The most profitable drugs of all

Jefferies tabulated the top performers in two decades of drug launches, and came up with some interesting observations.

The hepatitis C pill Harvoni was the top performer out of the gate, generating massive sales in its first two years in particular. Other drugs that generated strong initial sales were the HIV drug Biktarvy and the cystic fibrosis therapeutic Orkambi. The common thread here is that they’re oral drugs: As Jefferies points out, the top oral pills cumulatively generated more revenue than did biologics in the first years of launch. 

However, biologics like Keytruda, Opdivo, and Avastin are sort of sleeper successes: In later years on the market, these drugs picked up a lot more steam, suggesting biologics may, indeed, bring in more revenue in the long run. They generally have a higher price point, and tend to treat rarer chronic conditions.

Drugs like Harvoni (and by extension, Sovaldi) have produced remarkable health outcomes but also famously diminishing commercial returns.