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Author: Jean-Claude Muller, 穆卓Executive Editor at BtoBioInnovation  jcm9144@gmail.com

SPECIAL REPORT #21.12

The Top 20 Drugs and Vaccines by Worldwide Sales in 2020

Every year, shortly after the first quarter results, Fierce Pharma, with the assistance of Evaluate Pharma, issues the list of the Top 20 drugs by worldwide sales. We have examined their extensive report and are summarising some of their findings.

The 2019 podium with AbbVie’s Humira, Merck’s Keytruda and Bristol Myers Squibb’s Revlimid is reconfirmed in 2020.  Three newcomers make the list: AstraZeneca’s Tagrisso, Astellas’ Xtandi and Roche’s Ocrevus. Three former blockbuster drugs come off the list: Biogen’s Tecfidra, Roche’s Herceptin and Gilead’s Genvoya. Three drugs see a strong decline from their 2019 sales: Bristol Meyers Squibb’s Opdivo, Roche’s Avastin and Roche’s Rituxan. In spite of a fierce biosimilar competition J&J’s Remicade makes the cut with 2020 sales slightly superior to the ones of 2019.

2020 Drug Sales in $ billion

1. Humira from AbbVie, the anti-inflammatory reference drug at $20.39 billion.  On top of the list since 2012. Increase in sales of +3.5%. Stronger biosimilar competition expected in 2021.
2. Keytruda from Merck at $14.38 billion. The oncology drug leader in the field of checkpoint inhibitors. Sales up +29%. Could become the #1 selling drug in 2021 competing with Humira and BioNTech/Pfizer’s COVID-19 vaccine.
3. Revlimid from Bristol Myers Squibb at $12.15 billion. An oncology drug from the former Celgene portfolio. Sales up +20% partially due to a significant price increase. Will start losing some ground in 2021 with the launch of biosimilars but with a slow erosion due to recent approval of new indications.
4. Eliquis from Bristol Myers Squibb and Pfizer at $9.17 billion. A potent orally active anticoagulant for the treatment of atrial fibrillation. Strong sales increase of +37% in Q1 2021 due, in part, because blood thinner have been shown to improve overall COVID-19 outcomes.
5. Imbruvica from AbbVie and Johnson & Johnson at $8.43 billion. A blood cancer drug with a high price. Reported sales split are $4.30 billion for AbbVie and $4.13 billion for J&J. Biosimilar competition expected in 2021.
6. Eylea from Regeneron and Bayer at $8.36 billion. The reference drug for the treatment of age-related macular degeneration. Sales were up +7% in spite of the expected competition from Novartis’ Beovu which encountered safety concerns.
7. Stelara from Johnson & Johnson an anti-inflammatory drug at $7.94 billion. Sales were up +20% in the already crowded ulcerative colitis market.
8. Opdivo from Bristol Myers Squibb at $7.92 billion. In the harsh competition in the checkpoint inhibitor field Opdivo is clearly falling behind with almost half the sales of Merck’ Keytruda. Sales were down – 2% but BMS is optimistic with seven new approvals in 2020, including some gastro-intestinal cancer indications.
9. Biktarvy from Gilead at $7.26 billion an HIV treatment. Sales were up +53% from the $4.74 billion sales in 2019. The strong Biktvary sales increase come nevertheless at Gilead’s own costs as it cannibalises some of its other HIV treatments such as Truvada. Aggregate sales of Gilead’s HIV treatments were at $16.94 billion in 2020. The strongest competition should come from GSK, Pfizer and Shionogi’s JV: ViiV Healthcare.
10. Xarelto from Johnson & Johnson and Bayer at $6.93b. This orally active anticoagulant facing the end of its patent exclusivity did far less than Equilis with sales down – 9%. Sales splits were $4.58 billion for Bayer and $2.35 billion for J&J
11. Enbrel from Amgen at $6.37 billion.  A rheumatoid arthritis drug. Sales down from $7.2 billion in 2019. Amgen had a significant win against Sandoz/Novartis to obtain patent extension in the U.S.
12. Prevnar 13 vaccine from Pfizer at $5.95 billion. A pneumococcal 13-valent conjugate vaccine with a +10% growth. Prevnar is the top vaccine selling drug in 2020. This will clearly not be the case in 2021 with the emergence of COVID-19 vaccines, but Pfizer will still lead the pack.
13. Ibrance from Pfizer at $5.93 billion. A cancer treatment for breast cancer with sales increase of +9%. Failure in early HR-positive, HER-2 negative breast cancer may favour new incomers.
14. Avastin from Roche at $5.32 billion. Roche suffered from strong biosimilar competition in the U.S. mainly led by Amgen and Allergan, leading to sales decrease of -25% in revenues in 2020.
15. Trulicity from Eli Lilly at $5.07 billion. A reference anti-diabetic drug which received FDA approval of decreasing cardiovascular events. A few month earlier Novo Nordisk’s Ozempic had received a similar CV approval.
16. Ocrevus from Roche at $4.61 billion, a drug for the treatment of multiple sclerosis (MS). With a +24% increase in sales in the last quarter, Ocrevus will become Roche’s top medicine by sales in 2021. The crowed MS market will contemplate the strong entry of Novartis’s Kesimpta and other drugs from BMS and J&J.
17. Rituxan from Roche at $4.52 billion. A lymphoma cancer dug. The launch of biosimilars by Teva, Celltrion, Pfizer and Amgen has triggered a decrease in sales of -31% and seen the ranking of Rituxan slide from the 10^th to the 17^th position.
18. Xtandi from Astellas in partnership with Pfizer at $4.39 billion. A reference drug for prostate cancer. U.S. sales were up +22%.
19. Tagrisso from AstraZeneca at $4.33 billion. A non-small cell lung cancer drug with sales up + 36% mainly due to strong geographic extensions including China. Possibly the most efficient 3^rd generation EGFR inhibitor.
20. Remicade from Johnson & Johnson at $4.195 billion, an anti-inflammatory drug, first approved in 1998. In spite of a very strong competition from biosimilar entries since 2016, J&J managed to keep Remicade, in the game through very aggressive contracting and selective price cuts. As a consequence, sales were up from $3.75 billion in 2019.

Two remarks to this report.

Six companies appear more than once: Pfizer (4), Roche and Johnson & Johnson (3), AbbVie, Bayer and Bristol Myers Squibb (2)

Three TOP 10 companies are missing in the list: GlaxoSmithKline, Novartis and Sanofi.                                                 

Last minute news from Pfizer.

“In his Q1 report from today, Pfizer updated its assumptions related to BNT162b2 revenues for 2021. Revenues for BNT162b, its COVID-19 vaccine, are now estimated at approximately $26 billion (previously approximately at $15 billion). The BNT162b2 revenue projection incorporated within Pfizer’s 2021 financial guidance includes 1.6 billion doses that are expected to be delivered in 2021 under contracts that have been signed through mid-April 2021. This guidance may be adjusted in the future as additional contracts are executed.”

Unnecessary to state that BNT162b will be on top of the list of the drugs and vaccines sales in 2021.

Paris, May 4, 2021

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