Top 20 Prescription Drugs Based on 2021 Total Revenue

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The pharmaceutical companies have shown continual efforts towards developing enhanced and innovative treatment options to address the unmet needs of patients with disease eradication being the goal of developing these treatments
Advancements in cellular and molecular biology have increased the possibilities for generating new pharmaceutical products imposing major impacts on the prevention, diagnosis, and treatment of human disease. Humira has once again secured the top position with total revenue of $21.15B, followed by Keytruda and Eliquis
Our team at PharmaShots has compiled a list of the top 20 prescription drugs based on their 2021 revenue

Company: Roche

First Approved: US (Jun 08, 2012), EU (Mar 04, 2013)

Total Revenue: $4.33B

Indications Approved: Breast Cancer

Perjeta is a HER2/new targeting receptor antagonist designed specifically to prevent HER2 receptors from pairing with other HER receptors including EGFR/HER1, HER3, and HER4 on the surface of cells. It is indicated in an IV form for the treatment of Metastatic or Early Breast Cancer. Perjeta’s 2021 revenue decreased by 1.4% vs 2020. In Mar’21, Health Canada approved Perjeta as a neoadjuvant treatment for patients with HER2-positive, locally advanced, inflammatory, or early-stage breast cancer

Company: AstraZeneca

First Approved: US (Nov 13, 2015), EU (Apr 24, 2017)

Total Revenue: $5.01B

Indications Approved: Non-Small Cell Lung Cancer

Tagrisso is an oral third-generation irreversible EGFR TKI, approved as adjuvant therapy post-tumor resection in the treatment of adult patients with Non-Small Cell Lung Cancer whose tumors have EGFR exon 19 deletions or exon 21 L858R mutations. The product’s 2021 revenue was boosted by 15.9% vs 2020. On Nov’21, AstraZeneca & HUTCHMED initiated a P-III (SACHI) trial for the evaluation of Tagrisso combined with Orpathys in patients with lung cancer.

Company: Pfizer

First Approved: US (Feb 03, 2015), EU (Nov 09, 2016)

Total Revenue: $5.44B

Indications Approved: HER2 Negative Advanced Breast Cancer

Ibrance is an oral kinase inhibitor indicated for adult patients with HR-positive, HER2-negative advanced, or metastatic breast cancer given in combination with an aromatase inhibitor as initial endocrine-based therapy or with fulvestrant in patients with disease progression following endocrine therapy. The product’s 2021 revenue inclined by 1.0% vs 2020. On Jun’21, Pizer & AstraZeneca reported promising follow-up results from the P-III (PALOMA-3) trial evaluating Ibrance in combination with Faslodex for the treatment of HR-positive, HER2-negative advanced breast cancer.

Company: Roche

First Approved: US (Mar 28, 2017), EU (Jan 08, 2018)

Total Revenue: $5.54B

Indications Approved: Multiple Sclerosis

Ocrevus is a humanized monoclonal antibody developed to target CD20-positive B cells, an immune cell type that is thought to have a significant contribution to myelin and axonal damage. Given in an IV form, this mAb is indicated for the treatment of relapsing forms of multiple sclerosis. Ocrevus’ 2021 revenue increased by 13.30% vs 2020. On Apr’21, Genentech reported results from the P-III (ORATORIA) study evaluating Ocrevus in patients with early-stage RRMS and PPMS.

Company: Gilead Sciences

First Approved: US (Oct 22, 2020), EU (Aug 08, 2022)

Total Revenue: $5.56B

Indications Approved: COVID-19

Veklury is a nucleotide analog depicting a broad-spectrum antiviral activity both in vitro and in vivo against multiple emerging viral pathogens including Ebola, SARS, Marburg, MERS, and SARS-CoV-2. It has been globally approved or authorized for the treatment of COVID-19 as an IV dose. Veklury’s 2021 revenue was boosted by 97.9% vs 2020. In Apr’21, Gilead expanded the availability of Veklury across India by donating ~450,000 vials of Veklury to the Government of India.

