Top 20 Prescription Drugs of 2026

Shots:  Mounjaro/Zepbound, Keytruda, and Dupixent emerged among the leading prescription drug products in 2025, generating $36.51B, $31.68B, and $18.48B, respectively. Strong patient demand, expansion across approved indications, broader access, market-share gains, and new clinical and regulatory milestones continued to shape the performance of the leading prescription therapies  The global prescription drugs market was valued at approximately $1.43T in 2025 and is projected to grow to $1.59T in 2026, reaching $2.37T by 2030, at a 10.5% CAGR from 2026 to 2030. Rising chronic disease prevalence, increasing healthcare expenditure, expansion of branded drug portfolios, adoption of innovative therapies, and growing demand for cost-effective generics are expected to remain key market growth drivers  The report ranks the Top 20 Prescription Drug Products of 2026 based on product revenues reported for fiscal year 2025, with revenues converted to USD. Products containing the same active pharmaceutical ingredient (API) are grouped together, with their combined revenues used for ranking purposes. The report highlights each product’s approved indications, year-over-year revenue performance, and the key factors driving growth or decline  20. Vyndaqel Family  Non-Proprietary Name: Tafamidis  Company: Pfizer  First Approved: US (Nov 13, 2015), EU (Feb 1, 2016)    Total Revenue: $6.38B    Vyndaqel family (tafamidis) is a transthyretin stabilizer approved for the treatment of wild-type or hereditary transthyretin-mediated amyloidosis with cardiomyopathy (ATTR-CM) in adults, reducing cardiovascular mortality and cardiovascular-related hospitalization; Vyndaqel is also approved in several countries for transthyretin amyloid polyneuropathy (ATTR-PN)  Vyndaqel family generated $6.38B in 2025, compared with $5.45B in 2024, representing a 17.04% YoY increase. Growth was primarily driven by strong demand and continued patient diagnosis, particularly in the US and developed international markets, alongside improved US patient affordability. This was partially offset by lower US net pricing from higher manufacturer discounts under the Medicare Part D redesign and new lower-priced payer contracts  In April 2026, Pfizer reached settlement agreements with three generic manufacturers over VYNDAMAX patent litigation, extending the effective US patent expiry to June 1, 2031, subject to other litigation  19. Prevnar Family  Non-Proprietary Name: Pneumococcal Conjugate Vaccines  Company: Pfizer  First Approved: US (Nov 13, 2015), EU (Feb 1, 2016)    Total Revenue: $6.49B    Prevnar family (pneumococcal conjugate vaccines) is a pneumococcal vaccine family approved for the prevention of invasive pneumococcal disease, pneumonia, and otitis media caused by Streptococcus pneumoniae. Prevnar 20 is approved for individuals 6 weeks of age and older, with otitis-media prevention specifically covering children 6 weeks through 5 years of age  Prevnar family generated $6.49B in 2025, compared with $6.41B in 2024, representing a 1.29% YoY increase. Growth was primarily driven by strong uptake of the adult indication in international markets, new pediatric launches in emerging markets, and higher U.S. adult demand following the CDC recommendation extending vaccination to adults aged 50–64, partly offset by lower pediatric sales and international competitive pressure  In May 2026, Pfizer reported positive P-II results for its next-generation pediatric pneumococcal vaccine program, supporting progression toward a pivotal study  18. Cosentyx  Non-Proprietary Name: Upadacitinib  Company: Novartis  First Approved: US (Jan 21, 2015), EU (Jan 15, 2015)    Total Revenue: $6.66B    Cosentyx (secukinumab) is a human interleukin-17A (IL-17A) antagonist approved across multiple inflammatory conditions, including Plaque Psoriasis, Psoriatic Arthritis, Ankylosing Spondylitis, Non-radiographic Axial Spondyloarthritis, Enthesitis-Related Arthritis, and