2025 Top 10 Drug Sales Growth

Ask AI · How Will the Era of Super-Blockbuster Drugs Reshape Competition in the Pharmaceutical Industry?

The landscape remains marked by historic sites; we continue to ascend. The growth in drug sales also follows the pattern of “talent emerges in every generation, each leading the trend for a few years.”

By 2025, the top ten drugs with the fastest sales growth will generate a combined additional annual revenue of $47 billion (annual increase, not total sales). The list’s structure is very clear: two metabolic drugs (four brands) drive unprecedented incremental volume, while the growth of other drugs mainly comes from the continued penetration of mature blockbuster products in immunology, inflammation, and oncology within existing patient populations, as well as expansion of indications bringing in new patients.

Looking at individual product increments, the top ten in 2025 are: Mounjaro ($11.425 billion), Zepbound ($8.616 billion), Skyrizi ($5.844 billion), Dupixent ($4.908 billion), Wegovy ($4.304 billion), Ozempic ($3.172 billion), Darzalex ($2.681 billion), Rinvoq ($2.333 billion), Keytruda ($2.198 billion), and Kisqali ($1.75 billion).

Data Source: FirstWord Pharma

The core signal from this list is very prominent: the decisive factors for growth are increasingly concentrated in large chronic disease markets that can simultaneously meet the needs of huge patient bases and long-term medication use. The metabolic disease and obesity sectors exemplify this most thoroughly.

01

Analysis of Top Incremental Products in 2025

1. Tirzepatide: Soaring to New Heights

In 2025, Tirzepatide’s annual incremental revenue exceeds $20 billion, with Mounjaro contributing $11.4 billion and Zepbound $8.6 billion. This level of growth can reshape the annual growth structure of a large pharmaceutical company, and more importantly, the way incremental volume is generated. The simultaneous expansion of indications for diabetes and obesity means the same production and commercial systems are expanding in two massive patient groups at once, without relying solely on marginal penetration of a single market. This structure will directly amplify scale effects: increased supply chain capacity, expanded prescription channels, and reduced patient acquisition costs can be shared between the two brands, making it easier to sustain high base growth.

Within a year, Tirzepatide pushes incremental revenue into the $20 billion range, and Semaglutide also sees significant growth in the same period. When the leading product’s annual incremental volume diverges from that of followers by hundreds of millions or billions, the competition enters a new phase: the focus shifts from efficacy differences to supply capacity and coverage expansion. The larger the gap in incremental revenue, the more easily the leading product can leverage real-world experience, clinical inertia, and bargaining power in reimbursement negotiations. Followers will need stronger new momentum to reverse the trend.

2. Semaglutide: Growth Slowing

Semaglutide’s incremental revenue in 2025 remains among the industry’s top tier. Wegovy adds $4.3 billion, Ozempic $3.2 billion, totaling about $7.5 billion. In the top ten list, this is a strong position. Compared to Tirzepatide, the gap has widened to hundreds of millions or billions, and the leading and chasing products’ annual increments are no longer in the same magnitude.

Such gaps will alter the competitive logic of the field. When demand is large enough, the upper limit of annual incremental growth is more determined by capacity—production stability, prescription channel coverage, and patient initiation and retention efficiency. Persistent differences in incremental revenue mean the leading products’ advantages in real-world use, reimbursement negotiations, and prescription inertia are more easily accumulated. Meanwhile, if growth falls short of expectations, it will quickly impact capital market valuation and management’s strategic decisions, increasing pressure on leadership.

Early 2026, administration forms become a new variable. The oral version of Wegovy is expected to enter early approval in January 2026, and Eli Lilly’s oral GLP-1 molecule, orforglipron, is anticipated to gain regulatory progress within the following month. Both efforts aim to expand accessible patient populations, lower long-term medication barriers, and open larger space for incremental growth in the next phase.

3. Skyrizi and Rinvoq: Expanding Indications in the Post-Humira Era

Skyrizi will add about $5.8 billion in 2025, ranking third; Rinvoq adds $2.3 billion, also entering the top ten. These two products form AbbVie’s most critical immune growth pillars after Humira. Skyrizi’s volume expansion results from multiple clinical scenarios, providing a stable prescription base for psoriasis and psoriatic arthritis, with continued expansion in inflammatory bowel disease (IBD) prescriptions boosting incremental scale.

This growth pattern resembles platform-type asset expansion. The broader the indication coverage, the more dispersed the source of new patients, making the overall growth curve less susceptible to fluctuations in any single disease area. Nearly $6 billion in annual incremental revenue indicates Skyrizi is still in expansion, driven by patient pool growth and deeper penetration.