Company: Amgen, Pfizer & Takeda

First Approved: US (Nov 02, 1998), EU (Feb 03, 2000)

Total Revenue: $5.65B

Indications Approved: Rheumatoid Arthritis, Polyarticular Juvenile Idiopathic Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, Plaque Psoriasis

Enbrel is a subcutaneous dimeric fusion protein consisting of the extracellular ligand-binding portion of the human 75-kilodalton (p75) TNFR linked to the Fc portion of human IgG1. It is indicated for the treatment of adult patients with moderate to severely active rheumatoid arthritis. Enbrel’s 2021 revenue declined by 10.9% vs 2020. In Jun’21, NICE recommended the use of adalimumab, etanercept, and infliximab in combination with methotrexate for the treatment of rheumatoid arthritis

Company: Vertex

First Approved: US (Oct 21, 2019), EU (Aug 21, 2020)

Total Revenue: $5.69B

Indications Approved: Cystic Fibrosis

Trikafta/Kaftrio is an oral medicament used for the treatment of patients aged ≥6yrs. with Cystic Fibrosis causing severe effects on the lungs, digestive system, and other organs. It is used in combination with Ivacaftor in patients with Cystic Fibrosis caused due to F508del mutation in the CFTR gene. Kaftrio’s 2021 revenue was boosted by 47.4% vs 2020. On Apr’21, The EC approved the combination therapy Kaftrio with Ivacaftor/Tezacaftor/Elexacaftor to treat Cystic Fibrosis

Company: Sanofi & Regeneron

First Approved: US (Mar 28, 2017), EU (Sep 27, 2017)

Total Revenue: $5.97B

Indications Approved: Atopic Dermatitis

Dupixent is a fully human monoclonal antibody in the form of a subcutaneous injection that inhibits the signalling of the IL-4 and IL-13 pathways. It was developed using Regeneron’s VelocImmune technology. Dupixent’s 2021 revenue was inclined by 38.8% vs 2020. In Oct’21, Regeneron & Sanofi reported results from the P-III (PRIME2) study evaluating Dupixent in adults with uncontrolled prurigo nodularis which is a chronic type 2 inflammatory skin disease

Company: Johnson & Johnson

First Approved: US (Nov 16, 2015), EU (Apr 28, 2017)

Total Revenue: $6.02B

Indications Approved: Multiple Myeloma, Light Chain Amyloidosis

Darzalex is a combination of daratumumab which is a CD38-directed cytolytic antibody and hyaluronidase which is an endoglycosidase given subcutaneously for the treatment of patients with Multiple Myeloma & Light Chain Amyloidosis. It is co-formulated with rHUPH20 using Halozyme’s Enhanze Drug Delivery Technology. Darzalex’s 2021 revenue increased by 43.7% vs 2020. On Dec’21, Johnson & Johnson reported the US FDA’s approval for Darzalex in combination with Kyprolis and dexamethasone for the treatment of multiple myeloma.

Company: Eli Lilly

First Approved: US (Sep 18, 2014), EU (Nov 21, 2014)

Total Revenue: $6.47B

Indications Approved: Type 2 Diabetes

Trulicity is a glucagon-like peptide (GLP-1) receptor agonist given in the form of a subcutaneous injection to patients with Type 2 Diabetes for the reduction in blood sugar levels and risk of major cardiovascular events. It is recommended to be taken with a suitable diet and exercise for diabetes control. Trulicity’s 2021 revenue rose by 27.6% vs 2020. In Oct’21, Eli Lilly entered into a strategic partnership with Cipla to enhance the outreach of Eli Lilly’s Trulicity and Humalog across India.

Company: Johnson & Johnson & Bayer

First Approved: US (Jul 01, 2011), EU (Sep 30, 2008)

Total Revenue: $7.82B

Indications Approved: Pulmonary Embolism, Deep Vein Thrombosis, Risk of Stroke & Systemic Embolism, Coronary Artery Disease, Peripheral Artery Disease

Xarelto is an anticoagulant prescribed in the form of a tablet or oral suspension for the prevention of Deep Vein Thrombosis (DVT), to reduce the risk of Stroke and Systemic Embolism in patients with Nonvalvular Atrial Fibrillation. It is formulated using rivaroxaban as an active ingredient which is a factor Xa inhibitor approved for the pediatric treatment and secondary prevention of Venous Thromboembolism (VTE). Xarelto’s 2021 revenue decreased by 0.5% vs 2020. On Feb’21, Bayer received approval for Xarelto in the UK for the treatment of children with VTE and to prevent VTE recurrence.

