In 2023, the competition in the medicine circle is fierce, who will take the crown of 'medicine king'?

2022 has come to an end, and due to the impact of the new crown epidemic, the past year can be described as a variety of sentient beings. For better or worse, major pharmaceutical companies have also handed over their 2022 answers.

The new 2023 has begun, and recently the well-known industry media Evaluate Vantage has predicted the world's top ten best-selling drugs and top ten pharmaceutical companies this year.

Table 1.Top 10 Worldwide Best-Selling Drugs Forecast for 2023

Image credit: Evaluate Vantage

Keytruda climbs to the top

According to Evaluate Vantage, Keytruda will overtake Comirnaty as the best-selling drug due to expanded indications and declining demand for coronavirus vaccines.

Keytruda's success is attributed to Merck's successful expansion strategy, which is currently approved for the treatment of 38 indications in 18 types of cancer. According to Merck's third-quarter 2022 financial report, Keytruda sales were $5.4 billion, a year-on-year increase of 20%, a considerable increase. According to Pfizer's third-quarter 2022 financial report, Comirnaty sales fell 65% to $4.402 billion from $8.848 billion in the second quarter, and Paxlovid fell from $8.115 billion to $7.514 billion.

Over the next 12 months, strong demand is expected to increase Keytruda's new sales by $3 billion, taking the title of the world's best-selling drug.

But driven by the coronavirus pandemic, Pfizer has consistently ranked at the top of the rankings and could become the best-selling pharmaceutical company in 2023. Three years after the start of the pandemic, COVID vaccines and antivirals have kept Pfizer at the top of the list.

According to Evaluate Vantage's forecast, the two product lines will help Pfizer rank first on the 2023 prescription drug sales list, far ahead of competitors including Merck and Novartis.

Image credit: Evaluate Vantage

Jedi fight back

The launch of new drugs may prompt a change in the response strategies of leading companies in the coming years, while accelerating the pace of strategy development due to the decline in demand for coronavirus products.

In the future, AbbVie, Johnson & Johnson, Novartis, Roche and Bristol-Myers Squibb will all join the "ranking battle", although some companies will face the imminent expiration of patent protection.

Table 2. 2023 Global Drug New Sales Top 10 Forecast

According to the financial data released so far, Humira defended the 2022 "drug king" champion with sales of $15.658 billion, which is only $198 million more than Merck's K drug, which is in second place. But Humira will lose patent protection in the United States this month, and there are currently nine authorized biosimilars waiting to be marketed, making the decline in AbbVie's sales unpredictable. Price could be a key battle between competitors and could accelerate Humira's sales decline.

While few products can compensate for Humira's loss, AbbVie's new autoimmune drugs, Skyrizi and Rinvoq, will generate $2.5 billion in new sales and have the potential to help Abbvie rise to the top of the list of the world's largest companies; AbbVie is expected to generate $64 billion in revenue in 2028.

According to Johnson & Johnson's 2022Q3 financial report, sales of Stelara, Johnson & Johnson's best-selling autoimmune disease treatment drug, increased by 3% year-on-year to $2.45 billion, but it has fallen short of consensus expectations. Moreover, Stelara will lose patent protection next year, and competition in the United States is on the verge of breaking out. But Johnson & Johnson can be boosted with the multiple myeloma drug Darzalex, a promising new source of sales that is expected to become the fourth-best-selling drug in 2028.

Bristol-Myers Squibb has made finding new sources of sales supplements a top priority, and Bristol-Myers Squibb will face a steep patent cliff from 2026 onwards, with blockbuster oral anticoagulant Eliquis and PD-1 inhibitor Opdivo beginning to lose patent protection.

Future winners

The companies that are expected to see the fastest growth in sales in 2023 are Novo Nordisk and Eli Lilly. While the two companies aren't even in the top 10 in terms of total sales, the two players have their own killer apps, Ozempic, Wegovy and Mounjaro, and demand for type 2 diabetes and obesity drugs will continue to rise in the future.

In fact, thanks to the GLP-1/GIP dual agonist Mounjaro, which was first approved in May last year, Lilly may soon be squeezed into the top 10 global pharmaceutical companies. On the other hand, troubled British player GSK may fall out of the top 10 list. At present, GSK has withdrawn from the field of oncology, and in 2023, with multiple trump cards such as the shingles vaccine and other vaccines, GSK still hopes to occupy a place on the Top10 list.

With obesity rates and the prevalence of type 2 diabetes on the rise, Novo Nordisk's Wegovy and Ozempic are starting to shine, expected to bring in $4 billion in new sales by 2023.

Notably, the names of CSL and Grifols are starting to emerge as two non-large pharmaceutical companies that deliver significant top-line sales growth next year due to increasing demand for mature immunoglobulin and plasma franchises. At the same time, Daiichi Sankyo is preparing to enter the top ten with Enhertu, the HER2-ADC drug in collaboration with AstraZeneca, as a weapon, which may set off another wave in the field of breast cancer treatment.

Conclusion

From the prediction list, the PD-L1 track is highly competitive, and it remains to be seen whether K drugs can expand their indications again to defend the championship. It's exciting that rising stars are constantly shining brightly, bringing more treatment options to patients around the world. At the same time, it is expected that each star product will continue to make efforts and continue to take the flower road.