EvaluatePharma World Preview 2020 - 0

EvaluatePharma ®
World Preview 2020,

Outlook to 2026
13th Edition – July 2020

Welcome to the EvaluatePharma
®
World Preview 2020, Outlook to 2026
The thirteenth edition of EvaluatePharma’s

World Preview brings together our most popular
analyses to provide top-level insights into
the expected performance of the biopharma
industry between now and 2026, based on
EvaluatePharma’s coverage of the world’s
leading pharmaceutical and biotech companies.
This year’s World Preview highlights trends in
prescription drug sales, patent risk, R&D spend,
global brand sales and market performance
by therapy area. Also included are our latest
analyses on innovation, risk and return, using
data from EvaluatePharma Vision, as well as a
new analysis of the impact on the biopharma
industry outlook from COVID-19.
Complimentary copies of the full report can

be downloaded at:
www.evaluate.com/PharmaWorldPreview2020
All intellectual property rights in this report remain that of Evaluate Ltd and/or its respective third party licensors. Whilst all reasonable steps have been taken to ensure that the data presented are
accurate, Evaluate Ltd cannot accept responsibility for errors or omissions. Neither does Evaluate Ltd warrant the accuracy, merchantability or fitness for a particular purpose of the data. Nothing in the
reports shall constitute investment, financial or legal advice and the contents of the reports are provided for information purposes only. The data is not intended to amount to advice and should not be
used as a determining factor in any investment decision. This report, and the data it contains, may not be lent, resold, hired out or otherwise disposed of by way of trade in any form of binding or cover
other than that in which it is published, without the prior written consent of Evaluate Ltd. Copyright © 2020 Evaluate Ltd. All rights reserved.
2 EvaluatePharma® World Preview 2020 Copyright © 2020 Evaluate Ltd. All rights reserved.
Foreword
Few could have predicted the global events leading up to this year’s
EvaluatePharma World Preview 2020. The COVID-19 pandemic has cast a long
shadow over the pharmaceutical industry – which is battling to find treatments –
and indeed over all the citizens of the world, who are adjusting to new ways of
living and working.
The long-term impact of the pandemic on the biopharma industry is still largely
unknown. As such, many of the forecasts in this year’s report will have been
made in something of a vacuum.
Some of the economic and social disruptions have already been felt, however.
Physical distancing and lockdown measures across the world have translated
into fewer doctor visits, the cancellation of routine operations and delays to
many patients starting new treatments.
Hundreds of clinical trials have been mothballed and trial readouts delayed;
smaller developers in particular are exposed here, as they rely on fresh data
for financial injections and partnering agreements. M&A transactions have also
stalled, as company executives get to grips with international travel bans and
virtual due diligence.
It remains to be seen whether the

pandemic will also impact drug
approvals, the lifeblood of the industry.
But the longer the disruption, the more likely it becomes that regulatory decisions
will slow, as agencies grapple with their own staffing issues.
Then there is the wider macro-economic picture. The loss of jobs and productivity
means that many are predicting a global economic recession, leaving governments
and individuals with less to spend on healthcare. The situation in the US, the
world’s biggest healthcare market, could have the biggest repercussions for the
sector, as a ballooning unemployment rate shifts millions of citizens from private
insurance coverage.
Investors, however, have largely shrugged off the pandemic risks, with the
potential seen in experimental COVID-19 treatments apparently outweighing any
short-term hits to performance.
Foreword
Merck & Co predicted the biggest impact on its

pharmaceutical revenues of the big pharma
groups, shaving $1.7bn from its 2020 sales
guidance; however, many other groups have
benefited from stockpiling of medicines.
At this stage, most large drug makers are working on the basis of a return to
business as usual by the end of the year. EvaluatePharma predicts that prescription
drug sales will grow 3.7% this year, to $904bn.
It is not hard to find healthy levels of growth throughout this report, driven by
demand for the new therapies that the biopharma sector is pushing through its
pipeline. The need for effective and innovative ways to treat disease is something
that even a global pandemic will not blunt.
Ryan Waters Lisa Urquhart

Senior Analyst, Evaluate Ltd Editor, Evaluate Vantage
Analysis Highlights
Worldwide Prescription Drug Sales 2020-26 in figures
+7.4% CAGR*
2020-26
DRIVERS BRAKES
-$7.8bn -1.9%
21.7% 530 2020 consensus 2019-26 CAGR decline
Proportion of 2026 Number of FDA NME forecast change for anti-rheumatics
industry sales from approvals anticipated between March and as Humira, Enbrel
oncology therapies from current clinical June in response and Remicade face
($311bn) pipeline to the COVID-19 biosimilar competition
pandemic
+3.2%
$239bn 10.8% $252bn 2019-26 CAGR of industry
R&D spend, down from
Additional sales 2020-26 CAGR for Sales at risk 4.6% between 2012-19.
in 2026 from orphan drugs between 2020 and Increasing pressure
biotechnology 2026 due to on pharma innovation
products vs. 2019 patent expiries or R&D efficiencies
improving?
* Compound Annual Growth Rate.
• Prescription drug sales expected to reach almost $1.4trn

in 2026. Despite the COVID-19 pandemic causing near-
term challenges across the healthcare sector, the industry
demand for innovative and effective therapies continues
to drive long-term growth.
• Keytruda set to be the top selling drug worldwide in 2026

with $24.9bn sales, a forecast almost double that of its
closest rival. Humira drops out of the worldwide and USA
top 10 in 2026 following adalimumab biosimilar entry in the
EU and USA biosimilar competition expected from 2023.
Analysis Highlights
• Roche will be the leading prescription drug company in 2026 with

sales of $61.0bn, retaining its top spot from 2019.
• Bristol-Myers Squibb will be the seventh largest prescription drug

company by revenues in 2026 following its acquisition of Celgene.
AbbVie moves up to fifth place following its acquisition of Allergan.
• Eli Lilly’s anti-diabetic and obesity drug tirzepatide is currently the

most valuable project in the pharmaceutical industry pipeline, with
an NPV of $7.8bn.
• Roche to remain the top biotechnology company, with a forecast

$48.6bn of biologic sales in 2026, despite a decrease in biotech
revenue market share of -5.8% owing to the effect of biosimilars.
• Oncology is the area with the largest proportion of clinical

development spending, with 37.4% of total pipeline expenditure
and 28.7% of total pipeline FDA approvals. Oncology will contribute
21.7% of total pharmaceutical sales in 2026, with immuno-oncology
sales increasing to $94.7bn between 2019-26 at a CAGR of 20.2%.
• Industry R&D spend is forecast to grow at a CAGR of 3.2% to 2026,

lower than the CAGR of 4.6% between 2012 and 2019. Roche to be
biggest spender on pharmaceutical R&D in 2026.
Table of Contents
Contents
8 COVID-19: Industry Impact
12 Pharma Innovation: Risk & Return
16 Worldwide Prescription Drug Sales (2012-2026)
18 Worldwide Prescription Drug Sales in 2026: Top 10 Companies
20 Worldwide Prescription Drug & OTC Sales by Technology (2012-2026)
22 Top 10 Most Valuable R&D Projects (Ranked by Net Present Value)
23 Worldwide R&D Spend by Pharma & Biotech Companies (2012-2026)
25 Pharmaceutical R&D Spend in 2026: Top 10 Companies
26 Worldwide Prescription Drug & OTC Sales by Therapy Area in 2026
28 2026: Top 10 Selling Products in the World
30 2026: Top 10 Selling Products in the USA
COVID-19: Industry Impact part 1 of 4
COVID-19 pandemic causes overall decrease in 2020 forecasts; the treatment of COVID-19. Consensus forecast sales in 2020
Merck & Co experiences the greatest forecast decline. have grown by $528m since March, with further forecast revisions
Since the start of the global lockdown caused by the COVID-19 expected from sell-side analysts after Gilead announced their
pandemic, analyst forecasts for 2020 product sales have dropped pricing of remdesivir on June 29th, 2020, and the European
by $4.9bn for the top 15 companies. With a decrease of $1.25bn, Commission granted remdesivir conditional marketing authorisation
Merck & Co is expected to lose the most sales this year of the on July 3rd, 2020.
top 15 companies, due to the pandemic. Around two thirds of the Many of the top 15 companies have experienced decreased
company’s pharmaceutical revenue is derived from physician- demand for physician-administered products. Novartis is expected
administered products, which have been heavily impacted by social to experience a loss of demand for its ophthalmology portfolio,
distancing measures leading to fewer patient visits; Keytruda’s 2020 with forecasts for Beovu and Lucentis declining by $185m and
forecasts alone have decreased by $448m. $102m respectively. Analysts anticipate a similar effect on demand
In its Q1 2020 results, Gilead announced that its HIV portfolio for AbbVie’s Humira (-$278m) and hepatitis C treatment Mavyret
experienced a boost in sales due to increased customer stockpiling (-$203m). In its Q1 2020 results, Roche noted a decreased demand
in response to the pandemic, along with the continued strong for some of its chronic disease and cancer portfolio, however,
uptake of Biktarvy, leading analysts to increase the drug’s forecast analysts raised 2020 forecasts by $301m for Actemra following the
by $788m. The company noted that it expects this sales boost to product’s use as a COVID-19 treatment.
reverse in subsequent quarters, as access to clinics and fewer As a result of the COVID-19 pandemic, GSK has seen increased
new patient starts impact demand for its HIV and hepatitis C demand for the now off-patent respiratory drug Ventolin HFA and has
products. On May 1st, 2020, the company received Emergency also experienced buyer stockpiling of HIV regimen Tivicay, causing
Use Authorisation from the US FDA for Veklury (remdesivir) for analysts to raise their 2020 forecasts by $97m and $102m respectively.
Figure 1: Total 2020 Product Consensus Forecast Change Between