Company: BMS & Ono Pharmaceuticals

First Approved: US (Dec 22, 2014), EU (Jun 19, 2015)

Total Revenue: $8.46B

Indications Approved: Unresectable or Metastatic Melanoma, Non-Small Cell Lung Cancer, Malignant Pleural Mesothelioma, Advanced Renal Cell Carcinoma, Classical Hodgkin Lymphoma, Squamous Cell Carcinoma of the Head and Neck, Urothelial Carcinoma.

Opdivo is a PD-1 immune checkpoint inhibitor designed to control the body’s immune system to help restore anti-tumor immune response. Given in the form of an IV injection, it is indicated for the treatment of patients across multiple cancers. Opdivo’s 2021 revenue was boosted by 6.9% vs 2020. In Mar’21 Bristol Myers Squibb (BMS) entered into a clinical trial collaboration and supply agreement with AVEO Oncology for Opdivo and Fotivda combination therapy.

Company: Gilead Sciences

First Approved: US (Feb 07, 2018), EU (Jun 21, 2018)

Total Revenue: $8.62B

Indications Approved: HIV-1 Infection

Biktarvy is an antiviral agent comprising bictegravir, which is an HIV-1 integrase strand transfer inhibitor in combination with emtricitabine and tenofovir alafenamide both of which are HIV-1 nucleoside analog reverse transcriptase inhibitors. Given in an oral form, it is indicated for the treatment of HIV-1 infection in adults and pediatric patients who have no antiretroviral treatment history. Biktarvy’s 2021 revenue inclined by 18.9% vs 2020. In Oct’21, Gilead reported the US FDA’s approval for Biktarvy to treat HIV-1 in pediatric patients.

Company: Regeneron Pharmaceuticals & Bayer

First Approved: US (Nov 18, 2011), EU (Nov 22, 2012)

Total Revenue: $9.11B

Indications Approved: Age-Related Macular Degeneration, Macular Edema, Diabetic Macular Edema, Diabetic Retinopathy

Eylea is an intravitreal injection indicated for the treatment of patients with Neovascular (Wet) Age-Related Macular Degeneration (AMD) Macular Edema following Retinal Vein Occlusion (RVO), Diabetic Macular Edema (DME), and Diabetic Retinopathy (DR). It is an engineered protein designed to attach and block the effects of VEGF-A. Eylea’s 2021 revenue increased by 14.4% vs 2020. In Aug’21, Regeneron reported results from the P-II proof-of-concept trial evaluating Eylea (8mg) in adults with Wet Age-Related Macular Degeneration.

Company: Johnson & Johnson

First Approved: US (Sep 25, 2009), EU (Jan 16, 2009)

Total Revenue: $9.13B

Indications Approved: Psoriasis, Psoriatic Arthritis, Crohn’s Disease, Ulcerative Colitis

Stelara is a human interleukin-12 (IL-12) and interleukin-23 (IL-23) antagonist which selectively inhibits the IL-12 and IL-23 pathways. It is prescribed in the form of subcutaneous or IV injections for the treatment of Plaque Psoriasis, Active Psoriatic Arthritis, Crohn’s Disease, and Ulcerative Colitis. Stelara’s 2021 revenue was boosted by 18.6% vs 2020. In Oct’21, Johnson & Johnson reported results from two studies evaluating Stelara in adults with moderate to severely active Crohn's Disease and Ulcerative Colitis

Company: Johnson & Johnson & AbbVie

First Approved: US (Nov 13, 2013), EU (Oct 21, 2014)

Total Revenue: $9.78B

Indications Approved: Mantle Cell Lymphoma, Chronic Lymphocytic Leukemia, Small Lymphocytic Lymphoma, Waldenström’s Macroglobulinemia, Marginal Zone Lymphoma, Chronic Graft versus Host Disease

Imbruvica is a Bruton’s tyrosine kinase inhibitor given in the form of capsules, tablets, or oral suspension for the treatment of adult patients with Mantle Cell Lymphoma, Chronic Lymphocytic Leukaemia, and Waldenström’s Macroglobulinaemia. It is co-developed by Cilag (J&J) and Pharmacyclics (AbbVie). Imbruvica’s 2021 revenue increased by 3.6% vs 2020. On Jan’21, Health Canada approved Imbruvica in combination with Rituximab to treat patients with previously untreated Chronic Lymphocytic Leukemia.

