The top 15 best-selling cancer drugs in 2022

Oncology drugs remain the fastest growing category in pharma, and forecasters say the top 15 will be hauling in almost $90 billion by 2022.

If there was any doubt that the oncology market is set to reach unprecedented heights, FiercePharma's top 15 list of cancer drugs in 2022 should eliminate it.

All told, by 2022, the top 15 cancer drugs are expected to collectively make almost $90 billion in sales. To put that in perspective, that represents about one-fourth of the entire U.S. pharma market in 2014, according to QuintilesIMS data. It's also bigger than pharma's haul in Japan or China that year.

It will likely be no revelation that three drugs among the top six on our list—provided courtesy of EvaluatePharma and Chempetitive—come from the highly touted PD-1/PD-L1 or checkpoint inhibitor class. 

This brand-new category of cancer drugs works by activating the immune system, enabling it to recognize cancer cells and destroy them. The class has achieved unprecedented efficacy in a broad range of cancers and provides a much-needed new treatment approach alongside chemotherapy and targeted cancer drugs, which tend to lose efficacy over time.

But with that efficacy advance comes the thorny issue of pricing. The cost of medicines is under scrutiny by lawmakers around the world, and market watchers can't rule out some sort of clampdown by payers, both public and private. Drugmakers must now carefully select a price point for new meds—one that won't encourage payers to restrict their use.

That's even more important as immuno-oncology moves toward combination cocktails. Using combinations of drugs is nothing new in oncology, but it's particularly pertinent now as checkpoint inhibitors are tested alongside just about every other possible treatment, old and new. As clinical data on those cocktails emerge in the coming years, the relative importance of individual drugs could fundamentally change, and their prices along with it.

To illustrate the fast pace of change in oncology, take a look at the big names that have disappeared since our last top cancer drug list just three years ago. Among the missing are Takeda's multiple myeloma drug Velcade and Johnson & Johnson's oral prostate cancer med Zytiga, both of which are expected to be superseded by newer drugs and could potentially face generics if patent suits don't go their way. Others, notably Novartis' Gleevec and Eli Lilly's Alimta, will certainly see sales hit by generic rivals. 

Even as the immuno-oncology meds have ascended, nine of the top-selling 15 drugs in 2022 will still be monoclonal antibodies. First approved in the late 1990s, these therapies quickly became the preferred option for various cancers, and particularly blood cancer. Three of these—all from Roche—are first-generation cancer antibodies due to face biosimilar competition within the next couple of years. At the moment, it's tough to predict just how much biosimilar copies will eat into their sales. But the fact that the three are predicted to remain in the top flight after decades on the market indicates that brand strength will still play a major role.

Do you have thoughts about the top-selling cancer drugs in 2022? Will the list change much as that date approaches? As always, let us know.

The top 15 best-selling cancer drugs in 2022