The most innovative and inventive drug companies of 2022 set the foundation for success before the pandemic

April 20, 2022, 9:30 AM UTC

Innovation, a force which ostensibly drives the lifeblood of the biopharmaceutical industry, is an oft-misunderstood concept. Not every act of invention is one of innovation—innovation implies staying power, the long-term realization of the value of an invention, and a foundation for future growth. Creating a new drug means little if it can’t be leveraged in a way that provides value to patients and the public, to stakeholders, and to the drug’s maker.

IDEA Pharma, a life sciences strategy firm which advises biotech and pharmaceutical companies on the best pathways to true innovation in drug development, is out with its 11th annual Pharmaceutical Innovation and Invention Index (PII), published first on The clear 800-pound gorilla in the room is the COVID-19 pandemic, still afflicting much of the world today. (You can find Fortune’s coverage of the 2020 and 2021 PII lists here and here.)

The pandemic’s effect on the biotech and pharma pecking order cannot be overstated. In just a single year, Pfizer and partner BioNTech’s COVID vaccine nearly doubled the drug giant’s revenues, with $36.8 billion of its 2021 revenues, or 45% of its global $81.3 billion in sales, fueled by the vaccine alone. Pfizer is expecting another $32 billion in vaccine sales this year in addition to $22 billion in sales of its COVID-fighting antiviral, Paxlovid. For context, AbbVie’s arthritis and psoriasis treatment, Humira, the world’s best-selling drug for nearly a decade, garnered $20.7 billion in 2021 sales. Merck’s extraordinarily successful cancer immunotherapy Keytruda rang in fourth on the best-seller list, behind Moderna’s COVID vaccine.


the proportion of Pfizer’s 2021 global sales attributed to its COVID vaccine

Eye-popping sales wrought by a global crisis raise a conundrum for a list built around innovation: How much credit do these companies deserve for capitalizing on a once-in-a-lifetime event? Is it even fair to include COVID drugs on a ranking based on the premise of long-term, sustainable value?

The answer is a resounding yes. The successes by firms such as Pfizer, Moderna, AstraZeneca, and Johnson & Johnson in the COVID vaccine race were not merely a reflection of luck or good timing (though those no doubt helped)—they also speak to institutional and scientific work years in the making and the ability to effectively pivot to meet the needs of the moment.

“The reason that Pfizer was in the position that it was in, to do what it did with the COVID vaccine, is the same as the penicillin story,” said Mike Rea, CEO of IDEA Pharma. “We all think of penicillin as, you know, petri dish type stuff, but it took a long time to get to the point where it could be scaled and distributed to do something useful with it.”

That dovetails with the success stories of Pfizer, BioNTech, and Moderna. “What Pfizer did this time around to set up their success was, for one, to be in the water when the wave came,” Rea added, explaining that Pfizer partner BioNTech was already on the hunt for a flu vaccine using mRNA technology, which the companies were able to leverage in their development of a COVID vaccine. “That ability to pivot shows an agile, innovative mindset, as does the ability to scale up manufacturing and distribution quickly. Pfizer executives have publicly stated how much they focused on their processes for this stuff in the last four years, so it’s not even like they had, you know, a blank sheet of paper and just decided to do this in 2020. The structures were in place before then.”

It’s a similar story with the much smaller biotech Moderna, which had been crafting its experimental mRNA platform for a decade before COVID hit. Meanwhile, Pfizer benefited deeply from remote patient monitoring initiatives it had already used for years in other disease spaces, and which proved invaluable in gathering real-world data as new coronavirus strains emerged over the past two years.

Beyond COVID, the past year also saw the continued vigor of smaller, leaner biotechs relative to longstanding drug giants which have failed to keep up and adjust to a new competitive landscape, and the rise of Asian companies such as BeiGene and Takeda. Below is a sampling of highlighted companies from this year’s Innovation and Invention Index.


Innovation vs. Invention

as defined by IDEA Pharma:

Invention: Bringing ideas or technologies together in a novel way to create something that did not exist before.

Innovation: Return on invention; creation of meaningful value from invention.


Highlighted companies

*Figures are for latest fiscal year-end. In U.S. dollars.


Innovation ranking: 1
Invention ranking: 5

Number of employees: 79,000
2021 revenue: $81.3 billion
Headquarters: New York City

Number one on this year’s list is Pfizer for all of the aforementioned success of its COVID vaccine Comirnaty and the advent of Paxlovid. In addition to those highlights, Pfizer also nabbed Food and Drug Administration (FDA) approvals for two other infectious disease therapies: TicoVac, a pioneering vaccine for tick-borne encephalitis in young children, and Prevnar 20, the latest product in Pfizer’s long-standing adult pneumonia vaccine franchise. Pfizer was one of just three companies (alongside Merck and France’s Sanofi) to achieve three novel FDA drug approvals in 2021.


