Top 10 Cancer Drug Companies of 2024
But the lists themselves don’t tell the whole story, because while Roche, Celgene and Bristol-Myers may be set to retain their top rankings, they can’t say the same for their market share.
Look at 2017. The trio of drugmakers together held a 45.8% share of the market, with longtime cancer leader Roche controlling 26.4% all on its own. In 2024, though, market intelligence firm EvaluatePharma expects to see much more parity. The top three’s share will shrink to 26.2%, with Roche’s dropping all the way down to 11.9%. And the No. 2 through No. 5 companies—BMS, Johnson & Johnson, Pfizer, AstraZeneca and Merck—will boast shares within less than a percentage point of one another.
And it won’t just be the heavy hitters clawing for a piece of the pie. Last year, companies outside the top 10 grabbed just 21.5% of the market. That number is set to nearly double by 2024—swelling to 39.7%—thanks to big recent approvals for companies including Gilead Sciences, Eli Lilly, Tesaro, Clovis and more.
So what does this all mean for an already ultracompetitive lung cancer field? Things are about to get even more competitive. Read on to learn more about EvaluatePharma's forecasts—which were generated in June 2018 and can be found at Evaluate Ltd.—and the market battles that will determine whether they become reality.
1. Roche
2017 cancer sales: $27.45 billion2024 cancer sales: $27.82 billion
Rank change: None
The big picture: You can bet that Roche execs were paying particularly close attention to AstraZeneca’s recent release of a positive, preliminary slice of late-stage data for camizestrant, its oral SERD (Selective Estrogen Receptor Downregulators) for hormone receptor-positive, HER2-negative breast cancer. The Basel-based pharma giant has been angling — alongside Eli Lilly — to beat a path to the market with a best-in-class oral SERD that can be expected to rack up billions a year, provided they get in early on a field that has been a primary concern for years.
The lead for the Swiss drugmaker, which has dominated the cancer landscape for years, is about to get a lot less commanding. In 2017, its market share will drop to 11.9% from 26.4% as six of its top 10 competitors—J&J, Pfizer, AstraZeneca, Merck & Co., AbbVie and Astellas—grow sales by double digits.
One big part of Roche’s forthcoming sales stagnation? Biosimilar rivals, which are readying copies of older blockbusters Rituxan, Herceptin and Avastin. Those copycats are expected to roll out over the next few years, with some already on the market overseas.
To fill the void, Roche is looking in part to immuno-oncology product Tecentriq, which currently bears approvals in lung cancer and bladder cancer. There’s just one problem: Its rivals do, too, and analysts say Roche’s data doesn’t seem to stack up to competitor Merck’s in the all-important front-line lung cancer market.
That’s not to say the drug can’t find other markets to control, and recently, trial wins have hinted that Tecentriq may just find some key niches. In September, Roche said Tecentriq had prolonged the lives of patients with extensive-stage small cell lung cancer by an average of 12.3 months, compared with 10.3 months for solo chemo; analysts say an approval in that department could rake in up to $1.5 billion. And in July, Tecentriq became the first in its class to post a win in tough-to-treat triple-negative breast cancer.
Roche is also looking to find new sales avenues for its older drugs through combinations. It’s paired Tecentriq and Avastin in areas such as lung cancer and liver cancer, and last year it won an FDA approval for a combination of Herceptin and newer breast cancer treatment Perjeta in postsurgery patients, despite data that analysts labeled “weak.”
2. Celgene
2017 cancer sales: $11.65 billion
2024 cancer sales: $18.55 billion
Rank change: None
When it comes to Celgene’s cancer portfolio—and its overall portfolio, for that matter—Revlimid is king. The megablockbuster generated $8.2 billion in sales last year, and it’s on track to surpass that number in 2018, with $7.14 billion collected through the first nine months of the year.
Of course, not everything for the drug has come up roses as of late. In December, the Big Biotech said it had fallen short in a non-Hodgkin lymphoma trial, missing out on the $500 million in annual sales by 2022 that a new indication could have brought. And investors are already looking ahead to what biosimilars will do to Revlimid’s sales.
