--- title: "Star dual antibodies face dual pressure from medical insurance price cuts and entry of giants, is AKESO trapped in a life-and-death situation without monetization of its traffic?" type: "News" locale: "en" url: "https://longbridge.com/en/news/278895648.md" description: "Akeso is facing dual pressures from price reductions in medical insurance and intensified competition. The target price for its core product, Ivosidenib, has been lowered by Nomura Orient International Securities by 7% to HKD 112.73. It is expected that the drug sales will reach RMB 1.8 billion in the second half of 2025, but the overall profit performance is relatively weak. Ivosidenib has shown excellent performance in clinical studies, having previously outperformed Pembrolizumab, but is currently facing challenges due to factors such as medical insurance negotiations and sales volume not meeting expectations" datetime: "2026-03-12T13:24:08.000Z" locales: - [zh-CN](https://longbridge.com/zh-CN/news/278895648.md) - [en](https://longbridge.com/en/news/278895648.md) - [zh-HK](https://longbridge.com/zh-HK/news/278895648.md) --- # Star dual antibodies face dual pressure from medical insurance price cuts and entry of giants, is AKESO trapped in a life-and-death situation without monetization of its traffic? This report (chinatimes.net.cn) reporter Zhang Siwen and Yu Na reported from Beijing Once hailed as the "benchmark" for domestic innovative drugs, AKESO (stock code: 9926.HK) seems to be descending from its pedestal with its core product, Ivosidenib (PD-1/VEGF dual antibody). Recently, Nomura Orient International Securities lowered its target price by 7%, from HKD 120.64 to HKD 112.73, maintaining a "neutral" rating. The brokerage pointed out in its report that the target price was adjusted due to the narrowing gap with peers in the PD-1/VEGF field. The report predicts that AKESO's drug sales in the second half of 2025 may reach RMB 1.8 billion, but the overall profit performance is weak. This star drug, the world's first to head-to-head defeat the "king of drugs" Pembrolizumab (K drug), while establishing a differentiated leading position based on "hard clinical data," is also facing significant pressure due to price reduction pressures from medical insurance negotiations, sales volume not meeting expectations, and competition in the field. **The Birth of a "Miracle Drug"** The rise of Ivosidenib began with its robust clinical data. As the world's first approved dual antibody with a "tumor immunity + anti-angiogenesis" synergistic mechanism, Ivosidenib significantly outperformed the K drug in the head-to-head phase III clinical study (HARMONi-2) announced in September 2024, achieving statistically significant benefits in progression-free survival (PFS) and showing an objective response rate (ORR) advantage of 50% versus 38.5%. This result directly shook the benchmark status of the K drug (the anti-cancer drug Pembrolizumab, commonly known as "Keytruda," developed by Merck & Co., which was once hailed as a groundbreaking cancer immunotherapy) in the global oncology treatment field and led to a surge in research and development targeting PD-1/VEGF. With this milestone breakthrough, Ivosidenib had already secured a total of USD 5 billion in overseas licensing deals as early as 2022, with an upfront payment of USD 500 million, supporting half of the company's market value with just one drug. At that time, the market painted a "perfect blueprint" for it, claiming it to be the world's first, with the best efficacy; holding huge licensing fees in overseas markets; and expecting annual treatment costs to remain around RMB 160,000 in the domestic market, with annual sales projected to reach RMB 5 billion by 2025 and peak sales to achieve RMB 2 billion in annual profit by 2028. Market sentiment was high, discounting peak profits four years ahead into the stock price. However, the reality of market operations is not just about rising without falling; its internal logic is far more complex than a simple upward curve First, the price has "plummeted." Ivosidenib was included in the national medical insurance catalog by the end of 2024, and starting from January 1, 2025, the medical insurance execution price will be significantly reduced to 736 yuan per unit (100mg specification), a decrease of over 70% compared to the previous price of 2,299 yuan. Based on this calculation, the annual treatment cost for patients has dropped sharply from around 160,000 yuan to about 32,000 yuan. Such a deep price cut directly compresses 80% of the profit margin. Secondly, the sales volume has far from reached expectations. According to Akeso's 2025 mid-year report, the company's commercial revenue in the first half of the year was 1.402 billion yuan, a year-on-year increase of 49.20%, mainly due to the sales growth of core products like Ivosidenib after being included in