13. Cosentyx

Combining dermatology and rheumatology applications has helped make Cosentyx a rare double-threat powerhouse. (Novartis)

Company: Novartis
2020 sales: $4 billion
Key patent expirations: 2025 to 2026

When Novartis' Cosentyx arrived in 2015 as the first next-gen psoriasis treatment in the United States, the med's blockbuster status was assured. In fact, the drug reached that milestone during its first full year on the market. 

But another guarantee came with the launch—competition and plenty of it.

Despite challenges, the drug has managed to stay ahead of its rivals by adding indications and satisfying doctors and patients along the way.

Cosentyx weathered the pandemic with a 14% jump in sales in 2020, and it followed that with another 11% increase in the first quarter of 2021. But the immunology field is only getting more competitive.

Last year, pharmacy benefit organization Express Scripts removed Cosentyx from its list of preferred drugs in favor of its less-expensive rival, Eli Lilly’s Taltz. Then earlier this year, Cigna, which owns Express Scripts, added a $500 sweetener to entice users to switch from Cosentyx to Taltz.

RELATED: Cigna’s $500 gift to psoriasis patients who switch to Eli Lilly’s Taltz is ‘rehearsal’ for Humira biosimilars: analyst 

Another next-gen psoriasis competitor, Johnson & Johnson’s Tremfya, achieved blockbuster status in 2019. AbbVie’s Skyrizi did the same last year. Cheaper biosimilars for older treatments—such as Johnson & Johnson's Remicade—have been on the market for a few years and biosims for AbbVie’s Humira will follow in 2023.

While Humira biosims will ratchet up pricing pressure in immunology, Cosentyx can stand behind its own patent protections until around the middle of the decade, Moody's analysts said. Two firms from China, Bio-Thera Pharmaceuticals and Shanghai Junshi Biosciences, are among those developing a biosimilar version of Cosentyx.

As Cosentyx inches toward the end of its successful run, Novartis can lean on a diverse portfolio going forward. Cosentyx was the company’s bestselling drug last year, but its sales represented only 8% of Novartis’ $48.7 billion haul in 2020.

RELATED: Novartis CEO touts 25 potential—and diverse—blockbuster launches. But is its portfolio too scattered?

Novartis had a whopping 14 drugs which topped the $1 billion mark last year. First-quarter results from this year show 16 drugs on the blockbuster track. 

A report by Jefferies last year warned of an impending patent cliff for Novartis with the loss of exclusivity for Tasinga, Promacta, Jakavi, Gilenya and Entresto—drugs that earned a combined 10.5 billion last year—in the coming years. But Jefferies pointed to “underappreciated” drugs in the company’s late-stage pipeline which could make up that difference.

13. Cosentyx