An efficient reporting system has seen all the listed multinational pharmaceutical companies announcing results for 2021, which has given us the opportunity to update our industry statistics and drug database. This report provides the first snapshot of the global and US rankings of the top 20 drug companies for 2021. Comparisons are made with historical data to show how different company strategies have evolved. 2021 was characterised by a strong rebound in performance following the pandemic-affected year in 2020. Much of the growth was driven by antibody-derived drugs and vaccines for treatment and prevention of COVID-19. ► Global market: Hardman & Co estimates that the global prescription drug (Rx) market had growth of 13.7% in 2021, to $1,059bn, up from $931bn in 2020. Underlying growth, excluding COVID-19 vaccines and therapies, was 5.9%, which is consistent with figures given in the annual reports of some drug companies. ► US market: The US market was an important driver of growth, rising 12.2% to $422bn in 2021, from $376bn in 2020, representing 40% of the global market. Despite some continuing limitations caused by COVID-19, the FDA had another productive year, approving 50 new chemical entities (NCEs). ► Biopharmaceuticals: The spend on drugs classified as biopharmaceuticals grew 27.9% to $313bn in 2021, representing 30% of the global market. Drugs derived from antibodies remained an important driver (+20.2% to $187bn), but the performance was boosted dramatically by vaccines (+170% to $90.0bn). ► Best-selling drugs: The global COVID-19 vaccination programme made Comirnaty (Pfizer) the best-selling product in 2021, with sales of $36.8bn. Humira (AbbVie) remains the biggest drug, with ex-factory sales of $20.7bn (+4.3%). The top 10 drugs had global sales of $147.7bn in 2021, representing 13.9% of the entire market. On a cumulative sales basis, there are now eight drugs in the $100bn club. ► R&D investment: The top 20 drug companies by sales reinvested 19.8% of Rx drug sales back into new drug development, spending $133bn out of the total spend of $156bn by the 40 largest companies. The average R&D spend was $6.7bn, ranging from $13.3bn (Roche) to $2.2bn (Vertex).