Top 20 Drugs in the World 2017

Luca Dezzani, MD


The global prescription drug market is expected to grow by 6% from 2016 to 2022 to reach nearly USD 1.05 trillion by 2022. The top 20 drugs are manufactured by 14 companies and account for a total 10% of global prescription drug market in 2016. The total revenue generated by top 20 products was estimated to be USD 0.128 trillion. A large number of the drugs in the list are primarily for the treatment and management of cancer, diabetes, inflammatory disorders, and HIV or HCV infections. A report by Reuters predicts an average of 45 new drug launches each year henceforth, and suggests that the rising costs will be partially offset by a higher level of drugs going off patent, including the anticipated effect of biosimilars entering the market.

1. Humira (Adalimumab): Indicated in the treatment of autoimmune diseases and moderate to severely active rheumatoid arthritis. It tops the prescription-drug list of 2016 with an annual growth of 15% accounting for USD 16 billion sales globally. Humira is manufactured by AbbVie Inc. (U.S.). The patent for this product expired in 2016 in the U.S. and will expire by 2018 in Europe creating competitive opportunities for biosimilars market.
2. Harvoni (Ledipasvir/sofosbuvir): this product from Gilead Sciences is indicated in treating HCV/HIV infection. It is the second most prescribed drug in the market accounting for revenue of USD 9 billion. Wide patent range will aid the company’s overall growth which may be partially offset by the declining growth of -34% of this product from 2015-2016.  
3. Enbrel (Etanercept): It is another drug indicated for autoimmune diseases including rheumatoid arthritis, psoriasis and other inflammatory conditions. It is co-marketed by Amgen Inc. in the U.S. and Pfizer Inc. in Europe. Pfizer also has a co-promotion agreement with Takeda Pharmaceutical Company Ltd. to market Enbrel in Japan. The product holds 3rd position in the prescription drug list.
4. Rituxan (Rituximab, MabThera): Biogen and Roche co-markets the product indicated in the treatment of cancer. The patent for this product expired in 2015 which may result in significant decrease in sales. The product currently holds 4th position in the prescription drug market due to high revenues and growth of nearly 3%.
5. Remicade (Infliximab): indicated for autoimmune diseases and produced by J&J and Merck, Remicade sales decline by 11% in 2016 compared to 2015 sales. In February 2015, the Company lost market exclusivity for Remicade in major European markets and no longer has market exclusivity in any of its marketing territories. The Company is experiencing pricing and volume declines in these markets as a result of biosimilars competition and expects the declines to continue.
6. Revlimid (Lenalidomide): This is produced by Celgene and the revenues have increased by over 20%, from 2015. The product is indicated for the treatment of multiple myloma and will go off patented in 2027, which makes it an extremely important product in the company’s portfolio. The product holds 6th position in the prescription drug market.
7. Avastin (Bevacizumab): manufactured by Roche Avastin is used for advanced colorectal, breast, lung, kidney, cervical and ovarian cancer, and relapsed glioblastoma. Sales continued to grow strongly in the International region (+18%), especially China, following the approval of the lung cancer indication.
8. Herceptin (Trastuzumab): Another product manufactured by Roche, used for treating cancer mainly breast and gastric. Herceptin sales were up 4%, helped by additional reimbursement approvals in China and continued growth in the US due to longer duration of treatment in combination with Perjeta.
9. Januvia/Janumet (Sitagliptin): This product is used for the treatment of type 2 diabetes. Merck manufactures the product and the worldwide sales were estimated to be USD 6.1 billion in 2016, an increase of 2% compared with 2015. Sales growth was driven primarily by higher volumes in the United States, Europe and Canada, partially offset by pricing pressures in the United States and Europe, and lower sales in Venezuela due to the Company’s reduced operations in that country.
