What will happen to the 20 best-selling drugs in the world in 2019 by 2026?

For drug manufacturers, billions of dollars in drug sales are considered a huge success. However, for the best-selling class of drugs in the pharmaceutical industry, the sales threshold is set higher. The following are the top 20 drugs with global sales in 2019 based on Evaluate Pharma data.

However, as the patents of certain drugs expire, biosimilars have been launched to seize market share. By 2026, the drugs on the list will face different fates.

The following are global drug sales in 2019 as calculated by Evaluate Pharma and the top ten drugs.

1.Humira

Sales in 2019: $19.73 billion

Estimated sales in 2026: US$6.83 billion
Estimated compound annual growth rate: -14%

In 2019, Humira generated $19.73 billion in sales for AbbVie, which is almost certain to be the peak sales of the drug. The drug will soon face the challenge of more biosimilars and other blockbuster drugs. Europe has already encountered the impact of biosimilars. In 2019, sales in the European market fell by 31.1% to 4.3 billion U.S. dollars. American biosimilars will begin to enter the market in 2023. According to Evaluate Pharma's forecast, these competitions will cause Humira's sales to drop significantly to US$6.83 billion in 2026.

Although the decline is steeper than expected, AbbVie believes that the erosion of sales share will gradually disappear in the next few years, and the drug still has a chance to occupy two-thirds of the EU market. If the US market also stabilizes a good share in the future This may be a positive signal for Humira’s future sales.

2.Keytruda

Sales in 2019: $11.12 billion
Estimated sales in 2026: $24.91 billion
Estimated compound annual growth rate: +12%

In 2019, Keytruda's sales reached 11.12 billion U.S. dollars, ranking second on the list, and the drug's prospects are brighter as more indications are approved. According to Evaluate Pharma's forecast, Keytruda's sales can reach US$24.91 billion in 2026.

Since this year, Keytruda has made many progress. In January, it was approved by the FDA for specific high-risk non-muscle invasive bladder cancer (NMIBC) patients; in June, it was approved as the first-line treatment for unresectable or metastatic microsatellite instability (MSI-H) or mismatch repair defects ( dMMR) Patients with colorectal cancer. In May of this year, the drug has obtained positive results in four indications, including MSI-H metastatic colorectal cancer, HER2-positive gastric cancer, hepatocellular carcinoma and renal cell carcinoma. Continuous expansion of indications and positive test results will help Keytruda surpass Humira to become the new overlord.

3.Revlimid

Sales in 2019: $11.11 billion
Estimated sales in 2026: N/A
Estimated compound annual growth rate: N/A

In the second half of last year, BMS completed a huge acquisition of Xinji. The core assets of this acquisition include Revlimid, a star product for multiple myeloma. Sales of the drug in 2019 were 11.11 billion U.S. dollars, and Evaluate did not predict the sales of the drug in 2026.

Over the years, Revlimid has been known for its aggressive price hikes and has also attracted criticism from consumers and politicians, but these voices do not seem to have bothered its sales. Revlimid was first approved in 2005. Last year, the drug escaped the challenge of Indian patents and delayed the impact of generic drugs in the Indian market until 2023. The patent rights in the US market will expire in 2027. The exclusivity of the drug in Europe will expire in 2024 and is expected to weaken the drug's long-term potential.

4.Opdivo

Sales in 2019: $8.06 billion
Estimated sales in 2026: $11.62 billion
Estimated compound annual growth rate: +5%

Opdivo's sales in 2019 were US$8.06 billion, and Evaluate Pharma predicts that it will grow by 5% to US$11.62 billion per year until 2026.

Unlike Keytruda single drug, Opdivo and Yervoy have achieved many new indications. This joint strategy will also continue to promote the company's overall cancer drug line sales in the next few years. Opdivo combined with Yervoy as a dual immunotherapy, has a potential synergistic mechanism that works in a complementary way to help destroy tumor cells. It has been approved in the United States to treat 5 types of cancer, including melanoma, renal cell carcinoma, and colorectal cancer. Cancer, hepatocellular carcinoma, non-small cell lung cancer.

