2024 marked a transformative year for RNA therapeutics. What began as a pandemic-driven innovation sprint has evolved into a diversified, multi-platform frontier of modern medicine.

While Pfizer and Moderna continue to lead with their mRNA vaccines, companies like Alnylam, Sarepta, and Novartis are proving that RNA technologies are no longer niche—they’re foundational. From tackling rare genetic diseases to entering chronic care markets, RNAi and ASO platforms are expanding their therapeutic reach, signaling a future where RNA isn’t just one tool in the box—it’s the blueprint for precision medicine.

The RNA therapeutics industry has firmly entered a new era—one where scientific innovation is directly translating into commercial viability and improved patient outcomes. In 2024, RNA-based treatments proved they are far more than a pandemic-era phenomenon. They have matured into a diversified and strategically critical component of the global pharmaceutical market.

This year’s sales data reveals a dynamic, multi-modal ecosystem led by mRNA vaccines and increasingly complemented by RNA interference (RNAi) and antisense oligonucleotide (ASO) technologies. While mRNA continues to dominate in terms of sales volumes, particularly due to its successful deployment in vaccines, RNAi and ASO are carving out growing market shares in treating rare, genetic, and chronic conditions—many of which had previously limited therapeutic options.

From blockbuster vaccines to targeted rare disease therapies, RNA therapeutics are reshaping the definition of personalized medicine, offering tailored solutions based on genetic mechanisms. Importantly, the chart also showcases a strategic diversification trend: companies are no longer betting on a single RNA platform but are increasingly building multi-RNA modality portfolios to address broader disease areas.

Here’s a deeper breakdown of how 2024 shaped up for RNA therapeutics:

Top Performers: Vaccines Still Rule

At the top of the leaderboard are the COVID-19 mRNA vaccines:

• Pfizer’s COMIRNATY® leads with $3.38 billion in sales.

• Moderna’s SPIKEVAX™ follows with $3.1 billion.

These figures, while significantly lower than pandemic-era peaks, still highlight the enduring importance of mRNA platforms, not just in pandemic preparedness but potentially in future infectious disease and oncology applications.

Alnylam and Sarepta: Rare Disease Trailblazers

Alnylam Pharmaceuticals cements its position as a leader in RNAi therapeutics with:

• Amvuttra® (vutrisiran): $970 million

• Onpattro® (patisiran): $256 million

• Givlaari® (givosiran): $253 million

• Oxlumo® (lumasiran): $167 million

Together, these drugs represent Alnylam’s stronghold in treating genetic disorders such as hATTR amyloidosis and acute hepatic porphyria.

Sarepta Therapeutics, with combined $967 million in sales from Exondys 51, Vyondys 53, and Amondys 45, reflects the growing relevance of ASO-based therapies for Duchenne muscular dystrophy (DMD). The tight race with Alnylam signals Sarepta’s steady climb and the viability of ASO technologies in rare neuromuscular diseases.

Novartis and Biogen: RNA Additions to Broader Portfolios

• Novartis’ LEQVIO® (inclisiran) raked in $754 million, spotlighting RNAi’s role in cardiovascular disease, a non-rare and chronic setting.

• Biogen’s SPINRAZA® (nusinersen) generated $485 million, though facing competition from newer SMA therapies like gene therapy Zolgensma.

These numbers show that large-cap pharma players are successfully incorporating RNA platforms into broader therapeutic strategies.

Emerging Players & Innovations

Several players are rising in the RNA space:

• Astellas/Iveric Bio’s Izervay®: $208 million – highlighting ophthalmic RNA therapies.

• Ionis-AstraZeneca’s Wainua®: $93 million

• Geron’s Rytelo®: $77 million – a notable entry in the telomerase inhibition space.

• Moderna’s Mresvia™: $25 million – its new entrant in RSV, indicating pipeline diversification.

Others like Ionis’ Qalsody®, Tegsedi®, and Waylivra® are still building traction but are important markers of Ionis' deep commitment to ASO-based treatments.

Conclusion: RNA Therapeutics Enter Mainstream Maturity

The 2024 RNA therapeutics sales landscape reflects:

• The mainstream acceptance of RNA as a powerful therapeutic modality.

• An ongoing shift from pandemic-driven vaccine sales to chronic and rare disease applications.

• Diverse modalities (mRNA, RNAi, ASO) catering to a wide therapeutic spectrum—from cardiovascular and neurology to ophthalmology and oncology.

As competition intensifies and regulatory agencies become more experienced with RNA-based treatments, we can expect accelerated approvals, broader indications, and more personalized therapeutic approaches in 2025 and beyond.