Follow the money and you’ll spot the biology that paid off in 2024. PD-1 immunotherapy kept oncology on top, with Keytruda ringing up $29.5 billion in revenue. In obesity and diabetes, the top five GLP-1/GIP incretins (Ozempic, Mounjaro, Wegovy, Rybelsus and Trulicity) pulled in **$46.1 billion**, up a remarkable **37.8 %** year over year. And Dupixent, the IL-4/IL-13 antibody born from cytokine-mapping work, climbed 22% to $14.2 billion.
While the metabolic incretin surge is undeniable, comparing therapeutic areas requires careful attention to scope. The $46.1 billion for GLP-1/GIP represents sales from just five blockbuster drugs. Adding the estimated **$19.5 billion global market for branded insulins** brings the broader metabolic total (using this specific drug roll-up + insulin market) to approximately **$65.6 billion**.
This $65.6 billion figure still trails the **$81.2 billion (+9% YoY)** generated by the **top 20 immunology drugs alone**. Therefore, comparing apples-to-apples at the top-drug level, immunology maintains a lead of roughly **$15.6 billion** over this combined metabolic cohort.
Both categories lag significantly behind the overall oncology market, estimated at **$220.8 billion (+11% YoY)** globally. Note that broader market estimates for immunology (≈ $103.2 billion) and GLP-1s (≈ $53 billion) include numerous smaller drugs, generics, regional sales, and mark-ups, differing from the direct drug-sales roll-ups used for the primary comparison here. Want the full dashboards, growth tables and pipeline maps? Our FY 2024 Pharma 50 Deep Dive preview page is up now, and the complete series drops in May.
Meanwhile, the 2024 data underscore the impact of patent expiries and shifting health priorities. AbbVie’s Humira revenue dipped 37.6% to $9.0 billion as biosimilar competition took hold. Similarly, Pfizer/BioNTech’s Comirnaty vaccine sales plunged nearly 50% year-over-year to $7.8 billion amid slack COVID-19 demand. Conversely, Gilead’s HIV therapy Biktarvy hit $13.4 billion in full-year 2024 sales, up 13% on higher uptake and pricing.
| Therapeutic Area Category / Scope | 2024 Sales (USD B) | Approx. YoY Growth (%) | Basis for Figure |
|---|---|---|---|
| Oncology (Global Market) | 220.8 | 11% | Global Rx Market Estimate* |
| Immunology (Global Market) | 103.2 | 5–8% | Global Market Estimate* |
| Immunology (Top 20 Drugs) | 81.2 | 9% | Drug Roll-up (Top 20)* |
| Metabolic (Top 5 GLP-1/GIP + Insulin) | 65.6 | 21% | Drug Roll-up + Market Estimate* |
| ↳ Top 5 GLP-1/GIP only | 46.1 | 37.8% | Drug Roll-up (Top 5)* |
| ↳ Branded Insulin only | 19.5 | Low Single-Digit | Global Market Estimate* |
In summary, while the top GLP-1/GIP drugs booked about 46 billion (+38%) in 2024, even adding branded insulin (for a total metabolic ≈ $66 billion) leaves the segment trailing the $81 billion top-20 immunology drugs by roughly $16 billion. Yet, with metabolic growth outpacing immunology significantly, this gap could potentially close within a few years if current trends persist.
