For the first time in 10 years global sales of pharmaceuticals are forecast by Evaluate to take a downturn because of growing pricing pressures.

Analysts at the group are projecting that sales will hit $1.06 trillion in 2022, down from the $1.12 trillion forecast last year for the same period.

The fall also marks the first time in a decade of Evaluate analysis that total drug sales have failed to beat previous year forecasts, the group noted.

“The continued political and public scrutiny over pricing of both the industry’s new and old drugs is not going to go away and we are starting to feel the impact now,” said Antonio Iervolino, head of forecasting at Evaluate.

“Market access is becoming harder,” and “the increasing cost of taking a novel therapy to market, now at $4 billion over the last 10 years puts additional pressure on the productivity of the industry and its longer term sustainability,” he added.

Cancer immunotherapies like Keytruda (pembrolizumab) and Opdivo (nivolumab) are expected to help drive the sector to its expected trillion dollar sales target, while orphan drugs are now set to make up a third of pharma sales by 2022 despite questions over their cost, according to the World Preview report.

In other headline predictions: patent expiries could wipe out $194 billion worth of pharma sales during 2016-2022, potentially signalling a second patent cliff; AbbVie’s Humira (adalimumab) will continue to be the leading product in the USA in 2022, with sales of $12.0 billion; and Keytruda is due to knock off Opdivo as the top-selling PD-1/PD-L1 product.

Also, Novartis, Pfizer and Roche will be competing head to head for pole position on worldwide RX sales in 2022, but according to Evaluate, Novartis seems to have a slight edge.