North America should continue to lead global pharmaceutical sales up to 2022, with $635 billion in revenue expected that year, drugmaker AstraZeneca said in a recently published outlook on the industry.

Worldwide, the report says growth rates will be driven by increasing revenue in developing markets over the five-year period ending in 2022. The Indian subcontinent should see a combined annual growth rate (CAGR) of 10%, followed by the Commonwealth of Independent States (CIS) with 8%, Latin America with 7.8% and Africa with 7.3%.

In established markets, North America is expected to again show significant sales growth, averaging 6.4% over the period, according to the forecast. This will be fueled by access to high-value drugs, healthcare awareness and – in the US –high per capita expenditure on healthcare, along with the region’s strong GDP growth.

The EU drugs sector is projected to generate revenues of $280 billion by 2022, with Southeast and East Asia posting around $206 billion.

Astra Zeneca says sales growth in growth in Asia Pacific is being enhanced by the increasing affordability of drugs and low-priced generics, as well as the rise of GDP per capita in the region and government initiatives to support healthcare and rapid urbanization.

The report sees market growth in China remaining below historical levels with a 4.9% CAGR expected during the period up to 2022, reflecting a continuing slowdown in the major hospital sector.

On the brighter side for drugmakers, strong growth is forecast for China’s cancer, cardiovascular and respiratory drug markets, due to what is described as “the disease burden in the Chinese population.”

Among individual countries, the US, China, Japan, Germany and France led the world pharmaceutical sales market in 2018, with the US, at 47.2%, accounting for nearly half.

The global pharmaceutical market was worth $934.8 billion in 2017, according to a calculation by the global investment banking boutique Torreya, and is expected to triple in size by 2060 on an inflation-adjusted basis.