By Alex Rivera, Unicorn Analytics
China’s GLP-1 space is changing fast. A few years ago it felt like a hot, supply-constrained market. Now you’ve got a wave of new approvals, insurance negotiations heating up, and patents starting to expire. Prices are already under pressure. The question is whether we’ll see the same kind of brutal, one-time cuts that insulin went through.
Short answer: not right away. Longer term? Probably something that looks a lot more like a slow squeeze.
**What happened with insulin**
Back in 2021 China did a big national volume-based procurement for insulin. Average price drop was around 48%. Both foreign and domestic makers took hits. Hospitals promised volume, companies cut prices to get the contracts. It worked because insulin was already a mature, highly substitutable market with clear efficacy standards and plenty of manufacturing capacity.
Later rounds showed the system isn’t pure race-to-the-bottom either. Some products that bid too low earlier got price bumps in the renewal. Policymakers started caring more about supply stability. So the lesson is: insurance will crush excess margins, but they also don’t want the market to collapse.
**Why GLP-1 is different (for now)**
GLP-1s are still innovating. You’ve got single-target, dual-target (GLP-1/GIP, GLP-1/GCG), and even triple agonists. Indications go beyond diabetes into obesity, heart risk, fatty liver, sleep apnea. Weight loss results, side effects, dosing frequency, and hard outcome data all still matter. They’re not fully interchangeable commodities yet.
But price pressure is already here. Domestic players are launching, and the basic semaglutide patent in China expired in March 2026. Novo and Lilly have already cut list prices on some weight-loss formulations — high-dose Wegovy dropped about 48% in certain provinces. That wasn’t a government tender. They did it themselves to protect share.
So you’re probably looking at three overlapping layers of pressure:
1. Insurance negotiation on the diabetes indication (lower price for hospital access and reimbursement)
2. Self-pay obesity market (brand + efficacy + retail competition)
3. Real volume-based procurement only once patents are gone and there are lots of near-identical molecules
**PegBio’s PB-119 as an example**
PegBio(02565.HK)’s visepegenatide (PB-119) got approved in late 2025 for type 2 diabetes. Once-weekly, domestic Class 1 drug. They highlight PEGylation, no titration, and some metabolic benefits beyond glucose. It cleared the preliminary review for possible National Reimbursement Drug List inclusion in 2026, but final listing and price are still open.
Getting on the reimbursement list would mean more volume, but almost certainly at a lower price. Their IP helps against direct copies, but it doesn’t stop semaglutide, tirzepatide, mazdutide or other domestic GLP-1s from being treated as alternatives in negotiations. Obesity data and stronger cardiovascular outcomes are still missing, which limits leverage.
**Bottom line**
Don’t expect a sudden 50% average cut like insulin. Expect a longer grind: competing launches and patent cliffs first, then insurance linking price more tightly to clinical value. The companies that hold up better will be the ones that can actually differentiate — new indications, better data, lower costs, or stronger commercial execution — not just the ones that happen to have a GLP-1 asset.
Curious what others think. Anyone following the Chinese GLP-1 names closely?