1. Pembrolizumab (Keytruda, Merck)
Sales: $29.48 billion (+18%)
Highlights: A PD-1 inhibitor covering 40+ cancer indications, with a new first-line treatment for pleural mesothelioma in 2024; developing a subcutaneous formulation to extend the patent cycle (original patent expires in 2028).
Challenges: The FDA plans to restrict its use in patients with low PD-1 expression.
2. Semaglutide (Ozempic, Novo Nordisk)
Sales: $16.9 billion (+26%)
Highlights: A GLP-1 drug used for type 2 diabetes, cardiovascular protection, and chronic kidney disease; significant future growth potential. - Challenges: The U.S. Inflation Reduction Act (IRA) mandates price cuts, and Novo Nordisk is contesting this through litigation.
3. Bictegravir/Emtricitabine/Tenofovir Alafenamide (Biktarvy, Gilead)
Sales: $13.4 billion (+13%)
Highlights: An HIV drug occupying over 50% of the U.S. market, with patent protection until 2033 and no impact from the IRA.
4. Apixaban (Eliquis, BMS/Pfizer)
Sales: $13.3 billion (+9%)
Highlights: A blood thinner with successful joint marketing.
Challenges: Patent expiration in 2026, with generics already approved; a 56% price cut after IRA negotiations, prompting both companies to launch cost-cutting plans.
Challenges: Patent expiration in 2026, with generics already approved; a 56% price cut after IRA negotiations, prompting both companies to launch cost-cutting plans.
5. Dupilumab (Dupixent, Sanofi/Regeneron)
Sales: $13 billion (+23%)
Highlights: An immunotherapy drug for atopic dermatitis, asthma, and newly approved chronic obstructive pulmonary disease (COPD), with patent protection until 2031.
6. Risankizumab (Skyrizi, AbbVie)
Sales: $13 billion (+23%)
Highlights: An immunotherapy drug for atopic dermatitis, asthma, and newly approved chronic obstructive pulmonary disease (COPD), with patent protection until 2031.
6. Risankizumab (Skyrizi, AbbVie)
Sales: $11.7 billion (+50.9%)
Highlights: An anti-IL-23 drug with the fastest growth, helping AbbVie reduce reliance on Humira, with patent protection until 2031.
7. Daratumumab (Darzalex, Johnson & Johnson)
Sales: $11.7 billion (+20%)
Highlights: A multiple myeloma drug with patent protection until 2029, driving growth in J&J's oncology portfolio.
8. Ustekinumab (Stelara, Johnson & Johnson)
Sales: $10.3 billion (-4.6%)
Highlights: An anti-inflammatory drug whose sales declined due to biosimilar competition after patent expiration in 2023.
9. Adalimumab (Humira, AbbVie)
Sales: $9 billion (-37.6%)
Highlights: Once the world's best-selling drug, it faced biosimilar competition after patent expiration in 2023, with market share dropping from 82% (Q3 2023) to 72% (2024).
10. Gardasil (Merck)
Sales: $8.6 billion (-3%)
Highlights: The only vaccine on the list, approved for men in China in 2024, but supply was suspended due to high inventory; patent expires in 2028, with policy uncertainties ahead.
Summary Trends
Growth Drivers: Oncology immunotherapy (Keytruda), metabolic diseases (Ozempic), and immunotherapies (Skyrizi/Dupixent) are major growth areas.
Key Challenges: Patent cliffs (Humira/Eliquis), policy-driven price cuts (IRA impacts on Ozempic/Eliquis), and biosimilar competition (Humira/Stelara).
Corporate Strategies: Developing new formulations (Keytruda's subcutaneous version), expanding indications (Darzalex/Ozempic), and patent portfolio management (extending protection periods).
