Cancer Drugs Dominate Top 10 Best-Selling Drugs in 2018

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Adalimumab (Humira, AbbVie) remains the top selling drug for 2 years running, racking up $19.9 billion in global sales in 2018 and $18.4 billion in 2017, according to a biobusiness brief in Nature Reviews Drug Discovery.​

Two factors that might keep Humira on top a bit longer: AbbVie recently increased by 6.2% the list price of the blockbuster rheumatoid arthritis treatment. In late 2018, the US Food and Drug Administration (FDA) approved a biosimilar of Humira (Hyrimoz, Sandoz), but due to the patent protection, it won't hit the market until 2023.

Coming in second in 2018, as in 2017, is the blood cancer drug lenalidomide (Revlimid, Celgene), with sales of $9.7 billion in 2018, up from $8.2 billion in 2017.

The programmed cell death–ligand-1 (PD-L1) inhibitor pembrolizumab (Keytruda, Merck) for lung cancer and other tumor types jumped from outside the top 10 last year to third on this year's list. Sales of pembrolizumab reached $7.2 billion in 2018 compared with sales of just $3.8 billion a year earlier, according to the Nature brief by Lisa Urquhart of EP Vantage, London, UK.

A rival checkpoint inhibitor nivolumab (Opdivo, Bristol-Myers Squibb), with a variety of approved indications including lung cancer and melanoma, also broke into the top 10 this year, taking the number 7 spot, with sales of $6.7 billion in 2018, up from $4.9 billion in 2017.

Wedged in between the two immunotherapies are three other cancer drugs, all from Roche:

- Trastuzumab (Herceptin) sits fourth on the list of top sellers, bringing in $7.1 billion in 2018, with no change from 2017 sales.

- Bevacizumab (Avastin) holds the number 5 spot with sales of $7 billion in 2018, up slightly from $6.8 billion in 2017.

- Rituximab (Rituxan) sits at number 6 with $6.9 billion in sales in 2018, down from $7.5 billion in 2017.

It's unclear how long these three cancer brand-name drugs will remain in the top 10 given recent the approval of biosimilars in the US for each one.

Rounding out the top 10 is apixaban (Eliquis, Bristol-Myers Squibb) at number 8. The direct factor Xa inhibitor used for treatment of venous thromboembolic events and prevention of stroke in people with atrial fibrillation had 2018 sales of $6.4 billion, up from $4.9 billion in 2017.

The pneumococcal vaccine Prevnar 13 (Pfizer) ranked ninth on the list with sales of $5.8 billion in 2018 ($5.6 billion in 2017).

Ustekinumab (Stelara, Johnson & Johnson) is number 10 on the list. The interleukin-12/interleukin-23 inhibitor used for moderate to severe plaque psoriasis, active psoriatic arthritis, and moderately to severely active Crohn's disease, had sales of $5.7 billion in 2018, up from $4 billion a year earlier.

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