Second-quarter 2025 earnings across major pharma revealed a consistent theme: gross-to-net spreads continued to widen. The average GTN discount across the top 20 branded manufacturers hit 52.3%, up from 49.8% a year earlier. Three companies reported GTN expansion that materially affected guidance.
Pfizer reported net revenue of $12.8 billion, beating consensus by $400 million, but the beat came entirely from Paxlovid government stockpile orders. Excluding Paxlovid, the underlying portfolio showed 3.2% net price erosion. The Seagen oncology franchise contributed $850 million but carried lower gross margins than Pfizer's legacy portfolio.
AbbVie posted the quarter's most notable GTN story. Humira net revenue fell 37% year-over-year to $2.6 billion as biosimilar competition drove both volume loss and increased rebating to maintain formulary positions. However, Skyrizi and Rinvoq combined for $4.8 billion with a GTN discount of only 22%, demonstrating the margin benefit of products still early in their lifecycle.
Eli Lilly was the clear winner. Mounjaro/Zepbound revenue hit $5.5 billion with a GTN discount under 15%, reflecting the pricing power of a supply-constrained product with no meaningful competition. Lilly's total company GTN of 34% was the lowest among large-cap pharma, a direct result of portfolio mix shifting toward GLP-1 products.
