Big Drugs Will Erode Orphans’ Share of Drug Sales
The orphan drug pipeline is healthy. Sales of today’s orphan pipeline candidates are collectively forecast to top $100 billion in 2032. The most valuable late-stage orphan programs are expected to sell over $1 billion each that year; in net present value terms, the top five exceed $7 billion.
Yet orphan pipeline drugs’ share of overall prescription drugs sales is expected to fall over the next seven years, from a projected 30% peak in 2027 to 22% in 2032. This likely reflects growing interest and investment in big drugs for big diseases – including most prominently GLP-1 based therapies, fast expanding beyond diabetes/obesity into cardiovascular, autoimmune and other conditions Eli Lilly’s Phase 3 oral GLP-1 orforglipron is projected to sell almost $20 billion in 2032, providing a significant boost to non-orphan drug sales.
Figure 5: Worldwide Pipeline to 2032: Orphan vs. Non-Orphan
As public investor interest returns cautiously to biopharma, momentum remains with such multi-indication products addressing widespread disorders. Drugs for obesity/diabetes, central nervous system (CNS) conditions like acute pain or schizophrenia, cardiovascular or auto-immune disorders are especially attractive to Big Pharma seeking to fill loss-of-exclusivity revenue gaps of $300bn by the end of the decade. They also tend to be less risky than most orphan drugs. Many hit validated targets, offering convenience and/or tolerability advantages rather than a novel mechanism of action.
