Lin ZhangAugust 25, 2021
2020, the year of the COVID-19 pandemic, presented significant challenges to every market in the world. However, the pharmaceutical market has still been able to adapt to this new situation and continues to grow quickly. Specifically, there is a significant emergence of countries like China, Brazil, and India that are becoming bigger players in this field and presenting a higher growth than the European and the American pharmaceutical markets. Still, the U.S. is currently responsible for 48.7% of all pharmaceutical sales. (1) The COVID-19 pandemic has put health concerns at the forefront, and the importance of the pharmaceutical market is evident.
Some of the drugs have been especially popular. Here are the top 20 best-sellers from 2020 and the predictions for 2025.
The top pharmaceuticals of 2020 was Humira (adalimumab) from AbbVie, which is a biologic therapy administered as a subcutaneous injection. It reached $19,832,000,000 in sales worldwide. The drug is used for some of the most complex and serious diseases such as rheumatoid and psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, and ulcerative colitis. It is indicated for inflammatory diseases. (2)
Spot number two is taken by Keytruda (pembrolizumab) from Merck with a $14,380,000,000 sales volume. It is indicated for the treatment of certain patients with various cancers, i.e. non-small-cell lung cancer (NSCLC), melanoma, classical Hodgkin Lymphoma (cHL), urothelial carcinoma, head and neck squamous cell carcinoma (HNSCC), gastric orgastroesophageal junction adenocarcinoma, and microsatellite instability-high (MSI-H) or mismatch repair deficient cancer. Spot three belongs to Eliquis (apixaban) from Bristol Myers Squibb and Pfizer with $14,117,000,000 in sales. It’s used for blood clots and stroke prevention. (2)
Next (No.4), there is Revlimid (lenalidomide), also from Bristol Myers Squibb, and sales of $12,106,000,000. It is indicated for myelodysplastic syndrome, multiple myeloma, and mantle cell lymphoma. Regeneron Pharmaceutical and Bayer preset number five, Eylea (aflibercept) with $10,722,220,000 in sales and used for age-related macular degeneration, macular edema, and diabetic retinopathy. AbbVide and Janssen sold Imbruvica (No.6) or ibrutinib for $9,442,000,000. The number 6 medication is used for chronic lymphocytic leukemia and lymphoma. (2)
At number seven with $8,073,560,000 in sales, there is Dupixent or dupilumab from Sanofi Genzyme and Regeneron Pharmaceuticals, used for atopic dermatitis, asthma, chronic rhinosinitus. Number 8 has Stelara or ustekinumab from Janssen, $7,707,000,000 in sales, used for plaque psoriasis and psoriatic arthritis. Number 9 features Biktarvy or bictegravir, emtricitabine, and tenofivir from Gilead Sciences for HIV, sold for $7,259,000,000. Number 10 has Opdivo from Bristol Myers Squibb, with annual sales for $6,992,000,000, another cancer medication for several anti-cancer indications including bladder, blood, colon, head and neck, kidney, liver, lung, melanoma, and stomach. (2)
At number 11, there is Xarelto from Janssen, reaching $6,498,020,000, which helps reduce the risk of stroke in atrial fibrillation and is used for deep vein thrombosis (DVT), pulmonary embolism, and DVT prophylaxis after surgery, specifically, knee or hip replacement. Prevenar13® from Pfizer takes spot number 12, and it is a pneumococcal vaccine that reached $5,850,000,000. Pfizer has the next spot as well with Ibrance (No.13) is a targeted therapy for HR-positive and HER2-negative breast cancer and a total annual sales number of $5,392,000,000. If you are looking for active pharma ingredients, then Pharmasources would be your best choice. Next comes Avastin (Bevacizumab, No.14) from Roche with $5,325,380,765, used for advanced colorectal, lung, breast, relapsed glioblastoma, kidney, cervical, and ovarian cancer. Januvia (No.15) or Janumet from Merck ($5,276,000,000) and Trulicity (No.16) from Eli Lilly ($5,068,100,000), both employed for type 2 diabetes are next. (2)
Number 17 has Enbrel from Amgen for psoriasis, rheumatoid arthritis, and psoriatic arthritis, juvenile idiopathic arthritis, and ankylosing spondylitis. It reached $4,996,000,000 in sales. Next two medications from Roche, number 18 and 19, Ocrevus and Rituxan that reached $4,579,827,458 and $4,520,000,000 respectively. Ocrevus is used for relapsing or primary progressive multiple sclerosis and Rituxan, from Roche and Pharmstandard, is used for autoimmune diseases, cancers, and certain types of vasculitis. Spot number 20 is occupied by Xtandi that was produced by Astellas Pharma and Pfizer and is used for prostate cancer with a total annual sales number of $4,390,000,000. (2)
This showcases various tendencies. Cancer still remains a significant problem, as are diseases associated with aging, and there is a high demand for drugs that can effectively be employed for various forms of the condition and that can produce the best results. Interestingly, among the best-selling drugs, there is Revlimid that has an uncertain mechanism of action but that produces effective results, showing the importance of novel drugs and also the continued development of the pharmaceutical market.
These are innovative medications and that have wide applicability and tend to be used over longer periods of time. For instance, Keytruda is employed for a course of treatment of about 2 years, although it can cause an autoimmune response. Another drug, Revlimid has an unknown mechanism, but it prevents tumors from creating their own blood vessels and impacts mitosis, how cells divide. (3) Furthermore, even though medications like Opdivo and Keytruda have significant and negative side effects, they remain important allies in the fight against cancer, which has positioned them at the top of the sales tables.
Currently, there has been a significant growth of spending on novel medicines, which is reflected in the list of best-selling drugs. This is a trend that is predicted to continue throughout the next few years, due to the demand and possibilities of the market (4). It is interesting that despite the pandemic, the best-selling drugs were not, generally, related to the COVID-19 situation or used to treat this condition. In a way, it reflects on the stability and importance of the pharmaceutical market to address the biggest health threats and also to provide medication that attacks chronic conditions and high-risk conditions like cancer.
Predictions for the future, specifically 2025, suggest that the same medications that appear in the list will continue to be employed and will become more popular. Research from GlobalData, as seen in the European Pharmaceutical Review, suggests that in four years, the top-selling drugs in the world will be Keytruda (cancer), Eliquis (anticoagulant). Revlimid (immunomodulatory agent), Opdivo (immunotherapy drug), and Imbruvica (cancer). (3)
As more medications are developed and approved, it remains to be seen whether the predictions for 2025 will prove entirely correct, although the current tendencies certainly support them.
1. EFPIA. (2020). The Pharmaceutical Industry in Figures. https://www.efpia.eu/media/554521/efpia_pharmafigures_2020_web.pdf
2. Buntz, B. (2021). Drug Discovery & Development. https://www.drugdiscoverytrends.com/50-of-2020s-best-selling-pharmaceuticals/
3. Rees, V. (2019). European pharmaceutical Review. https://www.europeanpharmaceuticalreview.com/article/102539/top-10-drugs-by-annual-revenue-in-2025/
4. The IQVIA Institute. (2021). Global Medicine Spending and Usage Trends: Outlook to 2025. https://www.iqvia.com/insights/the-iqvia-institute/reports/global-medicine-spending-and-usage-trends-outlook-to-2025
Lin Zhang, M.D., senior director of a health care industry company in the United States. With the experience in clinical medicine, biotechnology, health industry and other fields, he is responsible for the research and development of plant medicine, functional food and health products. He was a clinician and worked for the National Cancer Institute, FDA and the National Cancer Center of Japan for many years.
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