March and June: Top 15 Companies by 2020 Product Sales Source: EvaluatePharma, June 2020
1,000
Gains: Gains: Losses:
Tivicay $102m (+5.2%) Actemra $301m (+14.6%) Keytruda -$448m (-3.1%)
Ventolin HFA $97m (+10.5%) Bridion -$157m (-12.0%)
Losses: Gardasil -$111 (-2.6%)
500 Herceptin -$334m (-6.6%)
Lucentis -$191m (-10.4%)
Total 2020 Product Forecast Change ($m)
-500
Gains:
Biktarvy $788m (+12.0%)
Veklury (remdesivir) $528m
-1,000 Losses:
Losses: Beovu -$185m (-49.8%) Losses:
Truvada -$803m (-36.5%) Zolgensma -$112m (-10.8%) Humira -$278m (-1.4%)
Genvoya -$280m (-8.3%) Lucentis -$102m (-4.9%) Mavyret -$203m (-8.3%)
-1,500
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Table 1: Total 2020 Product Consensus Forecast Change Between

March and June: Top 15 Companies by 2020 Product Sales Source: EvaluatePharma, June 2020
WW Product Consensus Forecast

Rank Company 2020 Sales ($bn) Change March - June 2020 ($m) Change as % of current forecast
1. GlaxoSmithKline 31.7 650 2.1%
2. Eli Lilly 21.5 243 1.1%
3. Gilead Sciences 21.5 77 0.4%
4. Takeda 28.8 56 0.2%
5. Johnson & Johnson 43.7 -7 0.0%
6. Bristol-Myers Squibb 41.0 -119 -0.3%
7. Amgen 24.1 -285 -1.2%
8. AstraZeneca 25.2 -330 -1.3%
9. Novartis 39.5 -378 -1.0%
10. AbbVie 42.8 -512 -1.2%
11. Sanofi 32.7 -592 -1.8%
12. Roche 48.6 -619 -1.3%
13. Bayer 20.7 -657 -3.2%
14. Pfizer 39.9 -1,188 -3.0%
15. Merck & Co 39.6 -1,251 -3.2%
Total Top 15 501.3 -4,912 -1.0%
EvaluatePharma® finds that the greatest impact of the COVID-19 Analyst forecasts for products in the oncology and blood disease
pandemic on near-term forecasts is concentrated in areas with areas have also declined in the near-term, with drugs in these areas
mainly physician-administered drugs and chronic diseases. being mainly physician-administered; additional factors such as
Products treating diseases affecting the central nervous system prioritisation of COVID-19 patients at hospitals and clinics may have
have experienced the highest overall 2020 forecast change of any contributed to the reduction in demand. Endocrine therapies have
therapy area, decreasing by $1,442m from March to June. Social also experienced an overall forecast decrease of $840m, despite
distancing and lockdown measures have made accessing clinics some positive stocking effects seen for some products such as
more difficult, caused fewer surgeries and prompted patients to Eli Lilly’s diabetes portfolio, including Trulicity. Bayer experienced
delay appointments. This has lowered demand for products such as a decline in business in China for its diabetes treatment Precose
Merck’s anaesthesia agent Bridion and Roche’s multiple sclerosis (Glucobay), following restrictions in connection with the pandemic.
(MS) treatment Ocrevus. Outside the top five, sensory organs experienced a forecast decrease
Musculoskeletal drugs have experienced a 2020 forecast of $715m, largely attributed to patients delaying treatment during
decrease of $1,234m, with reduced demand for drugs like Humira lockdown due to reduced access to clinics, resulting in forecast
and Prolia caused by fewer new patient starts and barriers to declines for ophthalmic treatments such as Eylea and Lucentis.
in-clinic injections, despite positive inventory stocking effects Systemic anti-infectives had a 2020 forecast decline of only $27m.
experienced for some drugs. A reduction in new patient starts for Some positive effects have been seen in this area, including stockpiling
immunosuppressive therapies for conditions like rheumatoid arthritis of some HIV medications such as Tivicay and Biktarvy, whilst some
and MS has also been observed during the pandemic, in order to companies have reported the increased use of certain vaccines and
avoid immunocompromising vulnerable patients. Sales of medical anti-infective products in response to the pandemic. However, these
aesthetics such as AbbVie’s Botox are expected to be heavily positive effects have been outweighed by an expected decrease
impacted as patients are discouraged against non-emergency in demand, notably across HIV, hepatitis C and vaccines, which has
procedures during the pandemic (products formerly of Allergan are been driven by limited access to healthcare professionals and fewer
not included in the below analysis – see methodology*). patients seeking treatment during the pandemic.
Figure 2: Total 2020 Product Consensus Forecast Change Between

March and June: Top 5 Losses by Therapy Area Source: EvaluatePharma, June 2020
Key Forecast Losses
Central Nervous Bridion (Merck & Co)

System -$157m (-12.0%)
Keytruda (Merck & Co)

Oncology
-$448m (-3.1%)
Musculoskeletal Prolia (Amgen)

-$326m (-11.2%)
Soliris (Alexion)
Blood -$243m (-6.1%)
Precose (Bayer)
Endocrine
-$111m (-20.7%)
0 -200 -400 -600 -800 1,000 -1,200 -1,400 -1,600
Total 2020 Product Forecast Change ($m)
Table 2: Total 2020 Product Consensus Forecast Change Between

March and June: Top 5 Losses by Therapy Area Source: EvaluatePharma, June 2020
WW Product Consensus Forecast

Rank Therapeutic Category 2020 Sales ($bn) Change March - June 2020 ($m) Change as % of current forecast
1. Central Nervous System 82.7 -1,442 -1.7%
2. Oncology 157.0 -1,283 -0.8%
3. Musculoskeletal 71.6 -1,234 -1.7%
4. Blood 63.0 -1,222 -1.9%
5. Endocrine 64.3 -840 -1.3%
Other 303.7 -1,828 -0.6%
Total Change - -7,849 -
COVID-19: Industry Impact Methodology: “2020 Sales” represent the sum of all 2020 product sales forecasts per company or therapeutic
category.
“Change March - June 2020” compares the total change in 2020 product consensus forecasts in EvaluatePharma® over the period from April 1st
to July 1st, 2020, (covering the global lockdown due to COVID-19 and the Q1 2020 reporting period). Only products that were active at April 1st
and July 1st, 2020 within EvaluatePharma are included, and new products added post-April 1st, 2020 are excluded from analysis.
* Products formerly of Allergan have also been excluded from forecast change analysis following the acquisition of the company by AbbVie on
May 8th, 2020, resulting in a change of sell-side analysts in the EvaluatePharma® consensus forecast disrupting fair comparison. Current products
with EvaluatePharma single estimate forecasts have also been excluded.
COVID-19: Industry Impact

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Pharma Innovation: Risk & Return part 1 of 4
Biopharma R&D continues to direct its focus to oncology. Novel mechanistic approaches in gastro-intestinal and cardiovascular
EvaluatePharma finds that oncology remains an area of focus,
® push these therapy areas to the top of Evaluate’s innovation
with the highest number of predicted novel FDA approvals in the rankings, with 61% of predicted FDA approvals set to be first-in-class.
current US pipeline. The expected regulatory success in oncology Cardiovascular is the most expensive area in which to develop new
is unsurprising, considering a projected total clinical development therapies, with a forecast clinical development cost per approval of
spend of $82.0bn, over triple that of any other area. However, high $0.7bn, due to the requirement for high patient enrolment resulting
investment in oncology is set to see high return, with a forecast in a greater R&D cost burden. However, cardiovascular has the
$188.2bn in net present value (NPV), representing 34.8% of the highest NPV per approval of $1.7bn, suggesting that the chronic
value of the US clinical pipeline. nature of many cardiovascular diseases, combined with large patient
populations, can result in high sales returns.
Figure 3: Clinical Development Spend vs Risk Adjusted FDA Approvals

by Therapy Area of Current US Pipeline Source: EvaluatePharma Vision®, June 2020
90
80 Higher cost per approval Circle Area = Total NPV ($bn)
70
Total Clinical Development Spend ($bn)
Oncology
60
50
Endocrine
Respiratory
40
Cardiovascular
30 Musculoskeletal
Genito- Central Nervous System
Urinary Gastro-Intestinal
20 Lower cost per approval
Immunomodulators
Blood Systemic Anti-infectives
10
Dermatology
Sensory Organs
0
0 20 40 60 80 100 120 140 160 180
Risk Adjusted FDA Approvals
It’s not just the lab or clinic that

drives R&D innovation.
We all have a role to play in helping patients access the
treatment options they need – now more than ever.
Table 3: Clinical Development Spend vs Risk Adjusted FDA Approvals

by Therapy Area of Current US Pipeline Source: EvaluatePharma Vision®, June 2020
Risk Percentage of Total Clinical