Innovation ranking: 2
Invention ranking: 1

Number of employees: 83,100
2021 revenue: $37.4 billion
Headquarters: Cambridge, U.K.

Outside of the U.S., British drug giant AstraZeneca’s non-mRNA COVID vaccine was a solid success with $3.9 billion in sales—and enjoyed a resurgence on the Innovation and Invention rankings for the year. Its top performer was the lung cancer drug Tagrisso, which had revenues of $5 billion and is a targeted therapy for lung cancer patients with a certain mutation taken as a convenient once-daily pill. CEO Pascal Soriot has forecasted bigger 2022 sales for the company fueled by new cancer, kidney disease, and rare disease drugs even as its COVID franchise wanes in the face of a competitive field, explaining its high marks on both lists.


Innovation ranking: 3
Invention ranking: 13

Number of employees: 10,368
2021 revenue: $16.1 billion
Headquarters: Tarrytown, N.Y.

Regeneron is by far the largest traditional biotech on this year’s list with a market value exceeding $78 billion. While it hasn’t been in the limelight in recent years, it made a brief splash for its COVID-treating monoclonal antibody cocktail REGN-COV2 before it proved less effective against certain emerging coronavirus strains. But the foundations for a blockbuster future may lie with another drug, Dupixent, born of a collaboration with Sanofi. The asthma and atopic dermatitis (a.k.a. eczema) therapy raked in $6 billion in 2021 sales but could fly to more than $20 billion in annual sales by 2030 with increased patient uptake and new indications that could grow its market reach.

Johnson & Johnson

Innovation ranking: 4
Invention ranking: 4

Number of employees: 141,700
2021 revenue: $93.8 billion
Headquarters: New Brunswick, N.J.

Johnson & Johnson may be a major name in the COVID vaccine arena. But its coronavirus shot was not really the primary driver of its innovative fortunes. The company achieved a wide berth of success in new clinical trial data for existing cancer drugs such as Darzalex and the anti-inflammatory Stelara, and new approvals for novel treatments such as Rybrevant for patients who express mutations in certain lung cancers and Invega Hafyera, the first and only twice-yearly long-acting injection to treat schizophrenia.

Merck & Co

Innovation ranking: 4
Invention ranking: 10

Number of employees: 67,500
2021 revenue: $48.7 billion
Headquarters: Kenilworth, N.J.

Merck’s Keytruda is now the second best-selling non-COVID drug in the world, behind AbbVie’s Humira. The monoclonal antibody has been approved in a host of deadly cancers, ranging from melanoma to lung cancer, and demonstrated the ability to not just allow patients to live without their disease worsening, but to extend how long they live. But just look at what the company has achieved beyond old therapies—it won three novel 2021 FDA approvals for, respectively: Welireg for the treatment of Hippel-Lindau disease, a rare disorder which causes non-cancerous tumors and cysts to grow inside the body; Vaxneuvance, a pneumonia vaccine geared for competition against Pfizer’s Prevnar 20; and Verquvo, which cut hospitalization and death risk in chronic heart failure patients in clinical trials.


Innovation ranking: 6
Invention ranking: 7

Number of employees: 8,000
2021 revenue: $1.2 billion
Headquarters: Beijing, China and Cambridge, Mass.

BeiGene may not be a household name. But the oncology-focused biotech has done the diligent grunt work required to land itself a spot in this year’s top 10 biopharma innovators list. “BeiGene, particularly in the U.S. market, they haven’t been sexy about it, they’ve just done it, they’ve executed,” said IDEA Pharma chief Rea. “They have launched well and done well with the stuff they’ve put out there and that everyone thought they wouldn’t. Not all teams that win championships or tournaments play the same game—they might win by playing defense, not win by playing offense. They might just do the Moneyball thing and get to first base quickly. And I think that’s what BeiGene have done.”


Innovation ranking: 7
Invention ranking: 18

Number of employees: 47,099
2021 revenue: $30.2 billion
Headquarters: Tokyo

Japan’s largest drugmaker has approached drug development from a place of humility. But don’t let that overshadow its willingness to tackle a wide range of diseases in need of new treatments, such as its newly approved lung cancer drug Exkivity. “Takeda have been on a wild ride for a few years and embraced a diversity of therapy areas,” Rea said. “They’ve got diversity of modalities, including cell therapies. Clearly they have a focus in oncology, which they’re doing well in, they’ve got some neuroscience drugs in the portfolio. So they’ve been quietly logging successes where others have tried to diversify and haven’t been able to.”