10. Lantus (Insulin glargine): A long-acting human insulin analog produced by Sanofi. The revenues from Lantus stood at USD 6.05 billion in 2016, a decline of 11% from the previous year. The U.S. patent for the product expired in August 2014. It was once one of the top-selling diabetes product in the world.
11. Prevnar 13/ Prevener (Pneumococcal 13-valent Conjugate Vaccine): the decline in Prevnar 13/Prevenar 13 revenues, primarily driven by an expected decline in revenues for the adult indication in the U.S. due to a high initial capture rate of the eligible population following its successful fourth-quarter 2014 launch, which resulted in a smaller remaining opportunity window compared to the prior-year, as well as the unfavorable impact of the timing of government purchases for the pediatric indication (down approximately USD 450 million).
12. Xarelto (Rivaroxaban): This anti-coagulant from Bayer and J&J has the highest growth rate within the top-20 prescription drug list of around 27%. It aids in the reduction of the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation; deep vein thrombosis (DVT) and pulmonary embolism (PE), and reduction in the risk of recurrence of DVT and of PE.
13. Eylea (Aflibercept): It is produced by Regeneron Pharmaceuticals and Bayer. It was approved by the U.S. Food and Drug Administration (FDA) for use in retinal indications, delivered U.S. net sales growth of 24.2% over 2015, and continues to be the market-leading branded anti-VEGF therapy in the United States. The global growth rate was estimated by 27% from 2015-16.
14. Lyrica (Pregabalin): It is an anti-epileptic from Pfizer Inc. The product grew by 3% from 2015-2016 reaching USD 5 billion. The patent for Lyrica is set to expire in 2018, which will very likely ensure high sales figures for the product till the end of that period. It is mostly indicated in neuropathic pain associated with diabetic peripheral neuropathy; postherpetic neuralgia; fibromyalgia; and pain associated with spinal cord injury.
15. Neulasta/ Peglasta and Neupogen / Gran (Pegfilgrastim and Filgrastim): Neulasta is a recombinant human granulocyte-colony stimulating factor (G-CSF) from Amgen and Kyowa Hakko Kirin. It is used to decrease the incidence of infection during cancer treatment. The U.S. patent for the product expired in June 2015. The revenues of the product stood at USD 4.7 billion in 2016, reduced by 1% from the previous year.
16. Advair /Seretide (Fluticasone and Salmeterol): Advair is indicated for asthma and maintenance treatment of COPD. The product’s revenues stood at USD 4.3 billion in 2016. The sales of the product declined by 5% between 2015 and 2016 and 13% between 2014 and 2015. The sales are expected to decline further after the U.S. patent expiry in 2016.
17. Copaxone (Glatiramer acetate): It is a subcutaneous injection formulation for the treatment of multiple sclerosis. The product’s patent expired in 2014. Copaxone accounted for USD 4.2 billion (including $3.5 billion in the U.S.), or 19% of Teva Pharmaceuticals revenues in 2016, and contributed a significantly higher percentage to profits and cash flow from operations during the period.
18. Sovaldi (Sofosbuvir): It is an oral formulation, dosed once a day for the treatment of HCV as a component of a combination antiviral treatment. Sovaldi sales accounted for 14%, 17% and 45% of our total antiviral product sales for 2016, 2015 and 2014, respectively. In 2016, product sales were USD 1.9 billion in the United States, USD 891 million in Europe, USD 635 million in Japan and USD 580 million in other international locations.
19. Tecfidera (Dimethyl fumarate): Manufactured by Biogen, this drug is used for treating multiple sclerosis. The product shows growth of 9% over the previous year, primarily due to price increases and higher sales volume in U.S. and expansion of the product launch in emerging markets across the globe.
20. Opdivo (Nivolumab): It represents the major part of Bristol-Myers Squibb’s immune-oncology portfolio, accounting for USD 3.8 billion out of USD 5 billion of the segmental revenues. It is a fully human monoclonal antibody that has been approved and continues to be investigated as an anti-cancer treatment. U.S. and international revenues increased in both periods due to higher demand resulting from the rapid commercial acceptance for several indications including melanoma, head and neck, lung, kidney and blood cancer.