Will China's homegrown obesity drugs reshape the global weight-loss market?

Straits Times

4 days ago

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Mazdutide, China's first home-grown weight-loss drug, marks a turning point in the nation's effort to combat rising obesity with local innovation.
– For three weeks since mid-July, video editor Meng Meng, 38, has been injecting herself with a weekly weight-loss drug, hoping it will finally help her shed the weight she has long struggled with.
Standing at 163cm tall and weighing 70kg, the mother of one from Wuhan city has a body mass index (BMI) of 26, which classifies her as overweight under China's health guidelines.
Her doctor deemed her eligible for prescription weight-loss drugs and recommended that she use them for six months to a year to reach her ideal weight of 60kg.
The drug she is taking is not the well-known Danish drug Ozempic but a newly approved Chinese one called mazdutide,
developed by Suzhou-based biopharmaceutical firm Innovent Biologics . The Chinese company licensed the rights to mazdutide for use in Greater China from patent holder Eli Lilly, an American pharmaceutical company.
'I know of colleagues who use Ozempic but I've not considered it because it's a foreign brand,' said Meng Meng, who did not want to be identified by her full name due to privacy concerns. 'So when mazdutide became available, I thought I would try it as I trust that China's domestic drugs are reliable.'
She has lost 2kg in three weeks, she said.
China's first home-grown weight-loss drug, which received regulatory approval in late June, marks a turning point in the nation's effort to combat rising obesity with local innovation.
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Backed by a nationwide anti-obesity campaign and growing research and development firepower, China's drugmakers are racing to roll out cheaper or more innovative alternatives that are poised to challenge the dominance of Western blockbusters such as Ozempic and Wegovy at home and potentially abroad.
A looming patent expiry for semaglutide, the key drug in Ozempic and Wegovy, in China will open the door for Chinese drugmakers to launch biosimilar versions – or near-identical copies of the original drug – and carve out a share of the fast-growing global weight-loss market.
In the battle of the bulge, Innovent's mazdutide is just the start.
In China, at least 98 glucagon-like peptide-1 (GLP-1) drugs for weight loss are currently in late-stage trials, of which 52 are considered to be innovative molecules or formulations such as oral pills, unlike existing pre-filled injection pens, said Ms Helen Chen, global sector co-head for healthcare at LEK Consulting, based in Shanghai, citing an analysis done by her firm in June.
Of the 98 drugs, 20 are semaglutide injections, which put them in direct competition with Ozempic and Wegovy.
'Chinese biopharmas are excellent fast followers. I would not really be surprised that there are Chinese products in the race for any hot new trend in drug development,' said Ms Chen, who is also a Greater China managing partner at the consulting firm.
Already, Novo Nordisk, the Danish drugmaker behind Ozempic and Wegovy, has sounded the alarm.
Once Europe's most valuable company worth US$650 billion (S$835 billion) in 2024, Novo on Aug 6 warned of far slower growth as copycat versions of its popular drugs enter the market. It had earlier cut its full-year sales and profit forecasts.
The company's blockbuster drugs – Ozempic, approved in 2017 for type 2 diabetes, and Wegovy, a higher-dose version marketed specifically for weight loss launched in 2021 – contain semaglutide, an active ingredient that mimics the natural hormone GLP-1, to regulate blood sugar and suppress appetite.
In recent years, they have gained global attention for their ability to help users lose considerable amounts of weight.
US drugmaker Eli Lilly, which makes competing GLP-1 drugs Mounjaro and Zepbound – the brand names for tirzepatide, which is also used for weight loss – is likewise feeling the heat.
Its next big bet is orforglipron, an experimental daily oral GLP-1 pill seen as its up-and-coming blockbuster weight-loss drug. But on Aug 7, the company's shares took a tumble after it reported less-than-stellar weight-loss results that fell below what some analysts were predicting.
Come March 2026, competition will intensify even more when the patent for semaglutide in China is set to expire, years ahead of the patent's expiry in the United States in 2031, and Europe in 2033.
Internal medicine physician Ni Jun from Raffles Hospital Shanghai said Chinese pharmaceutical firms may start launching generic or biosimilar versions, which would then put pressure on all companies to lower prices as patients and doctors weigh their options.
For now, mazdutide, as a relatively new drug, is more expensive than Ozempic and Wegovy, but cheaper than Mounjaro. He estimated that mazdutide costs 3,000 yuan to 4,000 yuan per month compared with about 2,000 yuan for Wegovy, depending on the dosage.
