Talk about the top 10 drugs sold globally in 2020

01 Humira (Adalimumab, Adalimumab)

Original research company: AbbVie

Mechanism of action: TNFα inhibitor

Global approved indications: ulcerative colitis; uveitis; psoriasis; Crohn's disease in children; hidradenitis suppurativa; rheumatoid arthritis; ankylosing spondylitis; Crohn's disease; psoriatic arthritis; Juvenile rheumatoid arthritis; plaque psoriasis

Approved indications in China: Crohn's disease in children; rheumatoid arthritis; ankylosing spondylitis
.

2020 sales: $20.
39 billion

Adalimumab has experienced a decline in sales of 3.
9% in 2019, and will have a 3.
5% global growth in 2020
.

2019 is the first year when Adalimumab is facing competition from European biosimilars.
Its international sales volume fell by as much as 31% that year.
However, during the new crown epidemic in 2020, patients are inconvenient to go to the hospital for consultation and tend to maintain the original treatment method.
Sales of Lumumab will increase every quarter of 2020, from US$4.
77 billion in the first quarter to US$5.
15 billion in the fourth quarter

In the next few years, adalimumab will still be in the leading position in the immune field.
Its biggest rival is Johnson & Johnson's Stelara, with sales of US$7.
71 billion last year
.
With the patent expiration date approaching in 2023, the US biosimilar market is also intensifying competition

Since 2012, Adalimumab has remained the world's best-selling drug.
If it remains the number one in 2021, it will surpass Lipitor and become the world's best-selling drug ever
.

02 Keytruda (Pembrolizumab, Pembrolizumab)

Original research company: Merck

Mechanism of action: PD-1 blocker

Global Approved Indications: Colorectal Cancer; Triple Negative Breast Tumor; Squamous Cell Carcinoma; Renal Cell Carcinoma; Endometrial Cancer; Esophageal Cancer; Small Cell Lung Cancer; Non-small Cell Lung Cancer; Merkel Cell Carcinoma; Hepatocellular Carcinoma; Head and Neck Partial squamous cell carcinoma; melanoma; primary mediastinal B-cell lymphoma; cervical cancer; transitional cell carcinoma; Hodgkin's disease; urinary system tumors; gastric cancer; high microsatellite instability cancer; head and neck cancer
.

Approved indications in China: non-small cell lung cancer; melanoma
.

       2020 sales: $14.
38 billion

       When immune targets became a direction for cancer treatment, Merck seized this opportunity.
After AbbVie’s adalimumab patent expires in 2023, K drug is regarded as a strong first competitor.

.

       The immuno-oncology market is changing rapidly.
The sales of O drugs, which are also PD-1 inhibitors, have been declining, while K drugs have received 7 FDA approvals in the past 10 months
.

       Drug K can be used to treat advanced cancers with a large number of gene mutations.
These TMB-H cancers often occur in children and are difficult to cure.
This is a very important advancement
.
At the same time, Keytruda has also obtained approval for recurrent or metastatic skin squamous cell carcinoma that cannot be cured by surgery or radiotherapy, as well as colorectal cancer for metastatic or inoperable microsatellites with high instability or mismatch repair defects First-line treatment for patients

       It was subsequently approved for the treatment of Hodgkin’s lymphoma and breast cancer, as well as an approval last month for the treatment of patients with locally advanced or metastatic esophageal or gastroesophageal junction cancer
.
Merck strives to extend the service life of K drugs through combinations and alternative routes of administration

       03 Revlimid (Lenalidomide)

       Original research company: Celgene Corp

       Mechanism of action: IL6 inhibitor; CRBN inhibitor; COX-2 inhibitor; TNFα inhibitor

       Worldwide approved indications: marginal zone B-cell lymphoma; follicular center lymphoma; peripheral T-cell lymphoma; mantle cell lymphoma; multiple myeloma; myelodysplastic syndrome

       China Approved Indication: Multiple Myeloma

       BMS acquired Celgene for 74 billion yuan in 2019

       2020 sales: $12.
15 billion

       Revlimid was approved by the FDA in 2005, and there was a low period after the acquisition in 19 years, but its sales reached more than US$12 billion last year, making it the third-largest drug in annual sales
.
Reaching this achievement is inseparable from Revlimid’s multiple price increases.