Hidradenitis Suppurativa Cosentyx generated $6.66B in 2025, compared with $6.14B in 2024, representing an 8.58% YoY increase. Sales grew across all regions, driven by continued demand from recent launches, particularly Hidradenitis Suppurativa and the IV formulation in the US, alongside volume growth in core indications including psoriasis, psoriatic arthritis, ankylosing spondylitis and non-radiographic axial spondyloarthritis  In March 2026, the US FDA expanded Cosentyx’s label to include pediatric patients aged 12 years and older with moderate-to-severe Hidradenitis Suppurativa, making it the only IL-17A inhibitor approved for this pediatric population and marking Cosentyx’s fourth pediatric indication 17. Tagrisso  Non-Proprietary Name: Upadacitinib  Company: AstraZeneca  First Approved: US (Nov 13, 2015), EU (Feb 1, 2016)    Total Revenue: $7.25B    Tagrisso (osimertinib) is a third-generation, irreversible EGFR tyrosine kinase inhibitor (EGFR-TKI) approved across NSCLC, including EGFR-mutated locally advanced or metastatic NSCLC, EGFR T790M mutation-positive NSCLC, adjuvant treatment of early-stage EGFR-mutated NSCLC, and unresectable Stage III EGFR-mutated NSCLC following platinum-based chemoradiotherapy. It is also approved with chemotherapy for 1L treatment of locally advanced or metastatic EGFR-mutated NSCLC  Tagrisso generated $7,254.00M in 2025, compared with $6,580.00M in 2024, representing a 10.2432% YoY increase. The growth was driven by continued demand across both adjuvant and metastatic settings, reinforcing Tagrisso’s position as a backbone therapy for EGFR-mutated NSCLC  In September 2026, AstraZeneca and HUTCHMED reported positive P-III SANOVO results showing that Tagrisso + Orpathys (savolitinib) significantly improved progression-free survival vs. Tagrisso alone in previously untreated patients with EGFR-mutated, MET-overexpressing locally advanced or metastatic NSCLC  16. Entresto  Non-Proprietary Name: Sacubitril/valsartan  Company: Novartis  First Approved: US (Jul 7, 2015), EU (Nov 19, 2015)    Total Revenue: $7.74B    Entresto (sacubitril/valsartan) is an angiotensin receptor-neprilysin inhibitor (ARNI) approved for Adult Heart Failure and Pediatric Heart Failure, including reducing the risk of cardiovascular death and hospitalization for heart failure in adults and treating heart failure due to systemic left ventricular systolic dysfunction in pediatric patients  Entresto generated $7.74B in 2025, compared with $7.82B in 2024, representing a 0.94% YoY decline. Sales declined primarily because of generic competition in the US, which began in the third quarter of 2025, while continued growth in ex-US markets, where Entresto is also approved for heart failure and for hypertension in China and Japan, partially offset the decline  In July 2025, Novartis reported positive P-IV PARACHUTE-HF results showing that Entresto outperformed enalapril on a composite endpoint in patients with heart failure with reduced ejection fraction caused by chronic Chagas disease  15. Eylea/Eylea HD  Non-Proprietary Name: Aflibercept  Company: Regeneron Pharmaceuticals & Bayer  First Approved: US (Nov 18, 2011), EU (Nov 21, 2012)    Total Revenue: $7.89B    Eylea/Eylea HD (aflibercept) is a vascular endothelial growth factor (VEGF) inhibitor approved across multiple retinal conditions, including neovascular (Wet) age-related macular degeneration, diabetic macular edema, diabetic retinopathy, retinopathy of prematurity, and macular edema following retinal vein occlusion   Eylea/Eylea HD generated $7.89B in 2025, compared with $9.54B in 2024, representing a 17.33% YoY decline. The decrease was driven by intense competition, biosimilar entries, patient shifts toward Eylea HD, and lower net selling prices; Regeneron reported Eylea sales falling sharply while Eylea HD sales increased to $2.56B in 2025  In April 2026, the US FDA approved an extended dosing schedule for Eylea HD, allowing patients with wet AMD and