GLP-1 (Glucagon like peptide 1) receptor agonists, a commonly prescribed drug class in the treatment of type 2 diabetes (T2D), successfully mimic a natural gut hormone, increasing production of insulin in the human body. While initially developed to help regulate blood sugar levels, they have also been found to promote appetite suppression, leading to weight loss in patients. Per recent Clarivate estimates, the therapeutic market for these drugs is valued at approximately $1.7 billion1 in 2023 in Mainland China, largely due to the recent success of semaglutide (Novo Nordisk’s Ozempic) in the country.
While the drug has been on the mainland China market since 2021, its recent success can be attributed to the growing enthusiasm towards GLP-1 drugs that offer promising weight loss benefits.
Mainland China is at the forefront of the GLP-1 revolution
Mainland China presents an enormous commercial opportunity for drug developers in this space, as the total number of people living with T2D and obesity is the highest anywhere in the world. Clarivate epidemiological forecasts forecast the total obese population in the country to exceed 500 million2 by 2033, suggesting a huge paradigm shift in the way the disease is currently dealt with. With only two3 GLP-1 drugs currently approved for weight loss—Huadong Medicine’s version of daily dosed liraglutide and thrice-a-day dosed beinaglutide from Benamae Pharma—the gap is substantial and leaves a solid market opportunity for weight loss drugs.
What’s leading to the boom in development of semaglutide biosimilars?
A nationwide obesity problem is at the heart of semaglutide biosimilar development in Mainland China. Hangzhou Jiuyuan Gene Engineering (owned by Huadong Medicine) is expected to be the first domestic manufacturer to secure approval for their version of the drug once semaglutide goes off-patent in 20264 in Mainland China. The company filed for marketing approval of their semaglutide biosimilar for the treatment of T2D with the National Medical Products Administration (NMPA) in April 2024, and this is expected to amplify clinical development of semaglutide biosimilars from domestic manufacturers in the next two to three years.
A crowded semaglutide biosimilars pipeline is shaping up in Mainland China
*Biosimilars of semaglutide include both T2D and obesity patient segments (April 2024)
Source: Clarivate Cortellis
In a three-way battle, will price beat innovation?
Competition is expected to intensify in the next few years as both Novo Nordisk and Eli Lilly plan to launch their respective weight-loss drugs in Mainland China. While Wegovy® (Novo Nordisk) carries the same chemical compound semaglutide for weight loss, Lilly is expected to gain market approval on tirzepatide (Mounjaro® for T2D / Zepbound® for obesity) soon. Innovent Biologics, a domestic manufacturer, is currently evaluating its anti-diabetic and weight-loss GLP-1 drug, mazdutide, in a phase 3 trial in Mainland China, backed by Eli Lilly. Robust clinical data around multiple cardiometabolic indicators supported by all three assets is poised to lead widespread adoption in Mainland China. However, availability of cost-effective biosimilars of semaglutide starting 2026 is likely to influence patient perception of the drug in a price-sensitive Chinese market, especially for obese patients in the absence of reimbursement for weight loss drugs.
Centralized drug procurement – will the NHSA challenge semaglutide’s status quo?
The last time Novo Nordisk went for centralized drug procurement to get its insulins included in round 6 of Mainland China’s Value Based Pricing regimen, most long-acting and rapid-acting insulins were given substantial price cuts, impacting the sales of a solid billion-dollar segment in Mainland China. With biosimilars of semaglutide lined up for approval and launch, and with Ozempic inching closer to achieving blockbuster status, the NHSA will endeavor to initiate centralized drug procurement for semaglutide biosimilars. While this would warrant a price cut for the manufacturers, patients will eventually get access to quality medicines at a reduced cost and with a guarantee of supply to the public medical institution network.
With the Mainland Chinese therapeutic market for weight loss drugs undergoing a significant expansion spearheaded both by multinationals and domestic manufacturers, many biopharmaceutical companies will seek to capitalize on this momentum to enter the market and compete for share. While domestic firms are well-positioned to succeed in their home territory, owing to lesser logistical challenges, multinationals developing and selling GLP-1 drugs continue to expand access in a market driven by brand loyalty and strong word of mouth, backed by superior clinical data.
References:
- China In-Depth: Type 2 Diabetes
- Clarivate Epidemiology
- China In-Depth: Obesity / Overweight
- Novo Nordisk 2023 annual report
For Clarivate in-depth analysis of Mainland China’s GLP-1 receptor agonists market, read our China In-Depth | Type 2 Diabetes and China In-Depth | Obesity / Overweight content. Contact us to learn more about the Mainland China healthcare market and disease-specific trends.
To learn more about key domestic and multinational company drugs launching into the Mainland China marketplace, please download our Drugs to Watch 2024 report.