Celgene, though, is looking to its up-and-comers to fill the void—and in the meantime, newer cancer players are chipping in. Last summer, the New Jersey drugmaker and partner Agios snagged an FDA OK for Idhifa, a relapsed/refractory acute myeloid leukemia (AML) drug for patients with an IDH2 mutation. That group represents between 8% and 19% of all AML patients, and Idhifa is the first oral targeted inhibitor that treats the patient pool. Celgene expects $500 million in the setting. Vidaza, which brought in $458 million through the year’s first nine months, also plays in the AML space.
Pomalyst is another blockbuster on Celgene’s roster, and it competes in the multiple myeloma arena alongside big brother Revlimid. Through the first nine months of the year, the product had already churned out $1.47 billion in sales. Celgene has CAR-T therapies working their way through the clinic in the myeloma field, too, and those could eventually back up Pomalyst.
3. Bristol-Myers Squibb
2017 cancer sales: $8.52 billion
2024 cancer sales: $14.71 billion
Rank change: None
Once upon a time, industry watchers predicted that Bristol-Myers Squibb’s Opdivo would top Merck & Co.’s Keytruda to lead the class of PD-1/PD-L1 immuno-oncology drugs. These days, though, that time feels like a distant memory.
Thanks to a series of trial mishaps in the all-important previously untreated lung cancer field, Opdivo has fallen behind its archrival—and the fact that Keytruda has notched success after success in the clinic hasn’t helped BMS, either. Keytruda already boasts not one but two approvals in the lucrative first-line market, while some analysts recently said that Bristol-Myers may still be a year or more away from snagging one of its own.
That’s not to say the drug isn’t generating sales in plenty of other key markets. Its pairing with Bristol-Myers’ original checkpoint inhibitor, CTLA4 drug Yervoy, has helped both drugs pump up sales with approvals in areas such as previously untreated melanoma, previously untreated kidney cancer and more.
Outside the immuno-oncology realm, BMS boasts leukemia drug Sprycel and newer multiple myeloma contender Empliciti. While the myeloma space is particularly crowded—Johnson & Johnson’s Darzalex and Takeda’s Ninlaro won their first approvals right around the same time as Empliciti—Bristol-Myers and partner AbbVie are making headway. In August, the FDA bestowed its “breakthrough” tag on the drug as part of a cocktail that also features Celgene’s Pomalyst and low-dose dexamethasone, meant for relapsed and refractory patients who have received at least two prior treatments.
4. Johnson & Johnson
2017 cancer sales: $6.15 billion
2024 cancer sales: $14.31 billion
Rank change: +1
Johnson & Johnson may not have as wide an oncology portfolio as some of its rivals do, but the products it does have are rock-solid. In 2017, four of its cancer fighters checked in with sales above the blockbuster threshold, and analysts say a new approval from this year is destined for blockbuster land, too.
That would be Erleada, the follow-up to J&J’s leading cancer product, Zytiga. The elder drug pulled in $2.51 billion in prostate-cancer sales last year despite fierce competition from Xtandi from Astellas and Pfizer. Erleada, for its part, nabbed a February approval in nonmetastatic prostate cancer, months ahead of schedule, getting a head start on Zytiga’s archnemesis. Leerink Partners analysts, for their part, expect Erleada to go on to rack up $1.3 billion in peak sales.
J&J is also a force on the multiple myeloma side, where its Takeda-partnered Velcade long reigned supreme. The standby is still churning out big numbers—it amassed $1.11 billion in 2017 sales outside the U.S., where J&J markets the drug—but it too has a follow-up ready to lead a new generation of myeloma therapies. That’s Darzalex, which by last year had already generated more for the year than its predecessor at $1.24 billion.
Darzalex’s numbers are only set to keep growing, thanks to a landmark FDA green light in May. The agency gave the drug a go-ahead—in combination with Velcade and prednisone—in previously untreated patients who are transplant-ineligible, making Darzalex the first-ever monoclonal antibody to score an OK in newly diagnosed patients.
And then there’s powerhouse Imbruvica, which J&J has shared with AbbVie since the latter’s buyout of Pharmacyclics. That drug pulled in $1.89 billion last year, and a recent combo approval for patients with Waldenström macroglobulinemia should keep sales on the up and up. AstraZeneca, though, is mounting a challenge with Calquence, a drug that’s expected to eventually take on Imbruvica in chronic lymphocytic leukemia.
