Dear reader, when we discuss the best-selling medications of all time, we’re exploring more than just products with massive sales; we’re highlighting milestones in the history of global medicine and healthcare. Over the past decades, numerous drugs have emerged to address critical health needs for millions worldwide, achieving unprecedented financial success and international reach thanks to their clinical effectiveness and sometimes groundbreaking marketing strategies and patents.

Throughout the history of pharmaceuticals, certain medications have achieved extraordinary sales, becoming major global successes. At the top of this list is the biologic drug HUMIRA® (adalimumab) by Abbvie. It holds the title of the best-selling drug of all time, having accumulated more than $200 billion in sales over twenty years since its market launch. HUMIRA retained its dominance for nearly a decade, primarily due to its effectiveness in treating autoimmune diseases such as rheumatoid arthritis and psoriasis, combined with extended patent exclusivity.However, starting in 2023, after its patent expiration, HUMIRA experienced a noticeable 32% decline in annual sales, to approximately $14.4 billion, primarily due to the introduction of biosimilar alternatives into the market.

Another prominent example is KEYTRUDA® (pembrolizumab) by Merck, considered a rising star in pharmaceutical revenues. KEYTRUDA, used to treat various types of cancer, has become a cornerstone in oncology treatments, having secured over 40 distinct therapeutic approvals globally. Its sales soared dramatically in recent years, reaching $25 billion in 2023, making it the top-selling medication globally that year. This upward trend continued, and in 2024, KEYTRUDA achieved around $29.5 billion in revenues. At this pace, KEYTRUDA is expected to surpass HUMIRA’s historical sales record soon, potentially becoming the highest-grossing drug ever.

Lipitor® (atorvastatin), produced by Pfizer, is another remarkable success story in the pharmaceutical world. It dominated sales during the first decade of the 2000s, generating approximately $150 billion in cumulative sales by 2017. Lipitor's massive popularity resulted from its proven effectiveness in lowering cholesterol levels and reducing the risk of heart disease, paired with one of the most successful marketing strategies ever employed by the pharmaceutical industry. Reports indicate that during its first 14.5 years on the market, Lipitor generated approximately $125 billion, driven by exceptional clinical outcomes and aggressive marketing campaigns that outperformed those of its competitors.

The list of the most lucrative medications also includes several other blockbuster treatments, each generating tens of billions in sales. For example, ENBREL (etanercept), indicated for rheumatoid arthritis, amassed roughly $81 billion over its lifetime, while RITUXAN (rituximab), a key cancer treatment, earned about $82 billion cumulatively. Additionally, newer immunological treatments have also achieved substantial commercial success. Novartis’s COSENTYX (secukinumab), prescribed for psoriasis and arthritis, reached nearly $5 billion in revenues during 2023 alone, mainly benefiting from its effectiveness in treating common conditions.Emerging medications for conditions like diabetes and obesity have also rapidly become commercial successes. OZEMPIC® (semaglutide) notably reached around $14 billion in global revenues in 2023, rising to approximately $16.9 billion in 2024, reflecting a yearly growth rate of about 26%, driven primarily by the increasing global prevalence of obesity and type 2 diabetes.

It’s also important to note the remarkable sales achieved by vaccines during the COVID-19 pandemic. Pfizer-BioNTech’s COVID-19 vaccine, Comirnaty®, recorded exceptional global revenues, totaling around $37 billion in 2021 alone, making it the highest-selling drug worldwide that year, though this was a uniquely temporary phenomenon.

Ultimately, dear reader, these remarkable sales figures underscore more than mere commercial success; they represent groundbreaking achievements in global healthcare. These medications have shaped medical practice, improved patient outcomes, and addressed significant public health challenges, leaving an indelible mark on medical history and continuing to impact millions of lives worldwide.