If there was one song that could be the pharma industry’s anthem during 2018-2019, it would be the David Bowie/Freddie Mercury hit “Under Pressure.” With the Trump administration’s and Congress’ efforts to reign in drug prices, pharma executives have a lot to keep them up at night.

Med Ad News editors rank and profile the world’s top 50 companies that generate revenue from healthcare products in this 33rd annual special report.

The Outcomes Creativity Index (OCI) represents a ranking of pharmaceutical companies and brands according to creativity and innovation. The OCI is an aggregate score-based creative achievement representing these leading U.S. and international healthcare award shows: The Outcomes LLC/Med Ad News Manny Awards; Cannes Lions; LIA: Health & Wellness; Clio Health; The One Show; The MM&M Awards; The Global Awards; and The Creative Floor Awards.

The world’s leading prescription drug will still bring in plenty of revenue over the next few years, but AbbVie has already begun moving on to what’s next.

Amgen continues to set the stage for the future after a record-setting 2018, strengthening the company’s long-term ability to innovate, compete and grow.

AstraZeneca is rebuilding the company’s strength by making oncology one of the primary focuses in R&D and launching new drugs and indications in this therapy area.

As Bayer battles rulings and upcoming trials over the safety of the weedkiller Roundup, the company is continuing to expand R&D capabilities in pharmaceuticals.

Family-owned Boehringer Ingelheim reported a satisfactory 2018 and made some strategic acquisitions in 2019.

Bristol-Myers Squibb’s top two products just keep growing, and now the company may be adding a $10 billion brand via the planned acquisition of Celgene.

One of the world’s great biotechs just keeps churning out innovative new drugs and profits, even after the company’s roller-coaster Sovaldi/Harvoni experience.