Clinical Adjusted Total Clinical Risk Development NPV Risk Adjusted First-in-
Development FDA NPV Development Adjusted FDA Spend per Per Approval First-in-Class Class Ratio
Rank Therapeutic Category Spend ($bn) Approvals ($bn) Spend Approvals NPV Approval ($bn) ($bn) Approvals (%)
1. Oncology 82.0 152 188.2 37.4% 28.7% 34.8% 0.5 1.2 69 45%
2. Central Nervous System 26.5 55 76.0 12.1% 10.4% 14.1% 0.5 1.4 27 49%
3. Immunomodulators 15.9 34 49.2 7.3% 6.4% 9.1% 0.5 1.4 19 57%
4. Musculoskeletal 14.0 22 24.6 6.4% 4.2% 4.6% 0.6 1.1 10 44%
5. Cardiovascular 13.8 19 32.8 6.3% 3.6% 6.1% 0.7 1.7 12 61%
6. Gastro-Intestinal 12.7 23 15.5 5.8% 4.3% 2.9% 0.6 0.7 14 61%
7. Systemic Anti-infectives 11.9 54 34.7 5.4% 10.2% 6.4% 0.2 0.6 18 34%
8. Blood 8.4 24 26.0 3.8% 4.5% 4.8% 0.4 1.1 9 40%
9. Respiratory 7.3 16 19.6 3.3% 3.0% 3.6% 0.5 1.2 9 54%
10. Endocrine 7.2 14 15.6 3.3% 2.6% 2.9% 0.5 1.1 5 35%
11. Dermatology 6.9 29 15.2 3.1% 5.5% 2.8% 0.2 0.5 13 44%
12. Sensory Organs 4.4 26 20.9 2.0% 4.9% 3.9% 0.2 0.8 13 48%
13. Genito-Urinary 2.5 13 7.8 1.1% 2.5% 1.4% 0.2 0.6 5 40%
Various 5.8 49 14.3 2.6% 9.2% 2.6% 0.1 0.3 22 45%
Total 219.3 530 540.4 100% 100% 100% - - 244 -
Inclusion criteria: Analysis refers to products which are in US clinical development (Phase I-III), or filed with the FDA. Only NMEs with no prior global
approval are included, with risk adjustments applied to approval of US lead indication only, follow-on indications are excluded.
Methodology: ‘Clinical Development Spend’ by Therapeutic Category is calculated using EvaluatePharma Vision’s proprietary R&D Cost model
and represents the sum of the costs of all commercial clinical trials currently listed on ClinicalTrials.gov for products currently in active clinical
development (PI-Filed) – clinical development spend is typically 50% of total R&D expenditure.
‘Risk Adjusted FDA Approvals’ represents the total number of approvals expected from the industry’s current pipeline after applying EvaluatePharma
Vision’s proprietary product-specific probability of technical and regulatory success (PS-PTRS) to adjust for the level of risk associated with each
pipeline candidate.
‘Risk Adjusted First-in-Class Approvals’ represents the total number of products expected to be the first product approved with its unique mechanism
of action after applying the PS-PTRS to adjust for the level of risk associated with each pipeline candidate.
NPV sourced from EvaluatePharma Vision’s NPV Analyzer on July 1st, 2020.
Colour coding: The colour applied to ‘Risk Adjusted FDA Approvals’ and ‘NPV’ percentages refers to being above (green) or below (red) the ‘Clinical
Development Spend’ percentage. The blue colour scale applied to the remaining columns reflects the range within that column, with the darker
shade representing a higher number.
But pharma struggles to identify which novel drugs will deliver

the growth needed to invest in next-gen therapeutics.
R&D costs are rising, only 53% of phase III

drugs reach the market and just 20% of NMEs
generate 90% of commercial returns.
EvaluatePharma® finds that of the phase III assets currently in the Immunomodulators have the potential for extremely high returns
US pipeline, blood products are most likely to be approved by with average forecast US peak sales of nearly $2.2bn. This higher
the FDA with an average product-specific probability of technical return is complemented by a lower risk profile with a median PS-
and regulatory success (PS-PTRS) of 70%, based upon data from PTRS of 47%. Other therapy areas with similar risk:return profiles
EvaluatePharma Vision. Biopharma continues to focus on research are respiratory and dermatology, with an average forecast US peak
in the oncology space, with 103 new molecular entities in phase sales of nearly $1.3bn and $1.1bn respectively, along with an average
III development in the US, albeit with high developmental risk at PS-PTRS of 47% and 53% respectively. However, dermatology has
an average PS-PTRS of 38%. The trend towards highly targeted a much lower average R&D expenditure per product of $262m,
therapies and smaller patient populations, along with the high with respiratory being double this figure at $525m. Endocrine
volume of oncology therapies in development, may explain the therapies show the highest average R&D expenditure per product
comparatively low average US peak sales of ~$0.8bn for oncology in phase III of $788m, mostly attributed to the large-scale nature
products in phase III. of diabetes trials.
Figure 4: PTRS vs Predicted Peak Sales by Therapy Area of

Current US Pipeline Phase III Assets Source: EvaluatePharma Vision®, June 2020
2,400
2,200 Higher risk, higher return Lower risk, higher return

Immunomodulators
2,000 Circle Area = Average Clinical

Central Nervous System Endocrine
Development Spend ($m)
Average Peak Sales USA ($m)
1,800 Cross-axis lines indicate

the median value
1,600
Sensory Organs
1,400
Cardiovascular Genito-Urinary Respiratory
1,200
Dermatology
1,000
Musculoskeletal
Gastro-Intestinal
800 Oncology Blood
600 Systemic Anti-infectives

Higher risk, lower return Lower risk, lower return
400
30% 35% 40% 45% 50% 55% 60% 65% 70% 75%
Average PS-PTRS (%)
The result? From 2012-2019, pharmaceutical sales

grew at only half the rate of R&D spending, even as the
number of approved NMEs steadily increased.
It’s time for a new approach.
Table 4: PTRS vs. Predicted Peak Sales by Therapy Area of

Current US Pipeline Phase III Assets Source: EvaluatePharma Vision®, June 2020
Average Average Peak Average Clinical Product

Rank Therapeutic Category PS-PTRS (%) Sales USA ($m) Development Spend ($m) Count
1. Blood 70% 803 272 17
2. Systemic Anti-infectives 54% 642 274 33
3. Dermatology 53% 1,076 262 26
4. Musculoskeletal 51% 719 345 19
5. Respiratory 47% 1,335 525 9
6. Immunomodulators 47% 2,160 244 38
7. Gastro-Intestinal 47% 800 404 19
8. Endocrine 46% 1,940 788 9
9. Sensory Organs 43% 1,259 112 24
10. Genito-Urinary 42% 1,137 122 14
11. Oncology 38% 777 268 103
12. Cardiovascular 35% 1,588 338 29
13. Central Nervous System 35% 1,689 331 54
Various 56% 326 96 27
Median 47% 1,106 273 -
Total - - - 421
Inclusion criteria: Analysis refers to products which are in phase III of US clinical development. Only NMEs with no prior global approval are included.
Methodology: ‘Clinical Development Spend’ by Therapeutic Category is calculated using EvaluatePharma Vision’s proprietary R&D Cost model and
represents the sum of the costs of all commercial clinical trials currently listed on ClinicalTrials.gov for the included products – clinical development
spend is typically 50% of total R&D expenditure.
‘Average PS-PTRS’ is calculated using the average of EvaluatePharma Vision’s proprietary product-specific probability of technical and regulatory
success (PS-PTRS) for the lead indication of each product within the specified therapy area.
‘Average Peak Sales USA’ is sourced from EvaluatePharma Vision’s NPV Analyzer on July 1st, 2020, and is calculated based on proprietary trending
algorithms to the year of loss of exclusivity.
Colour coding: The blue colour scale applied to the columns reflects the range within that column, with the darker shade representing a higher
number.
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Worldwide Prescription Drug Sales part 1 of 2
(2012-2026)
Prescription drug market continues to grow; high sales risk from include the FDA approved Palforzia, Trodelvy and Tukysa, along
patent expiries; orphan drug market to almost double. with Veklury (remdesivir) and Actemra, both being investigated for
EvaluatePharma® finds that prescription (Rx) drug sales are set COVID-19 treatment. On May 1st, 2020, remdesivir was issued with
to grow at a CAGR of +7.4% between 2020 and 2026, with sales an Emergency Use Authorisation by the FDA for the treatment of
expected to reach almost $1.4trn. When compared to the 2012 COVID-19 in adults and children hospitalised with the disease.
through 2019 Rx sales CAGR of +2.7%, this highlights the continued The orphan drug market continues to grow, and is set to double
impressive sales acceleration of the healthcare sector. 2020 will from $127bn sales in 2019 to a forecast $255bn in 2026,
prove to be an atypical year for biopharma following the global highlighting the trend that drugmakers are targeting more
lockdowns caused by the coronavirus outbreak, as we forecast specialised diseases with smaller patient populations.
a slight decline in Rx sales growth rate in 2020 (+3.7%) and 2019 Consensus forecasts indicate that $252bn of sales are at risk
(+3.8%) compared to 2018 (+4.7%), which may be largely attributed between 2020 and 2026, with 2023 set to see the expiry of key
to the pandemic. patents for a number of biologics including Humira and Stelara.
WW Rx sales, excluding generics, are set to be over $1.0trn in 2023. A host of high profile patent expiries are also expected in 2025
If excluding both generic and orphan sales, Rx sales will reach the and 2026, with major drugs like Perjeta, Prolia, Xgeva, Xeljanz,
same milestone in 2026. The growth rate for the Rx market from Farxiga and Yervoy having patent expiries in 2025, whilst Eliquis
2021 until 2026 is expected to grow considerably, with the highest and Prevnar 13 go off patent in 2026. In spite of the patent expiry in
year-on-year growth of +8.2% forecast in 2025. The impressive 2026, Eliquis is still forecast to retain a spot within Evaluate’s WW
forecast growth can be attributed to some highly anticipated drug top 10 selling drugs ranking in 2026.
launches over the coming years. Anticipated drug launches in 2020
Figure 5: Worldwide Total Prescription Drug Sales (2012-2026) Source: EvaluatePharma, June 2020
1,600
1,400 +7.4% CAGR 2020-26
1,200
WW Prescription Drug Sales ($bn)
1,000
1,035
800 960
887
823
774
600 724
665 685
617 644
607 592 607
589 590
400
214 235 255

