For the first time, analyst group lowers 2022 sales forecast as pricing backlash takes a toll

Evaluate analysts predict Merck's Keytruda will grow 38% annually through 2022, to sales of $9.5 billion that year.

For a decade, each new projection for drug sales from analyst group Evaluate has been higher than the last as new blockbusters and price hikes have pushed up its forecasts. Not this year.

For the first time since it has been publishing its World Preview reports, the life science commercial intelligence firm has lowered its forecast for industrywide drug sales, based largely on new attention to pricing.

While some standout performances from drugs like cancer meds Keytruda and Opdivo will continue to push drug sales upward, Evaluate has reduced its 2022 projection by $60 billion, to $1.06 trillion. That is down from the $1.12 trillion in 2022 sales it had projected last year. 

"Despite all this, the long-term outlook for the industry remains broadly positive," Evaluate head of forecasting Antonio Iervolino and EP Vantage editor Lisa Urquhart wrote in a foreword. Drug sales are expected to grow 6.5% yearly over the period.

Pricing isn’t the only factor playing into the projection, of course. The analysts see $194 billion worth of pharma sales at risk from patent losses between 2016 and 2022, and they note that market access is becoming increasingly tough to secure. PCSK9 cholesterol meds from Amgen, Sanofi and Regeneron have seen limited uptake, Iervolino said in a release, as has GlaxoSmithKline’s severe asthma treatment Nucala.

Further, Iervolino said in a statement that “the increasing cost of taking a novel therapy to market, now at $4 billion over the last 10 years, puts additional pressure on the productivity of the industry and its longer term sustainability.”

Biosimilars are also picking up and will hurt branded sales going forward, the report notes.

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But while some meds and companies are struggling in the current pharma environment, Evaluate’s report also highlights some anticipated standout performers for the next few years. The analysts see Merck’s immuno-oncology stalwart Keytruda growing at a staggering 38% annually through 2022 to sales of $9.5 billion that year, ranking fourth on Evaluate’s projection of the industry’s biggest products for 2022. Bristol-Myers Squibb’s rival med Opdivo is projected to grow 13% annually to $9.9 billion, good for third place in the sales rankings.

AbbVie’s Humira will hold its No. 1 rank by drug sales in 2022, according to Evaluate, with $15.9 billion in sales that year. The analysts expect Celgene’s Revlimid to climb 13% each year to $14.2 billion, ranking second.

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When Evaluate released its report last year, the group predicted Roche would narrowly beat out Novartis and Pfizer to be the largest pharma company by sales in 2022. That’s changed this time around, as the analysts now expect Novartis will lead the pack with $49.8 billion in 2022 drug sales.

But Pfizer and Roche aren’t expected to be far behind, with $49.7 billion and $49.6 billion in sales, respectively, for 2022. The industry drops off from there as Sanofi is expected to rank fourth with $41.7 billion. Celgene and Shire will grow the fastest over the period at 15% and 10%, respectively, according to Evaluate.

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Drug pricing has commanded public and political attention for nearly two years since former Turing Pharma CEO Martin Shkreli hiked the price of an old toxoplasmosis med overnight by 5,000% back in 2015. Numerous controversies have kept attention on the issue since then, and top drugmakers have looked to distance themselves by taking pricing pledges or releasing portfolio-wide pricing data.

The debate has also spread to industry middlemen, and now several proposals are under consideration in Congress and state legislatures aimed at reining in drug costs. According to reports this week, the Trump Administration is working on an executive order of its own to direct executive agencies to implement value-based purchasing and to pursue trade policies that protect pharma’s IP rights abroad.

While his agency isn’t in charge of drug prices, President Trump’s FDA commissioner, Scott Gottlieb, has moved to address the issue as well. Last month, Gottlieb said the FDA would publish and regularly update a list of medications that are off patent and have no competition, work to improve generic review times and seek to “curtail gaming” of regulations by the industry that allows companies to extend patent monopolies.