We are entering an unprecedented era of 'super heavyweight drugs'.

The latest report from Evaluate shows that by 2032, the global prescription drug market will exceed $2 trillion, with annual sales of single drugs exceeding $70 billion, and five drugs entering the $20 billion club. The definition of a drug king will be completely rewritten.

However, beneath the feast, there is a turbulent undercurrent: the impact of over $500 billion in generic drugs is approaching, and the US pricing iron fisted and geopolitical rifts are tightening simultaneously.

The most profound power shift in this gamble comes from the East.

The report reveals that in the total value of global biopharmaceutical transactions in 2026, the proportion involving Chinese assets is expected to exceed two-thirds; In the list of the most valuable assets under research, bispecific antibodies born in China topped the list. Collaboration is replacing one-time buyout, and Chinese pharmaceutical companies are transforming from innovative suppliers to deep sharers of global value.

The card table has reopened.

01、 "Super Heavy Drug" Era

In the Evaluation report, by 2032, the total global drug sales will surpass the $2 trillion mark, with five drugs each generating over $20 billion in annual sales revenue. The top 20 best-selling drugs will account for nearly one-fifth of the industry's total revenue.

In this dazzling galaxy, the brightest star belongs to Lilly, whose GIP/GLP-1 dual receptor agonist Mounjaro/Zepbound will undoubtedly ascend to the throne.

Evaluate predicts that the sales of Tilpoltide in 2032 will exceed 70 billion dollars, which will not only make it the "single drug with the largest sales in history", directly surpass Humira, the former drug king, Keytruda, the current drug king, and even dwarf the sales myth created by Pfizer/BioNTech during the COVID-19.

Supporting this prediction is the profound moat constructed by Eli Lilly in the field of metabolic diseases. Evaluate pointed out that Lilly's market leading position in this field relative to Novo Nordisk will be further consolidated.

Among the top ten best-selling drugs predicted for 2032, only Eli Lilly's Tilpotide series and newly launched oral weight loss GLP-1 drug Foundayo account for nearly half of the market share. Not only that, the triple agonist retatrutide and the amygdalin receptor agonist eloralinide are expected to contribute an additional $10 billion in 2032.

In contrast, Novo Nordisk's Ozempic/Egovy series is expected to slip out of the top ten rankings. But this does not mean the decline of the Danish giant. Evaluate believes that Novo Nordisk's existing product line and the next generation of investigational combination therapy CagriSema can still contribute over $25 billion in revenue by 2032.

If obesity is the biggest single gold mine, then autoimmune diseases are the fertile ground that nourishes the ecosystem. The report reveals that by 2032, the overall growth rate of immune modulators is expected to surpass that of metabolic and endocrine drugs.

AbbVie is undoubtedly the best successor in this field, with its injectable IL-23 antagonist Skyrizi expected to dominate the second place on the list with sales exceeding $33 billion; Another product, oral JAK inhibitor Rinvoq, is expected to earn nearly $17 billion due to its wide indications in rheumatoid arthritis, atopic dermatitis, and other fields, ranking sixth. AbbVie is successfully filling the gap left by the expiration of the Xiumeile patent by deeply exploring the potential of multiple products in the pipeline.

In the field of oncology, Daiichi Sankyo and AstraZeneca's ADC drug Enhertu remain the crown jewels, expected to rank seventh, continuing to validate the vast prospects of ADC drugs as "magic bullets". At the same time, Johnson&Johnson's CD38 monoclonal antibody Darzalex and Argenx's FcRn antagonist Vyvgart still maintain strong value rigidity in their respective rare disease sub segments.

02、from 5% to two-thirds

If heavyweight drugs are the protagonist of the Evaluation report, then China's rise is the hidden thread that runs through the entire drama, and can even be said to be the most shocking plot.

The report clearly states that China has become the main source country for Western pharmaceutical companies to introduce authorized assets, and is also an important birthplace of "built to buy biotechnologies".

In the global list of the most valuable assets under research compiled by Evaluate, the top spot is not held by laboratories in Silicon Valley or Boston, but by the bispecific antibody ivonescimab jointly developed by Kangfang Biotechnology and Summit Therapeutics. Evaluate calculates its net present value (NPV) to exceed $25 billion and predicts that by 2032, this drug will generate $8.5 billion in sales.

