While dealmaking and investment dollars may be flowing across biopharma once again, acute challenges tied to policy, pricing and more continue to dog the industry, even as pipelines bring massive sales opportunities to bear.
Together, medications tackling obesity and inflammatory conditions are expected to help push global pharmaceutical sales above $2 trillion in 2032, data intelligence outfit Evaluate wrote Tuesday in its World Preview 2026 report. It will be a time of heavy hitters, according to Evaluate, which predicts that five drugs will each reap sales beyond $20 billion that year, with the top 20 best-selling medications of 2032 tipped to collectively account for nearly a fifth of total revenues.
In essence, the “big drugs era continues,” Evaluate said of its forecast.
That attitude is reflected in a resurgence of M&A activity driven by the industry’s “hunt for de-risked, multi-indication assets,” the report surmises, where China is now leading other countries as a source of licensing assets for Western drugmakers, as well as “built-to-buy biotechs,” the report points out.
Still, drug pricing pressures and policy tumult in the U.S. are dovetailing with an industry-wide patent cliff and ever-increasing crowding in popular indications, posing several notable challenges for biopharma companies as the next few years play out.
Headlining Evaluate’s 2032 forecast is Eli Lilly’s diabetes and obesity med tirzepatide—sold in those respective indications as Mounjaro and Zepbound in the U.S.—which the Evaluate team figures will generate more than $70 billion during that year, driving a significant portion of the $2 trillion industrywide haul.
As a point of reference, that performance would cement tirzepatide’s place as the “biggest drug ever,” eclipsing the value generated by past and present sales juggernauts like Humira and Keytruda, and even Pfizer and BioNTech’s COVID-19 vaccine, the report notes.
Evaluate’s 2032 augury also assumes a further entrenchment of the market leadership Eli Lilly has gained over rival Novo Nordisk in the GLP-1 space in recent years. Lilly’s Mounjaro, Zepbound, and newly launched oral GLP-1 for obesity, Foundayo, collectively make up “nearly half” of total 2032 sales of the top ten best-selling drugs in Evaluate’s forecast.
Moreover, Lilly boasts two entrants in the report’s roster of the top ten most-valuable R&D prospects—its triple-G agonist retatrutide and the amylin receptor agonist eloralintide—which could together tack on another $10 billion in 2032 sales.
Conversely, Novo’s semaglutide franchise of Ozempic and Wegovy is expected to “slip just outside the 2032 top ten best-sellers,” per Evaluate, which attributed the fall in part to less potent weight loss than Lilly’s offerings, which target two hormone receptors to semaglutide’s one.
That isn’t to say that Novo will be struggling, Evaluate caveated, adding that the Danish pharma’s current GLP-1 franchise and its nearest-term asset CagriSema—which combines semaglutide with an amylin agonist called cagrilintide—could still collectively bring home more than $25 billion in 2032 sales for the company.
While the immense revenue potential stemming from obesity assets is unsurprising, drugs for autoimmune diseases represent the next greatest opportunity, thanks to their ability to treat myriad conditions in a single asset via self-directed immune system attack, Evaluate said.
In fact, immunomodulators are expected to outgrow metabolic and endocrine drugs as a class overall through 2032, according to the report.
That prediction is reflected in the assumed No. 2 top-selling drug of 2032 behind tizerpatide, AbbVie’s injectable IL-23 antagonist Skyrizi, which could reel in more than $33 billion that year.
Meanwhile, AbbVie has been squeezing the pipeline-in-a-product potential of Skyrizi’s sister medication, the oral JAK inhibitor Rinvoq, “even harder” in terms of breadth of indications, Evaluate said. That drug—cleared in conditions like rheumatoid arthritis and atopic dermatitis, is expected to rank 6th in 2032 sales at just below $17 billion, according to Evaluate’s forecast.
Over in oncology, Daiichi Sankyo and AstraZeneca’s Enhertu is expected to rank highest among cancer assets at No. 7 in 2032, further validating the success of and interest in the antibody-drug conjugate class, while assets like Johnson & Johnson’s Darzalex in multiple myeloma and argenx’s Vyvgart for myasthenia gravis will continue to “hold significant value” for the rare disease space, as Evaluate sees it.