5. Pfizer
2017 cancer sales: $5.86 billion
2024 cancer sales: $14.03 billion
Rank change: +1
Pfizer has plenty of drugs in its oncology stable, including a couple of brand-new ones. The problem? In some areas, its newer products are playing from behind.
Not so with Ibrance, though. Pfizer’s cancer king was the first CDK 4/6 drug out of the gate back in 2015, and it racked up blockbuster sales before new rivals Kisqali from Novartis and Verzenio from Eli Lilly even came around. Ibrance bears green lights in more than 80 countries, and about 160,000 women have been treated with the product since it first rolled out, a Pfizer executive said recently.
Unfortunately for Pfizer, it can’t boast that kind of market lead in a lot of the fields where it competes. Take PD-1/PD-L1, for example: Bavencio, which it shares with Merck KGaA, was the fourth drug in the class, after Merck & Co.’s Keytruda, Bristol-Myers Squibb’s Opdivo and Roche’s Tecentriq. And while it was the first of the group to nab an OK in metastatic Merkel cell carcinoma, it’s still well behind its rivals in lung cancer, the largest market for I-O drugs.
The lag is even more pronounced for Pfizer’s two newest oncology approvals, Vizimpro and Talzenna. Vizimpro, a once-failed targeted lung cancer drug for patients with EGFR mutations, is going up against Roche’s Tarceva, Boehringer Ingelheim’s Gilotrif and AstraZeneca’s Tagrisso. And Talzenna will have to work to gain traction in a PARP field that already features AZ and Merck’s Lynparza, Clovis Oncology’s Rubraca and Tesaro’s Zejula.
Pfizer has other drugs ready chip in with backup, though. Xalkori, though recently topped in trials by first-line ALK-positive lung cancer contenders, still put up $594 million in sales last year. And the prostate cancer therapy Xtandi, shared with Astellas, chipped in $590 million, and the two companies have plans for new uses. They're currently running a pair of trials in hormone-sensitive disease, one examining Xtandi’s effects on patients whose cancer has metastasized and one focusing on those whose cancer has yet to spread.
Meanwhile, kidney cancer giant Sutent is still turning out blockbuster numbers, and follow-up Inlyta could soon see more play, thanks to new immuno-oncology combos for the disease.
6. AstraZeneca
2017 cancer sales: $4.02 billion
2024 cancer sales: $13.73 billion
Rank change: +2
Perhaps no company has pushed more aggressively into oncology in recent years than AstraZeneca, and that push is set to bump the British drugmaker up on the list by two spots, Evaluate predicts—more than any other drugmaker in the top 10.
One drug that’ll help lead the charge? Imfinzi, AZ’s entrant in the PD-1/PD-L1 class of immuno-oncology products. The drug earlier this year won a blockbuster nod in previously treated, stage 3 lung cancer, a sizable market that analysts think it’ll have to itself for years to come.
Just how much Imfinzi will be able to pitch in on AZ’s top line remains to be seen, though. Its future hinges on an ongoing trial in the all-important first-line lung cancer arena, where it so far hasn’t been able to show success.
AstraZeneca’s got plenty more going for it in oncology department, though—and it’s been quick to remind investors who are hyperfocused on I-O. For one, it boasts PARP inhibitor Lynparza, which brought in $269 million through the first six months of the year and is riding high on a new breast cancer approval.
Then there’s Tagrisso, a targeted lung cancer drug whose sales grew by 89% year-over-year in H1 to hit $760 million. It’s bolstered by a new indication in first-line EGFR-mutated lung cancer, where it this year became the new standard of care.
AZ is also counting on big things from Calquence, an October approval last year that’s expected to challenge Johnson & Johnson and AbbVie juggernaut Imbruvica in blood cancers.
7. Merck & Co.
2017 cancer sales: $4.11 billion
2024 cancer sales: $13.21 billlion
Rank change: None
Merck’s Keytruda may be stealing the immuno-oncology show these days, but the way Evaluate sees it, the New Jersey drugmaker will still be slated seventh in oncology sales when 2024 comes around.
On the other hand, that year, the pharma giant will register more than $9 billion higher in cancer sales than it did last year, and much of that increase will come thanks to the company’s PD-1 moneymaker.
As anyone who has been following the I-O race knows, lung cancer is the most competitive field for the new generation of cancer fighters, and that’s because it represents a mammoth market—and financial opportunity. Currently, Keytruda leads rivals from Bristol-Myers, AstraZeneca, Roche and the Pfizer-Merck KGaA team in that department, boasting two approvals in the front-line setting to their collective zero.
