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The COVID-19 pandemic has had a profound impact on the best-selling pharmaceuticals, leading to shifts in the list with Pfizer and BioNTech’s Comirnaty surpassing AbbVie’s Humira for the No. 1 spot in 2021. That momentum continued in 2022, with Pfizer and BioNTech jointly raking in $59.1 billion in revenue from the sales of the COVID-19 vaccine. Although Comirnaty maintained its position as the best-selling pharmaceutical of 2022, it experienced a roughly 5% drop in sales compared to the previous year.

As the best-selling pharmaceuticals of 2022 demonstrate, signs are emerging that the reign of COVID-19 vaccines and  other therapies appears to be slipping.. The two companies — and Moderna — plan on hiking prices to address the weakening demand.

Humira: The second best-selling pharmaceutical of 2022 looking strong

Meanwhile, the heavyweight tumor necrosis factor (TNF) blocker Humira, which had been the best-selling prescription medicine for most of the past decade, raked in $21.2 billion in 2022, securing the second spot among the best-selling pharmaceuticals.

Next in line was Merck & Co.’s cancer immunotherapy drug Keytruda, which generated $20.9 billion in revenue. The company is now working on a new subcutaneous formulation to protect its blockbuster drug from potential competition starting in 2028. Keytruda’s compound patent is protected from expiration in major markets until at least that year and into the following decade in the E.U. and Japan. Keytruda appears to be poised to reclaim the crown as the best-selling drug in 2023.

Other COVID-19 therapies in the fourth and fifth positions

In the fourth slot in 2022 was Pfizer’s COVID-19 antiviral Paxlovid, which, despite not meeting expectations, still managed to generate $18.9 billion in revenue, making it one of the best-selling pharmaceuticals.

Other top-selling drugs included Moderna’s Spikevax COVID-19 vaccine, which secured the fifth position with $18.4 billion in revenue, and the anticoagulant Eliquis by Bristol Myers Squibb and Pfizer, which occupied the sixth spot with $18.2 billion in sales.

While COVID-19 took center stage again in 2022, drugs for cancer, autoimmune diseases, and cardiovascular diseases continued to be strong growth drivers, as this list of best-selling pharmaceuticals of 2022 demonstrates. As the demand for COVID-19 vaccines continues to ebb, it is likely that the industry will continue to shift its focus back toward these core therapeutic areas.

Drug name

Manufacturer(s)

2022 Sales

Indication(s)

