The journal Nature Reviews Drug Discovery published the prediction of the top 10 global best-selling drugs in 2025. Pembrolizumab, commonly known as "K drug", topped the list, followed by semaglutide, which has been popular in the field of weight loss in recent years, and its "rival" dual-target telpotide, which is consistent with the sales performance of these drugs in the first three quarters of this year. Among the top ten lists, 4 GLP-1 products entered the forecast list, all of which belong to the field of metabolic therapy. In addition, Dupixent (dupixentumab) and Skyrizi (lishengqizumab), two autoimmune drugs that are frequent guests on the best-selling drug list, are still on the list, ranking 4th and 5th.

▍With a wide range of indications, "K drug" is expected to become the "king of medicine" again
In the 2025 forecast, "K drug" still ranks first. In 2023, the global sales of K drug reached 25.011 billion US dollars, ranking first in the world's best-selling drugs for the first time and becoming the new "king of medicine". In the first half of 2024, "K drug" once again topped the "king of medicine", with global sales of 14.217 billion US dollars. Merck's financial report shows that in the first three quarters of 2024, pembrolizumab contributed 21.646 billion US dollars, an increase of 18% year-on-year.

The strong growth in K drug sales is inseparable from the expansion of indications. Since its launch in 2014, K drug has been approved for 40 indications worldwide, covering a variety of cancer types. Since 2023, 10 new indications such as cervical cancer have been successively won.

▍The weight loss field has ushered in an explosion, and many GLP-1 products have been listed
GLP-1, as one of the three hot targets for the development of non-insulin hypoglycemic drugs, has also shown great potential and broad industry prospects in the field of weight loss drugs in recent years. Four products entered the forecast list this time, two of which are semaglutide with different trade names of Novo Nordisk; two are telopolide with different trade names of Eli Lilly.

In December 2017, the FDA approved semaglutide for the treatment of type 2 diabetes, with the trade name Ozempic, and in June 2021, approved a higher dose of semaglutide for weight loss, with the trade name Wegovy.

According to Novo Nordisk's financial report, Ozempic sales reached 65.653 billion Danish kroner (about 69 billion yuan) in 2023, a year-on-year increase of 53%, and Wegovy sales reached 21.729 billion Danish kroner (about 22.839 billion yuan), a year-on-year increase of 481%.

Its competitors are not to be outdone. In November 2023, Eli Lilly's blockbuster weight loss drug telopolide (trade name: Zepbound) was approved by the FDA for obesity or overweight indications. Unlike semaglutide, which has a single target, telpotide is a GLP-1R/GIPR dual-target agonist. In May 2022, the FDA approved it for improving blood sugar control in adults with type 2 diabetes under the trade name Mounjaro. The results of the SURMOUNT-3 Phase III clinical trial announced by Eli Lilly in October 2023 showed that telpotide was better than semaglutide in weight loss, which also attracted attention.

Less than nine months after the weight loss indication was approved for marketing, Zepbound achieved sales of US$483 million (approximately RMB 3.429 billion), and sold US$2.96 billion (approximately RMB 21.016 billion) in the first three quarters of 2023, a year-on-year increase of 1,354%.

https://mp.weixin.qq.com/