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Since 2012, Humira (adalimumab) has been the global single product "drug king"
for nine consecutive years.
With the outbreak and epidemic of the global pandemic, in 2021, this honor changed to Pfizer/BioNTech's COVID-19 vaccine Comirnaty, and it is predicted that the drug will continue to win the crown
in 2022 with a result of $29 billion.
However, the medicine king will soon change hands again, and the new overlord may rule the rivers and lakes for longer
.
Recently, Nature Reviews Drug Discovery released an article predicting the top 10 list of best-selling drugs in the world in 2023
.
Screenshot source: References
Merck's PD-1 monoclonal antibody Keytruda (Pembrolizumab, K drug) will replace Comirnaty as the new drug king, and the ten drugs on the list have sales of more than $10 billion, as detailed in the table below
.
Table 1 Top 10 global best-selling drugs forecast in 2023
Source: References, PharmacoIntelligence Headlines
PD-1 market is hot:
PD-1 market is hot:K drugs are at the top of the list, and O drugs are ranked up
K drugs are at the top of the list, and O drugs are ranked upIn 2023, Keytruda is expected to replace Comirnaty as the new global drug king with nearly $24 billion
.
Keytruda (Pembrolizumab, K Drug) is an anti-PD-1 monoclonal antibody developed by Merck for the treatment of a variety of cancers, which was first approved by the US FDA in September 2014, becoming the second approved PD-1 monoclonal antibody
.
In 2015, former U.
S.
President Jimmy Carter announced that his melanoma had been cured by Keytruda, making the drug a god
of war.
At present, K drugs have been approved for 38 indications in 18 tumor types, and its sales are expected to soar in the next few years
.
Although K drug will face the challenge of key patent expiration in 2028, Merck has built a strict patent protection network for it, and consolidated its barriers in the field of oncology by continuously expanding the indications of single drug and combination drugs, and the "drug king" status of K drug will be difficult to shake
in the next few years.
PD-1/L1 checkpoint blockers have achieved remarkable results in previously difficult tumor types, making the two drugs among the top 10
best-selling drugs in the world.
The other is Opdivo (Nevolumab, O drug)
from Bristol-Myers Squibb (BMS).
O drug was first approved in Japan in July 2014 for the treatment of melanoma, and is the world's first approved PD-1 inhibitor
.
Although O drug was launched before K drug and its sales far exceeded other PD-1, with the expansion of K drug indications and the first success in the field of first-line treatment of lung cancer, O drug lost its leading position
.
At present, only 11 oncology indications have been approved in the United States, and its sales are expected to exceed $11 billion in 2023, ranking sixth
in the list of best-selling drugs in the world.
Covid drugs/vaccines remain strong
Covid drugs/vaccines remain strongThe former medicine king ranked again
The former medicine king ranked againAlthough the article predicts a gloomy sales outlook for COVID-19-related drugs, there will still be three related drugs in the top 10 in 2023
.
Among them, Pfizer/BioNTech's new crown pneumonia vaccine Comirnaty is expected to have sales of $21.
7 billion in 2023, and the sales of the new crown oral drug Paxlovid are expected to be $15.
6 billion, ranking second and third
in the global best-selling drug list, respectively.
Moderna's mRNA coronavirus vaccine, Spikevax
Sales will also exceed $10 billion, ranking among the top 10
best-selling drugs in the world.
However, future drug demand is still difficult to predict, and the actual sales of Comirnaty, Spikecax, and Paxlovid in 2023 are most likely not as ideal
as currently forecast.
One is that the world's vaccine stocks are plentiful; Second, price volatility, Pfizer has said it will increase Comirnaty's price by four times, and Moderna is likely to follow suit; Third, it depends more on whether more new variants of the SARS-Cov-2 virus emerge, causing current treatments and products to fail, and making sales also lower than expected
.
As things stand, demand for COVID-19-related products will keep the former drug king Humira (adalimumab) slipping into fourth
place next year's list.
AbbVie's great success in intellectual property protection enabled Humira to appear on the U.