Company: BMS & BeiGene

First Approved: US (Dec 27, 2005), EU (Jun 14, 2007)

Total Revenue: $12.89B

Indications Approved: Multiple Myeloma, Myelodysplastic Syndromes, Mantle Cell Lymphoma

Revlimid is an oral immunomodulatory drug indicated for the treatment of patients with certain cancers and serious conditions affecting blood cells and bone marrow including Multiple Myeloma, Myelodysplastic Syndromes, and Mantle Cell Lymphoma. It is a thalidomide analog which in combination with dexamethasone is indicated for the treatment of Multiple Myeloma. Revlimid’s 2021 revenue inclined by 6.1% vs 2020. On Jan’21, NICE recommended the use of Revlimid for the treatment of newly diagnosed Multiple Myeloma patients.

Company: BMS & Pfizer

First Approved: US (Dec 28, 2012), EU (May 18, 2011)

Total Revenue: $16.73B

Indications Approved: Pulmonary Embolism, Deep Vein Thrombosis, Risk of Stroke & Systemic Embolism, Recurrence of DVT and PE

Eliquis is a factor Xa inhibitor prescribed in the form of a tablet to lower the risk of stroke or a blood clot in patients with atrial fibrillation. It is jointly developed and commercialized by Bristol-Myers Squibb (BMS) and Pfizer. Eliquis’ 2021 revenue was boosted by 18.6% vs 2020. In Sep’21, BMS and Pfizer reported the U.S. Court of Appeals for the Federal Circuit upheld a previous victory for the companies protecting two Eliquis patents - the drug's composition of matter patent and a formulation patent. Eliquis is expected to retain exclusivity until April 1, 2028

Company: Merck & Co.

First Approved: US (Sep 04, 2014), EU (Jul 17, 2015)

Total Revenue: $17.19B

Indications Approved: Melanoma, Non-Small Cell Lung Cancer, Head and Neck Squamous Cell Cancer, Classical Hodgkin Lymphoma, Primary Mediastinal Large B-Cell Lymphoma, Urothelial Carcinoma, Gastric Cancer, Esophageal Cancer, Cervical Cancer, Hepatocellular Carcinoma, Renal Cell Carcinoma, Endometrial Carcinoma, TMB-H Cancer, Cutaneous Squamous Cell Carcinoma, Triple-Negative Breast Cancer

Keytruda is an anti-PD-1 therapy prescribed in a form of an intravenous injection for the treatment of patients with Melanoma, Non-Small Cell Lung Cancer, Head and Neck Squamous Cell Cancer, Classical Hodgkin Lymphoma, etc. It is a humanized monoclonal antibody that blocks the interaction between PD-1 and its ligands (PD-L1 and PD-L2) which in turn activates T-lymphocytes. Keytruda’s 2021 revenue increased by 19.5% vs 2020. On Jul’21, Merck reported the US FDA’s approval for Keytruda to treat patients with high-risk early-stage Triple-Negative Breast Cancer.

Company: AbbVie, Johnson & Johnson & EISAI

First Approved: US (Dec 31, 2002), EU (Sep 08, 2003)

Total Revenue: $21.15B

Indications Approved: Rheumatoid Arthritis, Juvenile Idiopathic Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, Crohn's Disease, Plaque Psoriasis

Humira is an injectable tumor necrosis factor blocker that reduces inflammation by specifically targeting and blocking TNF-α. It is indicated for the treatment of adults with Rheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, Adult Crohn’s Disease, and Plaque Psoriasis and has been approved across North America and the European Union. Humira’s 2021 revenue rose by 3.9% vs 2020. In Feb’21, AbbVie reported the US FDA’s approval for Humira to treat pediatric patients with moderate to severely active Ulcerative Colitis.

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