Keytruda has also impressed in plenty of other cancer types, winning green lights in cancers including head and neck, cervical, lymphoma and more. Its indications across nine collective cancer types will all chip in sales that’ll contribute to its forthcoming leap.
Keytruda won’t be doing all the legwork on its own, though. Merck recently struck a pair of deals to gain access to two promising therapies that it hopes will come up big. Last July, it laid out $8.5 billion for half-ownership of AstraZeneca PARP inhibitor Lynparza, and it followed up this March with a $5.8 billion deal for a 50% stake in Eisai’s Lenvima.
Keytruda
Keytruda is the world's bestselling cancer drug by a large margin. (Merck & Co.)
Company: Merck & Co.
2023 sales: $25 billion
Diseases: Melanoma, non-small cell lung cancer, head and neck cancer, classical Hodgkin lymphoma, primary mediastinal large B-cell lymphoma, bladder cancer, microsatellite instability-high or mismatch repair deficient cancer, gastric cancer, esophageal cancer, cervical cancer, liver cancer, biliary tract cancer, Merkel cell carcinoma, kidney cancer, endometrial cancer, tumor mutational burden-high cancer, cutaneous squamous cell carcinoma, triple-negative breast cancer.After AbbVie's Humira lost U.S. market exclusivity and as demand for COVID vaccines plummeted at the end of the pandemic, Merck & Co.’s Keytruda was finally able to claim the title of the world’s bestselling medicine in 2023. But its reign may be short-lived.
In another major feat, a combination of Keytruda and Astellas and Pfizer’s Padcev won full FDA approval as a first-line treatment for advanced bladder cancer—regardless of the patient’s eligibility for chemotherapy. The approval came after the phase 3 EV-302 trial linked the Keytruda-Padcev combo to a 53% reduction in the risk of death compared with chemo. The results were welcomed with a standing ovation at the European Society for Medical Oncology meeting last year.
But the EV-302 readout was viewed as more of a success for Padcev and the antibody-drug conjugate modality, especially given Keytruda’s previous stumbles in first-line bladder cancer as a monotherapy and as part of a combination with traditional chemotherapy. Nevertheless, the EV-302 regimen speaks to Keytruda’s appeal as the combination partner of choice for newer drugs. Another candidate taking that approach is Moderna and Merck’s individualized cancer vaccine, mRNA-4157 (V940). The shot’s cocktail with Keytruda has drawn much interest because of its promising midphase data in resected melanoma.
However, not all attempts to pair Keytruda up have been successful. Some of the notable failures include Keytruda’s combos with AstraZeneca-partnered Lynparza and Eisai-shared Lenvima.
As Keytruda is slated to fall off the patent cliff in 2028, Merck has been working on a subcutaneous version to potentially soften the blow. However, Merck is behind its rivals BMS and Roche in terms of developing more convenient injections of their PD-1/L1 offerings.8. Novartis
2017 cancer sales: $7.88 billion
2024 cancer sales: $9.72 billion
Rank change: -4
There’s just one drugmaker on this list falling in the rankings come 2024—and that’s Novartis. The Swiss drugmaker will watch as four of its peers pass it by in the cancer sales department over the next six years, Evaluate predicts.
It didn’t always look that way. Back in April 2014, when the Basel-based pharma agreed to fork over $16 billion for GlaxoSmithKline’s cancer portfolio as part of a multibillion-dollar asset swap, it took a seat among the industry’s major cancer players. GSK melanoma drugs Tafinlar and Mekinist, among other drugs, joined Novartis’ own cancer-fighters Gleevec, Tasigna, Afinitor, Jakavi and more.
Novartis planned to “optimize” the Tafinlar and Mekinist launches, "positioning Novartis as the leader in treating melanoma," it said in a statement at the time.
That, of course, was before Merck’s Keytruda and Bristol-Myers Squibb’s Opdivo came along. Both immuno-oncology drugs, now blockbusters, got their start in melanoma before moving into a slew of other indications, and their makers have worked hard to move them earlier into treatment and test them as part of combo regimens.
Since then, Gleevec copies have launched, too, taking a big chunk out of the company’s oncology sales.