200 172 192
104 116 127 138 154
69 76 81 86 94
66 69 75 78 80 82 80 79 82 85 88 91 94 97 101
0
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026
Prescription excl. Generics & Orphan Orphan Generics
Worldwide Prescription Drug Sales (2012-2026) part 2 of 2
Figure 6: Worldwide Sales at Risk from Patent Expiration (2012-2026) Source: EvaluatePharma, June 2020
80 7.2% 8%
6.7%
70 7%
5.7%
60 5.3% 63 6%
5.0%
WW Sales ($bn)
50 4.4% 5%
52 4.1% 54
% at Risk
51 4.0% 3.7% 50
40 46 3.5% 4%
39
36 3.9% 3.9%
30 33 3%
31 32 31 1.8% 36 1.7%
20 25 29 27
23 22 1.2% 24 2%
21 20 21 21 20
18 16 12 16 17
10 15 1%
0 0%
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026
Total Sales at Risk Expected Sales Lost % Market at Risk
Patent Analysis: ‘Total Sales at Risk’ represents the worldwide product sales in the year prior to patent expiry, but are allocated to the
year of expiry. E.g. Lantus had sales of $7.1bn in 2015, this is shown above as ‘At Risk’ in 2016.
Table 5: Worldwide Prescription Drug Sales (2012-2026) Source: EvaluatePharma, June 2020
WW Prescription Sales ($bn)

Year 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026
Prescription 725 735 763 756 781 802 840 872 904 963 1,033 1,106 1,195 1,293 1,390
Growth per Year +1.4% +3.8% -0.9% +3.4% +2.7% +4.7% +3.8% +3.7% +6.4% +7.4% +7.0% +8.0% +8.2% +7.5%
Change vs. June 2019 ($bn) 28 12 8 7 6 14 - -
Generics 66 69 75 78 80 82 80 79 82 85 88 91 94 97 101
Generics as % of Prescription 9.2% 9.4% 9.8% 10.3% 10.3% 10.2% 9.5% 9.1% 9.0% 8.8% 8.5% 8.2% 7.9% 7.5% 7.2%
Prescription excl. Generics 659 666 688 678 701 721 760 792 823 878 946 1,015 1,101 1,195 1,290
Growth per Year +1.1% +3.3% -1.5% +3.4% +2.8% +5.4% +4.3% +3.8% +6.7% +7.7% +7.4% +8.4% +8.6% +7.9%
Orphan 69 76 81 86 94 104 116 127 138 154 172 192 214 235 255
Prescription excl. Generics

589 590 607 592 607 617 644 665 685 724 774 823 887 960 1,035
& Orphan
Prescription incl. Generics CAGR 2020-26 +7.4%

Note: Sales to 2019 based on company reported sales data. Sales forecasts to 2026 based on a consensus of leading equity analysts’ estimates for company product sales and segmental sales.
Table 6: Worldwide Sales at Risk from Patent Expiration (2012-2026) Source: EvaluatePharma, June 2020

Year 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026
Total Sales at Risk 52 33 31 51 39 32 31 46 16 12 36 63 21 50 54
Expected Sales Lost 36 23 21 18 20 25 22 15 29 16 17 27 21 20 24
% Market at risk 7.2% 4.4% 4.1% 6.7% 5.0% 4.0% 3.7% 5.3% 1.8% 1.2% 3.5% 5.7% 1.7% 3.9% 3.9%
Worldwide Prescription Drug Sales in 2026: part 1 of 2
Top 10 Companies
Roche to retain the top spot for worldwide prescription drug dropped by $1.6bn from 2018-19, with the company expecting
sales in 2026. further losses of around $2.8bn by 2026. Sanofi experienced a
Roche beats both Novartis and previous top company Pfizer to much smaller drop in Rx sales from 2018-19 of $0.2bn.
claim the top spot in 2019 and retains its place in 2026, mostly AstraZeneca, Bristol-Myers Squibb and AbbVie are the only
driven by sales of Ocrevus, Tecentriq, Hemlibra and Perjeta, which companies that have increased their forecast market share
together could potentially add around $25.4bn in sales for the between 2019-26. The acquisition of Celgene by Bristol-Myers
company in 2026. Roche’s recent acquisitions of gene therapy Squibb is the largest contributor to this change, causing the
company Spark Therapeutics and fibrosis specialists Promedior company to place in the top 10 this year with the combined
have also helped to continue to diversify the company’s portfolio. portfolio. AbbVie also completed their acquisition of Allergan for
Johnson & Johnson jumps from fifth place to second place in 2026, $63bn on May 8th, 2020, a strategic move that is set to diversify
which may largely be attributed to the strong forecast sales growth AbbVie’s current product portfolio and increase revenues in light of
of its blockbuster blood cancer treatment Darzalex, which is set to Humira’s looming loss of exclusivity in the USA in 2023. Sales of
add $8bn in sales in 2026. The company has also recently seen Humira are set to drop by around $12.9bn between 2019 and 2026.
excitement surrounding its COVID-19 vaccine candidate, along AstraZeneca’s sustained increase in market share year-on-year can
with fellow top 10 companies AstraZeneca, GlaxoSmithKline, be attributed to sales of Tagrisso, Lynparza and Imfinzi, which
Sanofi and Pfizer. continue to be major growth drivers for the company.
Whilst Novartis has managed to maintain its place in the top three from Takeda narrowly missed ranking in the top 10 in 2026, despite its
last year, the company is forecast to experience a significant drop in acquisition of Shire in 2019 significantly diversifying its product
WW prescription (Rx) drug market share, dropping by 1.3% between portfolio and increasing company revenue. In 2019, the company’s
2019 and 2026. Only Pfizer experienced a larger loss, with a marginally factor VIII replacement therapy Advate experienced a drop of just
greater drop in market share of 1.4% over the same period. under $1.0bn in sales, largely due to the patent expiring in June
2019, as well as Roche’s Hemlibra rapidly gaining market share in
Pfizer and Sanofi are the only companies in the top 10 to report
haemophilia A.
a decrease in Rx sales from 2018-19; Pfizer’s prescription sales
dropped by 3.2% to $43.8bn in 2019, which can most likely be The top 10 pharma companies showed a -6.2% decrease in market
attributed to Lyrica’s patent expiring in June 2019. Sales for Lyrica share overall, with Pfizer contributing -1.4% of that figure.
Figure 7: Worldwide Prescription Drug Sales in 2026: Top 10 Companies Source: EvaluatePharma, June 2020
70.0 +20%
61.0
+0 Sales ($bn) +18%
56.1 Ranking Change 2019 -26
60.0 54.8
+3 53.2 52.7
-1 51.1
+0 +2 +16%
WW Prescription Drug Sales ($bn)
-3
50.0 44.7
41.7 +14%
+3 41.0
CAGR 2019-2026 (%)

40.8
-2 +2 -2
+12%
40.0
+8.6% +10%
+8.5%
30.0 +7.2% +8%
20.0 +4.9% +6%

+3.8% +3.9%
+3.4%
+2.5% +2.6% +4%
+2.2%
10.0
+2%
0.0 +0%
Roche Johnson & Novartis Merck AbbVie Pfizer Bristol-Myers Sanofi AstraZeneca Glaxo-
Johnson & Co Squibb SmithKline
Worldwide Prescription Drug Sales in 2026: Top 10 Companies part 2 of 2
Table 7: Worldwide Prescription Drug Sales (2019-2026):

Top 10 Companies & Total Market Source: EvaluatePharma, June 2020
WW Prescription Sales ($bn) WW Market Share Rank

Rank Company 2019 2026 CAGR 2019 2026 Chg. (+/-) Chg. (+/-)
1. Roche 48.2 61.0 +3.4% 5.5% 4.4% -1.1pp +0
2. Johnson & Johnson 40.1 56.1 +4.9% 4.6% 4.0% -0.6pp +3
3. Novartis 46.1 54.8 +2.5% 5.3% 3.9% -1.3pp -1
4. Merck & Co 40.9 53.2 +3.8% 4.7% 3.8% -0.9pp +0
5. AbbVie 32.4 52.7 +7.2% 3.7% 3.8% +0.1pp +2
6. Pfizer 43.8 51.1 +2.2% 5.0% 3.7% -1.4pp -3
7. Bristol-Myers Squibb 25.2 44.7 +8.6% 2.9% 3.2% +0.3pp +3
8. Sanofi 34.9 41.7 +2.6% 4.0% 3.0% -1.0pp -2
9. AstraZeneca 23.2 41.0 +8.5% 2.7% 2.9% +0.3pp +2
10. GlaxoSmithKline 31.3 40.8 +3.9% 3.6% 2.9% -0.7pp -2
Total Top 10 366.1 497.1 +4.5% 42.0% 35.8% -6.2pp
Other 505.8 893.1 +8.5% 58.0% 64.2%
Total 871.8 1,390.3 +6.9% 100.0% 100.0%
Note: Bristol-Myers Squibb acquired Celgene on November 20th, 2019, for $74bn and AbbVie acquired Allergan on May 8th, 2020, for $63bn. The acquiring company now inherits all of the acquired
company products and forecast revenues, which accounts for the significant increase in Worldwide Prescription Drug Sales between 2019 and 2026.
Worldwide Prescription Drug & OTC part 1 of 2
Sales by Technology (2012-2026)

