The next five years: outlook and targets for global pharma
AI-translated from the Chinese original · editorially reviewed
Reprinted with permission: Pharmascan
Over the past three years, global pharmaceutical companies have faced one challenge after another. Despite the bottlenecks created by the pandemic, industry transformation, and drug development hurdles, some drugmakers have still performed well thanks to strong portfolios and standout products. By 2028, Roche is projected to top the revenue rankings, while the best-selling drug is expected to be MSD's Keytruda (pembrolizumab).
A fierce battle atop the pharma revenue rankings
According to the World Preview 2023 report, Roche's edge in monoclonal antibody development is expected to give it a narrow lead, putting it at the top of the 2028 corporate revenue rankings.
Roche was once expected to lead the pack by a wide margin, but M&A deals and clinical trial wins and losses can quickly reshape a company's outlook. Had its gantenerumab trial succeeded, Roche would have broken new ground in Alzheimer's disease and refreshed its pipeline—but the results fell short of expectations. Its TIGIT inhibitor tiragolumab likewise stumbled in the closely watched SKYSCRAPER-02 trial in small cell lung cancer, failing to extend progression-free survival or overall survival.
AbbVie is expected to hold on to second place in 2028 revenue. Humira long dominated the top of the best-seller rankings, peaking at US$21 billion in sales last year. Even as its patents began expiring this year and it lost exclusivity, AbbVie has not surrendered the number-two spot: the drugs carrying the torch after Humira—the JAK (Janus kinase) inhibitor Rinvoq (upadacitinib), the psoriasis drug Skyrizi (risankizumab), and the blood cancer drug Venclexta (venetoclax)—are all expected to perform well.
Pfizer, Novartis, and Bristol Myers Squibb each drop three places, landing at 4th, 6th, and 9th respectively. Pfizer's decline stems mainly from losing its COVID-19 vaccine revenue, while Bristol Myers Squibb faces patent expirations for the anticoagulant Eliquis (apixaban) in 2023 and the immuno-oncology drug Opdivo (nivolumab) in 2027.
The undisputed champion in drug sales
On the best-selling drug rankings, MSD's Keytruda takes first place. According to the Evaluate report, Keytruda will reach the US$30 billion sales milestone in 2028 (its sales for the first half of 2023 stand at US$12.1 billion). By comparison, no other drug is projected to reach even US$20 billion in 2028. Moreover, the US$30 billion figure excludes the subcutaneous formulation currently in Phase 3 trials—if those trials hit their primary efficacy endpoints, it is expected to add another US$2.4 billion in sales by 2028.
Oncology leads the disease areas with the brightest prospects
Through 2028, immunomodulation, oncology, and central nervous system are projected to be the three fastest-growing disease areas, each with a CAGR above 10%. Oncology will be the largest by sales: cancer drugs save lives and extend treatment duration, and the high demand for cancer therapies drives heavy investment in novel treatments. Under patent protection, once a drug becomes the treatment of choice for a given cancer, it can hold a leading position for the long term.
Immunomodulators are growing fastest, as genetics, environment, and stress continue to push up demand for psoriasis and atopic dermatitis treatments. Last comes the central nervous system area, spanning psychiatric and neurological drugs—multiple sclerosis and Alzheimer's disease both still need better therapies to address unmet needs.
Nancy Phelan noted: "We can expect the balance between sales forces and digital strategy to shift. Much of the focus used to be on sales representatives, but that will gradually give way to coexistence with digital strategies. Pharmaceutical companies already recognize they must move in a new direction."
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