Biopharma firms are having more clinical success treating Alzheimer’s disease and obesity and are taking latest approaches in oncology, and that is creating more mega-blockbuster drugs, in accordance with Bank of America. Analyst Geoff Meacham has identified 20 drugs which have the potential to generate $10 billion or more in annual sales by 2030 inside the universe of firms he covers. “Based on our evaluation, most mega-blockbusters share some common attributes including: 1) large addressable populations, 2) long duration of therapy, and three) favorable pricing,” said Meacham in a research note Friday. “That said, the most important drugs normally feature one, or best case two, of those attributes.” For instance, a drug like Covid-19 vaccines Comirnaty (Pfizer/ BioNTech ) or Spikevax ( Moderna ), can hit mega-blockbuster status with a low price but an enormous market of patients. A drug may wind up on this group if it treats fewer patients at the next cost equivalent to Merck’s Keytruda cancer treatment. Seven drugs on Meacham’s list are already out there, and have already hit the $10 billion or more benchmark. These include Pfizer’s Covid-19 treatment Paxlovid, AbbVie’s arthritis treatment Humira and Gilead’s HIV/AIDS treatment Biktarvy. Meaning a few of these drugs could also be already hitting the tip of their peak sales period. Meacham puts Humira and the Covid vaccines on this category. That leaves 13 drugs which have yet to hit the mark. A portion of the names on this list are still in early stage development, and subsequently carry some risks equivalent to the potential for the drug to not clear regulatory hurdles, meet the goals of clinical trials or to get ward off from medical insurance firms on pricing and coverage. Meacham has previously said that considered one of the drugs on this bucket, Eli Lilly’s tirzepatide, may very well be the primary $100 billion drug . It’s already approved as a treatment for type 2 diabetes, and sales are off to a powerful start. But many investors are hopeful about its potential as an obesity treatment . On Thursday, tirzepatide received word from the Food and Drug Administration that the agency would quick track the review of the applying for this use . Meaning tirzepatide could win approval to treat obesity as soon as late 2023 or early 2024. Nonetheless, Meacham’s eye-popping sales forecast relies on an expectation that the drug will even be used to treat other conditions equivalent to NASH, sleep apnea, kidney disease and heart failure. “From our evaluation, we predict that Lilly’s tirzepatide uniquely could capture all 3 market drivers and in dramatic fashion given the numerous development investment made across many indications. In our view, this may be very much underappreciated by investors given the acute deal with just T2D and obesity,” he said. Lilly’s stock is up 18% yr so far. On Sept. 28, it hit an all-time high of $341.70. In cancer treatment, Keytruda and Bristol Myers’ Opdivo have already achieved blockbuster status but biopharma firms are taking a look at combination immuno-oncology therapies. One example Meacham cited is Opdualag, which has been approved to treat metastatic melanoma. Bristol is studying its potential as a treatment for liver and lung cancer, which if successful could speed up Opdualag’s sales growth considerably, he said. Bristol shares have gained nearly 12% yr so far, while Merck’s stock is up 14% over the identical period. Finding effective treatments for Alzheimer’s has proven to be a challenge up to now, but investors have been encouraged by the recent results from a big, late-stage clinical trial for lecanemab, a treatment from Biogen and Eisai. This latest medication appears to assist patients greater than Biogen’s earlier treatment, Aduhelm. That drug won FDA approval but then struggled after Medicare limited coverage of the treatment. But the brand new medication appears to be more successful in slowing a patient’s cognitive decline. Hopes for the drug have catapulted Biogen shares . The stock is up greater than 42% yr so far. Lilly also has an Alzheimer’s treatment , donanemab. Updates from its phase 3 trial are expected by mid-2023. Meacham said he expects that multiple Alzheimer’s treatments can co-exist as a result of the big patient population. “We expect meaningful growth for lecanemab if it may obtain broad coverage from [the Centers for Medicare & Medicaid Services], and will turn into Biogen’s best-selling product and offset revenue erosion in other products,” he said.