diabetic macular edema who maintain a successful response after one year to receive treatment as infrequently as every 20 weeks (up to five months)  14. Rinvoq   Non-Proprietary Name: Upadacitinib  Company: AbbVie  First Approved: US (Aug 16, 2019), EU (Dec 16, 2019)    Total Revenue: $8.3B    Rinvoq (upadacitinib) is a selective and reversible JAK inhibitor approved across multiple immune-mediated conditions, including Rheumatoid Arthritis, Psoriatic Arthritis, Atopic Dermatitis, Ankylosing Spondylitis, Non-radiographic Axial Spondyloarthritis, Ulcerative Colitis, Crohn’s Disease, Polyarticular Juvenile Idiopathic Arthritis, Giant Cell Arteritis, Alopecia Areata, and Non-segmental Vitiligo  Rinvoq generated $8.3B in global net revenue in 2025, compared with $5.97B in 2024, representing a 39.07% YoY increase. The growth was primarily driven by continued strong market-share uptake and market expansion across all indications, with AbbVie reporting particularly strong demand across the immunology portfolio  In July 2026, the EC approved Rinvoq for adults and adolescents aged 12 years and older with non-segmental vitiligo who are candidates for systemic therapy, making it the first and only systemic medicine approved in the EU for this condition  13. Farxiga/Forxiga  Non-Proprietary Name: Dapagliflozin  Company: AstraZeneca  First Approved: US (Jan 8, 2014), EU (Nov 11, 2012)    Total Revenue: $8.49B    Farxiga/Forxiga (dapagliflozin) is a sodium-glucose cotransporter 2 (SGLT2) inhibitor approved across Type 2 Diabetes Mellitus, HF, and CKD  Farxiga/Forxiga generated $8,49B in 2025, compared with $7,65B in 2024, representing a 10.92% YoY increase. The growth was supported by continued demand across its diabetes, heart-failure and chronic-kidney-disease indications, which have significantly broadened its addressable patient population In April 2026, the US FDA approved the first generic versions of dapagliflozin (Farxiga) for certain type 2 diabetes indications  12. Ocrevus  Non-Proprietary Name: Ocrelizumab  Company: Roche  First Approved: US (Mar 28, 2017), EU (Jan 08, 2018)    Total Revenue: $8.87B    Ocrevus (ocrelizumab) is a humanized monoclonal antibody targeting CD20 and is approved for Multiple Sclerosis, including relapsing forms such as clinically isolated syndrome, relapsing-remitting disease, active secondary progressive disease, and primary progressive multiple sclerosis   In 2025, Ocrevus’ sales increased to $8.87B from $7.46B in 2024, up 18.9% YoY, driven by strong uptake of the subcutaneous formulation  In Jul 2026, Roche reported that Ocrevus remained one of its top growth drivers, supported by continued strong demand across global markets   11. Opdivo   Non-Proprietary Name: Nivolumab  Company: Eli Lilly  First Approved: US (Dec 22, 2014), EU (Jun 19, 2015)    Total Revenue: $10.28B    Opdivo (nivolumab) is a human PD-1 blocking monoclonal antibody approved across multiple cancer indications, including Melanoma, Non-Small Cell Lung Cancer, Renal Cell Carcinoma, Urothelial Carcinoma, Colorectal Cancer, Gastric Cancer, Esophageal Cancer, Hepatocellular Carcinoma, and Head and Neck Squamous Cell Carcinoma   In 2025, Opdivo’s sales increased to $10.28B from $9.3B in 2024, up 10.5% YoY, primarily driven by strong demand for combination cancer therapies, increased patient adoption, and continued momentum across global markets  In Aug 2026, the FDA granted accelerated approval to Tudriqev + Opdivo for adults with unresectable advanced cutaneous melanoma that progressed after an anti-PD-1-based regimen   10. Trikafta/Kaftrio  Non-Proprietary Name: Elexacaftor/tezacaftor/ and ivacaftor  Company: Vertex  First Approved: US (Oct 21, 2019), EU (Aug 21, 2020)    Total Revenue: $10.31B    TRIKAFTA/KAFTRIO (elexacaftor/tezacaftor/ and ivacaftor) is Vertex Pharmaceuticals’ CFTR modulator for CF. As of 2026, TRIKAFTA is approved for adults and pediatric patients aged 2 years and older with a clinical diagnosis of CF who have