Four years ago, Novo Nordisk's long-acting GLP-1 drug semaglutide became a sensation due to its powerful weight loss effects.
Since then, Novo Nordisk surpassed the French luxury giant LVMH in 2023, claiming the title of the highest market capitalization publicly traded company in Europe.
However, with Eli Lilly launching the more effective GLP-1/GIP dual-target weight loss drug tirzepatide, Novo Nordisk has increasingly fallen behind, with its market value evaporating by over 60% from July last year to now.
Although tirzepatide still holds a certain degree of exclusivity, the terminal price seems to be struggling under competitive pressures in the distribution channels.
A silent price war has already erupted among larger internet platforms targeting the miracle weight loss drug.
Recently, the pre-sale price for tirzepatide 10mg under Meituan's subsidy has dropped to as low as 450 yuan, lower than Alibaba and JD's self-operated platforms by several tens of yuan.
In this imminent price war, while the significant price drop of tirzepatide after its recent inclusion in the medical insurance catalog has impacted the pricing system in the outpatient market, a more critical factor points to the internal competition within the GLP-1 sector.
As the price of tirzepatide decreases, subsequent domestic GLP-1 drugs are facing harsher competition.
First in line is Innovent Biologics, whose GLP-1/GCGR dual-target drug mazdutide (2mg*2) is currently priced significantly higher than tirzepatide by around a hundred yuan.
If no price reduction is implemented, the market expansion for mazdutide is unlikely to be optimistic.
The challenges faced by homogeneous players are even more intense. According to incomplete statistics, there are currently no fewer than 10 pharmaceutical companies in China pushing for the listing of semaglutide, with around 10 more companies advancing the clinical processes for similar drugs.
The once blue ocean market has already transformed into a red ocean.
<h2>Meituan Fires the First Shot</h2>
The price war has finally reached the miracle weight loss drug.
Recently, the price of tirzepatide 10mg on the Meituan platform has dropped to 450 yuan.
Other platforms are also unwilling to be outdone. For the same specification, JD's Jingxi self-operated official store and Alibaba Health's official selection can also go as low as 483.9 yuan and 486.15 yuan, respectively, but still about 30 yuan more expensive than Meituan.
In addition to the price advantage, Meituan even advertised a slogan on the sales interface of tirzepatide stating &#34;If you don't lose weight, we will compensate,&#34; and held an event offering &#34;a weight loss of no less than 3kg in one month, with a thousand yuan medical beauty gift.&#34;
The price reduction has indeed achieved good results.
An insider from Meituan told Xin Feng that on the first day of the price reduction pre-sale event on December 24, the order volume for tirzepatide increased more than tenfold compared to the previous period.
This is one of the rare price competitions in the pharmaceutical health business segment of internet platforms.
Previously, the competition among Alibaba, JD, and Meituan in the pharmaceutical health sector mainly focused on seizing the first launch rights of new drugs, but prices were generally consistent.
Since the beginning of this year, although Alibaba, JD, and Meituan have engaged in a delivery war, subsidizing users, the three parties have not launched a price subsidy war in the pharmaceutical health sector.
On one hand, the prices of some drugs are still related to medical insurance payments, making the pricing system complex.
One major reason for the significant price drop of tirzepatide is that it exchanged a price reduction for eligibility to enter the medical insurance catalog, which has become a price anchor in the outpatient market
Although the specific prices for medical insurance negotiations have not been announced, data disclosed by some doctors on social media platforms indicate that the out-of-pocket monthly cost for Tirzepatide in hospitals can be as low as around 300 yuan.
However, the indications for Tirzepatide's inclusion in medical insurance are limited to blood sugar control in adult patients with type 2 diabetes, with strict restrictions on the medication population—adult patients with type 2 diabetes who have poor blood sugar control (HbA1c ≥ 7.0%) despite dietary control and exercise, and treatment with metformin and/or sulfonylureas. The weight loss indication has not been included in medical insurance.
This means that the large consumer group for weight loss cannot enjoy reimbursement benefits and still faces the situation of having to pay the full amount out of pocket.
This is precisely the logic behind the price cuts by major e-commerce platforms: with the low price of hospital medical insurance establishing a price anchor, the out-of-hospital market aims to attract this portion of self-paying customers who are excluded due to indication restrictions, pulling the retail price of Tirzepatide down to a range close to the medical insurance payment standard.
On the other hand, the past scarcity of new drugs has given upstream pharmaceutical companies sufficient bargaining power, making it difficult for internet platforms to break through the upstream pricing system.
However, some innovative pharmaceutical companies are now changing their approach.
In September of this year, Patrick Johnson, President of International Business at Eli Lilly, stated in an interview that they are applying a &#34;consumer-oriented&#34; business strategy similar to that in the U.S. globally, including partnerships with telemedicine and digital platforms to cover patient populations from the UK, China, to the UAE—most of these patients need to pay out of pocket for weight loss drugs.
