China Just Approved a Homegrown GLP-1 Drug. Here's Why Healthcare Leaders Should Pay Attention.
The incretin market is about to get a lot more competitive, and the implications go well beyond endocrinology.
On January 30, China's National Medical Products Administration approved Sciwind Biosciences' ecnoglutide injection, marketed as Xianyida, for adults with type 2 diabetes. It's the world's first approved cAMP-biased GLP-1 receptor agonist, and it comes from a Hangzhou-based company that most Western health system leaders have never heard of.
That’s about to change.
What Xianyida Actually Is
Ecnoglutide is a once-weekly injectable GLP-1 receptor agonist, similar in mechanism to Novo Nordisk’s Ozempic and Eli Lilly’s Mounjaro. What makes it different is its cAMP signaling bias, an engineering approach that Sciwind says enhances biological efficacy. The drug completed three Phase III clinical trials before approval, with results published in The Lancet Diabetes & Endocrinology.
In weight loss trials, participants on the highest dose (2.4 mg) lost more than 15% of their body weight by week 48. Nearly 93% of participants lost at least 5% of their body weight, roughly seven times the rate of the placebo group. The drug also reduced liver fat by an average of 53% in the 2.4 mg cohort.
Those numbers put ecnoglutide in the same performance range as Wegovy.
Sciwind has also filed for weight management approval in China, meaning this isn’t just a diabetes play. It’s a full metabolic franchise in the making.
Why the Timing Matters
China has 148 million adults with diabetes, the highest number of any country in the world. That makes it the single largest addressable market for incretin therapies, and domestic competition is intensifying fast.
Ozempic sales in mainland China, Taiwan, and Hong Kong fell 7% in 2025, the first decline since its 2021 China approval. The reason is straightforward. China has now approved GLP-1 therapies from Eli Lilly (Mounjaro), Innovent Biologics (mazdutide), and Guangzhou Innogen (efsubaglutide alfa), in addition to Xianyida. Both the Innogen and Lilly medicines were recently added to China’s state-run health insurance scheme for type 2 diabetes patients, putting direct pricing pressure on Novo Nordisk.
Novo’s CFO acknowledged the shift publicly, noting that “competition is entering more at this point in time.”
The Global Play
Sciwind isn’t content with China alone. The company is in active licensing discussions with a U.S. partner to bring ecnoglutide to American patients, and is pursuing partnerships in Latin America and the Middle East. CEO Pan Hai has said pricing in China would stay in line with competitors, but the company won’t engage in a “price war.” The licensing model suggests Sciwind is betting on partnerships over direct commercialization in Western markets.
This mirrors a pattern we’ve seen across biotech in the last few years. Chinese-developed therapeutics are reaching clinical milestones that rival Western incumbents, and the companies behind them are increasingly looking outward.
What This Means for Health System Leaders
If you’re a CIO, CMIO, or VP of clinical informatics, this story matters for several reasons.
First, formulary complexity is increasing. The GLP-1 category already requires sophisticated clinical decision support logic. Adding new entrants with differentiated mechanisms (like cAMP bias) means your pharmacy and therapeutics committees will need better data infrastructure to evaluate options and guide prescribing.
Second, prior authorization workflows are going to get more complicated. As more GLP-1 options enter the market with different payer coverage rules, the administrative burden on your teams grows. If your revenue cycle and prior auth systems aren’t AI-enabled yet, the pressure to modernize is only going to increase.
Third, the global supply picture is shifting. One of the persistent challenges with Ozempic and Mounjaro has been supply constraints. Domestic Chinese production of competitive alternatives could eventually ease global supply pressure, or it could fragment the market in ways that make procurement strategy more complex. Either way, your supply chain intelligence needs to keep up.
Finally, the metabolic care landscape is expanding rapidly. GLP-1 therapies are moving beyond diabetes and obesity into MASH/NAFLD, cardiovascular risk reduction, and possibly neurodegenerative conditions. The health systems that build flexible, AI-informed care pathways now will be best positioned when these indications arrive.
The Bottom Line
Xianyida’s approval is one data point in a much larger story. The GLP-1 market is globalizing, diversifying, and accelerating. For healthcare technology leaders, the question is whether your clinical and administrative systems are built to handle what’s coming.
At RealActivity, we help healthcare organizations build that readiness, aligning AI strategy across clinical decision support, administrative workflows, and operational planning. If the convergence of precision therapeutics and health system operations is on your radar, let’s talk.
References
China National Medical Products Administration. Drug approval announcement, January 2025.
Sciwind Biosciences. Corporate announcement and product information, 2025.
Novo Nordisk; Eli Lilly. Product information for semaglutide and tirzepatide.
Nature Reviews Drug Discovery. GLP-1 receptor signaling and biased agonism overview.
Ecnoglutide Phase III trial results. The Lancet Diabetes & Endocrinology, 2025.
Wilding JPH et al. Once-weekly semaglutide in adults with overweight or obesity. NEJM, 2021.
International Diabetes Federation. IDF Diabetes Atlas, 10th Edition.
Innovent Biologics; Guangzhou Innogen regulatory disclosures, 2025.
National Healthcare Security Administration, China. National Reimbursement Drug List updates, 2025.
Novo Nordisk Investor Relations. 2025 earnings transcript and financial statements.
Nature Biotechnology. Trends in Chinese biopharma global licensing activity.
American Medical Association. 2023 Prior Authorization Physician Survey.
SELECT Trial Investigators. Semaglutide and cardiovascular outcomes. NEJM, 2023.
AASLD guidance on metabolic-associated steatohepatitis and emerging therapies.
Paul J. Swider is CEO and Chief AI Officer at RealActivity, where he leads clinical and administrative AI strategy for healthcare organizations. He is the founder of the Boston Healthcare Cloud & AI Community and speaks globally on responsible AI adoption in healthcare.