By mid-2026, new competitive variables may emerge in the psoriasis field, such as Johnson & Johnson’s oral IL-23 inhibitor, icotrekinra, which is expected to bring positive impact. Oral treatments often influence new patient choices, depending on efficacy, safety, prescribing habits, and reimbursement coverage. The most certain conclusion now is that the incremental growth curve may face more intense competition, with the specific impact awaiting further market feedback.

4. Dupixent: Urgency to Lead

In 2025, Dupixent’s incremental revenue is about $4.9 billion. This figure, for any large pharmaceutical company, can significantly influence the annual growth structure. Nearly $5 billion in one product’s annual contribution means the company’s overall revenue elasticity heavily depends on its continued expansion.

Its growth is based on a large patient population across multiple diseases. Allergic and inflammatory diseases tend to require long-term treatment; once prescription pathways are stable, patients tend to stay on therapy longer, with new and existing patients jointly driving revenue growth. For such assets, the scale of incremental growth is not a short-term stimulus but a result of ongoing expansion of the treated population.

Risks are less about current growth and more about the time horizon. Patent exclusivity is expected to end in the early to mid-2030s, leaving limited time for the company to develop replacement products. Each year of high growth now increases the scale requirements for future substitutes. The capital markets will factor this time constraint into valuation models, and management’s pressure will become more explicit.

02

Oncology Drugs: Delivery Routes and Indication Expansion

Keytruda achieved $31.7 billion in 2025, remaining the industry’s top revenue generator, but with only about $2.2 billion in new sales—near a decade-low. For a product with over $30 billion in base sales, shrinking incremental growth often indicates nearing market saturation, with future gains relying more on formulation optimization and treatment scenario adjustments. The subcutaneous version is being developed under this context, aiming to optimize administration, improve convenience, and stabilize patient structure before patent expiry around 2028.

Darzalex added about $2.7 billion in 2025. Growth mainly stems from earlier treatment lines and broader patient coverage. Multiple myeloma requires long-term management; earlier treatment initiation extends potential treatment duration. Expanding indications to include refractory multiple myeloma extends the patient pool to earlier stages, supporting longer revenue curves.

Kisqali’s incremental revenue in 2025 is about $1.75 billion. The key driver is expanding into adjuvant therapy for ER-positive, HER2-negative breast cancer. Compared to previous use mainly in late-stage or metastatic disease, adjuvant therapy involves a larger patient base, more standardized treatment pathways, and more concentrated prescription initiation, making short-term revenue growth more feasible. The company believes it could become one of the best-selling drugs in history, with the core variable being the depth of penetration and treatment duration in this adjuvant population.

03

The Era of Super-Blockbuster Dominance

The four metabolic and obesity-related brands together added approximately $27.5 billion, about 58.3% of the top ten’s total incremental volume, forming a super-growth segment. The underlying logic stems from two stable, strong demand curves: diabetes provides a large, persistent chronic disease population, while obesity offers faster growth and larger expansion potential. Both groups share a common feature: long-term treatment, with continuous medication use leading to cumulative revenue over time—distinct from acute or short-course therapies.

In the immunology and inflammation sector, three drugs—Skyrizi, Dupixent, and Rinvoq—added about $13.1 billion, or 27.7%. Their growth relies more on multi-indication coverage and prescription penetration effects: once a product establishes a stable prescription base across multiple chronic diseases, new patients come from various disease scenarios, making overall growth less vulnerable to fluctuations in any single indication.

The three oncology drugs contributed about $6.6 billion, or 14.0%. These assets share high base volumes, mature clinical pathways, and incremental growth mainly from earlier treatment lines, indication expansion, and larger patient populations, rather than pure market penetration.

When incremental sales reach hundreds of billions, it indicates that the industry has entered an era dominated by super-sized blockbuster drugs.

Leading companies will focus future development on these golden fields capable of supporting hundreds of billions in incremental volume: first, long-term treatment for large chronic disease populations; second, platform mechanisms with cross-indication expansion potential, allowing reuse across multiple diseases; third, delivery methods and formulations that significantly lower long-term medication barriers, boosting prescription initiation and maintenance; and fourth, scalable supply and commercialization systems—capacity, channels, and patient acquisition—integrated into clinical value considerations.

In this landscape of super-giant products, industry competition will resemble a scale race. R&D priorities will shift toward projects with higher certainty and larger incremental potential, while mid-sized projects with limited expansion space will struggle for resources. Mergers, acquisitions, and licensing will favor assets that complement super-blockbusters, including indication expansion, new formulations, combination therapies, and manufacturing capacity capable of supporting long-term volume growth. The fact that incremental sales can reach hundreds of billions is reshaping the focus of R&D and commercialization in the coming years.

Ref.

King, S. Vital Signs: Pharma’s fastest growing drugs. FirstWord Pharma. 02.03.2026.

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