Blockbuster medicines now account for nearly half of prescription medicine spending worldwide, according to an Oct. 22 report from the IQVIA Institute for Human Data Science that analyzes blockbuster drugs from 2000 to 2024.
Here are seven things to know:
- IQVIA defines a blockbuster using an inflation-adjusted global sales threshold of about $2.4 billion, anchored to the $1 billion benchmark set by Tagamet in 1986. By that measure, the number of blockbusters grew from 19 in 2000 to 91 in 2024, representing about $700 billion in global sales.
- Blockbusters made up only 2% to 4% of global branded medicines each year but accounted for 63% of global branded medicine sales at list prices in 2024, up from 25% in 2000.
- The mix has moved from high-volume primary-care drugs to specialty medicines, which made up 63% of blockbusters in 2024. Oncology, immunology and diabetes treatments grew from 5% of blockbusters in 2000 to 60% in 2024.
- Sales are concentrating in “mega” blockbusters, drugs with at least five times the annual threshold in sales. They made up only 15% of blockbusters in 2024 but 46% of blockbuster sales, with annual sales of about 6.4 to 18.9 times the threshold.
- Blockbusters take an average of 4.8 years after launch to reach that status, and 67% do so within five years. That leaves an average of 12.1 years between reaching blockbuster status and U.S. loss of exclusivity, nearly 80% of their average protected commercial life cycle, though not all sustain blockbuster-level sales throughout.
- Nine of today’s mega blockbusters are expected to face U.S. loss of exclusivity between 2028 and 2036. IQVIA said that will pressure manufacturers to replenish their portfolios and could create savings for payers and health systems as generic and biosimilar competition arrives. The FDA’s move to ease biosimilar development could add to those savings.
- The shift toward specialty drugs bears on pharmacy budgets. New drugs are launching at a median net price of $257,000 a year, and Medicare is negotiating prices on 15 more drugs for 2028.
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