USA – Despite facing one of the industry’s steepest patent cliffs, Abbvie is expected to leapfrog Roche to become the largest pharma company by prescription sales in 2028, according to extended consensus forecasts from Evaluate Pharma.

Pfizer currently holds the top spot in Evaluate Pharma’s ranking of pharma companies by sales, thanks to the success of its Covid-19 vaccine Comirnaty.

Ranking AbbVie first is a significant shift for some analysts who have warned of dire consequences for the company as Humira approaches the patent cliff.

So far, the adaptable autoimmune therapy has survived biosimilar competition in Europe and is expected to generate US$20.8 billion in global sales by 2021.

Next year will bring a more ominous threat, as AbbVie will face biosimilar competitors in the United States.

However, the company expects newer autoimmune drugs Skyrizi and Rinvoq to generate US$15 billion in combined revenue by 2025, allowing it to absorb the hit.

While Abbvie will no longer enjoy US$20 billion-plus sales a year from Humira after 2023, a fairly long tail of demand is expected for the anti-TNF rheumatoid arthritis drug.

These sales, combined with increasing contributions from the Jak inhibitor Rinvoq, the psoriasis product Skyrizi, and the cancer drug Venclexta, are enough to give the company a razor-thin lead over second-place rival Roche.

According to analysts polled by Evaluate Pharma, they predict that the Illinois-based pharma giant will generate more prescription sales than any company in the industry in 2028.

They expect AbbVie’s US$65.7 billion in sales in 2028 to be closely followed by Roche’s US$65 billion. Johnson & Johnson (US$62.3 billion), Merck (US$59.7 billion), and Pfizer (US$57.1 billion) round out the top five in terms of projected revenue.

These figures are, of course, based on sellside analyst estimates compiled by Evaluate Pharma. In Abbvie’s case, maintaining this forecast advantage will be contingent on the company’s ability to successfully launch Rinvoq and Skyrizi in new indications.

On the slump

Pfizer, Novartis, and Bristol Myers Squibb have all fallen in the rankings, with the latter facing significant patent erosion of its own.

Over the next six years, cheaper knockoffs of three Bristol blockbusters – Revlimid, Eliquis, and Opdivo – could appear.

Given Roche and Abbvie’s razor-thin margins, it’s easy to see how their positions could shift, for example, if biosimilar erosion of Humira is more severe than the market currently anticipates.

In contrast, some of Roche’s long-term success is based on the potential of the novel immuno-oncology mechanism Tigit blockade, in which the company has a large stake.

Recent events cast serious doubt on those future sales. Tiragolumab has now failed in two of the ten Skyscraper studies, calling the Tigit mechanism into question.

It’s a good thing Roche’s multiple sclerosis drug Ocrevus, PD-L1 monoclonal antibody (Mab) Tecentriq, and hemophilia treatment Hemlibra are expected to grow rapidly over the next six years.

Merck & Co. and AstraZeneca are climbing the rankings thanks to rapidly expanding oncology franchises.

Astra’s Tagrisso and Lynparza annual sales are expected to double between 2021 and 2028, while Merck’s Keytruda is expected to earn US$30 billion in 2028, making it the best-selling drug of that year.

Pipeline expansion issues have pushed GSK and Sanofi to the bottom of the table. Neither company was able to capitalize on the Covid vaccine boom, and both are looking for new growth drivers.

In fact, given GSK’s current state, the UK developer’s position in the top ten could be threatened by Lilly, the 11th big pharma company, which is expected to generate US$38.9 billion in prescription drug sales in 2028.

The recently approved Mounjaro has shown promising results in both diabetes and obesity, and if the drug lives up to the more optimistic expectations, Lilly could rocket to the top of the list.

One major surprise is how far down the list Pfizer is; historically, its name has been found among the top three.

This indicates that Pfizer’s sales boom during the pandemic is expected to be short-lived, though it is also true that the spin-off of many older products into Viatris in late 2020 reduced the company’s bottom line.

Pfizer is expected to continue putting its Covid billions to work through acquisitions and licensing agreements.

Novartis, flush from the sale of its stake in Roche and struggling to boost revenue, may also pursue this strategy.

However, Bristol Myers Squibb’s slide down the rankings appears to be unavoidable. The company has one of the oldest pipelines on the list, with 72 percent of its 2021 revenue coming from products that are more than ten years old, and with age comes patent expirations.

So far, the group’s efforts to replenish its pipeline have been less than fruitful.

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