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The biggest-selling drug in 2018 will be…

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EvaluatePharma, a UK based company specializing in pharma and biotech analysis has been gazing long and hard into its crystal ball.

Having scrutinized the world’s leading 3,500 pharmaceutical and biotech companies they have come up with a list of what, they believe, will be the top 10 selling drugs in 2018.

  1. Januvia       (diabetes) – $9.7 billion
  2. Humira        (arthritis) – $8.2 billion
  3. Avastin        (cancer) – $7.5 billion
  4. Enbrel          (arthritis)  – $7.2 billon
  5. Revlimid     (myelodysplastic syndrome) – $6.75 billion
  6. Prevnar 13  (pneumococcal vaccine) – $6.72 billion
  7. Rituxan         (cancer) – $6.3 billion
  8. Lantus           (diabetes) – $5.9 billion
  9. Remicade     (arthritis) – $5.8 billion
  10. Advair            (COPD)  – $5.7 billion

Surprised?  No conventional molecules, no cholesterol lowering agents, no blood pressure meds and not a single new drug among the top ten.  However, they predict the #11 best seller will be GS-7977 – the much anticipated oral hepatitis C drug from Gilead Sciences .

Not so surprising, given the obesity epidemic sweeping the western world that 2 of the front runners are diabetes drugs. Likewise, given the globally aging population – 3 are for arthritis.

#5 may be a surprise to many. Few people had ever heard of myelodysplastic syndrome before ABC news anchor Robin Roberts announced last week that she has the disease.  Still, it’s predicted number 5 status doesn’t mean that an epidemic is expected – it’s still relatively rare with only 10,000 or so new cases detected each year. Its lofty status on the list is more to do with the price. It costs a staggering $10,000 or so for a 28 day supply of the pills.

Other predictions from the EvaluatePharma World Preview 2018 report:

  • Worldwide prescription drug sales are forecast to total $885bn in 2018 an increase of 3.1% from 2011
  • Over $290bn of pharmaceutical sales are at risk from patent expirations between now and 2018
  • Pfizer was the top company for prescription drug sales in 2011, but  Novartis will top the list by 2018
  • Global pharmaceutical R&D spend forecast will grow by 1.5% per year to $149bn in 2018
  • Anti-coagulants (blood thinners) are set to record highest growth of major therapy categories to 2018

Interesting stuff. But the problem with such long term predictive models is that they are but a snapshot  trying to project out six years.

In reality, life is a movie, with a frequently changing plot. For example if J&J’s canagliflozin can reduce obesity and improve blood sugar levels better than Januvia then the projected No. 1 ranking is suspect, at best.

Game Set and Match Sjögrens

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Earlier this year, we brought you news of Serena William’s  health scare after she was diagnosed with pulmonary embolism. Serena has since made a successful comeback to pro tennis, winning 18 straight matches between July and September, including titles at Stanford and Toronto, and becoming a finalist in the US Open. However, by some strange, sad twist of fate, her sister, Venus Williams, was forced to withdraw from the same tournament after being diagnosed with Sjögren’s syndrome.

Sjögren’s – a condition in which the body’s immune system attacks its own healthy tissues. It primarily affects glandular tissues – most notably the tear and saliva glands. It can result in dry eyes and a dry mouth. In addition, patients can experience muscle and joint aches and pains, as well as debilitating fatigue.

While a combination of genetic and environmental factors can lead to Sjögren’s, as with many autoimmune diseases, the onset of the condition is often preceded by an infection. It’s understandable how these symptoms might make it difficult, if not impossible, to play tennis at a high level.

“I think I’ve had issues with Sjögren’s for a while. It just wasn’t diagnosed,” Williams told ABC News. “The good news for me is now I know what’s happening.”

While Sjogren’s has no cure, there are treatments that make symptoms more manageable. In addition to over the counter (OTC) eye drops and mouth preparations, prescription products are available. They include Evoxac® (cevimeline), Salagen® (pilocarpine hydrochloride) and Numoisyn™ for dry mouth and Restasis® (cyclosporine ophthalmic emulsion) and Lacrisert® (hydroxypropyl cellulose ophthalmic insert) for dry eye. Additionally, anti-inflammatory drugs can reduce joint and muscle inflammation; and certain drugs can help to either suppress or modulate the overactive immune response.

Let’s hope Venus can recover as fast as her sister and that we can look forward to a 9th grand slam finals between the pair.