1. Comirnaty COVID-19 vaccine Pfizer/BioNTech $55,918,791,640 The COVID-19 infection topped the list of 2022’s best-selling pharmaceuticals. It sold slightly more last year.
2. Humira (adalimumab) AbbVie $21,237,000,000 rheumatoid and psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, ulcerative colitis
3. Keytruda (pembrolizumab) Merck $20,937,000,000 various cancers
4. Paxlovid Pfizer $18,933,000,000 prevention of severe COVID-19
5. Spikevax COVID-19 vaccine Moderna $18,435,000,000 reduce risk of COVID-19 infection
6. Eliquis (apixaban) Bristol Myers Squibb and Pfizer $18,269,000,000 blood clots
7. Dupixent (dupilumab) Sanofi Genzyme, Regeneron Pharmaceuticals $17,417,046,200 atopic dermatitis, asthma, chronic rhinosinitus with nasal polyps.
8. Eylea (aflibercept) Regeneron Pharmaceuticals, Bayer $12,721,221,200 age-related macular degeneration, macular edema and diabetic retinopathy
9. Biktarvy (bictegravir, emtricitabine, and tenofovir alafenamide) Gilead Sciences $10,390,000,000 HIV
10. Revlimid (lenalidomide) Bristol Myers Squibb (Celgene) $9,978,000,000 myelodysplastic syndrome, multiple myeloma, and mantle cell lymphoma
11. Stelara (ustekinumab) Janssen (Johnson & Johnson) $9,723,000,000 plaque psoriasis, psoriatic arthritis, ulcerative colitis and Crohn’s disease
12. Imbruvica (ibrutinib) Pharmacyclics (AbbVie) and Janssen (Johnson & Johnson) $8,352,000,000 chronic lymphocytic leukemia/small lymphocytic lymphoma with 17p deletion, Waldenström’s macroglobulinemia
13. Opdivo (nivolumab) Bristol Myers Squibb $8,249,000,000 various forms of cancer
14. Darzalex (daratumumab) (Janssen) Johnson & Johnson $7,977,000,000 multiple myeloma
15. Trikafta/Kaftrio Vertex Pharmaceuticals $7,686,800,000 cystic fibrosis
16. Xarelto (rivaroxaban) Janssen (Johnson & Johnson)/Bayer $7,460,849,000 reducing risk of stroke in nonvalvular atrial fibrillation, deep vein thrombosis, pulmonary embolism, DVT prophylaxis following knee or hip replacement surgery
17. Trulicity (dulaglutide) Eli Lilly $7,439,700,000 type 2 diabetes
18. Gardasil/Gardasil 9 (human papillomavirus 9-valent vaccine) Merck $6,897,000,000 various cancers caused by human papillomavirus
19. Prevnar family (pneumococcal vaccine) Pfizer $6,337,000,000 pneumococcal vaccine
20. Ocrevus (ocrelizumab) Roche $5,764,380,000 relapsing or primary progressive multiple sclerosis
21. Lagevrio (molnupiravir) Merck & Co. $5,684,000,000 oral antiviral authorized for treatment of mild to moderate COVID-19 illness
22. Tagrisso (osimertinib) AstraZeneca $5,444,000,000 non-small-cell lung carcinomas
23. Botox (cosmetic + neuroscience) AbbVie $5,334,000,000 cosmetic treatment of wrinkles, chronic migraine, overactive bladder, upper limb spasticity, cervical dystonia, and strabismus
24. Skyrizi (risankizumab) AbbVie $5,165,000,000 plaque psoriasis
25. Ibrance (palbociclib) Pfizer $5,120,000,000 HR-positive and HER2-negative breast cancer
26. Cosentyx (secukinumab) Novartis $4,788,000,000 plaque psoriasis, psoriatic arthritis, ankylosing spondylitis
27. Entresto (sacubitril/valsartan) Novartis $4,644,000,000 chronic heart failure and reduced ejection fraction
28. Januvia/Janumet (sitagliptin) Merck & Co. $4,513,000,000 type 2 diabetes
29. Farxiga (dapagliflozin) AstraZeneca $4,386,000,000 Type 2 diabetes mellitus, heart failure
30. Invega Sustenna, Xeplion, Invega Trinza/Trevicta Janssen (Johnson & Johnson) $4,140,000,000 schizophrenia, schizoaffective disorder
31. Enbrel (etanercept) Amgen $4,117,000,000 plaque psoriasis, rheumatoid arthritis, psoriatic arthritis, juvenile idiopathic arthritis and ankylosing spondylitis.
32. Perjeta (pertuzumab) Roche $3,903,085,000 HER2-positive breast cancer
33. Shingrix (zoster vaccine recombinant, adjuvanted) GSK $3,659,341,800 Vaccination against shingles
34. Hemlibra (emicizumab) Roche $3,650,965,000 hemophilia A
35. Prolia (denosumab) Amgen $3,628,000,000 osteoporosis, low bone mass
36. Tecentriq (atezolizumab) Roche $3,549,735,000 urothelial carcinoma, non-small cell lung cancer and triple-negative breast cancer
37. Pomalyst/Imnovid (pomalidomide) Bristol-Myers Squibb $3,497,000,000 multiple myeloma
38.Orencia (abatacept) Bristol-Myers Squibb $3,464,000,000 rheumatoid arthritis, juvenile idiopathic arthritis
39. Lynparza (olaparib) AstraZeneca/Merck & Co. $2,993,000,000 Ovarian cancer, breast cancer
40. Imfinzi (durvalumab) AstraZeneca $2,784,000,000 Various oncology indications
41. Tremfya (guselkumab) Janssen (Johnson & Johnson) $2,668,000,000 moderate to severe plaque psoriasis
42. Actemra/RoActemra (tocilizumab) Roche $2,579,455,000 rheumatoid arthritis, forms of juvenile idiopathic arthritis and giant cell arteritis as well as CAR T cell-induced severe or life-threatening cytokine release syndrome
43. Symbicort (budesonide formoterol) AstraZeneca $2,538,000,000 asthma, airflow obstruction in patients with COPD
44. Rinvoq (upadacitinib) AbbVie $2,522,000,000 moderate to severe rheumatoid arthritis in adult patients who have had an inadequate response to methotrexate
45. Verzenio (abemaciclib) Eli Lilly $2,483,500,000 HR-positive, HER2-negative advanced or metastatic breast cancer in combination with an aromatase inhibitor or fulvestrant
46. Taltz (ixekizumab) Eli Lilly $2,482,000,000 moderate to severe plaque psoriasis in adults, active psoriatic arthritis, active ankylosing spondylitis, and active non-radiographic axial spondyloarthritis
47. Vyndaqel (tafamidis)  Pfizer $2,447,000,000 treatment of transthyretin amyloid cardiomyopathy (ATTR-CM) in adult patients to reduce cardiovascular mortality and cardiovascular-related hospitalization
48. Genvoya (elvitegravir, cobicistat, emtricitabine and tenofovir alafenamide) Gilead Sciences $2,404,000,000 HIV-1 infection
49. Lantus (insulin glargine) Sanofi $2,379,630,600 diabetes
50. Remicade (infliximab) Janssen (Johnson & Johnson) $2,343,000,000 Crohn’s disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, plaque psoriasis