Top Companies and Drugs by Sales in 2020

NEWS & ANALYSIS

MARKET WATCH on Eylea, which accounted for almost 70% of sales last year, it is almost certain to rigorously defend its cash cow. Top companies and drugs by sales in 2020 Regeneron was not the only company to be heavily dependent on a single product last Having supplanted Novartis as the biggest Bumping up sales through acquisitions year; Gilead’s HIV treatment Biktarvy made pharma company by prescription sales in saw BMS add Revlimid (lenalidomide) and up more than one-third of group sales, a figure 2019, Roche managed to hang onto the title its $12 billion in yearly revenue through the that is expected to increase to more than 45% in 2020 (Fig. 1a). This success came despite $74-billion purchase of Celgene in 2019, giving in 2026, following Gilead’s less than successful lower sales than 2019, as some of its biggest it three of the top-ten- selling drugs in 2020. attempts to grow beyond its 2015 peak, which drugs, including multiple sclerosis treatment But this is just a short-term boost, as Revlimid was fuelled by hepatitis C therapies. There Ocrevus (ocrelizumab), were hit early in is set to lose patent protection in 2022, which had been hopes that the COVID-19 antiviral, the pandemic owing to hospitals delaying made BMS’s success in fighting off generic Veklury (remdesivir), could boost Gilead’s treatments and focusing on COVID-19. competition for Eliquis (apixaban) until at least sales, but decreasing hospitalization rates While second-placed company Novartis 2026 even more important. The blood thinner, have limited the number of patients eligible managed to increase its year-on- year sales, which overtook Johnson & Johnson and Bayer’s for treatment with the nucleotide analogue. they were still relatively muted as COVID-19 slower-growing rival Xarelto (rivaroxaban) in Indeed, despite COVID-19’s huge global again played its part. Novartis’s best-seller, 2018, is BMS’s second biggest growth driver impact in 2020, it had relatively little impact on the anti-IL-17 monoclonal antibody (mAb) behind Opdivo (nivolumab) and is forecast drug sales. But with Pfizer, one of 2020’s big- Cosentyx (secukinumab), was held back by to bring in almost as much as the PD1 inhibitor gest losers in terms of annual sales and ranking reductions in hospital-administered and by 2026, according to Evaluate Pharma. following the spinoff of Upjohn, already physician-administered infusions to treat Indirect generic competition could hurt predicting sales of $15 billion this year from the autoimmune diseases it is approved for, the chances of Eylea (aflibercept), 2020’s fifth its COVID-19 vaccine, that could all change. such as psoriasis. Challenges with treatment biggest-selling drug. Lucentis (ranibizumab), Lisa Urquhart administration also limited the uptake of the Novartis’s rival drug for wet age-related macu- Evaluate Vantage, London, UK. gene therapy Zolgensma (onasemnogene lar degeneration, is set to have biosimilar com- e-mail: [email protected] abeparvovec) for spinal muscular atrophy. petitors this year, which could cause doctors to https://doi.org/10.1038/d41573-021-00050-6 Usually the top five drug companies are start new patients on the cheaper alternatives, Competing interests a relatively stable group, but this year has rather than Eylea. Given Regeneron’s reliance The author declares no competing interests. been marked by some significant moves, with AbbVie and Bristol Myers Squibb (BMS) a Company Roche 47.5 moving up four and five places, respectively, 48.8 47.2 pushing Pfizer and Merck & Co. lower down Novartis 46.1 44.3 the table. AbbVie 32.4 43.1 Merck’s descent in the table should come Johnson & Johnson 40.1 as little surprise as it was one of the few 41.9 Bristol Myers Squibb 25.2 companies in the first quarter of 2020 to warn 41.4 Merck & Co. 40.7 that COVID-19 would hit its full-year pharma 35.8 sales. Nevertheless, the company still managed Sanoﬁ 34.9 35.6 to report a rise in revenues over the full year, Pﬁzer 43.8 largely thanks to its powerhouse: the cancer GlaxoSmithKline 30.6 31.3 2020 immunotherapy Keytruda (pembrolizumab). 28.4 Takeda* 28.7 2019 The PD1 inhibitor remains on track to be the 0 5 10 15 20 25 30 35 40 45 50 industry’s biggest selling drug in 2023, finally b Product (company) toppling Humira (adalimumab), which is Humira (AbbVie) 20.4 expected to see biosimilar competition enter 19.7 14.4 the market that year. Keytruda (Merck & Co.) 11.1 12.2 But for now Humira remains the top prod- Revlimid (Bristol Myers Squibb) 11.2 (Fig. 1b) 9.2 uct in 2020 , with full-year revenues Eliquis (Bristol Myers Squibb) 7.9 surpassing US$20 billion owing to AbbVie’s Eylea (Regeneron 8.4 Pharmaceuticals) 8.0 deals with biosimilar companies. The strength 7.9 Stelara (Johnson & Johnson) 6.6 of Humira, the successful launches of rheuma- 7.9 toid arthritis drug Rinvoq (upadacitinib) and Opdivo (Bristol Myers Squibb) 8.0 7.6 psoriasis treatment Skyrizi (risankizumab), Imbruvica (AbbVie) 5.7 plus the contribution from the BTK inhibitor Biktarvy (Gilead Sciences) 7.3 4.7 2020 Imbruvica (ibrutinib) for blood cancers and Xarelto (Bayer/ 6.9 6.4 2019 Botox following the acquisition of Allergan, Johnson & Johnson) helped to increase AbbVie’s sales by an impres- 0 2 4 6 8 10 12 14 16 18 20 22 sive 33%. With both Rinvoq and Skyrizi fore- Sales (US$ billions) cast to have revenues in excess of $7 billion by Fig. 1 | Top companies and drugs by sales in 2020. a | Top ten companies by sales of prescription 2026, AbbVie might not slip too far down the and over-the- counter drugs. *Data for Takeda are consensus forecasts. b | Top ten drugs by sales rankings when Humira sales start to decline. globally. Data for 2019 are included for comparison. Source: EvaluatePharma.

NAture Reviews | Drug DisCovery volume 20 | April 2021 | 253

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