Generic name: venetoclax
Company: AbbVie; Roche
2015 sales: N/A
2022 sales: $2.91 billion
Current indication: chronic lymphocytic leukemia
AbbVie and Roche's Venclexta is a first-in-class BCL-2 inhibitor that made its debut in 2016 in the U.S. for the treatment of patients with relapsed chronic lymphocytic leukemia (CLL) caused by a particular genetic mutation. The mutation—which results in the loss of a tumor suppressor gene called 17p—is seen in around 10% of all CLL cases and is associated with a particularly poor prognosis.
The Venclexta price tag of around $110,000 a year will help the drug overcome a small patient population, as will possible future indications such as combination therapy for CLL with Roche's MabThera/Rituxan (rituximab), non-Hodgkin lymphoma (NHL), acute myeloid leukemia and multiple myeloma.
It will face some tough competition, locking horns with other CLL treatments on our list, notably Celgene's Revlimid, as well as newer entrants such as Gilead's Zydelig (idelalisib) and of course AbbVie's own Imbruvica.
AbbVie CEO Richard Gonzalez is not worried about cannibalization in his company's portfolio, however, saying recently that in addition to making its own headway in the market, Venclexta helped to boost Imbruvica—and vice versa—and they could become the best-in-class combination for CLL. Meanwhile, Roche stands to gain in similar fashion from the use of the drug in tandem with its Gazyva, which also appears in the top 15.