       Both the previous Celgene and the current BMS are trying their best to ensure that Revlimid is protected from generic competition.
Soon after the acquisition was completed, the US Patent and Trademark Office rejected Revlimid's three patent invalidation applications
.
However, last year, BMS made a concession, allowing Indian generic drug manufacturers to produce a limited number of generic drugs after March 2022.

       BMS is willing to let go of the Revlimid generic drug market because they have just obtained two CAR-T approvals and they are in the early stages of anemia, multiple sclerosis and acute myeloid leukemia critical start-up phase.
BMS is full of future benefits Confidence
.

       04 Eliquis (Apixaban, Apixaban)

       Original research company: Bristol-Myers Squibb

       Mechanism of action: factor Xa inhibitor

       Global Approved Indications: Venous Thromboembolism; Thrombosis; Embolism; Stroke

       Approved indications in China: venous thromboembolism; thrombosis

       2020 sales: US$9.
17 billion

       Eliquis is a joint research and development of Pfizer and BMS.
It was approved by the EMA in 2011 and the FDA in 2012.
Its annual sales last year exceeded 9 billion yuan, making it the fifth best-selling drug in the world
.

       Pfizer's funds accounted for about half of development costs, and the two companies divided profits and losses equally
.
In some countries, Pfizer sells the drug and pays it to BMS

       During the 2020 COVID-19 pandemic, prescriptions for oral anticoagulants showed an overall downward trend.
By the beginning of 2021, the body volume had rebounded.
As relevant research showed that blood thinners can improve the efficacy of COVID-19, Eliquis' sales in the first quarter were sharp.
An increase of 37%, reaching US$2.
6 billion
.

       Eliquis' sales increased by 16% compared with the previous year.
Pfizer's combined revenue and direct sales with BMS totaled 4.
95 billion US dollars.
With the further expansion of the market, the prospects are good
.

       05 Imbruvica (Ibrutinib)

       Original research company: Pharmacyclics Llc

       Mechanism of action: BTK inhibitor

       Global Approved Indications: Macroglobulinemia; Chronic Lymphocytic Leukemia; Mantle Cell Lymphoma; Graft Versus Host Disease; Marginal Zone B-Cell Lymphoma

       China Approved Indications: Macroglobulinemia; Chronic Lymphocytic Leukemia; Mantle Cell Lymphoma

       2020 sales: $8.
43 billion

       Imbruvica is now one of the most important anti-blood cancer drugs in the world.
Its sales reached 8.
43 billion yuan last year, demonstrating its dominance in the BTK inhibitor market
.

       Imbruvica's 2020 sales are divided into AbbVie ($5.
31 billion) and Johnson & Johnson ($4.
13 billion)
.
AbbVie's revenue includes $1.

       Johnson & Johnson acquired 50% of Imbruvica for less than 1 billion in 2011.
Four years later, due to AbbVie’s 21 billion acquisition of Pharmacyclics and individual products, the price of Imbruvica skyrocketed
.
A year later, Imbruvica received key approval, becoming the first chemotherapy-free treatment for patients with first-line chronic lymphocytic leukemia

       But like other drugs, Imbruvica also faces challengers
.
The first is AstraZeneca’s Calquence, which was approved by the FDA in November 2019.
The long-term data released last year showed that the average condition of treated cell lymphoma patients lasted for 22 months without deterioration, and the survival rate reached 50% after three years.
Above
.

       Another competitor is Brukinsa from BeiGene, which is only approved for use in mantle cell lymphoma in the United States
.
The drug won a nod in China for recurrent SLL/CLL
.
At the end of last year, BeiGene showed that for marginal zone lymphoma, Brukinsa can cause a reaction in 74% of patients and completely eliminate cancer in 24% of patients within a year
.
The corresponding figures for Imbruvika were 48% and 5%, although the trial did not compare the two drugs with each other
.

