Evaluate’s orphan drugs report projects that orphan drugs will account for more than 21% of all prescription pharmaceutical sales by 2032, up from 15% in 2022. The analysis also forecasts rare disease therapies will drive more than $400 billion of projected global prescription drug sales in 2032, with the top selling orphans each reaching more than $6 billion in worldwide sales. The report attributes continued growth to policy wins despite broader pharma pricing and regulatory turbulence, and highlights a 2025 IRA-related change described as “orphan-friendly.” It also points to formulation developments, including Darzalex’s subcutaneous version that is expected to extend the Darzalex franchise’s effective lifespan. Evaluate also forecasts competitive shifts: Argenx is expected to move into the top rankings for orphans by 2032, potentially displacing Pfizer with its Vyvgart franchise. The report expects the orphan share of total prescription sales to soften after a projected 2027 peak as investment tilts toward larger-population therapies, including GLP-1-based drugs.