Making predictions about how stocks will perform is easy. Predicting with any significant degree of accuracy, on the other hand, is extremely hard.

I think that's especially true with biotech stocks. It's impossible to know which pipeline programs will flop or succeed beyond investors' wildest dreams. Despite these obstacles, I'm going to step out on a limb and make a prediction: These could be the best-performing biotech stocks through 2030, listed alphabetically and limited to biotech stocks that already have market caps of at least $5 billion.

1. Moderna

You might be surprised to see Moderna (MRNA 0.40%) on my list. Its share price has plunged over 30% this year. Moderna is roughly 86% below its peak set in 2021. However, I think this beaten-down biotech stock could realistically be one of the biggest winners through the rest of the decade.

Moderna won U.S. Food and Drug Administration (FDA) approval of respiratory syncytial virus (RSV) vaccine mResvia for adults ages 60 and older on May 31, 2024. This vaccine could generate peak annual sales in the ballpark of $1.5 billion.

The company hopes to win 10 product approvals through 2027. It expects to file for approvals of three of them in this year alone: a next-generation COVID-19 vaccine, a combination flu/COVID vaccine, and an RSV vaccine for adults ages 18 to 59. I think the combo flu/COVID vaccine could especially be a big hit for Moderna with Pfizer's combo vaccine failing to achieve one of its primary endpoints in a phase 3 study.

Beyond these programs, I'm most excited about the prospects for Moderna's cytomegalovirus (CMV) vaccine mRNA-1647 and its cancer vaccine mRNA-4157. Results from a late-stage study of mRNA-1647 are expected as early as the end of this year. Moderna and Merck are evaluating mRNA-4157 in phase 3 testing as an adjuvant treatment for melanoma in combination with Merck's blockbuster cancer immunotherapy Keytruda.

2. Vertex Pharmaceuticals

Vertex Pharmaceuticals (VRTX 0.60%) has so many potential growth drivers over the next few years that I hardly know where to begin. The big biotech built its success on the back of its cystic fibrosis (CF) franchise. It could soon have another powerful CF therapy on the market: The FDA set a PDUFA date of Jan. 2, 2025, for an approval decision on Vertex's vanzacaftor triple-drug combo.

The FDA should have more big news for Vertex only a few weeks later. It expects to announce an approval decision on suzetrigine in treating acute pain by Jan. 30, 2025. The drug could be a huge winner as a safe and effective non-opioid pain inhibitor.

Vertex could have two other potential blockbuster drugs on the market within the next few years. It's evaluating inaxaplin in a pivotal clinical study targeting APOL1-mediated kidney disease (AMKD). AMKD affects around 100,000 patients worldwide (more than CF). There are no approved therapy that treat the underlying cause of the disease. Another late-stage candidate, povetacicept, is advancing to a late-stage trial for treating IgA nephropathy, a kidney disease that affects roughly 130,000 patients in the U.S. alone.

Then there's the possible game-changer for Vertex. The company's pipeline features two programs in phase 1/2 clinical testing that hold the potential to cure type 1 diabetes. Clinical results so far have looked quite promising. It's not out of the question that by the end of the decade Vertex will be able to cure or at least be very close to curing a disease that impacts around 3.8 million people in North America and Europe.

3. Viking Therapeutics

Unlike Moderna and Vertex Pharmaceuticals, Viking Therapeutics (VKTX 0.78%) doesn't have any approved products on the market yet. I think it will be a much different story for Viking within the next few years, though.

The small biopharmaceutical company reported outstanding results from a phase 2 study of its experimental injectable obesity drug, VK2735. This program is advancing into phase 3 testing. Viking also expects to begin phase 2 testing of an oral version of VK2735 in the fourth quarter of 2024.

Another highly promising candidate could advance to late-stage studies soon after VK2735. Viking is scheduled to meet with the FDA for an end-of-phase-2 meeting in Q4 to discuss next steps for VK2809. The experimental drug holds considerable potential in treating nonalcoholic steatohepatitis, which is also known as metabolic-associated steatohepatitis.

These two programs alone could enable Viking to deliver explosive growth by the end of the decade. However, the company also has another candidate to keep your eyes on. It expects to report results from a phase 1b study of VK0214 in treating X-linked adrenoleukodystrophy later in 2024.