       In order to maintain the continuous growth of Imbruvica’s sales, AbbVie has built a strong patent wall around it, extending its exclusive patent period by 9 years to protect it from competition from biosimilars, thereby keeping the price high and bringing more benefits.
More benefits
.

       06 Eylea (Aflibercept Aflibercept)

       Original research company: Regeneron Pharmaceuticals Inc, Bayer

       Mechanism of action: PGF inhibitor; VEGFA inhibitor

       Global approved indications: macular edema; age-related macular degeneration; diabetic complications; wet macular degeneration

       Approved indications in China: macular edema; age-related macular degeneration

       2020 sales: $8.
36 billion

       Eylea's sales in 2020 are 8.
36 billion U.
S.
dollars, Regeneron accounts for 4.
95 billion U.
S.
dollars, Bayer is 2.
82 billion U.
S.
dollars, and the latter is sold in markets outside the United States
.

       Due to the impact of the new crown, new patients only used Eylea at the end of March and early April, but the performance of the drug in the first quarter was still better than most of the year.
In the second quarter, Eylea's sales fell by 4% , But still exceeded expectations.
By the fourth quarter, Eylea's sales increased by 10%, and the full-year sales increased by 7% compared to 2019
.

       Eylea’s competitor is Novartis’ Beovu, but last year it was reported that Beovu may be related to obstructive retinal vasculitis, which may cause vision loss
.
Regeneron and Bayer use this to promote Eylea's drug safety
.
In April 2020, the National Institutes of Health released data showing that Eylea can reduce the risk of developing vision-threatening complications by 68%
.

       But in the middle of last year, Novartis filed a lawsuit against Regeneron for the infringement of pre-filled syringe technology, thus starting a comprehensive patent war between Regeneron and Novartis in the field of ophthalmology
.

       07 Stelara (Ustekinumab, Usnumab)

       Original research company: Yang Sen

       Mechanism of action: IL12 inhibitor; IL23 inhibitor

       Global Approved Indications: Plaque Psoriasis; Ulcerative Colitis; Crohn's Disease; Psoriatic Arthritis; Psoriasis

       China Approved Indication: Plaque Psoriasis

       2020 sales: $7.
94 billion

       Stelara's approval for ulcerative colitis has a strong impact on its sales growth in 2020.
At the same time, the FDA has issued safety warnings to Stelara's JAK inhibitor competitors, which also helped its market share
.
Taking into account the increasingly fierce competition, Johnson & Johnson has drastically cut its IL-12/23 prices to remain competitive
.
But despite this, Stelara achieved $7.
94 billion in revenue last year, an increase of nearly 20% over 2019
.

       But Stelara is also facing price threats, mainly in two aspects.
One is competing drugs.
After Johnson & Johnson’s third-quarter performance report, it considers discounts and price reductions to ensure market share; the other is from the government’s pricing of drugs Control, coupled with the high unemployment rate and other effects, price pressure may continue until 2021
.

       08 Opdivo (Nivolumab, Nivolumab)

       Original research company: Ono Pharmaceutical; Bristol-Myers Squibb

       Mechanism of action: PD-1 blocker

       Worldwide approved indications: esophageal cancer; gastric cancer; esophageal squamous cell carcinoma; mesothelial tissue tumors; melanoma; non-small cell lung cancer; hepatocellular carcinoma; colorectal cancer; urinary system tumors; head and neck squamous cell carcinoma; head and neck Carcinoma; Transitional cell carcinoma; Hodgkin's disease; Renal cell carcinoma; Urogenital tumors

       China Approved Indication: Non-Small Cell Lung Cancer

       2020 sales: $7.
92 billion

       In terms of biopharmaceutical competition, I believe everyone is familiar with the dispute between O and K drugs, and they are like Pepsi and Cola
.

       During the research and development process, they competed with each other as immune checkpoint inhibitors, and were approved by the FDA in the same year
.
Early O drugs were in the leading stage, but later developments were completely opposite
.
With the continuous expansion of K drug market share, O drug's share continued to shrink, Keytruda sales increased by 29% in 2020, but Opdivo fell by 2%, and in each quarter of 2020 and the end of 2019 In one quarter, Opdivo's sales fell compared to the same period last year
.

