16. Ibrance

Ibrance posted $2.9 billion in U.S. sales, a mere 3% increase over 2017, while worldwide sales grew by 32%. (Pfizer)

16. Ibrance
2018 U.S. sales: $2.9 billion
Used for: metastatic breast cancer

Novartis’ Kisqali may be advancing, but Pfizer’s Ibrance continued to dominate the CDK 4/6 breast cancer field in 2018. But its huge lead in the market doesn't mean Ibrance's sales grew much year over year in the U.S.

In 2018, Ibrance posted $2.9 billion in U.S. sales, a mere 3% increase over 2017, while worldwide sales grew by 32%.

Competition from Kisqali and Eli Lilly's Verzenio wasn't the problem, though. Ibrance's central concern in 2018 was what Pfizer called a slowing CDK 4/6 market—and as-yet-unpersuaded physicians. Pfizer's then-CEO Ian Read told analysts on an August earnings call that the drug had cornered 91% market share and wasn’t in danger of losing its stranglehold as Kisqali and Verzenio continue to win label extensions. 

Pfizer was also forced to contend with a phase 3 trial failure in June for patients with HR-positive, HER2-negative breast cancer who've failed on previous hormone therapy. The data showed that Ibrance in combination with fulvestrant didn't help patients live longer over solo treatment with fulvestrant.

Despite that setback, Pfizer Oncology Global President Andy Schmeltz said in October that the drug “just barely missed” its required endpoints and that it still presented possibilities for profit in the future. For one, Pfizer has invested in sales reps, field-based medical reps and direct-to-consumer advertising in a full-court marketing press for its oncology offerings. 

16. Ibrance

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