[Updated May 21, 2024.]
[Scanrail/Adobe Stock]
The rise of metabolic disease drugs underscores the growing global burden of obesity and diabetes. With Ozempic’s sales reaching $13.9 billion in 2023, a 38% increase, GLP-1 therapies seem poised to play a significant role in treating metabolic disease.
In the chart below, bigger circles generally corresponds with more robust growth. Note the explosive sales growth of Mounjaro (tirzepatide), a GLP-1 receptor agonist that along with Zepbound (an obesity-targeted version of the same drug), in the chart below. Note: Mounjaro was launched in the middle of 2022 and only had sales data for two quarters. To normalize its representation, this visual extrapolated its 2022 full year sales by doubling the half-year sales figure. The growth rate and bubble size were calculated using this extrapolated 2022 sales value.
Sales figures in the chart are in millions of U.S.
While metabolic disease treatments made significant strides, oncology drugs continued to dominate the list of bestsellers. Keytruda, a strong-selling cancer immunotherapy since the mid-2010s, maintained its position as the highest-grossing drug with sales of $25 billion, a 19% increase from 2022. Other oncology treatments, such as Darzalex, Opdivo, and Tagrisso, also experienced growth.
It’s likely that the metabolic disease could soon overtake immunology as the second-largest sales category in the coming years. On a related note, AbbVie juggernaut Humira had a sales decrease of 32.2% compared to the previous year, thanks to biosimilar competition after Humira’s patent exclusivity expired.
Oncology and immunology continue to dominate the pharma landscape
The donut chart below provides a visual representation of 2023 drug sales by category for the top 50 drugs, highlighting the growing prominence of metabolic treatments while also demonstrating the continued dominance of oncology, which accounts for more than one-quarter of top-selling drug sales. Immunology makes up more than one-fifth.
Top 50 pharmaceuticals by sales in 2023
Note: Sales of drugs with more than one developer are added together (as in the case of the COVID-19 vaccine Comirnaty) unless one of those companies records the net sales for it, i.e., Dupixent. Data from companies’ respective annual reports.]
| Drug Name | Manufacturer(s) | Sales 2023 (USD M) | Sales 2022 (USD M) | Growth Rate | Indications |
|---|---|---|---|---|---|
| Keytruda (pembrolizumab) | Merck | $25,011 | $20,937 | 19.46% | Various cancers |
| Humira (adalimumab) | AbbVie | $14,404 | $21,237 | -32.17% | Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, plaque psoriasis, and others |
| Ozempic (semaglutide) | Novo Nordisk | $13,892 | $10,060 | 38.09% | Type 2 diabetes |
| Eliquis | Bristol Myers Squibb | $12,206 | $11,789 | 3.54% | Anticoagulant |
| Dupixent (dupilumab)* | Sanofi | $11,590 | $8,736 | 32.67% | Atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyps, prurigo nodularis, eosinophilic esophagitis |
| Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) | Gilead Sciences, Inc. | $11,850 | $10,390 | 14.05% | HIV-1 infection |
| Comirnaty (tozinameran) | Pfizer, BioNTech | $15,305 | $55,913 | -72.63% | COVID-19 vaccination |
| Stelara (ustekinumab) | Johnson & Johnson | $10,858 | $9,723 | 11.67% | Plaque psoriasis, psoriatic arthritis, Crohn’s disease, ulcerative colitis |
| Darzalex (daratumumab) & Darzalex Faspro (daratumumab and hyaluronidase-fihj) | Johnson & Johnson | $9,744 | $7,977 | 22.15% | Multiple myeloma |
| Eylea (aflibercept) | Regeneron, Bayer | $12,876 | $13,031 | -1.19% | Neovascular (wet) age-related macular degeneration (AMD) |
| Opdivo (nivolumab) | Bristol-Myers Squibb | $9,009 | $8,249 | 9.21% | Various cancers |
| Trikafta/Kaftrio | Vertex Pharmaceuticals Incorporated | $8,945 | $7,687 | 16.37% | Cystic fibrosis |
| Gardasil/Gardasil 9 | Merck | $8,886 | $6,897 | 28.84% | Human Papillomavirus prevention |
| JARDIANCE family | Boehringer Ingelheim | $8,120 | $6,415 | 26.58% | Type-2 diabetes, chronic heart failure, chronic kidney disease |
| Skyrizi (risankizumab-rzaa) | AbbVie | $7,763 | $5,165 | 50.30% | Plaque psoriasis, psoriatic arthritis, Crohn’s disease |
| Invega Sustenna/Xeplion/Invega Trinza/Trevicta | Johnson & Johnson | $7,140 | $4,140 | 72.46% | Schizophrenia, Schizoaffective disorder |
