic and Wegovy (semaglutide), the most-discussed drug class of the 2020s. The company has a unique foundation structure: the Novo Nordisk Foundation, a private Danish charitable foundation, controls approximately 77% of voting power and roughly 28% of economic ownership through Novo Holdings A/S. This means the foundation’s mission — to support Danish life-science research — has more influence over the company than any institutional shareholder.
At-a-glance comparison
| Rank | Company | Top Shareholder | Notes |
|---|---|---|---|
| 1 | Johnson & Johnson | Vanguard ~9.5% | Public |
| 2 | Pfizer | Vanguard ~9% | Public |
| 3 | Roche | Hoffmann family ~10% voting | Family + Novartis non-voting |
| 4 | Merck & Co. (US) | Vanguard ~9% | Public |
| 5 | AbbVie | Vanguard ~9% | Abbott spinoff 2013 |
| 6 | Novartis | Sandoz/Novartis Foundation | Family + foundation |
| 7 | AstraZeneca | Vanguard/BlackRock | UK-listed |
| 8 | Eli Lilly | Lilly Endowment ~10% | Foundation |
| 9 | Bristol-Myers Squibb | Vanguard ~8.5% | Public |
| 10 | Novo Nordisk | Novo Nordisk Foundation ~77% | Foundation-controlled |
My take
The two most interesting cap tables on this list are Novo Nordisk and Roche — and neither is American. Novo Nordisk being foundation-controlled means semaglutide profits flow into Danish life-science research, not into a billionaire family or a private-equity exit. Roche having the Hoffmann family still control voting after 130 years means the firm can prioritize a 20-year drug-development arc that wouldn’t survive a US-style activist campaign. Compare that to most of the US-listed pharma names where Vanguard and BlackRock dominate — and the system pulls toward shorter R&D timelines and bigger buyback programs. Whether that produces more durable scientific progress is genuinely debatable.
Frequently Asked Questions
Who owns Pfizer?
Pfizer is a publicly traded pharmaceutical company (NYSE: PFE) with no controlling shareholder. The largest shareholders are passive institutional investors: Vanguard at approximately 9%, BlackRock at about 7.6%, and State Street at roughly 4.5%. CEO Albert Bourla has led the company since 2019.
Who owns Eli Lilly?
Eli Lilly is publicly traded (NYSE: LLY) but the Lilly Endowment, a private charitable foundation funded by descendants of company founder Eli Lilly, remains one of the largest shareholders at approximately 10% of shares. Vanguard and BlackRock are also major institutional holders.
Who owns Roche?
Roche has a unique ownership structure. The Hoffmann-Oeri family (descendants of founder Fritz Hoffmann-La Roche) holds approximately 10% of voting shares but retains effective control of the company. Novartis holds approximately 33% of non-voting bearer shares, a position acquired in 2001.
Who owns Novo Nordisk (makers of Ozempic)?
Novo Nordisk is controlled by the Novo Nordisk Foundation, a private Danish charitable foundation. Through Novo Holdings A/S, the foundation controls approximately 77% of voting power and roughly 28% of economic ownership. The foundation’s mission is to support Danish life-science research.
Are most major pharma companies American?
No. Of the top ten pharma companies by 2025 revenue, six are headquartered in the United States (J&J, Pfizer, Merck, AbbVie, Eli Lilly, BMS), one in the UK (AstraZeneca), one in Denmark (Novo Nordisk), and two in Switzerland (Roche, Novartis). European pharma is roughly as large as US pharma when measured by total industry revenue.