A lot can change in five years. Take Vertex Pharmaceuticals (VRTX +0.57%), for example. In late 2020, the big biotech company's approved products focused on one indication – cystic fibrosis (CF). And Vertex's market cap was nearly half what it is today.
It's reasonable to assume that much will change for the company by 2030 as well. Where will Vertex Pharmaceuticals be in five years? Here's my best guess.
Image source: Vertex Pharmaceuticals.
What will remain the same for Vertex
I expect that some things that are true for Vertex today will still be applicable five years from now. For one thing, the company will remain the dominant player in the CF market.
Sure, a handful of potential rivals are developing therapies that target the underlying cause of CF. However, the most advanced of those programs are only in phase 2 clinical studies. It's unlikely that any of them will be in a position to challenge Vertex's virtual monopoly in CF by the end of the decade.
The company's newest CF therapy, Alyftrek, offers a more convenient dosing than its current blockbuster drug Trikafta/Kaftrio. I suspect that Alyftrek will be Vertex's top-selling CF product in five years.
Vertex will also continue to invest heavily in research and development. The focus of the company is and will remain to develop innovative therapies that treat serious diseases.
Major new markets
I think the biggest change for Vertex five years from now will be its success outside of CF. Non-opioid pain medication Journavx will likely be a huge winner. Casgevy should significantly increase sales as a functional cure for the rare blood disorders sickle cell disease and transfusion-dependent beta-thalassemia.
Vertex plans to file for regulatory approvals of zimislecel in 2026 for the treatment of severe type 1 diabetes (T1D). I expect the company will receive thumbs-ups from regulators, with the iscel cell therapy helping tens of thousands of patients by the end of the decade.
Povetacicept should be another commercial success story for Vertex by 2030. The drug could be gaining momentum in treating two kidney diseases by then – IgA nephropathy and primary membranous nephropathy. These two indications affect a combined 450,000 patients in the U.S. and Europe. That's more than four times larger than the global CF patient population.
Speaking of kidney diseases, Vertex could have another blockbuster drug on its hands with inaxaplin. This late-stage program targets APOL1-mediated kidney disease, which affects around 250,000 patients.
Investors are always forward-looking. Vertex's pipeline prospects five years from now will be key to its valuation, just as they are today. I wouldn't be surprised if povetacicept is well on its way toward securing approvals for other indications.
The big biotech company will almost certainly have other promising programs in late-stage testing by then as well. Top candidates include painful diabetic peripheral neuropathy therapy VX-993, myotonic dystrophy type 1 therapy VX-670, and CF messenger RNA therapy VX-522, which Vertex is developing in collaboration with Moderna (MRNA +1.05%).

NASDAQ: VRTX
Key Data Points
A prediction
How big might Vertex Pharmaceuticals be five years from now? There's no way to know for sure, but I have a prediction.
Vertex's market cap currently hovers around $109 billion. I predict the company will be worth at least $250 billion by the end of 2030 – and possibly significantly more. The biotech innovator could even rank among the world's 10 largest healthcare companies based on market cap.
Granted, Vertex needs some pipeline successes to make this happen. I think it will get them. To be sure, there's always a possibility that experimental drugs flop in clinical testing. However, Vertex has enough late-stage programs that achieved great results in early stage trials that its chances of reaching a market cap of $250 billion or more over the next five years look pretty good.
Vertex could also use some of its growing cash stockpile to fund additional acquisitions. A smart deal or two could enable the stock to skyrocket even if it experiences a clinical setback.