| Trulicity (dulaglutide) | Eli Lilly and Company | $7,133 | $7,440 | -4.13% | Type 2 diabetes, cardiovascular risk reduction |
| Eliquis (apixaban) | Pfizer | $6,747 | $6,480 | 4.12% | Nonvalvular atrial fibrillation, deep vein thrombosis, pulmonary embolism |
| Spikevax | Moderna | $6,700 | $18,470 | -63.72% | COVID-19 vaccine |
| Prevnar family (pneumococcal 13-valent conjugate vaccine) | Pfizer | $6,440 | $6,337 | 1.63% | Pneumonia, invasive disease, and otitis media caused by Streptococcus pneumoniae |
| Revlimid (lenalidomide) | Bristol-Myers Squibb | $6,097 | $9,978 | -38.90% | Multiple myeloma, Lymphoma, Myelodysplastic syndromes |
| Entresto (sacubitril/valsartan) | Novartis | $6,035 | $4,644 | 29.95% | Chronic heart failure, hypertension |
| Farxiga/Forxiga (dapagliflozin) | AstraZeneca | $5,997 | $4,381 | 36.89% | Type 2 Diabetes, Heart Failure, Chronic Kidney Disease |
| Tagrisso (osimertinib) | AstraZeneca | $5,799 | $5,444 | 6.52% | Early-stage EGFRm NSCLC, advanced EGFRm NSCLC |
| Ocrevus (ocrelizumab) | Roche | $5,750 | $5,730 | 5.97% | Relapsing or primary progressive multiple sclerosis |
| XTANDI | Daiichi Sankyo | $5,341 | $4,705 | 13.51% | Prostate cancer |
| Mounjaro (tirzepatide) | Eli Lilly and Company | $5,163 | $483 | 968.94% | Type 2 diabetes mellitus |
| Cosentyx (secukinumab) | Novartis | $4,980 | $4,788 | 4.01% | Psoriasis, ankylosing spondylitis, psoriatic arthritis, non-radiographic axial spondyloarthritis, hidradenitis suppurativa |
| Ibrance (palbociclib) | Pfizer | $4,753 | $5,120 | -7.17% | HR-positive/HER2-negative metastatic breast cancer |
| PRIVIGEN | CSL Behring | $4,675 | $4,024 | 16.18% | Immune Globulin Intravenous (Human), 10% Liquid |
| Xarelto (rivaroxaban) | Bayer | $4,414 | $4,757 | -7.21% | Stroke prevention in atrial fibrillation, treatment and prevention of deep vein thrombosis and pulmonary embolism |
| Shingrix (zoster vaccine recombinant, adjuvanted) | GSK | $4,287 | $3,659 | 17.16% | Herpes zoster (shingles) |
| Imfinzi (durvalumab) | AstraZeneca | $4,237 | $2,784 | 52.19% | Lung cancer, Bladder cancer, Liver cancer |
| Rinvoq (upadacitinib) | AbbVie | $3,969 | $2,522 | 57.38% | Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, atopic dermatitis, and others |
| Verzenio (abemaciclib) | Eli Lilly and Company | $3,863 | $2,484 | 55.52% | HR+, HER2- metastatic breast cancer, early breast cancer at high risk of recurrence |
| OFEV | Boehringer Ingelheim | $3,861 | $3,550 | 8.77% | Idiopathic pulmonary fibrosis, SSc-ILD, PF-ILD |
| Hemlibra (emicizumab-kxwh) | Roche | $3,726 | $3,651 | 2.05% | Haemophilia A |
| Enbrel (etanercept) | Amgen | $3,697 | $4,117 | -10.20% | Rheumatoid arthritis, plaque psoriasis, psoriatic arthritis, juvenile idiopathic arthritis, ankylosing spondylitis |
| Prolia (denosumab) | Amgen | $3,670 | $3,280 | 11.89% | Osteoporosis, low bone mass |
| Orencia (abatacept) | Bristol Myers Squibb | $3,601 | $3,464 | 3.95% | Rheumatoid arthritis |
| Imbruvica (ibrutinib) | AbbVie & Janssen | $3,596 | $8,352 | -56.94% | Chronic lymphocytic leukemia, mantle cell lymphoma, marginal zone lymphoma, and others |
| Pomalyst/Imnovid | Bristol Myers Squibb | $3,441 | $3,497 | -1.60% | Multiple myeloma |
| Tecentriq (atezolizumab) | Roche | $3,414 | $3,533 | 2.40% | Urothelial carcinoma, non-small cell lung cancer, triple-negative breast cancer |
| Perjeta (pertuzumab) | Roche | $3,385 | $3,916 | -5.71% | HER2-positive breast cancer |
| Vyndaqel family (tafamidis meglumine, tafamidis) | Pfizer | $3,321 | $2,447 | 35.72% | ATTR-CM and polyneuropathy |
| Wegovy (semaglutide) | Novo Nordisk | $3,321 | $874 | 279.98% | Obesity |
| Tremfya (guselkumab) | Johnson & Johnson | $3,147 | $2,668 | 17.95% | Moderate to severe plaque psoriasis |
| Botox Therapeutic (onabotulinumtoxinA) | AbbVie | $2,991 | $2,719 | 10.00% | Chronic migraine, overactive bladder, spasticity, cervical dystonia, and others |
*Note: For products with more than one manufacturer, sales figures have been combined. In the case of Dupixent, where Sanofi reports total net sales and Regeneron reports its share, only Sanofi’s net sales figure is used.
Filed Under: Drug Discovery, Immunology, Infectious Disease, Oncology
