Familiar faces took the Top 10 spots among pharmaceutical and biotechnology manufacturers in the 2026 IndustryWeek U.S. 500, a listing of the largest publicly traded U.S. manufacturing companies based on 2025 revenues. While there was some jockeying for position, all 10 of the leaders in the 2026 list also appeared at the top of the 2025 list, with Johnson & Johnson maintaining its No. 1 position in both years.

The big story in pharmaceuticals and biotechnology manufacturers in the 2026 IW 500 belongs to Eli Lilly, whose revenue and net income soared on the strength of two medicines—Mounjaro and Zepbound—both GLP-1 medications that target type 2 diabetes and weight loss, respectively. That explosive revenue growth pushed the company from the No. 6 position to the No. 2 position among pharma/biotech firms in the 2026 IW 500.

A few additional data points among pharmaceutical and biotechnology manufacturers:

• Moderna saw the biggest revenue decline, down nearly 40% as Covid-19 vaccine demand fizzled.
• Alnylam Pharmaceuticals Inc. enjoyed the biggest revenue gain, growing 65%, due largely to FDA approval of Amvuttra for ATTR amyloidosis with cardiomyopathy.
• Revenue for the top revenue performer in the 2026 IW 500, Johnson & Johnson, was slightly more than $94 billion, an increase of 6.05% over the previous year.
• The top two revenue-producing manufacturers grew net income by more than 90%.

Scroll through the slideshow of the Top 10 and look below for the full list of pharmaceutical and biotechnology manufacturing companies on the 2026 IW U.S. 500.