Pharmaceutical Executive Daily: Pharm Exec Ranks Top 50 Companies of 2026

Welcome to Pharmaceutical Executive Daily, your quick briefing on the top news shaping the pharmaceutical and life sciences industry.

In today's Pharmaceutical Executive Daily, Pharmaceutical Executive's 2026 Top 50 Companies report reveals a historic shakeup with Eli Lilly climbing to No. 1, FDA grants accelerated approval to Bristol Myers Squibb's Zenbexus as the first CELMoD therapy for relapsed or refractory multiple myeloma, and Pharmaceutical Executive speaks with PwC's Glenn Hunzinger on how patent cliffs and rising healthcare costs are reshaping biopharma dealmaking.

Pharmaceutical Executive's 2026 Top 50 Companies report reveals a shakeup at the top of the industry, with Eli Lilly climbing to the No. 1 spot in what the publication calls one of the most significant and sudden moves in the ranking's 26-year history. The overnight shift reflects rapidly changing franchise strength and market momentum across the industry's biggest players, even as manufacturers navigate mounting policy pressure in the U.S.

FDA has granted accelerated approval to Bristol Myers Squibb's Zenbexus, in combination with daratumumab and hyaluronidase-fihj and dexamethasone, for adults with relapsed or refractory multiple myeloma who have received at least one prior line of therapy including a proteasome inhibitor and an immunomodulatory agent. Zenbexus is the first FDA-approved CELMoD, a new class of cereblon-modulating protein degraders, and the approval is the first in relapsed or refractory multiple myeloma based on minimal residual disease-negative complete response, with the Phase III Excaliber-RRMM trial showing a 41% MRD-negative complete response rate compared with 21% for the comparator regimen.

Finally, Pharmaceutical Executive speaks with Glenn Hunzinger, U.S. Health Industries leader at PwC, on how biopharma dealmaking is evolving amid patent cliffs and unsustainable healthcare costs. Hunzinger argues that megamergers are giving way to targeted, strategic transactions in the $5 billion to $15 billion range, pointing to nearly $300 billion in M&A investment so far this year, even as U.S. healthcare spending climbs toward $5.5 trillion and grows at 9%, levels he calls unsustainable without fundamental industry transformation.

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