at least one CFTR variant that is responsive to treatment or results in production of CFTR protein  TRIKAFTA/KAFTRIO generated $10.31B in 2025, compared with $10.23B in 2024, representing a 0.72% YoY increase. Vertex attributed the performance primarily to continued strong patient demand, although the franchise is increasingly facing maturity as more eligible patients have already begun treatment  In April 2026, the US FDA expanded TRIKAFTA’s indication to cover CF patients aged 2 years and older with a CFTR variant that is either responsive based on clinical/in-vitro data or results in production of CFTR protein  9. JARDIANCE family  Non-Proprietary Name: Empagliflozin  Company: Gilead Sciences  First Approved: US (Feb 07, 2018), EU (Jun 21, 2018)    Total Revenue: $10.33B    JARDIANCE (empagliflozin) is BIand Eli Lilly’s SGLT2 inhibitor, now used across type 2 diabetes, heart failure and chronic kidney disease. Its current US approvals include improving glycemic control in adults and children aged 10 years and older with type 2 diabetes, reducing cardiovascular death in adults with type 2 diabetes and established cardiovascular disease, reducing cardiovascular death and heart-failure hospitalization in adults with heart failure, and reducing kidney and cardiovascular risks in adults with chronic kidney disease at risk of progression JARDIANCE family sales reached $10.33B in 2025, up from $8.72B in 2024, representing an 18.46% YoY increase. The growth was supported by continued demand across its diabetes and heart-failure uses, with the broader heart-failure and chronic-kidney-disease patient populations substantially expanding JARDIANCE’s commercial reach In March 2026, the EMA’s latest product information continued to recognize JARDIANCE for type 2 diabetes, symptomatic chronic heart failure and chronic kidney disease  8. Biktarvy  Non-Proprietary Name: Bictegravir/emtricitabine/tenofovir alafenamide  Company: Gilead Sciences  First Approved: US (Feb 07, 2018), EU (Jun 21, 2018)    Total Revenue: $14.33B    Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) is Gilead Sciences’ once-daily, single-tablet complete regimen for HIV-1 infection. Its US indication covers adults and pediatric patients weighing at least 14 kg who are treatment-naïve, restarting treatment without certain resistance mutations, or switching from a stable suppressive regimen Biktarvy generated $14.33B in 2025, compared with $13.42B in 2024, representing a 6.78% YoY increase. Growth was primarily driven by higher demand, including patients switching from Genvoya and other Gilead HIV therapies, partially offset by lower average realized prices following the US Medicare Part D redesign In July 2025, the US FDA expanded Biktarvy’s indication to include people with HIV who have an antiretroviral treatment history but are not virologically suppressed, provided there is no known or suspected resistance to the integrase inhibitor class, emtricitabine or tenofovir  7. Darzalex  Non-Proprietary Name: Daratumumab  Company: J&J  First Approved: US (Nov 16, 2015), EU (May 20, 2016)    Total Revenue: $14.35B    DARZALEX (daratumumab) is a CD38-directed monoclonal antibody used across multiple myeloma, with US approvals covering newly diagnosed patients who are either eligible or ineligible for autologous stem-cell transplant, relapsed/refractory disease across several prior-treatment settings, and monotherapy for heavily pretreated or double-refractory patients. DARZALEX FASPRO is also approved as monotherapy for high-risk smoldering multiple myeloma DARZALEX generated $14.35B in worldwide sales in 2025, compared with $11.67B in 2024, representing a 22.97% YoY increase. The strong performance was driven by continued market-share gains and overall market growth, reinforcing DARZALEX as one of Johnson & Johnson’s key oncology growth products In March 2026, the US FDA approved TECVAYLI + DARZALEX FASPRO for adults with relapsed or refractory multiple myeloma