2013 Statistics for global prescription medications: CNS therapeutics maintain a leading position among small molecule therapeutics.

Abstract

IMS Health recently released top-line market data on the top global prescription drugs in 2013, and once again, we are summarizing the key data.1−5 In spite of all the negative press regarding prescription drug sales, 2013 witnessed an 4.5% growth ($874.6 billion) over 2012 sales ($857.1 billion). Unlike the dramatic change in leading medications between 2011 and 2012, the 2013 list of top products was relatively unchanged since 2012. Once again, half of the top 10 global prescription drugs are biologics (Table 1), but of the top five small molecule drugs, two are CNS. AbbVie’s Humira (monoclonal antibody for TNFα) was the top global product of 2013, with global sales of $9.8 billion (an 18.5% increase over 2012). The next two top spots were taken by small molecules: the asthma/COPD therapeutic Seretide ($9.2 billion, 4.5% growth over 2012) and the statin Crestor ($8.1 billion, 1.5% growth over 2012). Amgen’s Enbrel (monoclonal antibody for TNFα, $7.9 billion) and Sanofi-Aventis’ Lantus (insulin glargine, $7.9 billion, reflecting a 23.3% increase over 2012) rounded out the top 5. The proton pump (H+/K+ ATPase) inhibitor Nexium ($7.8 billion, increased 7% over 2012) came in at number 6, and the antipsychotic Abilify landed at number 7 ($7.8 billion, increased 14.6% over 2012), which faces patent expirations starting in 2015. Johnson & Johnson/Merck’s Remicade (monoclonal antibody for TNFα number 8, $7.6 billion), Eli Lilly’s SNRI antidepressant Cymbalta ranks number 9 ($6.4 billion, 13.6% growth over 2012), and IDEC’s MabThera (a chimeric monoclonal antibody against CD20) rounded out the top 10 with sales of $6.2 billion.1 Table 1 Top 20 Global Prescription Drugs in Terms of Sales in 20131 Figure 1 Structures of the top selling small molecule drugs of 2013 globally. The top therapeutic classes, by spending in 2013, were comparable to those from 2012 (Table 2).1,2 Last year, oncology ranked number one, with global sales of $67.1 billion, followed by pain ($57.2 billion), antidiabetic ($54.3 billion), antihypertensives ($49.6 billion), antibacterial ($40.2 billion), and mental health ($39.4 billion). Overall, CNS held two of the top 10 positions: pain (number 2) and mental health (number 6). In 2013, growth was modest, with many areas, such as mental health, showing a net loss (−2.6%). However, antidiabetics and autoimmune diseases displayed robust increases, 10.2% and 14.4%, respectively. Once again, lipid regulators shouldered the greatest loss (−10.8%), largely due to the continued impact of other statin patent expirations. In terms of the top 20 classes, nervous system disorders ranked number 16 ($20.7 billion, 10.1% increase) and other CNS fell to number 17 ($18.5 billion, 6.4% increase). Thus, in the top 20 global therapy areas, CNS held four spots totaling over $135.4 billion in global sales (or 15.5% of the total global sales).1 Table 2 Top 10 Global Therapeutic Classes in 2013 in terms of Spending/Sales1 Due to patent expirations that impacted 2013 pharmaceutical sales globally, the rankings of the top pharmaceutical companies was essentially the same in 2013 as they were in 2012, albeit with minor juxtapositions (Table 3). Once again, Novartis captured the top position with sales of $50 billion, followed by Pfizer ($44.3 billion), Sanofi-Aventis ($38.1 billion), Merck & Co. ($36.3 billion), Roche ($36.1 billion), GlaxoSmithKline ($32.5 billion), Johnson & Johnson ($30.7 billion), AstraZeneca ($30.2 billion), Teva ($24.2 billion), and Eli Lilly ($23.0 billion).1 Table 3 Top 10 Global Pharmaceutical Corporations in 2013 in Terms of Sales1 Overall, CNS drugs performed exceptionally well in 2013, holding two spots in the global top 10 pharmaceutical products, and representing two of only five small molecule therapeutics in the top 10, as well as two of the top 10 therapeutic classes. Generic competition and patent expirations had a major impact on the top prescription drugs in 2013. Moreover, biologics once again held five of the top 10 spots. With more patent expirations looming in 2014/2015 for top selling drugs, coupled with the exodus from CNS drug discovery, it will be interesting to see the impact in next year’s data.