14. Imbruvica

AbbVie and Johnson & Johnson's Imbruvica will likely add big sales in the coming years. (AbbVie)

: AbbVie, Johnson & Johnson
2019 sales: $5.69 billion
Projected 2026 sales: $10.69 billion
Projected CAGR: +9%
Used for: chronic lymphocytic leukemia, mantle cell lymphoma, marginal zone lymphoma, Waldenström's macroglobulinemia, chronic graft vs. host disease

Riding pole position in the lucrative chronic lymphocytic leukemia (CLL) market, AbbVie and J&J's Imbruvica has had a steady climb to the top of both drugmakers' oncology bestseller lists. But a highly touted challenger in AstraZeneca's Calquence has arrived, and Imbruvica could have its hands full in the coming years. 

With a strong grasp on the CLL market, Imbruvica hit $5.69 billion in sales in its sixth year on the market. With four additional indications under its belt and a combo approval with Roche's Rituxan, Evaluate Pharma predicts the partnered cancer drug could hit $10.69 billion in sales in 2026, putting it among the industry's sales elite. 

Hitting that high mark would be a boon for AbbVie, which is looking for growth drivers after its $63 billion merger with Allergan that closed in May. 

RELATED: J&J, AbbVie's Imbruvica pads CLL lead with FDA green light in younger patients

In April, the FDA approved a combination of Imbruvica and Roche’s Rituxan in CLL patients 70 or younger who have yet to try other therapies.

Historically, patients in that group “who were fit enough to tolerate an aggressive treatment course” have received a chemo cocktail called FCR, for fludarabine, cyclophosphamide and rituximab. But in a phase 3 trial, the Imbruvica-Rituxan pairing showed it could best that regimen. At the 37-month mark, 88% of patients taking the Imbruvica combo hadn’t seen their cancer worsen, compared with 75% of FCR patients.

“This is the gold standard, most efficacious, potent therapy that we had in CLL up until this point,” Danelle James, M.D., head of clinical science at AbbVie’s Pharmacyclics, said of FCR in late 2018, when the companies unveiled the study’s first phase 3 data. “To really take out the gold standard is a great place to be in, in terms of having that proof and that evidence for physicians and patients.”

RELATED: AstraZeneca's Calquence steps up to challenge Imbruvica with big CLL green light

Meanwhile, Imbruvica is facing a strong challenger in Calquence after the FDA approved AstraZeneca's drug in previously untreated CLL patients in November.

And shortly thereafter, analysts liked what they saw in a head-to-head trial between Imbruvica and BeiGene’s Brukinsa. While the trial was testing the drugs in Waldenström's macroglobulinemia, Wall Streeters used it to gauge Brukinsa’s prospects in the much larger CLL field.

14. Imbruvica