after at least one prior line of therapy, including a proteasome inhibitor and an immunomodulatory agent  6. Eliquis  Non-Proprietary Name: Apixaban  Company: BMS & Pfizer  First Approved: US (Dec 28, 2012), EU (May 18, 2011)     Total Revenue: $14.44B    Eliquis (apixaban) is a direct oral factor Xa inhibitor used to reduce the risk of stroke and systemic embolism in adults with nonvalvular atrial fibrillation, prevent DVT following hip or knee replacement, treat DVT and pulmonary embolism (PE), reduce the risk of recurrent DVT/PE, and treat VTE and reduce recurrent VTE in pediatric patients from birth following initial anticoagulant treatment  Eliquis generated $14.44B in 2025, compared with $13.33B in 2024, representing an 8.32% YoY increase. The increase was driven primarily by higher demand, with US revenue benefiting from continued market-share gains; BMS reported US Eliquis prescription share rising from 67.3% to 70.3% on a total-prescription basis in Q4 2025   In April 2025, the FDA approved Eliquis Sprinkle (apixaban) oral suspension for the treatment of VTE and reduction in the risk of recurrent VTE in pediatric patients from birth and older, following at least five days of initial anticoagulant treatment  5. Skyrizi  Non-Proprietary Name: Risankizumab-rzaa  Company: AbbVie  First Approved: US (Apr 23, 2019), EU (Apr 26, 2019)    Total Revenue: $17.56B    Skyrizi (risankizumab-rzaa) is AbbVie’s IL-23 inhibitor, approved for moderate-to-severe plaque psoriasis and active psoriatic arthritis in adults and, following the latest US expansion, children aged 6 years and older, as well as moderately to severely active Crohn’s disease and ulcerative colitis in adults  Skyrizi generated $17.56B in global net revenue in 2025, compared with $11.71B in 2024, representing a 49.87% YoY increase. The strong performance was primarily driven by continued market-share gains and overall market growth across all approved indications, with US sales increasing 50.7% and international sales rising 44.6%   In June 2026, the US FDA expanded Skyrizi’s label to include children 6 years and older with moderate-to-severe plaque psoriasis or active psoriatic arthritis, making it the first and only IL-23 inhibitor approved in the US for pediatric patients in this age group weighing less than 40 kg  4. Dupixent  Non-Proprietary Name: Dupilumab  Company: Sanofi & Regeneron Pharmaceuticals  First Approved: US (Mar 28, 2017), EU (Sep 26, 2017)    Total Revenue: $18.48B    Dupixent (dupilumab) is a fully human monoclonal antibody targeting the IL-4 and IL-13 signaling pathways. As of 2026, its approved indications include atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), eosinophilic esophagitis (EoE), prurigo nodularis (PN), chronic spontaneous urticaria (CSU), COPD, bullous pemphigoid (BP), and allergic fungal rhinosinusitis (AFRS)  Dupixent generated $18.48B in 2025, compared with $13.61B in 2024, representing a 35.75% YoY increase. The gain reflected continued strong demand across its expanding indication base, with growth benefiting from uptake in established conditions as well as newer launches in CSU, COPD and BP  In April 2026, the US FDA expanded Dupixent’s reach by approving it for children aged 2 years and older with CSU whose symptoms remain uncontrolled with H1 antihistamines. This followed its initial US CSU approval in April 2025    3. Keytruda  Non-Proprietary Name: Pembrolizumab  Company: Merck & Co.  