S.
market only 20 years after its inception, which made the drug top the list of global best-selling drugs for nine consecutive years, creating a myth
that is difficult to surpass.
While Humira is likely to fall off the list in 2024, several of AbbVie's up-and-comers are likely to be on the top 10 best-selling drugs list in the coming years
.
Among them, Skyrizi (rosabizumab), as an anti-IL-23 monoclonal antibody, is considered to be a very effective drug for the treatment of psoriasis, and it is very likely to shine someday in the future
.
Biologics dominates
Biologics dominatesOnly 3 small molecule drugs made the list
Only 3 small molecule drugs made the listIn short, the status of monoclonal antibodies in the 2023 list is unassailable, which is both a sign of the growing importance of biologics in the medical field and a sign
of the success of developers in promoting these blockbuster products to many disease areas.
In the field of autoimmune diseases, in addition to AbbVie's Humira, two monoclonal antibodies will also be on the list of top 10 best-selling drugs, namely Dupixent and Stelara
.
Dupixent (dupilumab) is an anti-IL-3/IL-4 monoclonal antibody jointly developed by Sanofi and Regeneron Pharmaceuticals, which is mainly used to treat atopic dermatitis, as well as other chronic immune system diseases such as eosinophilic asthma and eosinophilic esophagitis, and Sanofi will also publish data
on chronic obstructive pulmonary disease next year.
Based on this, the article predicts that Dupixent's sales will reach $10.
6 billion in 2023, and Sanofi has predicted peak sales of the drug to exceed 13 billion euros ($14.
44 billion).
Launched by Johnson & Johnson in 2009, Stelara (ustekinumab) is the first biological therapy to selectively inhibit the IL-12 and IL-23 pathways for the treatment of a range of autoimmune diseases such as Crohn's disease and ulcerative colitis
.
Stelara had sales of $9.
134 billion in 2021 and is expected to exceed $10 billion
in 2023.
Contrary to the boom of biological drugs, small molecule drugs are cold
.
In the list of best-selling drugs in 2023, only 3 small molecule drugs are on the list, in addition to Pfizer's new crown oral drug Paxlovid, the other two are Eliquis, a factor Xa inhibitor of BMS, and Biktarvy
, an anti-AIDS drug of Gilead.
Eliquis, a leader in traditional medicines, will rank fifth
among the world's best-selling drugs in 2023.
Eliquis is a class of oral anticoagulants that inhibit factor Xa and is used to treat nonvalvular atrial fibrillation, deep vein thrombosis, and pulmonary embolism
.
Since going public in early 2013, Eliquis has been a reliable growth driver for BMS and Pfizer, with sales of $10.
762 billion
in 2021.
However, the star product will also face generic competition, and thanks to the agreed patent settlement agreement and key litigation, the Eliquis generic drug will enter the market
after 2026 and before 2031.
Rivals Bayer and Johnson & Johnson's Xarelto (rivaroxaban) may deal with generic competition
sooner.
Another small molecule drug in the top 10 is Gilead
Biktarvy (Biktarvy, bic teigravir, emtricitabine and tenofovir alafenamide) for HIV
.
Without COVID-19, the drug would remain the best-selling drug
for the treatment of infectious diseases worldwide.
In 2021, Biktarvy's sales increased by 18.
8% year-on-year to $8.
62 billion, and Biktarvy will continue to rank among the top 10
best-selling drugs in 2023.
But other small molecule drugs are not so lucky
.
For example, BMS's Revlimid (lenalidomide) has lost its market exclusivity in 2022 or will withdraw from the 10-billion-dollar "club"
.
Johnson & Johnson's Imbruvica sales will also decline, missing the top 10 best-selling drugs in 2023
.
Another notable aspect of the 2023 global best-selling list is that for the first time, annual sales of all drugs on the list exceeded $10 billion
.
Despite the global efforts to regulate drug prices, the rising trend of drug prices is still difficult to reverse in the short term, and the threshold for best-selling drugs will become higher
and higher.
References
References
https://doi.
org/10.
1038/d41573-022-00193-0
org/10.
1038/d41573-022-00193-0