Industry continues to shift towards biotechnology; Roche sales, including its major growth drivers Ocrevus, Tecentriq, Perjeta
remains the top biologic company. and Hemlibra.
Biotechnology products are forecast to take majority share in Amgen is projected to fall two places, likely due to Enbrel losing
the top 100 drugs by sales by 2026, with 55% of the total market share to competition, whereas Novo Nordisk is estimated to
top 100 product sales in 2026, up 16% compared to 2012. Global jump up to third position, driven by the high forecast growth of the
prescription sales of biotechnology products continue to grow company’s GLP-1 agonists Ozempic and Rybelsus, together
rapidly with a CAGR of 9.6% between 2019 and 2026, compared to forecast to book almost $15bn in sales in 2026.
conventional product growth of 5.5% in the same timeframe. AbbVie is anticipated to fall out of the top 10, a likely result of
Despite losing 5.8% of the market share, likely due to three of the Humira losing exclusivity in the USA in 2023. Novartis joins the
company’s biologic blockbusters (Avastin, Herceptin and Rituxan) top 10 with strong Cosentyx and Entresto forecasts on top of the
going off patent in 2018 and 2019, Roche remains the top biologic anticipated launch of Arzerra S.C. and inclisiran. The company
company by sales with an impressive 9.6% of the worldwide is also the only one in the top 10 projected to increase their global
biotechnology market in 2026. Roche is set to hold 9 out of the 50 biotechnology market share by 2026.
biotechnology products in the 2026 top 100 global products by
Figure 8: Worldwide Prescription Drug & OTC Pharmaceutical Sales:

Biotech vs. Conventional Technology Source: EvaluatePharma, June 2020
90%
80% 79% 78% 77%
80% 76% 74%
Technology % of Prescription & OTC Sales
72% 71% 70% 69% 68% 67% 66%

70% 65% 65%
60% Biotech Products Within Top 100

Rapid increase in share of Top 100 products: 2026 Split:
39%
50% - 2012: 39% 47% 53% Biotech: n=50 (avg. $4.6bn) 45% 55%
61%
- 2019: 53% Conv.: n=50 (avg. $3.8bn)
40% - 2026: 55%
30%
34% 35% 35%
31% 32% 33%
29% 30%
20% 26% 28%
23% 24%
21% 22%
20%
10%
0%
2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026
Biotechnology Conventional/Unclassified
Worldwide Prescription Drug & OTC Sales by Technology (2012-2026) part 2 of 2
Table 8: Worldwide Prescription Drug & OTC Sales by Technology (2012-2026) Source: EvaluatePharma, June 2020
Technology 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026
Biotechnology 20% 21% 22% 23% 24% 26% 28% 29% 30% 31% 32% 33% 34% 35% 35%
Conventional/Unclassified 80% 79% 78% 77% 76% 74% 72% 71% 70% 69% 68% 67% 66% 65% 65%
Total Prescription & OTC Sales 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
WW Sales ($bn)
Technology 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026
Biotechnology 149 162 174 179 197 215 242 266 284 312 344 378 416 461 505
Conventional 443 435 447 440 446 447 461 469 476 505 536 566 606 644 681
Other Unclassified Sales 170 177 181 171 175 177 176 175 180 183 191 201 212 228 246
Total Prescription & OTC Sales 762 774 802 791 818 839 879 910 940 999 1,071 1,145 1,235 1,333 1,432
Table 9: Worldwide Prescription Drug Sales from Biotechnology in 2026:

Top 10 Companies Source: EvaluatePharma, June 2020
WW Sales ($bn) WW Market Share

Rank Company 2019 2026 % CAGR 19-26 2019 2026 Chg. (+/-) Rank Chg.
1. Roche 41.1 48.6 +2.4% 15.4% 9.6% -5.8pp +0
2. Merck & Co 19.8 37.4 +9.5% 7.5% 7.4% -0.0pp +1
3. Novo Nordisk 17.9 28.1 +6.6% 6.7% 5.6% -1.2pp +2
4. Sanofi 15.6 25.2 +7.1% 5.9% 5.0% -0.9pp +3
5. Eli Lilly 14.1 22.5 +7.0% 5.3% 4.5% -0.8pp +3
6. Amgen 19.6 21.4 +1.3% 7.4% 4.2% -3.1pp -2
7. Johnson & Johnson 17.7 21.1 +2.5% 6.7% 4.2% -2.5pp -1
8. Bristol-Myers Squibb 12.2 20.6 +7.7% 4.6% 4.1% -0.5pp +1
9. Novartis 8.6 19.0 +12.0% 3.2% 3.8% +0.5pp +4
10. GlaxoSmithKline 8.7 16.1 +9.2% 3.3% 3.2% -0.1pp +2
Note: Company drug sales from undisclosed products are presumed to be from conventional (small molecule) technology.
Table 10: Worldwide Prescription Drug Sales from Top 100 Products Source: EvaluatePharma, June 2020
WW Sales ($bn) As a %
Technology 2012 2019 2026 2012 2019 2026
Biotechnology 99 167 230 39% 53% 55%
Conventional 158 151 189 61% 47% 45%
Total 257 318 419 100% 100% 100%
Top 10 Most Valuable R&D Projects
(Ranked by Net Present Value)
Eli Lilly’s anti-diabetic and obesity drug tirzepatide beats phase II tumour infiltrating lymphocytes (TIL) cell therapies, LN-144,
the competition to claim the most valuable project in the which has a Fast Track Designation from the FDA for the treatment
pharmaceutical industry pipeline. of advanced melanoma. Allakos completes the quartet at number
A familiar face from last year, Eli Lilly’s anti-diabetic and obesity nine with its phase III oesophagitis and gastritis asset, AK002.
entry tirzepatide has risen in the ranks from sixth place to the top Biogen’s highly anticipated and controversial Alzheimer’s drug
spot on the back of a strong show of confidence from Lilly, pitting aducanumab sits at the number six position. With the future
the drug directly against their current top seller Trulicity in the direction of Alzheimer’s research as well as the entire amyloid-beta
cardiovascular outcome trial, Surpass-CVOT. Novartis finds itself hypothesis resting on the shoulders of this once abandoned drug,
with the second most valuable pipeline asset in the industry in the the delay in the promised early 2020 filing with the FDA may
form of The Medicines Company’s lead asset inclisiran, following unnerve investors. However, Biogen remains positive about its
the acquisition of the company in January 2020. Approval of chances of regulatory success in what could be the first new
the drug is expected in H2 2020, and the RNAi asset is forecast Alzheimer’s disease treatment in more than 15 years, which is
to challenge Amgen’s Repatha for the top spot of the anti- enough to place it as one of the most valuable R&D projects.
hyperlipidaemic market by 2026. Bristol-Myers Squibb’s tyrosine kinase 2 (TYK2) inhibitor
The list is once again dominated by large-cap companies, with BMS-986165 places fourth, with high hopes placed on the drug to
only four projects coming from mid-cap biotechs. The leader of recover the potential psoriasis sales lost after the disposal of Otezla
the pack is argenx with its immunosuppressant efgartigimod, in the $74bn Celgene merger. Two new entries in the form of
currently sitting in third place following recent positive top-line GlaxoSmithKline’s belantamab mafodotin for multiple myeloma and
results from the phase III ADAPT trial in patients with generalised Roche’s spinal muscular atrophy therapy, risdiplam, complete the
myasthenia gravis. Following in fifth place is Vir Biotechnology’s top 10. Roche was granted a priority review for risdiplam by the FDA
collaboration with Alnylam Pharmaceuticals, ALN-HBV02, a novel in November 2019; however, the Prescription Drug User Fee Act
RNAi therapeutic for the treatment of chronic hepatitis B infection. (PDUFA) date for the New Drug Application was extended, with
Iovance Biotherapeutics sits at number eight with one of its two Roche now expecting a decision on August 24th, 2020.
Table 11: Top 10 Most Valuable R&D Projects (Ranked by Net Present Value) Source: EvaluatePharma Vision®, June 2020
WW Product Today’s
Phase Sales ($m) NPV
Rank Product Company (current) Mechanism of Action 2026 ($m)
1. Tirzepatide Eli Lilly Phase III Gastric inhibitory polypeptide (GIP) receptor 2,198 7,832
agonist; Glucagon-like peptide 1 (GLP-1)
receptor agonist
2. Inclisiran Novartis Filed Proprotein convertase subtilisin/kexin type 9 2,010 New Entry 7,422
(PCSK9) inhibitor
3. Efgartigimod argenx Phase III Neonatal Fc receptor (FcRn) antibody 2,002 New Entry 5,650
4. BMS-986165 Bristol-Myers Squibb Phase III Tyrosine kinase 2 (TYK2) inhibitor 1,810 New Entry 5,638
5. ALN-HBV02 Vir Biotechnology Phase II Hepatitis B polymerase RNAi therapeutic 1,164 New Entry 5,459
6. Aducanumab Biogen Phase III Beta amyloid A4 protein antibody 1,634 5,361
7. Belantamab GlaxoSmithKline Filed Tubulin polymerisation inhibitor; Tumour necrosis 1,251 New Entry 5,338
Mafodotin factor receptor superfamily member 17 (TN-
FRSF17) antibody
8. LN-144 Iovance Biotherapeutics Phase II Tumour infiltrating lymphocytes (TIL) cell therapy 1,473 New Entry 5,162
9. AK002 Allakos Phase III Sialic acid-binding immunoglobulin-type lectins-8 1,201 New Entry 5,126
(SIGLEC-8) antibody
10. Risdiplam Roche Filed Survival motor neuron 2 (SMN2) protein 1,412 New Entry 5,087
stimulant
Top 10 16,154 58,076
Other 224,783 506,663
Total 240,937 564,738 -4%
NPV of R&D Pipeline MAY 2019: 590,943
Note: Today’s NPV ($m) relates to the Net Present Value of the product as of July 1st, 2020, based on the EvaluatePharma Vision NPV Analyzer.
Worldwide R&D Spend by Pharma & Biotech part 1 of 2
Companies (2012-2026)
Industry R&D expenditure growth to slow down; proportion of The average proportion of R&D spend to worldwide prescription
R&D spend to pharmaceutical revenue decreases. (Rx) sales also looks to be decreasing, with an average of 18.9%
EvaluatePharma® finds that worldwide pharmaceutical R&D spend for 2020 through 2026, compared to 20.1% in 2012 to 2019. The
is forecast to grow steadily between 2019 and 2026 at a CAGR of decrease in R&D spending to Rx sales from 21.3% in 2019 to 16.7%
3.2% to reach $232.5bn, slower than the historical CAGR of 4.6% in 2026 suggests that the biopharma industry expects to reap
between 2012 and 2019. Worldwide pharmaceutical R&D spend the benefits of R&D investment made now in the coming years.
totalled $186.0bn in 2019 representing an increase of 3.0% on the Going forward, this data supports the industry trend towards more
previous year, a much slower increase compared to the 2018 year- specialised treatments with smaller patient populations, along with
on-year growth of 7.3%. biopharma investing heavily in ways to improve R&D efficiencies
such as the use of artificial intelligence.
Figure 9: Worldwide Total Pharmaceutical R&D Spend in 2012-2026 Source: EvaluatePharma, June 2020
260 +16%
240 +3.2% CAGR 2019-26

