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.