This means that for GLP-1 weight loss drugs, which have both medical and consumer attributes, pharmaceutical companies are attempting to break out of the traditional limitations of hospital sales and proactively leverage the traffic advantages and service capabilities of digital platforms to penetrate the large out-of-hospital consumer market more efficiently.
However, whether global pharmaceutical companies are willing to step down from their pedestal may still be pressured by the fierce competition for this drug.
&#34;On the surface, it seems to be medical insurance, but in fact, it is caused by intense market competition; the price reduction in medical insurance is just a catalyst, so it will continue to decline in the future,&#34; said Zhao Heng, founder of the medical strategy consulting company Latitude Health.
Next, whether the price of Tirzepatide (10mg) will fall below 300 yuan is being closely watched.
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<h2>Where will domestic GLP-1 go from here</h2>
The price reduction of Tirzepatide is putting more pressure on domestic GLP-1 pharmaceutical companies.
First and foremost is Innovent Biologics' GLP-1 drug Ma Shiduotai, which was launched in June this year and is also applicable for weight loss and diabetes treatment.
Ma Shiduotai adopts a dual-target mechanism of GLP-1/GCGR and is currently the only approved dual-target weight loss drug among domestic GLP-1 drugs.
However, Ma Shiduotai did not conduct head-to-head trials with Tirzepatide but used Semaglutide as a control.
During the 32-week treatment period, 48% of Ma Shiduotai patients achieved both blood sugar control (HbA1c &lt; 7.0%) and weight loss ≥ 10%, significantly higher than the 21% in the Semaglutide group
Currently, the price of Masitide (2mg*2) on Meituan, JD.com, and Alibaba's self-operated platform is 540 yuan, 580 yuan, and 630 yuan respectively, all of which are more than 100 yuan higher than that of Teriparatide.
The price war is adding more uncertainty to the future sales prospects of Masitide.
JP Morgan expects Innovent Biologics may adopt a flexible pricing strategy for Masitide to respond to the competition from Teriparatide, and points out that the market for weight loss drugs in China is vast, sufficient for the development of several blockbuster drugs.
However, the secondary market is &#34;voting with their feet.&#34; From the end of September this year to now, the stock price of Innovent Biologics has fallen by a cumulative 18.28%, with a maximum drawdown of nearly 30%.
The level of competition in the market is &#34;only increasing,&#34; and more domestic GLP-1 drugs will be launched in the future.
In the next two years, the price of single-target GLP-1 drugs may face an &#34;avalanche.&#34;
Currently, the price of Semaglutide has already exceeded 200 yuan.
In Alibaba Health's self-operated pharmacy, the price of Novo Nordisk's Semaglutide (Ozempic) 1.5ml specification can even be as low as 175 yuan, which is nearly a &#34;halving&#34; from the previous price of over 1,000 yuan.
To make matters worse, the core compound patent for Semaglutide in China will expire in 2026.
Currently, there are more than 10 pharmaceutical companies in China, including Chengdu Tianqing, Shiyao Group, Fosun Pharma, Sino-American Huadong, and Livzon Pharmaceutical, that are applying for the listing of Semaglutide, with about 10 other companies in Phase 3 clinical trials.
To cope with the fierce competition in the future, some domestic pharmaceutical companies are choosing to differentiate their product designs.
From the current situation, increasing the number of targets to achieve better weight loss effects may be difficult to &#34;outpace&#34; Eli Lilly.
After Teriparatide, Eli Lilly is actively promoting the GLP-1/GCG/GIP tri-target weight loss drug Retatrutide, which is currently in Phase 3 clinical trials, with market expectations for it to be launched in 2026, becoming the world's first approved GLP-1/GCG/GIP tri-target weight loss drug.
In comparison, companies such as Minwei Biotech, Federal Pharmaceuticals, and HUADONG MEDICINE are advancing the clinical research and development of tri-target GLP-1 drugs.
Some pharmaceutical companies are also focusing not only on weight loss in their product design but also on muscle gain.
For example, Laika Pharmaceuticals' ActRIIA monoclonal antibody LAE102 is designed to be used in conjunction with GLP-1 drugs to further reduce fat and significantly reduce muscle loss caused by GLP-1 drugs.
Recently, LAE102 has initiated a Phase I multi-dose expansion study in China for the treatment of obesity and has completed dosing for the first subject.
From the current battlefield, for domestic players still in the clinical phase, if they cannot match the efficacy of Eli Lilly's Retatrutide and cannot seize the initiative in progress, then continuing to &#34;compete&#34; in this track has limited significance

Is the moat of the weight loss miracle drug collapsing? Multiple pharmaceutical companies on three major platforms may be caught in a brutal price war