Taipei, Taiwan – Ozempic is big business in China.
Last year, Danish pharmaceutical giant Novo Nordisk doubled its sales of diabetes drugs in the country to about $700 million, or 5% of Ozempic’s global sales.
Ozempic was approved in China in 2021 as a diabetes treatment, but it was its anti-obesity ingredient, semaglutide, that spurred demand for the drug, which many Chinese call the “internet celebrity weight loss drug.”
Chinese female influencers and bloggers have been promoting the use of Ozempic on Chinese social media.
The same platform is also home to a number of “beauty challenges” that have been popular over the years, with mostly young women showing off their skinny figures.
“Overall, thinness is a beauty standard for women in China, and some will flaunt it and even risk their health to achieve it,” Pan Wang, a senior lecturer in Chinese and Asian studies at the University of New South Wales in Australia, told Al Jazeera.
For Wang, the surge in demand for Ozempic isn’t a surprise.
“These days, a lot of people in China are trying all kinds of methods and supplements to lose weight,” she said.
The desire to lose weight at all costs is not limited to young, beauty-conscious women on social media.
China has the highest number of overweight or obese people in the world, with about half of the population being overweight.
Rising obesity rates combined with stricter beauty ideals make the Chinese market attractive for drug makers like Ozempic, Wang said.
“There’s potential to make a lot of money.”
Pharmaceutical companies were not sitting idly by either.
Novo Nordisk has applied to China’s drug regulator for expanded use of Ozempic, amid growing speculation it is seeking marketing approval for the drug as a focused weight-loss treatment.
The company hopes that its drug, Wegovy, explicitly for weight loss, will be approved for sale in China this year.
In May, Indianapolis, Indiana-based pharmaceutical company Eli Lilly received approval from Chinese regulators for Tirzepatide, a rival to Ozempic.
China’s Hangzhou Jiuyuan Genetic Engineering, owned by pharmaceutical giant East China Pharmaceutical, applied for marketing approval for the first domestically produced rival to Ozempic earlier this year.
Despite these developments, demand for weight-loss drugs continues to outstrip supply, and Eli Lilly expects demand to continue to outstrip supply in 2024.
On Chinese e-commerce platforms such as Taobao, the price of Ozempic has risen to as much as 1,000 yuan ($138), double the price of the same drug at public hospitals.
While major companies are working with Chinese health authorities to increase supply, sales of counterfeit semaglutide products have skyrocketed on the Chinese internet.
“The grey market for weight loss drugs is booming in China,” Alan von Mehren, lead analyst and China economist at Danske Bank, told Al Jazeera.
“Weight loss drugs are a market with huge growth potential in China.”
Von Mehren said rising demand meant competition between suppliers would not be a major obstacle over the next few years.
“Rather, the limitation right now is capacity,” he said.
“Those who can invest in capacity and control capacity will probably end up capturing the lion’s share of the market.”
Von Mehren said state intervention and regulation will be crucial in determining who builds capacity and who is left out of the market in the near future.
“Until recently, the market was kind of a lawless place,” he said.
Ozempic is available without a prescription in China, but increasing off-label use has limited its availability to diabetes patients.
But starting last year, Chinese authorities have intervened.
Last February, censors removed more than 5,000 posts about people’s weight-loss experiences with Ozempic from the social media platform Little Red Book.
Last March, a police investigation into the development and sale of unregulated semaglutide products ended with a number of arrests and convictions.
Last month, six people were charged with selling diet chocolate that contained banned substances after children were rushed to hospital after ingesting them.
“As new drugs are approved in the Chinese market, we are likely to see greater involvement from Chinese authorities than when Ozempic was first launched,” von Mehren said.
Currently, China’s weight-loss drug market is dominated by Western products, but that could change with greater government intervention.
Novo Nordisk is already embroiled in a patent dispute brought by pharmaceutical giant China East Pharmaceuticals, which is seeking to launch a Chinese rival to Ozempic.
In 2021, East China Pharmaceutical filed a petition with the China National Intellectual Property Office to invalidate Novo Nordisk’s China patent for semaglutide, which is valid until 2026.
The patent was invalidated the following year, but Novo has appealed the decision and the Patent Office has yet to make a final decision.
“Unless and until a court of competent jurisdiction conclusively determines that this patent is invalid, JY29-2 cannot be commercialized. [the drug similar to Ozempic] “Before the patent expires,” an affiliate of East China Pharmaceuticals said in January.
If Novo’s patent is invalidated, the supply of weight-loss drugs in China could increase as more Chinese companies try to launch their own versions of Ozempic.
Meanwhile, foreign companies have long expressed concern about the preferential treatment given to Chinese companies in their home markets.
Chinese Premier Li Qiang tried to ease those concerns at the World Economic Forum in Davos in January, saying “China is open for business” and “there is plenty of potential for foreign investment.”
“Are they still prioritizing their own companies? Or are they ready to level the playing field to favour foreign companies?” von Mehren said.
“Patent disputes and Chinese authorities’ involvement in the weight loss market could be a small test of that.”