       In 2019, Keytruda received 7 FDA approvals, but the gain of O drugs was zero.
In terms of non-squamous non-small cell lung cancer, the combination therapy of O drugs and chemotherapy did not show a more obvious improvement effect than chemotherapy alone
.

       But in 2020, O drugs have received 7 FDA approvals, 2 of which are used in combination with Bristol's CTLA4 immunotherapy Yervoy for key NSCLC areas
.
Recently, there have been positive reviews about gastric cancer and esophageal cancer
.
In addition, in October last year, Opdivo reported another NSCLC victory-drug O combined with chemotherapy had a positive effect before surgery, drug O defeated multiple competitors including its terrible nemesis
.

       In a clinical trial in February this year, Opdivo was first shown to be effective in treating muscle-invasive bladder cancer
.
Then another clinical success was achieved in April.
Early-stage non-small cell lung cancer patients who underwent a combination of Opdivo and chemotherapy before surgery had a nearly higher probability of cancer-free resection tissues than patients who only used chemotherapy.
14 times
.
This is a milestone in Keytuda's unrealized applications
.

       The competition between PD-1 inhibitors is being rekindled
.

       09 Biktarvy

       Original research company: Gilead

       Mechanism of action: HIV integrase inhibitor; RT inhibitor; HIV-1 RT inhibitor

       Global approved indication: HIV infection

       China approved indication: HIV infection

       2020 sales: $7.
26 billion

       Biktarvy’s sales increased by 53%, jumping from the 17th best-selling drug to the 8th, far exceeding the original target
.

       Although Biktarvy’s sales jumped by US$2.
52 billion in 2020, a large proportion of patients who used Biktarvy were originally using other Gilead anti-HIV products, which had a sales drop of US$1.
93 billion
.
Overall, the sales of Gilead’s AIDS products in 2020 will be 16.
94 billion U.
S.
dollars
.
Although this figure accounts for 69% of the company's total revenue, Gilead’s HIV drug revenue has only increased by 3% compared to 2019
.

       Biktarvy's competitors do not only come from within the company, such as Descovy, its sales in the United States jumped from 1.
08 billion U.
S.
dollars in 2019 to 1.
53 billion U.
S.
dollars last year
.

       The competition outside the company is also very strong.
GSK has been in the AIDS field for 20 years.
ViiV Healthcare, a joint venture between Pfizer and Shionogi, will launch a strong challenger to the market every few years
.
ViiV is pinning its latest hope on Dovato, a two-drug combination with better safety, which generated sales of US$374 million in the first year after being approved in 2019
.

       10 Xarelto (Rivaroxaban, Rivaroxaban)

       Original research company: Bayer

       Mechanism of action: factor Xa inhibitor

       Worldwide approved indications: pulmonary embolism; stroke; venous thrombosis; embolism; venous thromboembolism; atherosclerosis

       Approved indications in China: pulmonary embolism; stroke; venous thrombosis; embolism

       2020 sales: $6.
93 billion

       In 2020, Xarelto's total revenue is approximately 6.
93 billion U.
S.
dollars, slightly more than its 6.
35 billion U.
S.
dollars in 2019
.
Bayer received US$4.
58 billion of this, while Johnson & Johnson received approximately US$2.
35 billion
.
The 9% sales growth is not enough to gain an advantage in the competition with Pfizer and BMS’s Eliquis, which has annual sales of approximately US$9.
17 billion, and Eliquis continues to dominate the blood thinner field
.

       The FDA approved Xarelto in October 2019 to help prevent blood clots in patients with acute illnesses without a high risk of bleeding during and after hospitalization
.
The FDA's nodding sign is Xarelto's sixth indication for blood clots, while Eliquis is for the third indication
.
In March last year, the American College of America released data showing that in patients with symptomatic peripheral arterial disease, the combination of Xarelto and aspirin reduced the risk of major limb and cardiovascular events by 15%
.

       Reference source:

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