Novo Nordisk, AstraZeneca and Lilly will top pharma's revenue growth in 2023: report

Entrenched pharma giants Pfizer, Merck & Co. and Johnson & Johnson may continue to hold the top spots as the biggest drugmakers by sales in 2023. But the list of companies on track to deliver the most growth is expected to look quite different.

Novo Nordisk, AstraZeneca and Eli Lilly will lead their biopharma peers with the biggest year-over-year revenue increases in 2023, Evaluate Vantage projects in its annual world preview report. The three companies look to add a bit less than $3.5 billion, around $2.5 billion and just short of $2 billion, respectively, in additional sales this year, Evaluate’s analysis shows.

Meanwhile, thanks to patent cliffs and declining demand for some top sellers, Merck and Sanofi are notably missing from Evaluate’s fastest-growing companies projection despite major contributions from their star meds Keytruda and Dupixent, respectively.

For Novo and Lilly, diabetes and obesity drugs are expected to fuel growth. High demand has outstripped supplies of Novo’s GLP-1 drugs Ozempic and Wegovy as well as Lilly’s rival drugs Trulicity and Mounjaro. For 2023, Novo’s Ozempic, Lilly’s Mounjaro and Novo’s Wegovy are expected to rank No. 3, No. 4 and No.7 in terms of delivering the biggest annual revenue increases for individual products, Evaluate projects.

Ozempic could add $2 billion in new sales, and new Mounjaro sales could come in slightly lower than that. For its part, Wegovy could see an additional $1.5 billion in new sales this year, according to Evaluate’s report.

Above those medicines in the individual drug growth rankings are Merck’s immuno-oncology star Keytruda and Sanofi and Regeneron’s inflammatory disease megablockbuster Dupixent.

Keytruda is expected to become the world’s bestselling drug in 2023 by adding nearly $3 billion sales to reach an annual total of about $24 billion, according to Evaluate. A bit over $2 billion will come for Dupixent as the IL-4/13 inhibitor is estimated to surpass $10 billion sales in 2023.

But neither top-performing drug could secure its developer a place in the fastest-growing companies rankings. In fact, Evaluate actually expects Merck’s total prescription drug sales to decline in 2023.

At both companies, aging diabetes drugs are hurting 2023 expectations. For Merck, the U.S. loss of exclusivity will tear a $1.5 billion hole in DPP-4 inhibitor Januvia’s annual sales in 2023, according to a projection provided by Evaluate Pharma’s Jacob Plieth. Sales for its sister combo med Janumet will also decrease by over $600 million by Evaluate’s estimates.

But the DPP-4 franchise won’t be Merck’s biggest problem. Amid tough competition from Pfizer’s Paxlovid, Merck’s COVID-19 antiviral Lagevrio (molnupiravir) will see sales plummet nearly $4.2 billion to just $1 billion in 2023, according to Evaluate. In contrast, Evaluate projected Paxlovid could stand as the world’s fourth top-selling drug in 2023 with about $13 billion sales.

As for Sanofi, the company’s popular insulin product Lantus will continue to suffer from interchangeable biosimilars. To make things worse, multiple sclerosis therapy Aubagio, currently Sanofi’s No. 4 brand behind Dupixent, influenza vaccines and Lantus, will lose U.S. patent protection in 2023.

Back to the fastest-growing companies rankings, Bristol Myers Squibb, Johnson & Johnson, Amgen and CSL ranked fourth to seventh, while Novartis, Grifols and Daiichi Sankyo rounded out the list.

Within BMS’ offerings, both PD-1 inhibitor Opdivo and Pfizer-shared anticoagulant Eliquis will add $1 billion-plus sales in 2023, Evaluate said.

AstraZeneca and Daiichi are each benefiting from cancer drugs, including their shared HER2 antibody-drug conjugate Enhertu. And AZ will enjoy an extra boost from Alexion’s rare disease portfolio.

CSL and Grifols made the list thanks to growing demand for immunoglobulin products, and CSL also has its newly acquired Vifor Pharma to thank.