Leming research | top 10 comprehensive evaluation of global pharmaceutical enterprises in 2021
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The list of top pharmaceutical products and companies based on sales will change every year. However, great changes have taken place in the global pharmaceutical industry in 2021. In the past, the global pharmaceutical industry made every effort to develop vaccines and drugs so that the world can recover from the covid-19 pandemic, which prompted many pharmaceutical enterprises to exceed billions of dollars in single product sales. For example, Roche, the company with the highest drug sales in 2020, fell to fifth place, while Pfizer, which ranked eighth in 2020 after stripping off its generic business, rose to first place. The past year has proved to be a good year for pharmaceutical companies. It is worth pondering that none of the top 20 pharmaceutical companies in the world in 2020 will have a decline in total revenue in 2021.

Pfizer (comirnaty) stole the limelight
Pfizer, whose fubitai / comirnaty (inn name tozinameran) is the best-selling drug in 2021, has the largest revenue from coronavirus vaccine, with global revenue of US $36.8 billion. This messenger rnacovid-19 vaccine developed jointly with Germany's biontech made Pfizer top in sales in 2021. Pfizer's global revenue increased from $41.7 billion in 2020 to $81.3 billion in 2021.

In 2020, Pfizer ranked eighth, second only to Roche, Novartis, GlaxoSmithKline, Alberta, Johnson & Johnson, Merck and Bristol Myers Squibb. However, in 2021, Pfizer led all these companies by billions of dollars. Global revenue at abbvie, the second-largest pharmaceutical company by sales, fell sharply to $56.1 billion. In fact, fubitai / comirnaty has become the fastest growing drug in the history of the pharmaceutical industry.

As early as December 2020, when Pfizer fubitai and spike VAX of Modena obtained the emergency use authorization (EUA) from the U.S. Food and drug administration, there were still many uncertainties about how to deliver the promised dose globally. But facts have proved that both fubitai and spikevax have achieved great success. Spikevax became the third largest drug sales in 2021, generating $17.7 billion in revenue for Modena / Moderna.

Analysts predict that Pfizer biontech and Moderna will sell more vaccines in 2022 for many reasons: first, sars-cov-2 can mutate frequently and is unlikely to be eradicated by medical and epidemic prevention measures in the medium and short term. Therefore, vaccination needs to be strengthened. Secondly, the younger people still need to be vaccinated regularly.

Pfizer fubitai / comirnaty combined with its antiviral drug paxlovid to fight covid-19. Despite the recent sharp decline in paxlovid's sales, Pfizer comirnaty and paxlovid are expected to help the New York based pharmaceutical giant achieve $100 billion in revenue in 2022.

Alberto Vicente II; Roche fell five points
Even if there is no covid-19 related product in the pipeline, Alberta has performed quite well in 2021 - due to the acquisition of Allergan's cash cow variety Humira (adalimumab), which has been successful in the continuous channel of anti-cancer pipeline drugs, it has risen from the fourth place in 2020 to the second place in 2021. Sales of ebavir's Btk inhibitor ibutinib and its psoriasis treatment drug skyrizi (risankizumab risazuzumab) increased by 85% in 2021. Humira brought $21.2 billion in sales to Alberta in 2021. However, with Humira's bio generic drugs scheduled to enter the market in 2023, the situation may change soon. 2022 and 2023 may be the transition years for abbvie, as it is committed to developing markets for its Humira successors rinvoq (upadacitinib) and skyrizi.

Roche became a big loser in 2021 because several imitations of its blockbuster drugs entered the market. In 2021, imitators of Roche's three blockbuster anti-cancer drugs Avastin, Herceptin and rituximab diverted $4.9 billion (4.73 billion Swiss francs) from the company's sales. A large part of Roche's growth comes from its multiple sclerosis drug ocrevus (ocrelizumab), hemophilia drug hemlibra (emicizumab), inflammatory disease treatment actemra (tocilizumab) and PD-L1 inhibitor tecentriq (atezolizumab). Due to concerns about the immunosuppressive effect of ocrevus on patients, the new crown pandemic led to lower than expected sales.

Like Roche, Novartis also fell last year. It fell from second place in 2020 to fourth place in 2021. Objectively speaking, Novartis has made great efforts to reverse the relatively poor pipeline layout. Last year, it sold its 33% stake in Roche for $20.7 billion. Novartis plans to use this money for acquisitions to strengthen its pipeline competitiveness. The Swiss drugmaker has also drawn up a restructuring plan that involves firing thousands of employees.

Before the new crown pandemic, Merck's keytruda (pembrolizumab) was touted as a drug that would surpass Humira in 2024. Tumor immune checkpoint inhibitors continue to grow significantly, with a significant increase in new indications and treatment guidelines. Keytruda is now used for nearly 40 indications. With sales of US $17.2 billion, keytruda has become the fourth largest drug sales in 2022.

