The top ten pharmaceutical companies and drugs with the highest global sales in 2021

While Pfizer has created a gap of more than $16 billion between it and its closest rival, AbbVie, sales of Comirnaty and other vaccines are expected to fall sharply in the coming years as most Western countries have already administered two or even three doses of the vaccine and the need for a fourth vaccination is falling due to the less pathogenic Omicron variant that is currently prevalent.

Despite the lack of COVID-19-related products, AbbVie's ranking rose one place to second in 2021, thanks to the outstanding performance of its cash cow Humira, BTK inhibitor Imbruvica, and the approval of its new psoriasis drug IL-23 inhibitor Skyrizi. However, as biosimilars of the former drug king adalimumab are set to enter the market in 2023, the company's ranking will inevitably decline.

The rapid growth of Pfizer and AbbVie directly affected the rankings of Novartis and Roche, which dropped two and three places respectively compared with their rankings in 2020. Neither company has any star products related to the COVID-19 pandemic. At the same time, the sales of Roche's major product in the central nervous system, Ocrevus, fell short of expectations due to the pandemic, while another best-selling drug, Avastin, was also affected by biosimilars. On the other hand, Novartis sold its 33% stake in Roche last year for $20.7 billion, which will support its rapid expansion of its pipeline through acquisitions.

Normally, Merck & Co.'s ranking would rise due to the continued strong sales of Keytruda, but due to the outstanding performance of the two COVID-19 vaccines, Keytruda ranked only fourth in the sales list in 2021. Merck ranked seventh in the revenue list. According to forecasts, the sales of PD-1 inhibitor Keytruda this year may reach US$20 billion. At the same time, as the demand for COVID-19 vaccines weakens, Keytruda is expected to win the title of the best-selling drug of the year in 2023 with sales of US$21.6 billion.

AstraZeneca entered the top ten in 2021 due to strong growth in oncology drugs and the acquisition of Alexion for $39 billion last year, which brought it several blockbusters in the field of rare diseases. Future growth will come from Enhertu (DS-8201), co-developed with Daiichi Sankyo, an innovative ADC drug for HER2+ breast cancer, which has shown impressive efficacy.

Although Bristol-Myers Squibb (BMS) owns three of the top 10 best-selling drugs, the company did not rank at the top of the list, ranking only sixth. In addition, due to the upcoming patent expiration of Revlimid (lenalidomide), the multiple myeloma blockbuster from Celgene, sales are expected to decline this year. The anticoagulant drug Eliquis entered the billion-dollar club for the first time, ranking sixth after lenalidomide. BMS's PD-1 inhibitor Opdivo returned to the growth curve in 2021, ranking ninth on the list of best-selling drugs with sales of US$7.6 billion, and multiple preoperative and postoperative indications (adjuvant treatment of bladder cancer, neoadjuvant treatment of lung cancer, adjuvant treatment of esophageal cancer and GEJ, and adjuvant treatment of melanoma) will help Opdivo narrow the gap with Opdivo.

Gilead has been pleased with strong sales of its HIV combination therapy Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide), but sales of its COVID-19 antiviral Veklury (remdesivir) have fallen sharply, to $5.6 billion in 2021. There are concerns about its over-reliance on drugs in the infectious disease field, with Biktarvy accounting for a third of Gilead's total sales in 2021. As a result, Gilead is under increasing pressure from other pipelines, especially since it has spent more than $38 billion to acquire companies such as Immunomedics and Kite Pharma since 2017.

GlaxoSmithKline (GSK) is no stranger to investors. With no drugs in the top 10 best-selling list and at the bottom of the top 10 drug revenue list, GSK is facing a critical year. Delays in its and Sanofi's COVID-19 vaccines have caused both companies to miss out on the fortunes enjoyed by Pfizer and Moderna, with Sanofi stagnating in eighth place. The performance of GSK's pharmaceutical division will be more closely watched following the spinoff of consumer health division Haleon in July.

Reference: https://doi.org/10.1038/d41573-022-00047-9

From: Lanting Club