Taipei, Taiwan – Ozempic is big business in China.
Last year, the Danish pharmaceutical giant Novo Nordisk doubled its sales of the diabetes drug in the country to almost $700m – 5 percent of Ozempic’s global sales.
Ozempic was approved in China to treat diabetes in 2021, but it has been its anti-obesity ingredient, semaglutide, that has fuelled demand for what many Chinese refer to as the “internet celebrity weight-loss drug”.
Chinese female influencers and vloggers have promoted the use of Ozempic on Chinese social media.
The same platforms are also the birthplace of a number of “beauty challenges” that have gained traction over the years where mostly young females display their thinness.
“Overall, ‘thinness’ is the beauty standard for women in China, and some are even willing to demonstrate it and pursue it to the detriment of their health,” Pan Wang, a senior lecturer in Chinese and Asian studies at Australia’s University of New South Wales, told Al Jazeera.
For Wang, the surging demand for Ozempic is no surprise.
“Many people in China are willing to try all kinds of methods and supplements to lose weight these days,” she said.
Those desperate to lose weight at almost any cost are not limited to young, beauty-conscious women on social media.
China has the largest number of overweight or obese people in the world, with about half the population carrying excess weight.
Rising rates of obesity, combined with demanding beauty ideals, make the Chinese market an enticing prospect for the makers of drugs like Ozempic, Wang said.
“There is potential for a lot of money to be made.”
Pharmaceutical companies have not been sitting idle.
Novo Nordisk has applied to China’s drug regulator to expand the use of Ozempic amid speculation it hopes to gain approval to market the drug specifically for weight loss.
The company expects its drug Wegovy, which is explicitly intended for weight loss, to be approved for sale in China this year.
In May, Indianapolis, Indiana-based pharmaceutical company Eli Lilly received approval from Chinese regulators for its Ozempic rival, Tirzepatide.
China’s Hangzhou Jiuyuan Gene Engineering, owned by pharmaceutical behemoth Huadong Medicine, earlier this year applied for approval to sell the first homegrown rival to Ozempic.
Despite these developments, the demand for weight-loss drugs has outstripped supply, with Eli Lilly expecting demand to outpace supply in 2024, as well.
On Chinese e-commerce platforms like Taobao, the price of Ozempic has risen as high as 1,000 yuan ($138), twice the cost of the same drug at a public hospital.
While established companies are working with Chinese health authorities to increase supply, the sale of counterfeit versions of semaglutide products has surged on the Chinese internet.
“The grey market for weight-loss drugs has been booming in China,” Allan Von Mehren, chief analyst and China economist at Danske Bank, told Al Jazeera.
“Weight-loss drugs fall within a market with massive growth potential in China.”
Von Mehren said the rising demand means that competition between suppliers will not be a major obstacle in the coming years.
“Instead, the limitation right now is the capacity,” he said.
“Whoever can invest in capacity and dominate capacity will probably be the ones that eventually claim the biggest slice of the market.”
Von Mehren said state intervention and regulation will be decisive in determining who will build capacity and who will be left out of the market in the near future.
“Until recently, the market has been like the Wild West,” he said.
People in China have been able to buy Ozempic without a prescription, with rising off-label use of the drug limiting its availability for diabetics.
But since last year, the Chinese authorities have stepped in.
In February of last year, censors removed more than 5,000 posts from the social media platform Xiaohongshu about weight-loss experiences attributed to Ozempic.
In March last year, police investigations into the development and sale of unregulated semaglutide products ended in a number of arrests and convictions.
Last month, six people were prosecuted for selling weight-loss chocolates containing banned substances after a child who consumed some of them ended up in the hospital.
“As new drugs are approved for the Chinese market, we will likely see the Chinese authorities increasing their involvement compared to when Ozempic was initially released,” Von Mehren said.
While Western products currently dominate the market for weight-loss drugs in China, more state intervention could change this.
Already, Novo Nordisk is engaged in a patent dispute initiated by Huadong Medicine – the pharmaceutical behemoth seeking to launch a Chinese rival to Ozempic.
In 2021, Huadong Medicine applied to China’s State Intellectual Property Office arguing that Novo Nordisk’s patent for semaglutide in China – valid until 2026 – should be invalidated.
The patent was invalidated the next year, but Novo appealed the decision, and the patent office has yet to make a final determination.
“Unless the competent court finally decides this patent is invalid, we will not be able to commercialise JY29-2 [the drug similar to Ozempic] before the expiration of the patent,” Huadong Medicine’s affiliate said in January.
If Novo’s patent is invalidated, it could lift the supply of weight-loss drugs in China as more Chinese companies seek to launch their own Ozempic equivalents.
On the other hand, foreign firms have long expressed concerns about Chinese companies enjoying preferential treatment in their home market.
At the World Economic Forum in Davos in January, Chinese Premier Li Qiang sought to assuage such concerns, saying “China is open for business”, and that there is plenty of “potential for foreign investment”.
“Do they still primarily favour their own companies? Or are they willing to level the playing field to accommodate foreign firms?” Von Mehren said.
“The patent dispute and the Chinese authorities’ involvement in the weight-loss market can be a small test of that.”