'It usually takes about five to 10 years for prices of new drugs to come down. But China has a volume-based procurement system and a large number of eligible patients, so the cost may drop faster,' Dr Ni said.
Dr Yanzhong Huang, senior fellow for global health at American think-tank Council on Foreign Relations (CFR), called mazdutide's approval as China's first domestically developed GLP-1/glucagon 'a major breakthrough', reflecting China's progress and ambition in closing the biopharma innovation gap.
He noted that clinical trials have demonstrated the drug's efficacy, which 'rivals established Western treatments while offering additional metabolic advantages'.
'By reducing reliance on costly imports and enhancing affordability, it is particularly significant, given China's vast diabetes population and non-communicable disease burden,' said Dr Huang.
Non-communicable diseases, such as heart disease, asthma and diabetes, are chronic conditions that are not contagious. Being overweight or obese increases the risk of developing many of these conditions.
China considers those with a BMI of 24 to 27.9 as overweight, and over 28 as obese, as Chinese and other Asian populations tend to have higher health risks at lower BMI thresholds compared with Western populations. The World Health Organisation classifies as overweight those with a BMI of 25 to 29.9, and as obese those with more than 30.
China is waging a three-year war on obesity as waistlines expand and health risks rise. The country's overweight population has more than doubled since 1992 to more than 50 per cent of the population, with projections showing that two in three Chinese could be overweight by 2030.
In April 2025, Beijing upgraded its nationwide weight management campaign under the Healthy China 2030 initiative, calling obesity 'a major public health threat' to Chinese people.
Rapid urbanisation, high-calorie diets, sedentary lifestyles and rising stress have all contributed to the surge.
Worldwide, weight loss is becoming a big business. The global obesity drug market is projected to hit US$150 billion by 2035, up from US$15 billion in 2024, according to Morgan Stanley.
But China's path to becoming a global weight-loss drug powerhouse is not without barriers.
For one thing, mazdutide cannot yet be sold outside of China. Innovent holds only the Greater China rights, which it licensed from Eli Lilly in 2019. The US drugmaker controls international development, which limits global expansion unless new agreements are struck.
There are also regulatory hurdles abroad to overcome.
Dr Daniel J. Drucker, an endocrinologist at the University of Toronto, said that while there is enormous global demand for weight-loss drugs, each region and country has very specific regulatory and commercial environments guiding drug approval.
Still, he added: 'There are currently lots of opportunities for innovative Chinese science to fill the gaps in the development of new GLP-1 drugs. Let's see how this plays out.'
LEK's Ms Chen said she expects Chinese pharma to go international.
'Multiple Chinese innovative GLP-1s have already been licensed by big pharma, starting with UK-based AstraZeneca's licensing of Chinese firm Eccogene's oral GLP-1 in late 2023,' said Ms Chen. Others may work on regional licensing or explore expanding into markets such as South-east Asia directly or with partners, she said.
Looming over China's drug export prospects is the threat of steep US tariffs.
On Aug 5, US President Donald Trump said he will soon be putting an 'initially small tariff' on pharmaceutical imports, but in one year, or a maximum of one and a half years, may raise it to 150 per cent, and then to 250 per cent to force pharmaceutical production back to American soil.
Global pharma giants such as Eli Lilly and Merck & Co operate scores of manufacturing sites worldwide.
Nearly 90 per cent of US biotech companies rely on imported components for at least half of their approved products, according to the Biotechnology Innovation Organisation. China is a key player in that supply chain.
CFR's Dr Huang said Chinese firms are likely to set their sights on emerging markets such as South-east Asia, India, Latin America and Africa where regulatory hurdles are lower than in the US or Europe.
He drew parallels between China's current GLP-1 roll-out and its earlier push into insulin.
'For insulin, after patents on analogs like glargine expired, Chinese firms launched biosimilars at significantly lower prices,' Dr Huang said, adding that government bulk purchasing and insurance coverage helped drive domestic access and market share.
While global pharmaceutical giants still dominate the high-end market, Chinese companies have rapidly expanded their footprint.
Dr Huang said GLP-1 drugs are emerging 'as a new front in US-China biotech rivalry', given their vast market potential and global health significance.
'This surge, fuelled by China's vast patient base for clinical trials and cost advantages, mirrors the country's rapid ascent in artificial intelligence and has prompted US concerns about eroding biotech advantages,' he added.