+14%
220 233
227
221
200 211 +12%
WW Pharma R&D Spend ($bn)
202
180 +4.6% CAGR 2012-19 195
188
R&D Spend Growth (%)

186
181 +10%
160
168
159
140 149
145 +7.3% +8%
136 139 +7.0%
120
100 +6%
+4.5% +4.5% +4.8%
80 +5.6% +4.0%
+4%
60
40 +3.4%
+2.9% +3.0% +2%
+2.5% +2.6%
20 +1.8%
+0.9%
0 +0%
2012 201 3 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026
Worldwide R&D Spend by Pharma & Biotech Companies (2012-2026) part 2 of 2
Table 12: Worldwide R&D Spend by Pharma & Biotech Companies (2012-2026) Source: EvaluatePharma, June 2020

Year 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026
Pharma R&D Spend 136.1 138.6 144.8 149.0 159.4 168.4 180.6 186.0 187.8 195.3 201.9 211.0 221.1 226.7 232.5
Growth per Year +1.8% +4.5% +2.9% +7.0% +5.6% +7.3% +3.0% +0.9% +4.0% +3.4% +4.5% +4.8% +2.5% +2.6%
WW Prescription Sales 725 735 763 756 781 802 840 872 904 963 1,033 1,106 1,195 1,293 1,390
R&D as % of WW 18.8% 18.8% 19.0% 19.7% 20.4% 21.0% 21.5% 21.3% 20.8% 20.3% 19.5% 19.1% 18.5% 17.5% 16.7%
Prescription Sales
Generics 66 69 75 78 80 82 80 79 82 85 88 91 94 97 101
Prescription excl. Generics 659 666 688 678 701 721 760 792 823 878 946 1,015 1,101 1,195 1,290
R&D as % of Prescription 20.7% 20.8% 21.1% 22.0% 22.7% 23.4% 23.8% 23.5% 22.8% 22.2% 21.3% 20.8% 20.1% 19.0% 18.0%
excl. Generics
CAGR 2019-26 on Pharma R&D Spend +3.2%. Cumulative 10 year R&D Spend (2010-19) $1,528bn.
Table 13: NME Approvals per Year (2007-2019) Source: EvaluatePharma, June 2020
Year 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Number of NMEs 25 31 35 26 35 44 35 51 56 27 55 62 53
Spend per NME ($bn) 4.9 4.2 3.6 4.9 3.9 3.1 4.0 2.8 2.7 5.9 3.1 2.9 3.5
Spend per NME ($bn) (3 year lag)* 4.7 3.7 2.9 3.7 2.7 2.4 5.1 2.6 2.4 3.0
2019 FDA approved novel drug count includes 48 drugs approved by Centre for Drug Evaluation and Research (CDER) and 5 drugs
approved by the Centre for Biologic Evaluation and Research (CBER).
Note: Forecast pharmaceutical research and development spend based on a consensus of leading equity analysts’ estimates for company level R&D spend, extrapolated to pharmaceutical R&D when
a company has non-pharmaceutical R&D activity.
*Spend per NME ($bn) (3 year lag) uses the R&D expense for 3 years prior to the NME approval instead of the same year. e.g. the 2019 figure of $3bn is the R&D expense in 2016 divided by the number
of NMEs in 2019.
Pharmaceutical R&D Spend in 2026:
Top 10 Companies
Roche leads as biggest spender on pharmaceutical R&D in 2026. reducing their spend by 5.2% and 4.6% respectively. The trend
EvaluatePharma finds that Roche considerably outspends its
® suggests that the top pharma companies are increasing their R&D
competitors to claim the position as the forecast top spender on efficiencies, potentially through collaborative R&D and utilising
pharma R&D in 2026, with a spend of $12.9bn. Of the top 10, Eli artificial intelligence, but also highlights that companies may be
Lilly is forecast to invest the highest percentage of prescription (Rx) investing heavily in R&D now to see return on their investment in
sales on R&D in 2026 with 22.7%. With regards to R&D expenditure the longer term. Bristol-Myers Squibb is forecast to have the highest
vs. total Rx sales, GlaxoSmithKline and Pfizer are increasing their growth in pharma R&D spend of the top 10, likely a result of taking
spend by 0.9% and 0.7% respectively, while the general trend for on Celgene operations. Overall, total R&D spend is expected to
the top 10 is in the opposite direction, with Eli Lilly and AstraZeneca increase at a CAGR of 3.2%, reaching $232.5bn in 2026.
Figure 10: Pharmaceutical R&D in 2026: Top 10 Companies Source: EvaluatePharma, June 2020
14.0
R&D Spend ($bn)

12.0
12.9 CAGR 2019-26 (%)
+3.3%
Pharma R&D Spend ($bn)
10.0 11.0 10.7

+3.3% +2.8% 9.7 9.7
8.0 9.4
+2.1% +2.7% +6.9%
6.0 7.6 7.5 7.3 7.0
+4.6% +5.1% +5.6% +3.3%
4.0
2.0
0.0
Roche Merck & Co Johnson & Novartis Pfizer Bristol-Myers GlaxoSmithKline AstraZeneca AbbVie Eli Lilly
Johnson Squibb
Table 14: Pharmaceutical R&D Spend (2019 & 2026):

Top 10 Companies & Total Market Source: EvaluatePharma, June 2020
Pharma R&D ($bn) CAGR R&D As a % of Prescription Sales

Rank Company 2019 2026 2019-26 2019 2026 Chg. (+/-)
1. Roche 10.3 12.9 +3.3% 21.3% 21.2% -0.1pp
2. Merck & Co 8.7 11.0 +3.3% 21.3% 20.6% -0.7pp
3. Johnson & Johnson 8.8 10.7 +2.8% 22.0% 19.1% -3.0pp
4. Novartis 8.4 9.7 +2.1% 18.2% 17.7% -0.4pp
5. Pfizer 8.0 9.7 +2.7% 18.2% 18.9% +0.7pp
6. Bristol-Myers Squibb 5.9 9.4 +6.9% 23.4% 21.0% -2.4pp
7. GlaxoSmithKline 5.5 7.6 +4.6% 17.7% 18.6% +0.9pp
8. AstraZeneca 5.3 7.5 +5.1% 22.9% 18.3% -4.6pp
9. AbbVie 5.0 7.3 +5.6% 15.4% 13.9% -1.6pp
10. Eli Lilly 5.6 7.0 +3.3% 27.9% 22.7% -5.2pp
Total Top 10 71.6 92.8 +3.8% 21.6% 20.4% -1.2pp
Other 114.6 139.7 +2.9%
Total 186.1 232.5 +3.2% 21.4% 16.7% -4.6pp
Note: Forecasted pharmaceutical R&D spend based on a consensus of leading equity analysts’ estimates for company-level R&D spend.
Worldwide Prescription Drug & OTC part 1 of 2
Sales by Therapy Area in 2026

