The golden age of GLP‑1 is over — high prices won’t drive growth anymore

A market once fuelled by runaway pricing is recalibrating

The runaway, high‑price era for GLP‑1 weight‑loss drugs has run its course. Semaglutide’s (司美格鲁肽) core compound patent in China reportedly expired on March 20, and with generics and competing molecules already rolling out, the days when a single injectable blockbuster could sustain explosive top‑line growth look to be ending. That does not mean the opportunity is gone. China’s penetration of GLP‑1s remains relatively low, so lower prices will expand the user base — but growth rates, margins and valuation models that assumed premium pricing need to be revised.

US price war set the template — China will be harsher

The recent duel between Novo Nordisk (诺和诺德) and Eli Lilly (礼来) in the US showed how quickly payors can blunt a high‑price winner. It has been reported that CVS will exclude Lilly’s Zepbound (tirzepatide, 替尔泊肽) from its preferred list while keeping Wegovy (semaglutide, 司美格鲁肽), and multiple headline price cuts have been announced or reported for Wegovy, Ozempic, Zepbound and several oral GLP‑1 launches. Truveta prescription data show that GLP‑1 prescription growth slowed markedly in late 2025 — overall growth of 5% with semaglutide nearly flat and tirzepatide the main growth driver — and first‑prescription rates have fallen, indicating demand elasticity and payor pushback. Who pays matters as much as what works.

China: faster, deeper cuts and a different playbook

China’s pricing mechanics magnify this shift. The country’s two‑track model — national reimbursement (医保) versus out‑of‑pocket — plus the lack of US‑style PBMs means negotiated cuts bite harder and faster. Semaglutide was already subjected to steep price drops after China’s 2021 and 2023 national reimbursement talks; it has been reported that tirzepatide entered China’s reimbursement list in 2026 with comparable, >50% cuts from list prices. At the same time, a wave of domestic copies is advancing: Jiuyuan (九源), Livzon Pharmaceutical (丽珠医药), Qilu Pharmaceutical (齐鲁制药), Lianbang Pharmaceutical (联邦制药) and Huadong Medicine (华东医药) have semaglutide filings in review, and their entry will intensify the 2026 price war.

New modalities, same race against time

Price competition will widen the market, but winners will be those who lower acquisition cost and broaden access. Oral GLP‑1 formulations and next‑generation approaches — including oral candidates like orforglipron (which reportedly shows superior weight‑loss in some comparisons) and a growing siRNA anti‑obesity pipeline — are already reshaping who the addressable users are. Early data for an oral Wegovy pill show a meaningful share of new users come from needle‑naïve patients, suggesting pills can expand demand. Still, efficacy, safety, cost and channel strategy will decide who survives when per‑patient revenue falls. The simple truth: the golden era of a single expensive injectable dominating the market is over. The race now is for scale at lower prices and for the next modality to capture the newly reachable mass market.