Several heavy hitters in the pharma space have reported in recent days. It’s been a mixed bag, to say the least. OPTO looks at the good, the bad and the ugly, and asks what it means for the space overall. 

The Good: AstraZeneca 

The UK’s largest listed company [AZN] reported strong 2025 revenue growth on February 10, boosted by high demand for its cancer drugs, and offered a positive outlook for the year ahead. The pharmaceutical group said revenue rose 8% to $58.7bn, with cancer medicines up 14% and respiratory and immunology treatments up 12%. Core EPS climbed 11% to $9.16.

The company expects revenue to grow by mid- to high-single digits in 2026 and core EPS by low double digits, staying on track for its $80bn revenue target by 2030.

The results mark a win for AstraZeneca, which reported 16 successful late-stage trials in 2025, including breast cancer drug Datroway and blood pressure treatment Baxdrostat. Oral weight-loss drug Elecoglipron is moving to phase 3 trials. 

AstraZeneca also began trading directly on the NYSE on February 2 to increase its exposure in the US, which accounts for nearly half its revenue.

The group continues to invest heavily in its two largest markets, the US and China. It became the first foreign company to sign a deal under the US “Most Favored Nation” drug pricing agreement, committing $50bn in US investment by 2030. In China, it plans $15bn of investment and struck a licensing deal with CSPC Pharmaceuticals worth up to $4.7bn to develop weight-loss and diabetes treatments.

AZN stock is up more than 44% over the last 12 months, and has been ticking steadily upwards over the last half-decade.

The Bad: Bristol Myers Squibb

Reporting on February 5, Bristol Myers Squibb [BMY] said it expect 2026 sales to decline, but less sharply than feared. The company projected revenue of $46bn–47.5bn, implying a 3% drop at the midpoint — well above analysts’ forecast of $44.18bn, according to FactSet.

The group reported adjusted Q4 earnings of $1.26 per share on $12.5bn in sales. Earnings fell 25% year on year, partly due to a 60-cent negative charge and licensing income, but exceeded expectations of $1.23. Revenue rose 1%, beating projections for $12.28bn.

Growth came mainly from Bristol Myers’ “growth portfolio,” which rose 16% to $7.4bn. Key drivers included immuno-oncology drugs as well as Camzyos, Breyanzi and Reblozyl. Camzyos, for obstructive hypertrophic cardiomyopathy, surged 59% to $353m, rivaling Cytokinetics’ [CYTK] newly approved Myqorzo. Breyanzi sales grew 49%, and Reblozyl, for anemia in certain blood disorders, rose 22. Schizophrenia drug Cobenfy, acquired via Bristol Myers’ $14bn Karuna Therapeutics deal, brought in $51m.

Bristol Myers is testing two protein-degrading therapies in difficult-to-treat multiple myeloma, with phase-3 results expected this year. Cobenfy is also in trials for Alzheimer’s disease psychosis. Additional studies include a blood thinner for atrial fibrillation and stroke prevention, and a phase-3 trial for idiopathic pulmonary fibrosis.

BMY stock climbed following the earnings call but has since fallen; it is up 10% year-to-date.

The Ugly: Novo Nordisk

Reporting on February 3, Novo Nordisk [NVO], maker of Wegovy and Ozempic, said it expected a sharp revenue decline in 2026, citing pricing pressure, rising competition and the loss of key patents.

CEO Mike Doustdar described 2025 as disappointing, noting that initial forecasts of 20% growth contrasted with the final yield of 10%. Growth came from the US (+8%) and international markets (+14%), while China underperformed due to distribution limits and restrictions on obesity-only promotions, giving competitors an edge. Novo reported 2025 sales of DKK309.1bn, up 6% year-over-year and slightly above Bloomberg’s consensus of DKK307.6bn. Obesity care rose 31% on a forex-adjusted basis, while GLP-1 diabetes treatments grew 6%. Operating profit of DKK127.7bn and net income of DKK102.4bn fell short of expectations.

Looking ahead, Novo expects 2026 sales to decline 5–13%, attributing the contraction to semaglutide patent expiries and pricing pressures under the US “Most Favored Nations” policy. The company proposed a final dividend of DKK7.95 per share and launched a DKK15bn share buyback program. Its Wegovy pill, launched in January, generated roughly 50,000 weekly prescriptions by January 23, driven by demand for the 1.5mg starting dose via the direct-to-consumer platform.

NVO stock cratered following earnings and is down a dismal 42% over the last 12 months. 

What Does This Mean for Investors? 

The mixed fortunes of these three stocks illustrate the diverging trajectories within big pharma. 

AZN delivered strong 2025 revenue growth, led by cancer and immunology drugs, and maintains a clear path to its $80bn 2030 target, making it a reliable growth play with US and China expansion upside. 

BMY faces modest near-term pressure, with 2026 sales expected to fall slightly, but its growth portfolio of oncology and rare-disease treatments continues to outperform, suggesting resilience amid broader headwinds. 

NVO stands out as a cautionary tale: revenue is set to decline sharply due to US pricing pressure, competition and patent expiries, indicative of elevated risk despite the continued success of Wegovy and GLP-1 drugs. 

This is how the fundamentals of the three stocks currently compare. 

Source: Yahoo Finance

Conclusion

The performances of AZN, BMY and NVO illustrate that big pharma is no longer uniformly defensive. While traditional perception casts the sector as a safe haven, recent results show that individual company strategies, product portfolios and regulatory exposures now drive markedly different outcomes. 

Growth remains concentrated in areas like oncology, immunology, rare diseases and obesity/diabetes treatments, where pipeline innovation can outweigh broader market pressures. Conversely, pricing pressures, patent expiries and US policy shifts — illustrated by Novo Nordisk’s projected revenue drop — can quickly offset strong product demand. 

Geographic exposure is also a thing: companies with diversified international sales and direct US market access, like AstraZeneca, are better positioned to weather local pricing constraints, while firms reliant on specific channels or regions may face volatility. 

All this means careful stock selection is crucial. Weigh pipeline robustness, regulatory risk, competitive positioning and market expansion opportunities to differentiate sustainable growth from near-term contraction in an increasingly complex landscape.