Merck's Keytruda will top pharma's sales rankings in 2028, with Roche taking the company category crown: Evaluate

Despite all the upheaval in the pharma industry over the last few years, many familiar names will remain at the top of the industry's sales charts toward the end of the decade.

That's one finding in Evaluate's new "World Preview 2023" report, which lays out projections for the top companies and drugs in 2028.

Thanks to its next-gen monoclonal antibodies, Roche should hoist the individual-company sales trophy by a slim margin, the report finds. As for top drugs, Merck's cancer superstar Keytruda is projected to be the world’s top-selling drug by a huge margin in 2028, according to the report.

On Evaluate's list of top 10 drugs by sales in 2028, Keytruda is expected to reach the $30 billion mark, with no other therapy predicted to hit $20 billion in sales. The team added that Keytruda’s figure does not include its subcutaneous formulation, which is currently in phase 3 testing and is projected to generate $2.4 billion in sales in 2028.

In addition to the revenue rankings, the report examines the potential impact of a variety of factors influencing the industry, including the Inflation Reduction Act, the Federal Trade Commission's crackdown on M&A, and shifts in payer and access dynamics.

Evaluate’s top 10 drugs projection is an update to its 2022 rankings (PDF) and includes two new treatments—Eli Lilly’s surging diabetes therapy Mounjaro, which zooms all the way to No. 4 with a $17 billion estimate, and Merck’s Gardasil, which takes the No. 9 slot with projected sales of $12 billion.

By 2028, Gardasil will have been on the market for more than two decades. But the HPV vaccine has seen a recent sales spurt because of growing demand in less developed nations. Merck recently reported that Gardasil generated $2.5 billion in sales in the second quarter, blowing away analyst expectations growing by 53% year over year.

On the new top 10 drugs list, Mounjaro and Gardasil supplanted Pfizer’s COVID-19 vaccine Comirnaty and AbbVie and Johnson & Johnson’s cancer drug Imbruvica, which were ranked Nos. 9 and 10 in last year’s projection, respectively.

Earlier this month, Pfizer expressed disappointment in Comirnaty’s $1.5 billion sales in the second quarter. The company also trimmed its 2023 revenue projection by $1 billion and said it was considering cost-cutting measures.

Novo Nordisk’s diabetes treatment Ozempic jumped from No. 5 on last year’s projection to No. 3 this time around. The drug now carries a sales estimate of approximately $17 billion in 2028.

Ozempic’s estimate does not include its formulations as obesity therapy Wegovy and as oral diabetes treatment Rybelsus, Evaluate said. Combining the products would put the franchise at $33 billion in estimated sales, topping the projection for Keytruda.

A drug that took a fall in the rankings was BMS’s Opdivo, which tumbled from No. 2 to No. 6. Regeneron and Sanofi’s Dupixent took its place, moving up a notch to No. 2.

Other drugs on Evaluate’s updated top 10 list include No. 5 Darzalex (J&J), No. 7 Skyrizi (AbbVie), No. 8 Biktarvy (Gilead Sciences) and No. 10 Trikafta (Vertex).

Roche takes top spot in 2028 sales

Evaluate also projected 2028 company revenues, with Roche replacing AbbVie as the leader, though not by much as there is little separating the estimated sales of the Swiss company with its closest peers. In 2028, Roche is now expected to narrowly beat out No. 2 Merck and No. 3 AbbVie. All are projected to generate revenue of between $62 billion and $65 billion.

Roche’s development of its next generation of monoclonal antibodies including cancer drug Tecentriq, multiple sclerosis treatment Ocrevus and eye disease med Vabysmo, is one reason for its industry leadership, Evaluate said.

There also was a noteworthy change at the bottom of the company top 10 rankings as Novo Nordisk and Lilly—both riding a surge in demand for their GLP-1 products—have replaced No. 9 Bristol Myers Squibb and No. 10 GSK.

Novo and Lilly's 2028 sales are projected to come in between $45 billion and $50 billion, Evaluate said.

Otherwise, there was little change in the company rankings. While J&J dropped a notch to No. 4, Pfizer, Novartis, AstraZeneca and Sanofi each held their spots at Nos. 5, 6, 7 and 8 respectively. All are projected to register sales between $54 billion and $60 billion in 2028.