Oncology set to remain as the largest therapy area in 2026. largely due to the wide utility of immunotherapeutic agents across
Oncology was the largest therapy area in 2019, and it prevails different therapy areas, with sales growth driven by Sanofi’s
as the leading therapy area in 2026, with a 21.7% market share Dupixent, Amgen’s Otezla (acquired from Celgene pre-BMS
and sales forecast to reach $311.2bn. The growth of oncology acquisition), Reata Pharmaceuticals’ bardoxolone methyl and
sales can be partly attributed to the growth of the immuno- Novartis’ Cosentyx.
oncology class, which is set to grow at a CAGR of 20.2% The anti-rheumatics sector is expected to decline with a CAGR
between 2019 and 2026, driven largely by the growth of the PD-1 of -1.9% from 2019 to 2026, resulting in sales of $49.7bn. The
inhibitors Keytruda and Opdivo. Within oncology, the sales of decrease in this area can be attributed to the entry of biosimilars in
immuno-oncology agents and protein kinase inhibitors are set to the market for Enbrel, Remicade and Humira, the latter of which is
make up 66% of sales in 2026. set to lose exclusivity in the USA in 2023, with WW sales expected
With a CAGR of 14.3% from 2019 to 2026, immunosuppressants to drop by around $12.9bn between 2019 and 2026.
is the therapy area with the highest growth rate over this period,
Figure 11: Top 10 Therapy Areas in 2026, Market Share & Sales Growth Source: EvaluatePharma, June 2020
26%
Key growth drivers:
24% Keytruda (MRK), Tagrisso (AZN), Tecentriq (ROG), Circle Area =
Key growth drivers:
Darzalex (JNJ), Ibrance (PFE), Opdivo (BMY) WW 2026 Sales ($bn)
22% Rinvoq (ABBV), Amjevita (AMGN),
Filgotinib (GILD) Key launches:
20% Enhertu (Daiichi Sankyo) launched in Jan 2020
Key growth brakes:
18% Humira (ABBV), Remicade (JNJ), Sub-category 2026 Sales (CAGR 2019-26): Oncology
WW Market Share (%)
Enbrel (AMGN) Immuno-oncology: $94.7bn (+20.2%)

16% Protein kinase inhibitors: $112.2bn (+9.6%) Key growth drivers:
14% Dupixent (SAN), Otezla (AMGN),
Key growth brakes: bardoxolone methyl (RETA),
12% Cosentyx (NVS)
Truvada (GILD),
10% Genvoya (GILD),
Mavyret (ABBV)
8%
Anti-diabetics
6% Vaccines Immunosuppressants
Anti-rheumatics Sensory
Anti-virals Organs
4%
2%
MS Therapies Bronchodilators Dermatologicals
0%
-3% -1% +2% +4% +6% +8% +10% +12% +14% +16% +18%
% Sales Growth: CAGR 2019-26
Table 15: Worldwide Prescription Drug & OTC Sales by Evaluate Therapy Area
(2019 & 2026): Top 15 Categories & Total Market Source: EvaluatePharma, June 2020
WW Sales ($bn) CAGR WW Market Share Rank

Rank Therapy Area 2019 2026 % Growth 2019 2026 Chg. (+/-) Chg. (+/-)
1. Oncology 145.4 311.2 +11.5% 16.0% 21.7% +5.8pp +0
2. Anti-diabetics 51.0 66.9 +3.9% 5.6% 4.7% -0.9pp +1
3. Immunosuppressants 24.0 61.3 +14.3% 2.6% 4.3% +1.6pp +4
4. Vaccines 32.5 56.1 +8.1% 3.6% 3.9% +0.3pp +1
5. Anti-rheumatics 56.9 49.7 -1.9% 6.3% 3.5% -2.8pp -3
6. Anti-virals 38.8 42.9 +1.5% 4.3% 3.0% -1.3pp -2
7. Sensory Organs 23.8 35.1 +5.7% 2.6% 2.4% -0.2pp +1
Top 8-15 continued over…
Worldwide Prescription Drug & OTC Sales by Therapy Area in 2026 part 2 of 2
WW Sales ($bn) CAGR WW Market Share Rank

Rank Therapy Area 2019 2026 % Growth 2019 2026 Chg. (+/-) Chg. (+/-)
8. Bronchodilators 27.8 32.2 +2.1% 3.1% 2.3% -0.8pp -2
9. Dermatologicals 13.8 32.0 +12.7% 1.5% 2.2% +0.7pp +3
10. MS therapies 22.7 25.0 +1.4% 2.5% 1.7% -0.7pp +0
11. Anti-hypertensives 23.4 22.4 -0.6% 2.6% 1.6% -1.0pp -2
12. Anti-coagulants 21.3 22.0 +0.5% 2.3% 1.5% -0.8pp -1
13. Anti-psychotics 11.2 21.0 +9.5% 1.2% 1.5% +0.2pp +2
14. Anti-fibrinolytics 13.4 19.7 +5.7% 1.5% 1.4% -0.1pp -1
15. Sera & gammaglobulins 11.5 19.5 +7.8% 1.3% 1.4% +0.1pp -1
Top 15 517.5 816.9 +6.7% 56.9% 57.1% +0.2pp
Other 392.5 614.6 +6.6% 43.1% 42.9% -0.2pp
Total WW Prescription & OTC Sales 910.0 1,431.5 +6.7% 100.0% 100.0%
Total ‘Prescription & OTC Sales’ includes:
WW Generic Sales 79.5 100.7 +3.4% 8.7% 7.0% -1.7%
OTC Pharmaceuticals 38.3 41.4 +1.1% 4.2% 2.9% -1.3%
Note: Sales in 2019 based on company reported data. Sales forecasts to 2026 based on a consensus of leading equity analysts’ estimates for product sales and segmental sales.
2026: Top 10 Selling Products in the World part 1 of 2
Keytruda remains king; outselling its rivals by two-fold in 2026. Pfizer’s blockbuster breast cancer treatment Ibrance sits in 6th
EvaluatePharma’s consensus forecast data indicates Keytruda will place with $9.7bn in sales and a CAGR of 10.0%, climbing from 10th
continue to dominate sales to become the top selling drug in the place in last year’s 2024 rankings. Similarly, Sanofi’s Dupixent,
world in 2026 with sales of $24.9bn, almost double that of its nearest which dropped out of the top 10 last year, sees a resurgence into
rival. Whilst it was the second highest selling drug in 2019, previously 8th place with a $9.4bn sales forecast, despite recent strong phase
eclipsed by AbbVie’s Humira, Keytruda saw seven FDA approvals in III data from Eli Lilly’s rival drug, lebrikizumab. Analysts have been
2019, allowing it to continue to pull away from fellow PD-1 antibody impressed by strong growth in the atopic dermatitis therapy area,
Opdivo, which ranks in 2nd place in 2026. Opdivo has seen a as well as plans to launch the anti-IL-4 & IL-13 MAb in a further 89
flatlining of quarterly sales since the middle of 2018, however, the countries in 2020. Vertex’s flagship cystic fibrosis drug Trikafta
sell-side consensus forecasts an acceleration of sales to hit $12.7bn also enters the top 10 following its FDA approval in October 2019,
in 2026. Bristol-Myers Squibb’s Eliquis is a close third with analysts showing very impressive growth with a 54.3% CAGR and $8.7bn
predicting $12.6bn in sales of the anticoagulant in 2026. Humira sales forecast in 2026.
finally drops out of the top 10, following adalimumab biosimilar
introduction Europe and pending loss of exclusivity in the USA.
Table 16: Top 10 Selling Products WW in 2026 Source: EvaluatePharma, June 2020
WW Product Sales ($m) Market

