Top 10 selling drugs for 2024
Keytruda tops the list, but GLP-1 agonists are coming up fast
Recent data published by Statista suggest that Merck’s Keytruda will be the top-selling drug globally this year, surpassing last year’s revenue by over $2 billion USD. Keytruda is a first-line treatment for several types of cancer, including melanoma, lung cancer, head and neck cancer, and Hodgkin lymphoma. It is classified as an immune checkpoint inhibitor because it blocks proteins that act as brakes on the immune system.
Keytruda is a monoclonal antibody that prevents the interaction between the PD-L1 receptor on tumor cells and the PD-1 receptor on T cells, which enhances the immune system’s ability to destroy cancer cells. For Keytruda to be effective, the tumor must express the PD-L1 protein on its surface, which is present in about 30% of all solid tumors.
Keytruda’s patents and market exclusivity protect it from competition until at least 2028, with possible extensions into the early 2030s. After these protections expire, biosimilar competition is expected to emerge, potentially impacting Merck’s market share and revenue from Keytruda. However, ongoing research and development efforts by Merck aim to maintain its position in the oncology field.
Speaking of patents. You can notice that AbbVie’s Humira, arguably the best selling drug of all time is missing from the projections for 2024. This is because AbbVie lost market exclusivity this year when its patent expired after 20 years. However, Skyrizi approved in 2019 with projected revenue of $9.9 billion in 2024 is making up some of the losses. While Skyrizi targets different pathways compared to Humira, it is also used to treat plaque psoriasis and other inflammatory conditions.
Other cancer-related drugs in the top 10 for 2024 include Darzalex and Opdivo. Darzalex, a monoclonal antibody developed by Janssen Biotech, a subsidiary of J&J, targets CD38 protein on the surface of multiple myeloma cells. This induces killing of tumor cells by so called natural killer cells in the body. Clinical trials have demonstrated significant efficacy of Darzalex in improving progression-free survival and overall response rates in multiple myeloma patients.
Opdivo is a monoclonal antibody developed by Bristol-Myers Squibb and is projected to generate $11.3 billion in revenue this year. It is another checkpoint inhibitor utilizing the PD-L1/PD-1 molecule blocking mechanism similar to Keytruda.
With patents expiring in 2028 for both Darzalex and Opdivo, we are likely to see them in the top-selling charts for a few more years to come.
This is the second year in a row that Ozempic (Novo Nordisk) has made the top 10 selling drug list, and it is projected to nearly double its revenue since last year, highlighting the growing prominence of GLP-1 receptor agonist drugs. Since Ozempic’s patents do not expire until at least 2031, it is likely to remain one of Novo Nordisk’s top revenue generators. However, emerging treatments that combine GLP-1 receptor agonists with other drugs for weight loss and type 2 diabetes suggest that similar medications may enter the top-selling charts in the upcoming years.
Sanofi’s Dupixent, an interleukin-4 and interleukin-13 blocker, is a monoclonal antibody drug with broad applications in the treatment of asthma and atopic dermatitis. Since its market introduction in 2018, Dupixent has quickly become a blockbuster drug due to its effectiveness and the high unmet need in these conditions. Its sales have grown significantly since its launch.
BMS’s Eliquis is an oral anticoagulant medication that blocks Xa clotting factor, preventing and treating blood clots. Eliquis has become one of the most widely prescribed anticoagulants globally since 2013 due to its efficacy and favorable safety profile compared to traditional anticoagulants like warfarin.
Biktarvy, developed by Gilead, is an antiretroviral medication used to control HIV-1 infection in adults and children. It has become one of the leading treatments for HIV-1 due to its convenience as a single-tablet regimen and its strong efficacy and safety profile. Biktarvy is also a strong player due to its versatility, being approved for both treatment-naive patients and those switching from other regimens.
Lastly, two preventative vaccines that made it to the top-selling chart include Comirnaty and Gardasil.
Comirnaty, also known as the Pfizer-BioNTech COVID-19 mRNA vaccine, dropped from 1st place in 2021 and 2022 ($40 billion USD both years) to 5th place in 2023 to 8th place in 2024 in terms of sales rankings but continues to generate significant revenue for Pfizer and BioNTech. This vaccine was one of the first to receive emergency use authorization and later full approval from the FDA in 2021. The vaccine has been updated to include formulations that target newer variants, such as the Omicron variant XBB.1.5.
Gardasil, developed by Merck and approved in 2006 for the prevention of human papillomavirus (HPV) infection, which is associated with various cancers, has been among the top 10 best-selling drugs for several years. Gardasil, along with Cervarix (GSK), is up to 99% effective in preventing HPV-associated cancers. These vaccines have significantly reduced the incidence of HPV-related cancers in vaccinated populations.
Trends to watch
GLP-1 receptor agonists, especially Mounjaro, are expected to become more prominent in the coming years. Kisunla (Eli Lilly), recently approved for Alzheimer’s disease, is anticipated to be a major player in the neurodegenerative disease market. Long acting HIV treatments, such as those being developed by Gilead could significantly impact the HIV treatment landscape by offering less frequent dosing options.
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DISCLOSURE: I have no business relationships with any company mentioned in this article.