Eli Lilly & Co.’s obesity and diabetes treatment “Mounjaro” has overtaken Merck & Co.’s cancer drug “Keytruda” to become the world’s top-selling pharmaceutical product.

According to Bloomberg News on the 7th (local time), Mounjaro posted sales of USD 8.7 billion (about KRW 12.6 trillion) in the first quarter of this year. Over the same period, Keytruda recorded sales of USD 7.9 billion (about KRW 11.4 trillion).

Keytruda took the top spot as the world’s best-selling pharmaceutical product in the first quarter of 2023 by surpassing AbbVie’s autoimmune disease treatment “Humira,” and had maintained its lead since then. However, for the first time this quarter, it ceded the crown to Mounjaro.

The gap becomes even wider when Eli Lilly’s obesity treatment “Zepbound” is included. Both Mounjaro and Zepbound are based on the same active ingredient, tirzepatide. The combined sales of the two products last year reached USD 36.5 billion, far exceeding Keytruda’s annual sales over the same period (USD 31.6 billion).

The market views this change not merely as competition between products but as a paradigm shift in the global pharmaceutical industry. Evan Seigerman, managing director at BMO Capital Markets, told Bloomberg, “We are now moving from the era of ‘King Keytruda’ to ‘King Tirzepatide,’” adding, “Considering efficacy and safety, this is not surprising.”

Keytruda was regarded as a “breakthrough new drug” that opened the era of immuno-oncology when it was approved in 2014, dramatically extending survival for many cancer patients. In contrast, tirzepatide is rapidly spreading on the back of a far larger mass market of obesity and diabetes.

Bloomberg reported that Lilly continues to post explosive growth despite entering the market later than competitor Novo Nordisk’s “Ozempic” and “Wegovy.” Demand is continuing to rise despite the appearance of copycat products during a period of supply shortages and U.S. government pressure to reduce drug prices.

Merck, meanwhile, is seeking new growth drivers ahead of Keytruda’s patent expiration in 2028. However, analysts say the company has yet to establish a clear presence in the obesity treatment market.

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