In April 2021, following the NMPA’s approval of semaglutide injection for type 2 diabetes in adults, the drug’s commercial journey in China officially began.

Bolstered by Musk’s celebrity endorsement and the weight-loss craze, semaglutide enjoyed a phenomenal “high start” in China. Financial reports show semaglutide sales in China hit DKK 4.821 billion in 2023, surging more than 119% from DKK 2.196 billion in 2022.

But Novo Nordisk’s traditionally conservative approach soon put semaglutide at a disadvantage in China.

In June 2024, the weight-loss version of semaglutide (Nuoyingying) was approved in China for obese patients with BMI ≥30 or overweight patients with BMI ≥27 and weight-related comorbidities. Once again, Novo Nordisk seized an early market advantage.

Logically, the narrative should have shifted—from a serious prescription drug to the broader consumer healthcare market, given that weight management was the key concept driving GLP-1’s explosive popularity. Yet Novo Nordisk clung to its traditional mindset, keeping hospital channels as its main battleground and underestimating e-commerce.

According to the 2025 Weight Management Blue Book released by CIConsulting, the diagnosis rate of obesity in China is currently below 40%. In other words, most overweight people do not visit hospitals for diagnosis and prescriptions; they are far more active in the off-hospital market.

Reportedly, the head of the health division at a major e-commerce platform once “flew personally to Novo Nordisk’s overseas headquarters” to persuade the company to list its products. Novo Nordisk only struck a strategic partnership with JD Health in April 2025—four years after the approval of semaglutide’s diabetes indication and nearly one year after its weight-loss indication. This misaligned strategy caused Novo Nordisk to miss its market window.

In contrast, Novo Nordisk’s rivals, especially domestic pharmaceutical companies, have placed far greater emphasis on e-commerce channels.

The most prominent example is Innovent Biologics. On June 27, 2025, mazdutide (Xin’erme) was launched, indicated for long-term weight control in adults with obesity or overweight. It became the world’s first approved GLP-1/GCG dual-receptor agonist for weight management.

In July of the same year, Innovent announced a partnership with JD Health to sell mazdutide on the e-commerce platform. Reports indicate that within a month, more than 6,000 doses were sold on JD Health, demonstrating exceptional market enthusiasm and rapid volume ramp-up.

A recent Jefferies report estimates that in 2025, sales of semaglutide for weight loss on Alibaba’s Tmall and JD platforms reached approximately RMB 260 million, while sales of Innovent’s mazdutide are projected to exceed RMB 400 million.

China International Securities (CIS) forecasts that mazdutide sales will reach RMB 720 million, RMB 1.98 billion, and RMB 2.98 billion in 2025, 2026, and 2027, respectively.

Yinno Pharmaceutical has also made e-commerce a key sales channel. In January 2025, Yinno’s ultra-long-acting GLP-1 drug isupeglutide alpha (Yinuoqing) was approved by the NMPA for the treatment of type 2 diabetes (T2D) in adults. Just one month later, it debuted on JD Health, and its sales exceeded RMB 50 million within approximately four months of launch.

With the expiration of its core patent, semaglutide in China is about to face a tidal wave of biosimilars.

By the end of 2025, marketing applications for semaglutide biosimilars from 10 companies had been accepted by the NMPA, including Jiuyuan Gene, Livzon Group, Huadong Medicine, Qilu Pharmaceutical, United Laboratories, Huisheng Biologics, CSPC Pharmaceutical Group, Chengdu Beite, Fosun Wanbang, and Chia Tai Tianqing. In addition, nearly 20 more biosimilars are in clinical stages.

The entry of generics will inevitably trigger a price earthquake.

Goldman Sachs previously predicted that generic launches could reduce semaglutide prices in China by around 25%. However, given the price wars already underway, this estimate may prove conservative.

Before generics even enter the market, the originator has already cut prices first.

On e-commerce platforms, the diabetes version Ozempic (1.34 mg/ml × 1.5 ml) has recently dropped to around RMB 360 per box, while the 1.34 mg/ml × 3 ml version ranges from RMB 589 to 800. This represents a notable decline from its 2021 reimbursement price: RMB 478.8 for the 1.5 ml version and RMB 813.968 for the 3 ml version, while e-commerce prices at that time were generally higher—around RMB 600 for 1.5 ml and RMB 1,000 for 3 ml.

Prices for the weight-loss version Wegovy have also diverged by dose, from a starting dose of 0.25 mg to a maximum of 2.4 mg, ranging from roughly RMB 185 to 900—a sharp drop from launch. At introduction, Wegovy 1.5 ml (0.68 mg/ml, 0.25 mg/dose × 4) cost RMB 1,396; 3 ml (2.27 mg/ml, 1.7 mg/dose × 4) cost RMB 2,126; and 3 ml (3.2 mg/ml, 2.4 mg × 4) cost RMB 2,706.

As Novo Nordisk’s fated rival, Eli Lilly’s tirzepatide (Mounjaro, Mufengda) has also cut prices.

In 2024, Lilly’s GLP-1/GIP dual-agonist tirzepatide received successive approvals in China for diabetes and weight loss. At launch, the monthly hospital cost for the 2.5 mg*4 formulation was about RMB 1,700–1,800, with off-hospital retail and e-commerce slightly higher at RMB 1,800–2,000+. Today, on one e-commerce platform, the 2.4 ml:10 mg strength has dropped to a minimum of RMB 438.

