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Expand chart
Data: Company filings; Chart: Thomas Oide/Axios

Cancer drug Keytruda is on pace to generate more than $17 billion of revenue this year after reaching a record $4.5 billion of sales in the third quarter.

Why it matters: Keytruda is close to becoming the highest-selling drug in the world and would be a Fortune 200 company on its own.

Driving the news: Keytruda continues to be the core of Merck, even though executives told Wall Street yesterday the company expects to collect between $5 billion and $7 billion, now through 2022, from its coronavirus pill molnupiravir.

  • That's a lot of money, but molnupiravir still wouldn't be half as much as what Keytruda brings in annually for Merck.
  • Keytruda represents "the vast majority of the company's revenue growth" and is the company's profit engine, Merck said in a filing earlier this year.

How we got here: Keytruda, which is administered intravenously in a hospital or outpatient office, has been on the market since late 2014 and has shown to be extremely effective.

  • Merck has obtained several new FDA approvals that expand the drug's label into more types of cancers.
  • Merck is also pushing to use the drug after surgeries as a way to prevent cancers from coming back.

Between the lines: Because Keytruda is given in a health care facility and not picked up at a pharmacy, the drug is billed and paid for in a different way, but still exposes cancer patients to high out-of-pocket spending regardless of their insurance.

  • Keytruda has a list price of almost $175,000 per year (and Merck just raised that price by another 2% this month).
  • That means insured patients who take the drug routinely hit out-of-pocket maximums, which could equal thousands of dollars every year.

The bottom line: Keytruda's patent doesn't expire until 2028, and given the lack of federal drug pricing reform, Keytruda will continue to be among the highest-selling drugs.

Go deeper

Updated Nov 17, 2021 - Axios Events

Watch: A conversation highlighting innovations in cancer care

On Wednesday, November 17th, Axios health care reporter Caitlin Owens and senior editor Sam Baker hosted a virtual conversation highlighting innovations in care for cancer prevention and treatment, featuring Rep. Terri Sewell (D-Ala.) and National Cancer Institute director Dr. Ned Sharpless.

Rep. Terri Sewell conveyed how the pandemic amplified the importance of early cancer detection, recent developments in the cancer detection space, and how issues of health equity extend to cancer prevention.

  • On the health disparities exposed by the pandemic: “The past two years have been like no other with this global threat and the COVID-19 pandemic, but COVID-19 has really laid bare a spotlight on systemic disinvestments in health care and health disparities in this country.”
  • On how screenings have improved cancer prevention: “I also know that when we put our minds to it, we can take the hardest of cancers and find screens and find therapies. I think about the fact that colon cancer used to be a kiss of death, and now we, because of screening, have brought the numbers of people who die from that cancer down. I’d like for that to be the case with pancreatic cancer…”

Dr. Ned Sharpless described the current state of cancer research and screenings after the pandemic, and the developments in science that have benefitted cancer patients over the last decade.

  • On the current state of cancer research: “It’s really a great time in cancer research in terms of the new ideas, new therapies all coming to benefit patients. But I think it’s also important to state we have a long way to go. We still have 600,000 Americans dying of cancer in the United States.”
  • On the pandemic’s impact on screenings: “We saw a dramatic decline in cancer screening of all types, for example mammography for breast cancer screening was down 95% at one point in early 2020...the rates of screening have largely recovered in the United States, but we believe we missed on the order of 10 million screening events during the pandemic.”

Axios VP of Growth Mia Vallo hosted a View from the Top segment with Prevent Cancer Foundation president & COO Jody Hoyos, who emphasized the importance of screenings for cancer prevention.

  • “There is no routine screening for the vast majority of cancers, and not enough people are using the cancer screenings we already have. So expanding the screenings available to people and increasing the uptake of existing screenings would be key in creating a world where no one dies of cancer.”

Thank you Prevent Cancer Foundation for sponsoring this event.

Americans are super-sizing their holiday travel

Illustration: Sarah Grillo/Axios

Americans are rushing back into holiday travel, and many are taking even longer trips now than they did before the pandemic began.

The big picture: After skipping Thanksgiving and Christmas gatherings last year, many people are eager to maximize this year's celebrations with friends and family. And flexible remote working arrangements make that easier than ever.

Updated 16 hours ago - Sports

The potential GOAT of chess faces intriguing challenger

Illustration: Sarah Grillo/Axios

The World Chess Championship between Norway's Magnus Carlsen and Russia's Ian Nepomniachtchi began on Friday, 1,094 days after Carlsen won his fourth consecutive title.

Why it matters: During the long, COVID-fueled layoff, chess entered a new era, and with the championship finally here, the age-old game is ready for its close-up.