But overall, Merck slipped from sixth to eighth. This is because Merck has spun off its women's health, biosimilars and well-known brand businesses to organon. However, its covid-19 antiviral drug molnupiravir can make up for the loss of revenue. Although the FDA has not yet fully approved the drug (it obtained the EUA in December 2021), the pre-sale agreement helped it achieve sales of $952 million in the fourth quarter.

BMS increased with eliquis and Revlimid; Johnson & Johnson ranked third

Bristol Myers Squibb (BMS) rose to sixth place from seventh place in 2020, thanks to its two drugs in the top ten - the anticoagulant eliquis (apixaban) ranked fifth and the tumor drug Revlimid (lenalidomide) ranked sixth. However, Revlimid will soon face competition - four generic drug companies have now been approved to sell the generic version of Revlimid after March 2022. Revlimid's sales are expected to gradually decline from $12.9 billion to $2.06 billion in 2026.

BMS reported global revenue of $46.4 billion, up 9% from $42.5 billion reported in 2020. In the field of immunooncology, opdivo (navuzumab) had sales of US $7.52 billion, while yevoy (ipimab) had sales of US $2 billion (an increase of 20%).

Johnson & Johnson pharmaceutical's revenue last year was $52.1 billion, up 14% from $45.6 billion in 2020. Darzalex, stelara and covid-19 vaccines for multiple myeloma increased in 2021, helping Johnson & Johnson rise from fifth to third. Johnson & Johnson covid-19 vaccine generated $2.4 billion in sales.

GlaxoSmithKline herpes zoster vaccine approved; Takeda suffered setbacks

GlaxoSmithKline fell four places - from third in 2020 to seventh in 2021. Although GlaxoSmithKline has no drugs in the top 10, the sales of covid-19 antibody treatment drug sotrovimab of GlaxoSmithKline and vir biotechnology contributed to a 7% increase in revenue in 2021. Shinrix, a vaccine used by the British drugmaker to prevent herpes zoster, was approved by the FDA in July. GlaxoSmithKline hopes to double sales of shingrix by 2026.

GlaxoSmithKline's consumer health sector is undergoing major restructuring this year. The Department generated 9.6 billion pounds ($13 billion) in revenue last year, and GlaxoSmithKline believes that it is the only way to promote growth through spin off and the development of new vaccines and special drugs.

Sanofi succeeded in keeping ninth place, although its global turnover increased from US $39.3 billion (36.04 billion euros) to US $41.6 billion (37.76 billion euros). It acquired kymab, tidaltherapeutics, translatebio, kadmon holdings, origimbiotechnology and amunix, which enhanced its pipeline layout in the fields of immunology, immunooncology and vaccines. Sanofi's chief financial officer said at this year's JPMorgan healthcare online conference that investment and M & A is the strategic end direction of the French pharmaceutical company in 2022 and beyond.

AstraZeneca's global revenue increased from $26.6 billion in 2020 to $37.4 billion in 2021. However, its ranking fell from ninth in 2020 to tenth in 2021.
AstraZeneca completed its $39 billion acquisition of alexion in July 2021. The rare disease franchise led by alexion C5 inhibitors soliris and ultomiris increased AstraZeneca's revenue by $3.1 billion.

Takeda encountered several clinical and registration setbacks in 2021, which is called the "turning year". For Gilead, sales of covid-19 antiviral drug veklury last year were $5.6 billion, helping its revenue grow by 11%.

Our point of view

2021 global top15 prescription drugs
Data source: company financial report
The new crown pandemic tells us that change is the only constant. It also tells us that products can be sold worldwide in a few months.
The industry pattern is constantly changing. On the one hand, we see that people are scrambling to develop varieties of anti novel coronavirus disease. On the other hand, FDA has restricted the use of monoclonal antibodies in treatment, such as bamlanivimab and etesevimab of Lilly and regeneron regen cov (cassirimab and imdevimab). The emergence of Omicron variant of novel coronavirus disease triggered the FDA to cancel the authorization of antibody therapy for GlaxoSmithKline and virbiotechnology in April, because the data showed that it was unlikely to be effective for Omicron variant.
In a clinical trial, paxlovid reduced the number of hospitalizations or deaths of high-risk patients by about 90%. In late April, it was reported that the demand for Pfizer's antiviral paxlovid has been surprisingly low, and its supply has far exceeded the actual demand of many countries such as the United States, the United Kingdom and South Korea.
Although Pfizer is expected to achieve more than $100billion in revenue this year, it largely depends on the results of the new coronavirus pandemic and new research on the novel coronavirus. Once a pandemic becomes endemic, many things will change. The first four months of 2022 tell us that vaccines such as comirnaty and spikevax will continue to perform well. But two years later, the reality before us may be very different.
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