Ivoxidan Kang is a first in class drug that targets both PD-1 and VEGF. The reason why it has won over demanding Wall Street analysts is that in a "head to head" phase III clinical trial, it defeated Merck's "K drug" in progression free survival data as a single drug first-line treatment for PD-L1 positive non-small cell lung cancer. This milestone victory completely breaks the stereotype that 'China can only do me too'.

At present, ivonescimab has been approved for marketing in China, and its US marketing application is in the critical review stage by the FDA. The results will be finalized in November this year. Once approved, this drug will become the first dual antibody ADC class heavyweight drug created by a Chinese company and successfully entered the core market in the United States.

At the same time, povetacicept, jointly developed by Vertex, Zaiding Pharmaceutical, and Ono Pharmaceuticals, is also eye-catching.

This dual BAFF/APRIL cytokine inhibitor has recently received FDA approval for its marketing application for IgA nephropathy and is being expanded to multiple autoimmune indications. Evaluate calculates its NPV to be $15.8 billion and predicts that sales will reach $3.5 billion by 2032.

It is worth mentioning that Zaiding Pharmaceutical holds exclusive rights to the drug in Greater China and Singapore, indicating that Chinese pharmaceutical companies are participating in the early layout and regional value distribution of high-value molecules globally through their keen BD vision.

This trend is more directly reflected on the trading side. According to a set of data from Evaluate, it is expected that by 2026, the proportion of Chinese assets involved in the total value of global biopharmaceutical transactions will exceed two-thirds, further soaring from over half in 2025, compared to only 5% five years ago.

The explosive growth from "5% to two-thirds" is driven by the global industry's extreme thirst for low-cost, low-risk, and multi indication potential assets.

Whether it is Hengrui Pharmaceutical's cooperation with Hercules in the United States through technology investment for metabolic combination product pipelines containing GLP-1, the total milestone amount exceeds billions of dollars; The nearly billion dollar ADC drug authorization agreement signed between Kolombotai and Merck confirms the early research and development of Chinese biotech companies, which have become the "core supermarket" for global pharmaceutical companies to fill the patent cliff gap and maintain growth.

03、The undercurrent of the golden age

However, in outlining this prosperous landscape, Evaluate also issued a warning to the industry. Despite the renewed activity of trading and investment funds in the biopharmaceutical industry, severe challenges related to policies and pricing will cast a shadow over this' golden age '.

The most direct challenge comes from the massive patent cliff. From 2026 to 2032, the potential sales loss risk of the entire industry facing the impact of generic drugs exceeds $500 billion. This is also the direct driving force behind industry mergers and acquisitions, which are expected to set a historical record of $200 billion this year - large pharmaceutical companies need external innovation to fill the huge revenue gap left by the expiration of core product patents.

The greater uncertainty comes from the pricing and regulatory environment in the United States. The Inflation Reduction Act (IRA) in the United States grants federal healthcare the power to directly negotiate drug prices, which has long suppressed popular drugs that have been arbitrarily raised in the past. At the same time, the personnel turmoil and uncertainty of approval standards experienced within the FDA have made pharmaceutical companies walk on thin ice when betting on heavyweight pipelines.

The report specifically points out that companies are caught in a dilemma when faced with the question of whether they tend to polish smaller and lower risk pipelines or take bold risks in research and development.

For Chinese elements that are deeply integrated into the global industrial chain, the Damocles sword of geopolitics remains high hanging. Evaluate bluntly mentioned the inevitable impact of the division between China and the United States in the life science ecosystem.

Recently, restrictions on Chinese CXOs and biotech companies, such as the Biosafety Act pushed by the US Congress, have increased the compliance costs of cross-border cooperation. This sense of deep dependence and attempt to decouple will force Chinese biotech companies to make more cautious choices on the path of globalization.

Anyway, the curtain of the $2 trillion era has already begun. The purity and geometry of Chinese elements will also be ultimately tested on this journey.

Reference article: Evaluate report