Pharma50: The 50 Best-Selling pharmaceuticals in 2021

Drug sales in 2021 hit record heights, with a handful of pharmaceutical companies handsomely rewarded for creating COVID-19 vaccines and treatments. This roundup of best-selling pharmaceuticals in 2021 highlighted a banner year for the industry.

Pfizer alone raked in $36.9 billion in sales from the Comirnaty vaccine it developed jointly with BioNTech. Demand for the COVID-19 vaccine helped catapult Pfizer to be 2021’s top pharmaceutical company. Continued demand for the Pfizer-BioNTech vaccine is likely to keep Pfizer as the biggest pharma firm of 2022 as well. (Look out for more insights from our annual Pharma 50 report.) 

The second-best-selling pharmaceutical of 2021 was AbbVie’s injectable biologic Humira, which generated $20.7 billion in sales. Next in line was Moderna’s COVID-19 vaccine, which drove $17.7 billion in revenue. Merck’s megablockbuster Keytruda rounded out the top four with $17.2 billion in revenue.

[This feature is a part of 2022’s Pharma 50 series.]

Novartis and Roche have struggled to commercialize COVID-19 therapies, although the latter has introduced a series of SARS-CoV-2 diagnostics. The two companies have thus dipped in the rankings in 2021 compared with last year.

Drug sales in 2021

A closer look at the 5 top best-selling pharmaceuticals in 2021

1. Comirnaty COVID-19 vaccine

The meteoric rise of the COVID-19 vaccine from Pfizer and BioNTech has little precedent in the pharmaceutical industry. Generating more than $59 billion in cumulative revenue in 2021, the vaccine added $36.8 billion to Pfizer’s bottom line in 2021. The vaccine also catapulted once little-known BioNTech into the top tier of the pharmaceutical industry. In 2021, the company’s €18.9 billion in revenue surpassed that of Bayer’s pharmaceutical division. In addition, BioNTech announced a pact with Matinas BioPharma that could potentially result in an oral COVID-19 vaccine. Pfizer is also betting on the future potential of mRNA-based vaccines. “Although mRNA is not the holy grail, we believe the technology has the potential to have a game-changing impact on global health, which is why we have developed a robust mRNA strategy and are aggressively building our platform,” said Pfizer CEO Dr. Albert Bourla.  

2. Humira (adalimumab)

AbbVie’s megablockbuster Humira (adalimumab) surpassed the $20 billion mark for the first time in 2021, hitting $20.694 billion. 

The company has sought to offset the impact of Humira biosimilar competition outside of the U.S. in recent years through price increases. In 2003, when Abbott Laboratories launched Humira, the drug cost $522 in the U.S. per 40-mg syringe. Since then, Abbott and eventually its spin-off AbbVie have hiked the drug’s price more than two dozen price times. Humira now costs $2,984 per syringe, according to an investigation by the U.S. House of Representatives. 

A series of Humira biosimilars are poised to hit the U.S. market in 2023.  

The company seeks to reduce its reliance on Humira, which accounted for 36.8% of its revenue in 2021. In its 2021 earnings call, AbbVie CEO Rick Gonzalez noted that the JAK inhibitor Rinvoq (upadacitinib) and the monoclonal antibody Skyrizi (risankizumab) will be “commercialized across all of Humira’s major indications plus atopic dermatitis.” 

“With the strong performance that we’re seeing in their initial indications and the robust data we’ve demonstrated across our broad development programs, we expect combined peak sales for Skyrizi and Rinvoq to exceed the peak revenues achieved by Humira,” Gonzalez said. “In hematological oncology, we’ve established a leading position with Imbruvica and Venclexta, which are both expected to remain important revenue contributors through the decade.”

3. Spikevax COVID-19 vaccine

Moderna’s Spikevax COVID-19 vaccine generated $17.7 billion in revenue in 2021, making the drug the third-best-selling product of the year. Brisk sales of the vaccine have helped Moderna bolster its pipeline, which includes vaccine candidates for flu, respiratory syncytial virus, cytomegalovirus, HIV, Zika and others. But while the company saw meteoric growth in much of 2021, Moderna must now work to convince investors that the company is more than a COVID-19 vaccine company. 

4. Keytruda (pembrolizumab)

First approved in 2014, immunotherapy drug Keytruda continues to be a core business driver for Merck & Co. Since its initial approval for advanced melanoma, Keytruda has won scores of additional oncology indications.

Biosimilar competition, however, will likely erode sales by the end of the decade. To reduce risk, Merck has ramped up investment in its oncology pipeline. Merck has “an expanding portfolio of commercial and developmental oncology assets beyond Keytruda, which offer meaningful growth opportunities beyond 2028,” Rob Davis, president and CEO of Merck & Co., said in the company’s Q4 2021 earnings report.

In addition, the company hopes that sales of the Gardasil vaccine for recombinant human papillomavirus can offset waning Keytruda sales in coming years. Davis anticipates that sales of Gardasil could “potentially double by 2030.”

The company is also looking to vaccines, cardiometabolic, neuroscience and other disease areas to help fuel growth.

5. Eliquis (apixaban)

Developed jointly by Bristol Myers Squibb and Pfizer, Eliquis continues to be a solid revenue driver. Generating $16.7 billion in total revenue, global drug sales were up 20% in 2021. “In the U.S., fourth-quarter sales increased 22% versus prior year, driven primarily by total prescription growth of 13%,” Bristol Myers Squibb Chief Financial Officer David Elkins said on the company’s 2021 Q4 earnings call. Eliquis remains the most popular oral anticoagulant in many countries. 

The COVID-19 pandemic helped stoke demand for apixaban given evidence that blood thinners could help reduce the death risk from patients with severe infections who are at risk for strokes and heart attacks.

A table containing 50 of the best-selling pharmaceuticals in 2021 follows: