5. Sanofi

On the heels of a restructuring, Sanofi will position itself among pharma's 5 biggest companies by sales, according to Evaluate. (Sanofi)

Headquarters: Paris, France
2017 prescription sales: $34.1 billion 
Projected 2024 sales: $47.4 billion 

Sanofi is currently following a five-year strategic roadmap outlined by CEO Oliver Brandicourt. Part of that plan includes consolidation in its traditional core areas such as diabetes and cardiovascular, as well as portfolio diversification in areas including oncology, immunology and rare diseases.  

As Evaluate Pharma sees it, Sanofi’s prescription drug sales will jump from $34.1 billion in 2017 to $47.4 billion, with major contribution from biologics, which will almost double to $26.2 billion for the period. On the backbone of that optimism are several Regeneron-partnered drugs.  

Leading the charge is “chief growth driver” Dupixent. Approved by the FDA in March 2017 for eczema, the drug just posted €176 million ($206 million) in Q2 2018, 12% above analyst expectations. Consensus sees 2022 sales of $4.0 billion, while Evaluate predicts it could reach nearly $8.1 billion by 2024, making it the world’s eighth best-selling drug at that time. On its way there, it is expected to be approved in asthma in October, and the partners are testing it in other Type 2 inflammations, including pediatric atopic dermatitis, nasal polyps and eosinophilic esophagitis. 

Rheumatoid arthritis therapy Kevzara faces an extremely competitive field as it tries to steal shares from TNF-alpha stalwarts, including AbbVie’s Humira. To earn a spot, Sanofi priced Kevzara at a steep discount from the TNF-alpha drugs in the hope that it could cross the blockbuster threshold.

PCSK9 inhibitor Praluent is losing out to rival Amgen’s Repatha. New outcome results showed it can cut the risk of CV events and all-cause mortality by 24% and 29%, respectively, in high-risk patients. While the partners recently landed a formulary deal with Express Scripts after a price cut, Bernstein analyst Ronny Gal called the pact a “capitulation,” an admission that the PCSK9 class will never get megablockbuster sales.  

The French pharma is also trying to play catch-up in the hot immuno-oncology filed. To do that, Sanofi and Regeneron have hit the gas on the development of PD-1 cemiplimab by investing $1 billion more over the pair’s initial 2015 agreement. Sanofi has also put John Reed, formerly head of research and early development at oncology leader Roche, behind the wheels of its own R&D efforts. 

Beefing up its rare disease and hemophilia business, Sanofi snatched up Biogen spinoff Bioverativ in an $11.6 billion deal and Abylnx for $4.5 billion. Bioverativ gave Sanofi hemophilia drugs Eloctate and Alprolix, which Jefferies analysts said would bring $1.37 billion in 2018. Ablynx’s first product, Cablivi, just won EU approval in a rare autoimmune blood-clotting disorder, with peak annual sales pegged at $500 million. 

In diabetes, Sanofi faces biosimilar competition to its flagship insulin analog Lantus. For the first half of 2018, Lantus sales dropped nearly 20% to €1.8 billion, but on the Q2 earnings call, Brandicourt said the impact of that patent loss has flattened off.  

To compensate for Lantus’ loss, Sanofi recently launched a new basal insulin Toujeo and a fast-acting insulin Admelog. In addition, Lexicon Pharma-partnered dual inhibitor of SGLT-1 and SGLT-2, Zynquista (sotagliflozin), has an FDA decision date set next March. Evaluate predicted the drug’s 2024 sales to be $753 million.  

For Sanofi’s total diabetes revenue, Evaluate analysts forecast it will decline from $7.16 billion in 2017 to $6.35 billion in 2024 as the company conscientiously looks outward for a new phase of growth.  

Still a key area of focus after the restructuring, vaccines sales will reach $8.13 billion in 2024, up from $5.76 billion in 2017, per Evaluate’s estimate. Pentacel and Fluzone will collectively contribute about $1.45 billion to the growth. Besides, the acquisition of Protein Sciences also gave Sanofi a head start on next-generation flu vaccine technology based on recombinant protein. 

5. Sanofi