That’s not to say Novartis’ cancer sales won’t be growing between now and 2024. They will, thanks in part to the company’s CAR-T therapy Kymriah, which is expected to eventually make a splash, despite early manufacturing woes. Zykadia should be making bigger top-line contributions down the line too, thanks to last year’s front-line ALK+ lung cancer approval.
Novartis is also hoping to get Kisqali going; the HR-positive, HER2-negative breast cancer drug, which competes with Pfizer’s Ibrance and Eli Lilly’s Verzenio, is off to a slower-than-expected start.
9. AbbVie
2017 cancer sales: $3.09 billion
2024 cancer sales: $8.47 billion
Rank change: +1
AbbVie made a splash in the oncology field back in 2015 when it shelled out $21 billion for a piece of cancer drug Imbruvica, which it now shares with Johnson & Johnson. Since then, it has worked to bring cancer-fighters up through its pipeline, too—and the combination of continued Imbruvica expansion plus the newer drugs has Evaluate predicting one step up for the Illinois drugmaker in the 2024 rankings.
One of those newer drugs is Venclexta, which nabbed a multibillion-dollar boost this summer when the FDA approved it in tandem with Roche’s Rituxan for certain chronic lymphocytic leukemia patients. Importantly, the agency’s OK covered patients with and without a 17p deletion; previously, it had restricted the drug’s use to those with the genetic mutation, which affects around 10% of CLL patients.
Analysts have said that the new nod alone could pad Venclexta’s sales by up to $2 billion, but on the U.K. side of the pond, cost watchdogs aren’t feeling the combo. They recently shot it down, citing problems with AbbVie’s economic models and a lack of evidence that the pairing works any better than Imbruvica does.
Speaking of Imbruvica, the drug has come through in a big way for AbbVie, delivering $2.14 billion in 2017 sales. But J&J and AbbVie—which at deal time predicted the drug would reap $7 billion in peak sales for its share alone—are still driving full speed ahead to widen the treatment’s reach.
In August, the pair picked up an FDA nod for the drug alongside Rituxan in patients with rare blood cancer Waldenström's macroglobulinemia, bringing Imbruvica’s total indication count to nine.
But Imbruvica has posted some disappointments, too. In July, the therapy struck out in previously untreated diffuse large B-cell lymphoma, failing to best a standard-of-care chemo regimen in a phase 3 study.
AbbVie has suffered other oncology setbacks, too. It originally thought late-stage cancer candidate ROVA-T would figure into its oncology sales sooner rather than later, but in March, the company ditched plans to seek a speedy FDA approval in third-line relapsed/refractory small cell lung cancer because of disappointing data.
10. Astellas
2017 cancer sales: $2.85 billion
2024 cancer sales: $5.83 billion
Rank change: +1
Astellas’ Xtandi, which it shares with Pfizer, has been blazing a blockbuster trail in the prostate cancer market for years, even with stiff competition from key Johnson & Johnson rival Zytiga. And that’s only set to continue in future years.
After recording nearly $3 billion in 2017 sales, the product this July picked up an FDA go-ahead to treat patients before their disease spreads through the body, an indication that industry watchers think could generate more than $1 billion on its own. Evaluate has said it expects the drug to churn out $4.71 billion in 2022, which would rank it among the top 15 best-selling cancer drugs that year.
And Astellas isn’t stopping there. It’s already studying Xtandi in additional subpopulations that could widen its patient pool and up its top-line contributions; the Japanese drugmaker and Pfizer are currently running a pair of trials in hormone-sensitive disease, one examining Xtandi’s effects on patients whose cancer has metastasized and one focusing on those whose cancer has yet to spread.
Just how much Xtandi grows, though, will depend on what kind of fight J&J’s Zytiga follow-up, Erleada, puts up. It bears its own approval in nonmetastatic disease, and Barclays analyst Geoff Meacham has said the two nemeses “essentially delivered identical outcomes” in trials.
Astellas also helps Roche’s Genentech market Tarceva, a targeted lung cancer drug. But that product is up against some stiff competition, too; AstraZeneca’s Tagrisso has topped its survival marks in trials, and Pfizer recently crowded the field with an FDA OK for newcomer Vizimpro.
Source: https://www.fiercepharma.com/special-report/top-10-cancer-drugmakers-2024
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