First Approved: US (Sep 04, 2014), EU (Jul 17, 2015)    Total Revenue: $31.68B    Keytruda (pembrolizumab) is Merck’s PD-1–blocking immunotherapy and is now approved across 21 indication categories in the US, spanning melanoma, NSCLC, malignant pleural mesothelioma, HNSCC, PMBCL, urothelial cancer, MSI-H/dMMR solid tumors, MSI-H/dMMR colorectal cancer, gastric/GEJ cancer, esophageal/GEJ cancer, cervical cancer, hepatocellular carcinoma, biliary tract cancer, Merkel cell carcinoma, renal cell carcinoma, endometrial carcinoma, TMB-H solid tumors, cutaneous squamous cell carcinoma, TNBC, and ovarian cancer  Keytruda/Keytruda QLEX generated $31.68B in 2025, compared with $29.48B in 2024, representing a 7.45% YoY increase. Merck attributed the increase to higher US demand and net pricing, driven by greater use in earlier-stage indications such as TNBC, NSCLC, RCC and HNSCC, alongside increased demand in metastatic urothelial and endometrial cancers; international growth was led by stronger uptake in TNBC, NSCLC and RCC  In August 2026, Merck and Moderna reported positive P-III INTerpath-001 results for intismeran autogene plus Keytruda in completely resected Stage IIB-IV melanoma. The combination achieved statistically significant and clinically meaningful improvements in both recurrence-free survival and distant metastasis-free survival vs. Keytruda alone, with the companies planning regulatory submissions  2. Ozempic/Wegovy/Rybelsus  Non-Proprietary Name: Semaglutide  Company: Novo Nordisk  First Approved: US (Dec 05, 2017), EU (Feb 8, 2018)    Total Revenue: $35.95B    Ozempic/Wegovy/Rybelsus (semaglutide) are Novo Nordisk’s semaglutide-based GLP-1 medicines, covering type 2 diabetes and obesity across injectable and oral formulations. Together, they form one of the company’s most commercially important product franchises  Combined revenue reached $35.95B in 2025, compared with $28.18B in 2024, representing a 27.56% YoY increase. Growth was supported by higher volumes, broader access and continued expansion of the semaglutide portfolio, including oral treatment options, although pricing and competitive pressure remained factors  In March 2026, Health Canada approved Ozempic to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease and/or chronic kidney disease  1. Mounjaro/Zepbound   Non-Proprietary Name: Tirzepatide  Company: Eli Lilly  First Approved: US (May 13, 2022), EU (Sep 15, 2022)    Total Revenue: $36.5B    Mounjaro/Zepbound (tirzepatide) is Eli Lilly’s dual GIP/GLP-1 receptor agonist, with Mounjaro used for type 2 diabetes and Zepbound for chronic weight management. Its rapid uptake has made tirzepatide one of Lilly’s biggest growth drivers  Combined Mounjaro and Zepbound revenue reached $36.5B in 2025, up from $16.46B in 2024, representing a 121.7% YoY increase. Growth was driven primarily by surging patient demand and higher sales volume, supported by expanded manufacturing capacity that helped Lilly meets previously constrained demand   In August 2026, Mounjaro received US FDA approval to reduce the risk of major adverse cardiovascular events, including cardiovascular death, non-fatal heart attack and non-fatal stroke, in adults with type 2 diabetes at high cardiovascular risk    Sources:  Company Website Press Releases   OANDA  Annual Filings    Criteria:  The report is based on prescription drug product revenues reported during fiscal year 2025, covering leading medicines across oncology, immunology, diabetes, cardiovascular, infectious diseases, respiratory, ophthalmology, and other major therapeutic areas to provide a comprehensive ranking of the world’s leading prescription drug products Products containing the same active pharmaceutical ingredient (API) are grouped together, with the revenues of the respective branded products combined for ranking purposes. For products with non-December fiscal year endings, revenue has been aligned to the January–December 2025 period using quarterly and annual financial filings. Where product-specific revenues were not separately disclosed, the relevant product, franchise, or therapeutic-area figures were used based on the company’s reported business structure and publicly available financial disclosures Revenues reported in different currencies have been converted into US dollars using exchange rates as of 31 December 2025 to ensure consistency and comparability across all products included in the ranking The post Top 20 Prescription Drugs of 2026 appeared first on PharmaShots.