5.Eylea

2019 sales: $7.99 billion
Estimated sales in 2026: $6.68 billion
Estimated compound annual growth rate: -3%

In recent years, Regeneron and Bayer's best-selling ophthalmic drug Eylea have swept the age-related wet macular degeneration market. Eylea's sales in 2019 were US$7.99 billion. By 2026, as Novartis Beovu seizes market share, sales will decline to US$6.68 billion.

In May, Regeneron CEO Len Schleifer said that in late March and early April, the total number of Eylea prescriptions and the rate of new patient admissions decreased.

6.Eliquis

Sales in 2019: $793 million
Estimated sales in 2026: $12.38 billion
Estimated compound annual growth rate: +7%

Eliquis has sales of 7.93 billion U.S. dollars in 2019 and is expected to maintain a 7% growth rate by 2026, with sales reaching approximately 12.38 billion U.S. dollars.

In December last year, the FDA approved two Aliquis generic products from Mylan and Micro Labs. In addition, the drug also faces challenges from 25 generic drug manufacturers. However, as BMS and Pfizer actively filed lawsuits and signed multiple settlement agreements, they successfully delayed the competition of generic drugs until 2026.

7.Enbrel

2019 sales: $7.2 billion

Estimated sales in 2026: US$4.02 billion
Estimated compound annual growth rate: -8%

Enbrel achieved sales of $7.2 billion in 2019, making it Amgen's best-selling drug. However, the patent dispute with Novartis has cast a dark cloud on Enbrel's performance. It is estimated that by 2026, the drug's sales will only be maintained at 4.02 billion US dollars.

A recent ruling in favor of Amgen may weaken future competition and provide hope for long-term sales growth. In early July, the U.S. Federal Court of Appeals upheld the 2019 New Jersey District Court’s ruling that Novartis’ biosimilars were withdrawn from the market. In 2019, the FDA approved the second biosimilar Samsung Bioepis, Eticovo, and Amgen immediately initiated a lawsuit against it.

8.Avastin

Sales in 2019: $7.12 billion
Estimated sales in 2026: $1.7 billion
Estimated compound annual growth rate: -19%

As biosimilar drugs swept the U.S. market in 2019, Avastin's sales will fall sharply in the future, from 7.12 billion US dollars in 2019 to 1.7 billion US dollars in 2026.

Amgen and Allergan launched Avastin biosimilar drug in July 2019, which is 15% lower than Roche's price. In January, Pfizer released a biosimilar drug called Zirabev, which was 23% lower than the original price. Mylan also submitted biosimilar drugs to the FDA for review at the beginning of this year, and is expected to usher in a final decision in December.

9.Stelara

2019 sales: $6.62 billion
Estimated sales in 2026: $6.32 billion
Estimated compound annual growth rate: -1%

With its unique mechanism of action and approved indications, Stelara has long occupied a place in the ranking of blockbuster drugs. Now, Stelara has expanded its use to four diseases, which will help the drug maintain sales in the next few years.

Stelara is an IL-12/23 inhibitor that has been on the market for 10 years. Although competition in this area including biosimilar drugs continues to increase, according to Evaluate Pharma, sales of the drug can still reach 6.32 billion US dollars by 2026.

10. Rituxan

2019 sales: $6.54 billion
Estimated sales in 2026: $1.84 billion
Estimated compound annual growth rate: -17%

Affected by generic drugs, Rituxan will suffer tremendous damage in the next few years. Sales of the drug reached US$6.54 billion in 2019, and by 2026, sales may plummet to US$1.84 billion.

In November last year, Teva launched the generic drug Truxima, with Rituxan's complete oncology indication label, the price was 10% lower than Rituxan, and other discounts and rebates were provided. Pfizer followed closely behind and launched Ruxience in January this year, which is 24% lower than Rituxan. Despite the continued decline in sales, Rituxan’s cumulative revenue should satisfy Roche. Evaluate’s estimates released in August last year showed that by 2024, lifetime sales of the drug will reach $136 billion.

Reference source: The top 20 drugs by global sales in 2019