medical insurance. However, if this figure is broken down to the annual expectations for Ivosidenib alone, it is far from the previously anticipated annual sales of 5 billion yuan. Nomura International Securities, in its latest research report, estimates that Akeso's total revenue for 2025 will be around 3.3 billion yuan. Although this figure aligns with market expectations, it also confirms that the actual sales pace of Ivosidenib has not reached the previously overly optimistic estimates. Akeso had previously set a revenue target of 4 billion yuan for 2025 and 10 billion yuan for 2026, but the revenue forecast from institutions shows a certain gap from these targets. A reporter from the China Times had attempted to contact the company for an interview regarding questions such as "How does the management evaluate this performance?" "What are the core reasons for not meeting expectations?" "Will there be adjustments to the revenue targets, and what will be the basis for these adjustments?" but has not received a response. Regarding the performance not meeting expectations, Zhou Di, a professor at Fangrong Technology and a senior engineer, as well as an expert in the National Science and Technology Expert Database of the Ministry of Science and Technology, told a reporter from the China Times that Akeso's revenue not reaching the 4 billion yuan target in 2025 and the expanded losses align with the growth pattern of innovative pharmaceutical companies in the early stages of commercialization: after dual antibody products are included in medical insurance, they enter a "volume for price" phase, compounded by high R&D investments of 731 million yuan, losses from Summit equity investments, and capacity depreciation, resulting in short-term losses being a commonality in the industry. Core profitability barriers include: price reductions from medical insurance leading to pressure on gross margins (79.4% gross margin in H1 2025, down 12.3 percentage points year-on-year); continued investment needed for the clinical advancement of dual antibodies + ADC pipelines; and the commercial scale effect has not yet fully manifested, with a relatively high sales expense ratio. Zhou Di believes that Akeso's profitability turning point depends on three key factors: sustained sales growth of core products (Ivosidenib is expected to achieve domestic sales of 5.4 billion yuan in 2026); realization of overseas licensing revenue (milestone payments and 15% sales share after Ivosidenib is approved by the FDA); and ADC 2.0 pipeline entering a harvest period, forming new revenue growth points. **Intensifying Industry Competition** Although Ivosidenib's clinical success has earned its reputation and activated the entire PD-(L) 1/VEGF dual antibody track globally, the rapid follow-up by "latecomers" poses a significant threat to it Currently known information indicates that Merck has introduced LM-299 from Lixian Pharmaceuticals; BioNTech acquired BNT327 through the acquisition of Promis and authorized part of its rights to BMS, while Pfizer introduced SSGJ-707 from 3SBio with a record-breaking upfront payment of $1.25 billion. Domestically, companies such as Shenzhou Cell, Huadao Tai (under Huahai Pharmaceutical), Rongchang Biologics, and Junshi Biosciences have also advanced similar products to late-stage clinical trials. Among them, Rongchang Biologics' RC148 has reached an authorization cooperation with AbbVie. As more competing products enter Phase II and III clinical trials, Ivosidenib may face pressure on pricing power and market share from multiple fronts. At the same time, competition has evolved from a single-drug efficacy comparison to a systematic confrontation of "IO+ADC" combination therapies. Giants like Pfizer and BioNTech are launching large-scale, multi-indication combination drug layouts around their respective PD-1/VEGF dual antibodies, along with self-developed or introduced ADC pipelines. This means that future market leaders will not only need a good drug but also need to build a treatment system covering multiple tumor types. In other words, although Akeso has attracted massive attention through Ivosidenib, it may also attract larger competitors. The market's pessimistic expectations are directly reflected in the company's stock price. Since the announcement on August 28 last year, when the company's founders Xia Yu and Li Baiyong cashed out nearly HKD 450 million, the company's stock price has plummeted. Following the "precise reduction," Akeso's stock price fell 7% on August 27, 2025, and during intraday trading on the 28th, it dropped over 7% to HKD 145.2. According to Wind data statistics, from August 27, 2025, to March 12, 2026, the company's stock price has cumulatively dropped by 33.73%, while the Wind secondary industry index only fell by 10.93% during the same period. 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