Evaluate’s 2026 Orphan Drugs Report forecasts global orphan drug sales will exceed $400 billion by 2032, driven by high‑value gene and cell therapies, extended uses of existing orphan brands, and continued premium pricing in ultra‑rare markets. The analysis projects orphan medicines will represent more than 21% of global prescription sales by 2032, up from 15% in 2022. Authors caution the trajectory faces headwinds including intensified regulatory scrutiny, pricing pressure, and competition for investor attention from large‑market therapeutics such as obesity drugs. The report highlights key franchises and companies expected to dominate the orphan market, including projected top sellers and corporate winners. The forecast underscores sustained investor and developer interest in rare disease R&D despite policy and reimbursement uncertainties that could influence future valuations and deal activity.