R&D dollars deciphered
Evaluate’s 2032 sales forecast accounts for a mix of both drugs approved and those expected to be soon. But when breaking down pipeline value specifically, the split between areas of focus is slightly different, with the top-ranked assets spanning obesity and “pan-cancer blockbusters.” The latter category includes a mix of modalities, from bispecific antibodies to next-generation protein degraders and molecular glues.
Summit Therapeutics and Akeso’s bispecific ivonescimab—which inhibits PD-1 and VEGF—carries a net present value (NPV) of more than $25 billion, putting it at the top of the pipeline value chart that Evaluate compiled. The drug has already scored clearance in China, with the FDA expected to weigh in on the asset in non-small cell lung cancer around mid-November. In 2032, the bispecific ADC could gin up sales of $8.5 billion, by Evaluate’s reckoning.
Elsewhere, Lilly’s retatrutide represents the member of the most valuable R&D cohort with the highest peak sales potential at $23 billion, Evaluate said, noting that the drug is joined by its cousin eloralintide in fifth place on the ranking.
Obesity is represented once again in the no. 3 spot on the top-valued R&D roster, with the position claimed by Amgen’s investigational antibody-peptide conjugate MariTide for Type 2 diabetes and chronic weight management.
Evaluate calculated an NPV of $27.7 billion for MariTide, which it estimates will rack up sales of $4.6 billion worldwide in 2032.
Apart from several other oncology contenders in Roche and Chugai’s breast cancer candidate giredestrant and Revolution Medicines’ daraxonrasib, two immunomodulators made their way onto the R&D value rankings in Immunovant and HanAll’s imeroprubart and Vertex, Zai Lab and Ono Pharmaceuticals’ povetacicept.
Imeroprubart, an FcRn inhibitor in development across multiple IgG-mediated autoimmune diseases like myasthenia gravis, among others, has earned an NPV of $16.9 billion versus a 2032 sales forecast of $5.1 billion, per Evaluate’s calculations.
Meanwhile, the dual BAFF and APRIL cytokine inhibitor povetacicept was recently accepted for review by the FDA in immunoglobulin A nephropathy, and the drug is also in development in multiple other potential autoimmune indications. Evaluate placed the medication’s NPV at $15.8 billion, forecasting 2032 sales at around $3.5 billion.
The road ahead
Biopharma’s BD comeback—illustrated by resurgent M&A trends and copious VC outpourings—comes in no small part thanks to the approach of a massive patent cliff for the industry, with Evaluate calculating more than $500 billion in sales at potential risk from generics between this year and 2032.
If dealmaking continues at its current pace, the total deal value logged in 2026 has a chance of reaching around $200 billion, representing a record for the industry and potentially “releasing much-needed investment to support the next generation of biotech start-ups,” Evaluate explained in a June 23 release.
At the same time, the data firm’s report put a spotlight on the industry’s increasing reliance on research—and at times the purchasing of entire biotechs—from China. For 2026, Evaluate is pinning expectations on Chinese assets to make up “more than two-thirds” of the year’s total deal value, marking a leap over more than a half in 2025 and a meager 5% less than five years ago.
The data intelligence firm noted that industry deals with Chinese biotechs are growing less transactional and more collaborative, which Evaluate said points to China’s broader long-term ambitions in the life sciences.
Moreover, the country is increasingly supplying key assets like GLP-1 related compounds, multi-specific and conjugate antibodies and, more and more frequently, discovery technologies to western companies, Evaluate pointed out.
But while the business environment certainly appears to be thriving, greater policy and geopolitical uncertainties—not to mention turmoil at the U.S. Food and Drug Administration—are continuing to keep drugmakers on their toes, according to the report.
As companies navigate those challenges, they must also contend with questions over just how fast China’s biopharma industry will truly go global, as well as whether it’s better to hone smaller, less risky pipelines or take big-risk swings in research and development.
Lastly, pharma firms must continue to grapple with the evolving realities of what payers and government procurement frameworks want, and the inevitable influence of the split between China and U.S. in the world’s life sciences ecosystem, Evaluate said.