Innovation ranking: 8
Invention ranking: 19

Number of employees: 3,082
2021 revenue: $22.5 billion
Headquarters: Mainz, Germany

F. Hoffmann-La Roche

Innovation ranking: 9
Invention ranking: 8

Number of employees: 100,920
2021 revenue: $68.7 billion
Headquarters: Basel, Switzerland


Innovation ranking: 10
Invention ranking: 20

Number of employees: 95,442
2021 revenue: $46.3 billion
Headquarters: Paris

Sanofi, long associated with its diabetes and infectious disease treatments, is another traditional pharma mainstay which saw renewed vigor in 2021 with three novel drug approvals. Those include: Nexviazyme for late-onset Pompe disease; the anti-parasitic Fexinidazole; and Rezurock, a drug Sanofi acquired through its purchase of Kadmon Holdings and which is approved to treat transplant patients with chronic graft vs. host disease. And its shared venture with Regeneron on the asthma and atopic dermatitis treatment Dupixent could pay huge dividends within a decade.

Bristol-Myers Squibb

Innovation ranking: 11
Invention ranking: 3

Number of employees: 32,200
2021 revenue: $46.4 billion
Headquarters: New York City

Vertex Pharmaceuticals

Innovation ranking: 12
Invention ranking: 15

Number of employees: 3,900
2021 revenue: $7.6 billion
Headquarters: Boston


Innovation ranking: 13
Invention ranking: 13

Number of employees: 50,000
2021 revenue: $56.2 billion
Headquarters: North Chicago


Innovation ranking: 13
Invention ranking: 9

Number of employees: 24,200
2021 revenue: $26 billion
Headquarters: Thousand Oaks, Calif.


Innovation ranking: 15
Invention ranking: 17

Number of employees: 14,400
2021 revenue: $27.3 billion
Headquarters: Foster City, Calif.


Innovation ranking: 15
Invention ranking: 25

Number of employees: 90,096
2021 revenue: $46.9 billion
Headquarters: Middlesex, U.K.


Innovation ranking: 17
Invention ranking: 12

Number of employees: 2,700
2021 revenue: $18.5 billion
Headquarters: Cambridge, Mass.


Innovation ranking: 18
Invention ranking: 23

Number of employees: 2,675
2021 revenue: $1.6 billion
Headquarters: Bothell, Wash.

Eli Lilly

Innovation ranking: 19
Invention ranking: 2

Number of employees: 35,238
2021 revenue: $28.3 billion
Headquarters: Indianapolis


Innovation ranking: 19
Invention ranking: 6

Number of employees: 104,323
2021 revenue: $52.9 billion
Headquarters: Basel, Switzerland


Innovation ranking: 19
Invention ranking: 27

Number of employees: 8,615
2021 revenue: $6.8 billion
Headquarters: Brussels, Belgium

Daiichi Sankyo

Innovation ranking: 22
Invention ranking: 25

Number of employees: 16,033
2021 revenue: $9.1 billion
Headquarters: Tokyo

Horizon Therapeutics

Innovation ranking: 23
Invention ranking: 32

Number of employees: 1,890
2021 revenue: $3.2 billion
Headquarters: Dublin

Novo Nordisk

Innovation ranking: 23
Invention ranking: 31

Number of employees: 47,792
2021 revenue: $22.4 billion
Headquarters: Bagsvaerd, Denmark


Innovation ranking: 25
Invention ranking: 23

Number of employees: 99,637
2021 revenue: $52.1 billion
Headquarters: Leverkusen, Germany


Innovation ranking: 26
Invention ranking: 28

Number of employees: 15,455
2021 revenue: $11.8 billion
Headquarters: Tokyo

Boehringer Ingelheim

Innovation ranking: 27
Invention ranking: 11

Number of employees: 52,391
2021 revenue: $24.4 billion
Headquarters: Ingelheim, Germany


Innovation ranking: 28
Invention ranking: 21

Number of employees: 9,610
2021 revenue: $11 billion
Headquarters: Cambridge, Mass.


Innovation ranking: 29
Invention ranking: 15

Number of employees: 11,237
2021 revenue: $6.1 billion
Headquarters: Tokyo

Shionogi & Co.

Innovation ranking: 29
Invention ranking: 22

Number of employees: 5,485
2021 revenue: $2.8 billion
Headquarters: Osaka, Japan

Merck KGaA

Innovation ranking: 31
Invention ranking: 29

Number of employees: 60,334
2021 revenue: $23.3 billion
Headquarters: Darmstadt, Germany


Innovation ranking: 32
Invention ranking: 20

Number of employees: 9,171
2021 revenue: $7.8 billion
Headquarters: Tokyo

Sy Mukherjee is a former Fortune health care reporter who is now part of the IDEA Pharma team.

Corrections, April 21, 2022: This article has been updated to reflect that BeiGene is also headquartered in Cambridge, Mass. Eisai’s 2021 revenue has also been updated.

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