'Eliquis: the cardio drug that cannot be beat'

 Bristol Myers Squibb’s clotbuster Eliquis is set to be this year’s biggest selling cardiac drug, Evaluate Pharma consensus forecasts suggest – and remarkably, it is forecast to retain the crown all the way to 2028. This comes courtesy of several court rulings preventing US generic competition until that year. Indeed the remarkable aspect of the top 10 drugs lists is the longevity of these products. Lipitor, only just dethroned by Keytruda as the bestselling drug of all time, was first launched in 1997 and is still bringing in swathes of cash for the generics business Viatris; Roche’s stroke therapy Activase is a decade older. Only two drugs not yet launched appear in the 2028 table: Cytokinetics’ cardiomyopathy project aficamten, due a pivotal readout this year, and Merck’s sotatercept, which already has highly positive pivotal data in pulmonary arterial hypertension. As for the leading companies, Novartis takes the current top spot buoyed by heart failure therapy Entresto; in 2028 it will also benefit from the PCSK9 Leqvio, though this will not make up for the sales shed by Entresto. All but one of this year’s top 10 companies will see their heart drug sales fall in the next five years. The exception is United Therapeutics, whose inhaled pulmonary arterial hypertension therapy Tyvaso is growing fast.

Top 10 cardiovascular drug sales: 2023
Product	Company	Indications	2023e sales ($bn)
Eliquis	Bristol Myers Squibb/Pfizer	Stroke prophylaxis	12.2
Entresto	Novartis	Chronic heart failure	5.8
Xarelto	Bayer/J&J	Stroke prophylaxis; Myocardial infarction, acute	2.9
Opsumit	Johnson & Johnson	Pulmonary hypertension	1.9
Lipitor	Viatris	Hyperlipidaemia	1.6
Repatha	Amgen	Hyperlipidaemia	1.6
Uptravi	Johnson & Johnson	Pulmonary hypertension	1.5
Tyvaso	United Therapeutics	Pulmonary hypertension	1.4
Lixiana	Daiichi Sankyo	Stroke prophylaxis	1.4
Activase	Roche	Myocardial infarction, acute	1.3
Source: Evaluate Pharma.

 

Top 10 cardiovascular companies 2023 & 2028
Company	2023e cardiovascular sales ($bn)		Company	2028e cardiovascular sales ($bn)
Novartis	7.8		Novartis	6.9
Pfizer	6.8		Bristol Myers Squibb	5.4
Bristol Myers Squibb	5.8		Merck & Co	4.0
Bayer	5.2		United Therapeutics	3.9
Johnson & Johnson	5.1		Pfizer	3.8
AstraZeneca	4.0		Sanofi	3.5
Sanofi	3.7		Bayer	3.4
Viatris	2.9		Johnson & Johnson	3.2
United Therapeutics	2.3		AstraZeneca	3.1
Daiichi Sankyo	2.0		Viatris	2.8
Source: Evaluate Pharma.

 

Top 10 cardiovascular drug sales: 2028
Product	Company	Indications	2028e sales ($bn)
Eliquis	Bristol Myers Squibb/Pfizer	Stroke prophylaxis	6.7
Tyvaso	United Therapeutics	Pulmonary hypertension	2.8
Entresto	Novartis	Chronic heart failure	2.7
Sotatercept	Merck & Co	Pulmonary hypertension	2.6
Repatha	Amgen	Hyperlipidaemia	2.2
Camzyos	Bristol Myers Squibb	Hypertrophic cardiomyopathy; Chronic heart failure	2.1
Leqvio	Novartis	Hyperlipidaemia; Atherosclerosis	2
Aficamten	Cytokinetics	Hypertrophic cardiomyopathy	1.7
Lipitor	Viatris	Hyperlipidaemia	1.5
Activase	Roche	Myocardial infarction, acute	1.5
Source: Evaluate Pharma. https://www.evaluate.com/vantage/articles/news/corporate-strategy-snippets/eliquis-cardio-drug-cannot-be-beat