Xarelto, Xtandi surge toward Europe's best-selling ranks, with Opdivo close behind

Xarelto packaging

Bristol-Myers Squibb and Pfizer’s Eliquis may be gaining on Xarelto in the U.S., but in Europe, the Bayer anticoagulant is expected to keep its lead all the way to 2022. That’s the word from EvaluatePharma analysts, who’ve totted up their expectations for the biggest-selling drugs on the continent that year.

In fact, the analysts expect Xarelto to be tops in Europe in 2022, with €2.72 billion in sales. That’s up from €1.3 billion in 2015. The drug should gain further steam from new indications--such as heart failure--the analysts said, and a new reversal agent from Portola should help as well. Worldwide, the drug is expected to come in 20th that year.

The rest of the meds in the European top five range from €2 billion to €2.5 billion in 2022 sales, and some of them have a long way to go to get to those benchmarks. For instance, Astellas Pharma’s prostate cancer med Xtandi racked up €586 million on the continent last year, but it’s pegged at almost five times that much in 2022 at €2.5 billion, putting it at second place on the European list.


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Bristol-Myers Squibb’s immuno-oncology treatment Opdivo is slated for even faster growth, with estimates mushrooming to €2.36 billion in 2022 from just €160 million now. And GlaxoSmithKline’s HIV med Triumeq is expected to swell more than ninefold over the same time period, to €2.05 billion from €242 million last year, earning fifth place in the process.

In fourth place comes Celgene’s reliable blockbuster Revlimid, a blood cancer treatment, with sales that are predicted to all but double to €2.22 billion in 2022 from €1.12 billion last year.

Europe’s particular market dynamics explain part of the difference between rankings in the region and those worldwide, EP Vantage noted. Reimbursements are won and calculated country by country, with reference pricing serving as a check on big price premiums in one country over another. Rollouts tend to be slower, and reimbursements can be tougher to win in some fields--such as cancer--compared with others. Opdivo and its impressive survival data have broken that mold, however, which is perhaps one reason why its growth is expected to mount so quickly.

Also contributing to the difference could be differences in forecast methods, which in Europe depends on government and historical sales data and proprietary methodology, EP Vantage notes. Overall, European drug sales are expected to amount to €206 billion in 2022; about 16% of that from drugs that are still in pharma pipelines.

- see the EP Vantage ranking

Special Report: The top 20 drugs in 2020 by worldwide sales - Opdivo - Xtandi - Eliquis - Triumeq

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