Rank Product Generic Name Company Mechanism of Action 2019 2026 CAGR Status
1. Keytruda pembrolizumab Merck & Co + Programmed cell death protein 1 (PD1) 11,121 24,910 +12.2% Marketed
Otsuka Holdings antibody
2. Opdivo nivolumab Bristol-Myers Squibb + Programmed cell death protein 1 (PD1) 7,989 12,677 +6.8% Marketed
Ono Pharmaceutical antibody
3. Eliquis apixaban Bristol-Myers Squibb Coagulation factor Xa inhibitor 7,929 12,551 +6.8% Marketed
4. Biktarvy bictegravir sodium; Gilead Sciences HIV-1 integrase inhibitor; HIV-1 nucleoside 4,738 11,711 +13.8% Marketed
emtricitabine; tenofovir reverse transcriptase inhibitor (NRTI)
alafenamide fumarate
5. Imbruvica ibrutinib AbbVie + Bruton’s tyrosine kinase (BTK) inhibitor 5,686 10,722 +9.5% Marketed
Johnson & Johnson
6. Ibrance palbociclib Pfizer Cyclin-dependent kinase 4 (CDK4) inhibitor; 4,961 9,683 +10.0% Marketed
Cyclin-dependent kinase 6 (CDK6) inhibitor
7. Tagrisso osimertinib mesylate AstraZeneca Epidermal growth factor receptor (EGFR) 3,189 9,514 +16.9% Marketed
inhibitor
8. Dupixent dupilumab Sanofi Interleukin-13 (IL-13) antibody; Interleukin-4 2,322 9,386 +22.1% Marketed
(IL-4) antibody
9. Trikafta elexacaftor; ivacaftor; Vertex Pharmaceuticals Cystic fibrosis transmembrane conductance 420 8,739 +54.3% Marketed
tezacaftor regulator (CFTR) potentiator; Cystic fibrosis
transmembrane conductance regulator
(CFTR) regulator
10. Ozempic semaglutide Novo Nordisk Glucagon-like peptide 1 (GLP-1) receptor 1,685 8,321 +25.6% Marketed
agonist
Total 50,040 118,214 +13.1%
Total WW Individual Products Forecast in EvaluatePharma® 709,060 1,156,341 +7.2%
Note: Sales represent company reported sales where available, otherwise based on an average of equity analyst estimates.
2026: Top 10 Selling Products in the World part 2 of 2
Figure 12: Top 10 Selling Products WW in 2026 Source: EvaluatePharma, June 2020
26,000 24,910
24,000
22,000
20,000
18,000
16,000
WW Sales ($m)
14,000
12,677 12,551
12,000 11,711
11,121
10,722
10,000 9,683 9,514 9,386
8,739
7,989 8,321
7,929
8,000
6,000 5,686
4,738 4,961
4,000 3,189
2,322
2,000 1,685
420
0
Keytruda Opdivo Eliquis Biktarvy Imbruvica Ibrance Tagrisso Dupixent Trikafta Ozempic
CAGR
2019-26 (%) 12.2% 6.8% 6.8% 13.8% 9.5% 10.0% 16.9% 22.1% 54.3% 25.6%
2019 2026
2026: Top 10 Selling Products in the USA part 1 of 2
Keytruda leads the pack; Biktarvy and Eliquis complete top three. antibody, Opdivo, is in 6th with a comparatively slow CAGR of 5.0%.
As in the world rankings, Merck’s blockbuster drug Keytruda is set Novo Nordisk’s Ozempic rises to 7th place with an impressive
to be the top selling product in the USA in 2026, with $12.7bn sales CAGR of 22.7%, with analysts excited about accelerating uptake in
forecast. Claiming second place in the table is Gilead’s Biktarvy, with the USA following launch in February 2018, plus potential launches
forecasts looking rosy for the drug, which is currently the number one in obesity and nonalcoholic steatohepatitis (NASH) in 2021 and
prescribed regimen across all HIV patients in the USA. Eliquis sales 2023 respectively. Trikafta enters the top 10 in 8th place with
continue to grow into 2026, leading it to complete the top three, $6.0bn sales forecast in 2026 and the highest CAGR of the group
with analysts noting opportunities for Bristol-Myers Squibb’s drug to at 46.2%. Previously EvaluatePharma’s most valuable R&D project
continue its growth and convert patients currently using warfarin. by NPV, the cystic fibrosis treatment has made a strong start with
$420m sales in 2019, following its early FDA approval in October
AbbVie’s BTK inhibitor Imbruvica sits in 4th place. The drug saw
2019, only three months after NDA application submission. Humira
strong sales in 2019 driven by increased patient uptake globally,
drops out of the top 10, despite AbbVie’s successful litigation to
primarily in chronic lymphocytic leukaemia (CLL), leading analysts
delay biosimilar entry into the USA until 2023.
to upgrade their forecasts for 2026 to $6.7bn. Keytruda’s rival PD-1
Table 17: Top 10 Selling Products in the USA in 2026 Source: EvaluatePharma, June 2020
USA Product Sales ($m) US Market

Rank Product Generic Name Company Mechanism of Action 2019 2026 CAGR Status
1. Keytruda pembrolizumab Merck & Co Programmed cell death protein 1 (PD1) 6,305 12,712 +10.5% Marketed
antibody
2. Biktarvy bictegravir sodium; Gilead Sciences HIV-1 integrase inhibitor; HIV-1 nucleoside 4,225 8,155 +9.8% Marketed
emtricitabine; tenofovir reverse transcriptase inhibitor (NRTI)
alafenamide fumarate
3. Eliquis apixaban Bristol-Myers Squibb Coagulation factor Xa inhibitor 4,755 7,812 +7.3% Marketed
4. Imbruvica ibrutinib AbbVie Bruton’s tyrosine kinase (BTK) inhibitor 3,830 6,655 +8.2% Marketed
5. Dupixent dupilumab Sanofi Interleukin-13 (IL-13) antibody; Interleukin-4 1,868 6,352 +19.1% Marketed
(IL-4) antibody
6. Opdivo nivolumab Bristol-Myers Squibb Programmed cell death protein 1 (PD1) 4,344 6,133 +5.0% Marketed
antibody
7. Ozempic semaglutide Novo Nordisk Glucagon-like peptide 1 (GLP-1) receptor 1,439 6,026 +22.7% Marketed
agonist
8. Trikafta elexacaftor; ivacaftor; Vertex Pharmaceuticals Cystic fibrosis transmembrane conductance 420 6,004 +46.2% Marketed
tezacaftor regulator (CFTR) potentiator; Cystic fibrosis
transmembrane conductance regulator
(CFTR) regulator
9. Ocrevus ocrelizumab Roche B-lymphocyte antigen CD20 antibody 3,068 5,909 +9.8% Marketed
10. Ibrance palbociclib Pfizer Cyclin-dependent kinase 4 (CDK4) inhibitor; 3,250 5,865 +8.8% Marketed
Cyclin-dependent kinase 6 (CDK6) inhibitor
Total 33,505 71,622 +11.5%
Total USA Individual Products Forecast in EvaluatePharma ®

358,392 639,754 +8.6%
Note: Sales represent company reported sales where available, otherwise based on an average of equity analyst estimates
2026: Top 10 Selling Products in the USA part 2 of 2
Figure 13: Top 10 selling products in the USA in 2026 Source: EvaluatePharma, June 2020
14,000
12,712
12,000
10,000
8,155
USA Sales ($m)
8,000 7,812
6,655
6,305 6,352 6,133 6,026 6,004 5,909 5,865
6,000
4,755
4,225 4,344
4,000 3,830
3,068 3,250
1,868
2,000 1,439
420
0
Keytruda Biktarvy Eliquis Imbruvica Dupixent Opdivo Ozempic Trikafta Ocrevus Ibrance
CAGR
2019-26 (%) 10.5% 9.8% 7.3% 8.2% 19.1% 5.0% 22.7% 46.2% 9.8% 8.8%
2019 2026
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EvaluatePharma ®

World Preview 2020,

13th Edition – July 2020

World Preview 2020, Outlook to 2026

The thirteenth edition of EvaluatePharma’s

Complimentary copies of the full report can

It remains to be seen whether the

Merck & Co predicted the biggest impact on its

Ryan Waters Lisa Urquhart

Worldwide Prescription Drug Sales 2020-26 in figures

* Compound Annual Growth Rate.

• Prescription drug sales expected to reach almost $1.4trn

• Keytruda set to be the top selling drug worldwide in 2026

• Roche will be the leading prescription drug company in 2026 with

• Bristol-Myers Squibb will be the seventh largest prescription drug

• Eli Lilly’s anti-diabetic and obesity drug tirzepatide is currently the

• Roche to remain the top biotechnology company, with a forecast

• Oncology is the area with the largest proportion of clinical

• Industry R&D spend is forecast to grow at a CAGR of 3.2% to 2026,

8 COVID-19: Industry Impact

12 Pharma Innovation: Risk & Return

16 Worldwide Prescription Drug Sales (2012-2026)

18 Worldwide Prescription Drug Sales in 2026: Top 10 Companies

20 Worldwide Prescription Drug & OTC Sales by Technology (2012-2026)

22 Top 10 Most Valuable R&D Projects (Ranked by Net Present Value)

23 Worldwide R&D Spend by Pharma & Biotech Companies (2012-2026)

25 Pharmaceutical R&D Spend in 2026: Top 10 Companies

26 Worldwide Prescription Drug & OTC Sales by Therapy Area in 2026

28 2026: Top 10 Selling Products in the World

30 2026: Top 10 Selling Products in the USA

Figure 1: Total 2020 Product Consensus Forecast Change Between

Table 1: Total 2020 Product Consensus Forecast Change Between

WW Product Consensus Forecast

1. GlaxoSmithKline 31.7 650 2.1%

2. Eli Lilly 21.5 243 1.1%

3. Gilead Sciences 21.5 77 0.4%

4. Takeda 28.8 56 0.2%

5. Johnson & Johnson 43.7 -7 0.0%

6. Bristol-Myers Squibb 41.0 -119 -0.3%

7. Amgen 24.1 -285 -1.2%

8. AstraZeneca 25.2 -330 -1.3%

9. Novartis 39.5 -378 -1.0%

10. AbbVie 42.8 -512 -1.2%

11. Sanofi 32.7 -592 -1.8%

12. Roche 48.6 -619 -1.3%

13. Bayer 20.7 -657 -3.2%

14. Pfizer 39.9 -1,188 -3.0%

15. Merck & Co 39.6 -1,251 -3.2%

Total Top 15 501.3 -4,912 -1.0%

Figure 2: Total 2020 Product Consensus Forecast Change Between

Key Forecast Losses

Central Nervous Bridion (Merck & Co)

Keytruda (Merck & Co)

Musculoskeletal Prolia (Amgen)

0 -200 -400 -600 -800 1,000 -1,200 -1,400 -1,600

Total 2020 Product Forecast Change ($m)

Table 2: Total 2020 Product Consensus Forecast Change Between

WW Product Consensus Forecast

1. Central Nervous System 82.7 -1,442 -1.7%

• Prescription drug sales expected to reach almost $1.4trn

• Keytruda set to be the top selling drug worldwide in 2026