Top companies and drugs by sales in 2019

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Roche is back on top. Over the past few years, the tussle for biopharma’s biggest company by sales has largely been contested by Novartis and Pfizer; but a winning streak of blockbuster launches, including the multiple sclerosis drug Ocrevus (ocrelizumab) and PD-L1 inhibitor Tecentriq (atezolizumab) have helped the Swiss group leapfrog both of its rivals to claim the number one spot in 2019 (Fig. 1a). The company was also assisted by the limited impact of biosimilar competition in the key US market for some of its previous biggest cash cows, including the cancer therapies Avastin (bevacizumab) and Herceptin (trastuzumab).

Fig. 1 | Top companies and drugs by sales in 2019. a | Top ten companies by sales of prescription and over-the-counter drugs. *Data for Takeda are consensus forecasts. b | Top ten drugs by sales globally. Data for 2018 are included for comparison. Source: EvaluatePharma.

Novartis also managed to move up last year, climbing one place higher in the company ranking to number two, owing to strong performances of its anti-IL-17 monoclonal antibody (mAb) Cosentyx (secukinumab) for psoriasis. However, its future position in the list is less clear. The performance of some of its newer products —including gene therapy product Zolgensma (onasemnogene abeparvovec) and heart failure product Entresto (sacubitril and valsartan) — should help replace sales lost to patent expiry of blockbusters such as the multiple sclerosis drug Gilenya (fingolimod) and the age-related macular degeneration (AMD) therapy Lucentis (ranibizumab). But the group has recently suffered heavy share price falls related to safety fears over its next-generation AMD drug Beovu (brolucizumab). If these continue to dog the product, Beovu’s US$1.47 billion 2024 sales forecast will not materialize.

In fourth place, Merck & Co. managed to switch places with Johnson & Johnson. Much of Merck’s progress has been driven by its checkpoint inhibitor Keytruda (pembrolizumab). The PD1 inhibitor is on track to be the industry’s biggest selling drug in 2024, with global sales estimated to hit $22.3 billion in that year, according to consensus forecasts from EvaluatePharma. However, Merck’s recently announced plans to spin out its women’s health, legacy and biosimilars businesses into a new company to focus on oncology, vaccines and animal health will see it slip down the rankings.

Pfizer will also feel the effects of the demerger of its consumer healthcare division and established medicines business. These changes will leave breast cancer drug Ibrance (palbociclib) and pneumococcal vaccine Prevnar 13 doing most of the heavy lifting. Future attempts to climb back up the polls might be hindered by what many see as a lack of pipeline innovation from the pharma giant, and recent management promises of new gene therapies will take time to get to market.

There has also been movement among the ranks of last year’s biggest selling drugs (Fig. 1b), with Keytruda usurping Celgene’s Revlimid (lenalidomide) to claim the number two spot. Much of Keytruda’s impressive advance over 2018 sales comes from its dominance in non-small-cell lung cancer and melanoma. Where Keytruda has triumphed, Bristol-Myers Squibb’s rival checkpoint inhibitor Opdivo (nivolumab) has failed to capitalize on its first-to-market advantage and last year lagged Keytuda by almost $4 billion in annual sales.

Bristol also boasts another drug in the top five with the anticoagulant Eliquis (apixaban), but with few future blockbusters in its pipeline, it is not surprising Bristol turned to M&A with its $74 billion acquisition of Celgene. The move delivered Revlimid’s $9 billion-plus annual sales and should ensure that the enlarged Bristol will make it into the top five biggest companies of 2020.

Those anticipating Humira (adalimumab) relinquishing its crown as the industry’s best-selling drug still have some time to wait. AbbVie’s legendary patent thicket around the drug means that any US biosimilars will not launch until 2023 at the earliest. However, AbbVie’s reliance on this ageing product is one of the reasons why the company, like Bristol, turned to M&A to freshen up its pipeline. The $63 billion AbbVie spent on Allergan not only gives it the mega-blockbuster Botox, but also the scale to move up next year’s company sales rankings.

Finally, while other companies held their relative positions at the bottom half of the table last year, Takeda was a new entrant following its $62 billion takeover of Shire, the largest acquisition of a foreign company in Japanese history.

doi: 10.1038/d41573-020-00047-7

Competing Financial Interests

The author declares no competing interests.

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