Drugs for specialty conditions, including autoimmune diseases and cancers, dominated the list of the 10 top-selling drugs in 2018 worldwide, according to a new report published in Nature Reviews.
 
An increasing number of specialty therapeutics are hitting the market and this trend has contributed to rising health care costs in the United States due to the high price tags of some of these medications. In 2017, specialty drugs accounted for one-third of the pharmacy industry’s total prescription dispensing revenues.
 
Six of the 10 drugs that made the list are used for cancer treatment. In oncology, the fast-paced, robust pipeline continues to catapult advancing treatments to the market, leading to quick adoption of these new therapies. Other ranked medications include drugs that treat autoimmune diseases, venous thromboembolic events, and a pneumococcal vaccine. However, looking ahead, the emergence of more biosimilar products may further challenge the sales of certain products for companies with looming patent expirations.
 
These are the top 5 specialty prescription drugs from the list with the highest sales in 2018:
  1. Adalimumab (AbbVie, Humira)
AbbVie’s adalimumab remained the top seller on the list in 2018, coming in at just under $20 billion in sales. This tops last year’s revenue of $18.4 billion. Several adalimumab biosimilars have been approved by the FDA, however, AbbVie’s patent is not set to expire until 2023 in the United States. Adalimumab is used for the treatment of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn disease, ulcerative psoriasis, chronic psoriasis, juvenile idiopathic psoriasis, hidradenitis suppurativa, and uveitis.
  1. Lenalidomide (Revlimid, Celgene)
Celgene’s lenalidomide, the top-selling oncology drug on the list, came in second with total 2018 sales of $9.7 billion, compared with last year’s total of $8.2 billion. Lenalidomide, a thalidomide analogue, is indicated for the treatment of multiple myeloma, deletion 5q myelodysplastic syndromes, and mantle cell lymphoma.
  1. Pembrolizumab (Keytruda, Merck)
Continued approvals in 2018 for Merck’s PD-1 checkpoint inhibitor pembrolizumab, such as for first-line lung cancer treatment, have helped boost sales. The oncology drug ranked third on the list with $7.2 billion sales in 2018, jumping up from $3.8 billion in 2017.
  1. Trastuzumab (Herceptin, Roche)
Trastuzumab, Roche’s monoclonal antibody used to treat human epidermal growth factor receptor 2-positive breast cancer, came in at $7.1 billion in sales for 2018, which remained the same from 2017. Currently, there are 4 FDA-approved trastuzumab biosimilars, which could present a challenge for the drug’s sales in the future, according to the report.  
  1. Bevacizumab (Avastin, Roche)
Roche’s anti-angiogenic therapy, bevacizumab, made $7 billion in 2018 sales, up from $6.8 billion in 2017. In combination with chemotherapy, bevacizumab is indicated to treat epithelial, ovarian, fallopian tube, or primary peritoneal cancer, cervical cancer, renal cell carcinoma, lung cancer, and colon cancer.
 
Following the top 5 biggest-selling drugs are rituximab (Rituxan, Roche) at $6.9 billion, nivolumab (Opdivo, Bristol-Myers Squibb) at $6.7 billion, apixaban (Eliquis, Bristol-Myers Squibb) at $6.4 billion, pneumococcal 13-valent conjugate vaccine (Prevnar 13, Pfizer) at $5.8 billion, and ustekinumab (Stelara, Johnson & Johnson) at $5.7 billion.
 
Reference
 
Urquhart L. Top drugs and companies by sales in 2018. Nature Reviews. Published March 12, 2019. doi: 10.1038/d41573-019-00049-0.