With semaglutide generics poised for launch, a new round of price cuts may have only just begun. Jishi Pharmaceutical, one of the domestic firms actively developing semaglutide generics, stated in an interview: “We expect prices to drop to around RMB 200 after domestic launches, with some formulations possibly falling to RMB 100–200.”

Notably, penetration of weight-loss drugs in China remains low. Lower prices may instead unlock this underdeveloped market.

Patent expiration is only the first hurdle semaglutide faces in China. What truly troubles Novo Nordisk is the next generation of products on the way—oral small molecules, ultra-long-acting formulations, dual agonists, and even triple agonists are lining up for launch. This is a generational battle.

In late 2025, Novo Nordisk’s oral version of Wegovy was approved by the FDA, becoming the world’s first oral GLP-1 receptor agonist for weight management. But Lilly followed closely, filing its small-molecule GLP-1R agonist orforglipron with the FDA at nearly the same time.

More critically, this January, Lilly submitted orforglipron for marketing approval in China ahead of Novo Nordisk.

Unlike Novo Nordisk’s peptide approach, Lilly has chosen a small-molecule synthetic route for oral formulations, which may offer advantages in manufacturing and cost control. Furthermore, orforglipron has fewer usage restrictions than oral Wegovy.

In September 2025, Lilly released head-to-head results comparing orforglipron with oral Wegovy. In patients with type 2 diabetes, orforglipron outperformed its rival in both glycemic control and weight loss.

On the core glycemic indicator, the highest-dose orforglipron group achieved a 2.2% reduction in HbA1c, compared with 1.4% for the top-dose oral Wegovy.

For weight loss:

• The 12 mg orforglipron group achieved a mean weight reduction of 6.7% (6.6 kg);
• The highest 36 mg group achieved 9.2% (8.9 kg);
• By comparison, the top oral Wegovy dose (14 mg) resulted in 5.0 kg (5.3%).

Novo Nordisk’s next-generation weight-loss product, CagriSema—a fixed-dose combination of semaglutide and the long-acting amylin receptor agonist cagrilintide—released Phase III results last month.

Among patients who completed treatment, the CagriSema group achieved 23.0% weight reduction, versus 25.5% for tirzepatide (15 mg). Overall, CagriSema showed 20.2% weight loss, lower than tirzepatide’s 23.6%.

Not only did it fail to surpass tirzepatide, but Lilly’s next-generation triple agonist (GLP-1/GIP/GCG) retatrutide is already advancing. Although retatrutide has not yet been filed in China, it has raised the weight-loss competition to a new dimension.

Its published Phase III (TRIUMPH-4) data show:

• 9 mg dose: mean weight reduction of 26.4% (29.1 kg);
• 12 mg dose: mean weight reduction of 28.7% (32.3 kg).

In 2025, Novo Nordisk acquired rights to UBT251, a GLP-1/GIP/GCG triple agonist, from United Laboratories for USD 2 billion.

On February 24, Novo Nordisk released top-line Phase II results for UBT251 in a Chinese population. Data showed that after 24 weeks of treatment, the highest-dose UBT251 group achieved a mean weight reduction of 19.7% (17.5 kg).

For comparison, Lilly’s retatrutide Phase II data showed a mean weight reduction of 17.5% at 24 weeks for the highest dose, reaching 24.2% at 48 weeks. Although not a head-to-head trial, UBT251’s weight-loss magnitude in the same period shows competitiveness, and follow-up data deserve continued attention.

In the dual/multi-target space, domestic players are also mounting a full-scale pursuit.

• Hengrui Medicine’s GLP-1/GIP dual agonist HRS9531 filed for marketing approval in September 2025, with Phase III data showing a maximum mean weight loss of 19.2% at 48 weeks.
• On March 7, Hansoh Pharma announced that its GLP-1/GIP dual agonist olepeglutide (HS-20094) met its primary endpoint in its first Phase III study. At 48 weeks, olepeglutide achieved a mean maximum weight reduction of 19.3% from baseline, with up to 97.2% of patients achieving ≥5% weight loss.

In ultra-long-acting formulations, Zitai Biologics’ zoveglucotide (ZT002) injection is undergoing Phase III weight-loss trials in China (HORIZON-1), with the potential to become the world’s first once-monthly GLP-1 drug on the market. Its Phase II data showed weight reduction of up to 13.8% at 24 weeks with no plateau, and a near-zero discontinuation rate due to gastrointestinal adverse events.

China has undoubtedly become the world’s largest GLP-1 R&D hub. More than 100 GLP-1 drugs are in global clinical development, nearly half from Chinese companies.

Patent expiration is never an end, but a starting point for reshuffling. For China’s GLP-1 market, the outcome of this battle no longer hinges on a single product, but on who can truly address consumers’ core demands: balancing efficacy and safety, ensuring convenient administration, and enabling sustainable long-term weight management.

Amid intensifying price wars, accelerating technological iteration, and the rise of domestic innovation, Novo Nordisk may lose more than just a patent—it may lose the discourse power of an era.