365亿美元新“药王”诞生：代谢病主导时代开启

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2025年全球“药王”权杖完成里程碑式交接。近日，全球各大药企发布2025年财报，礼来替尔泊肽以365.07亿美元销售额登顶，诺和诺德司美格鲁肽361亿美元紧随其后，连续两年夺冠的默沙东K药退居第三。两款GLP-1药物包揽冠亚军，标志着治疗时代的权力交接，从肿瘤免疫主导转向代谢疾病领域崛起，本质是不同治疗领域市场潜力的直接体现，全球医药产业格局迎来历史性重构。1决战2025年四季度，新“药王”实现...

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begins","themeId":null,"isJumpTheme":false,"ttsUrl":null,"symbols_score_info":{"NVOH":0.6,"NVO":1.93,"MRK":1.9,"LLY":1.96,"NVOX":0.6},"content_text":"2025年全球“药王”权杖完成里程碑式交接。近日，全球各大药企发布2025年财报，礼来替尔泊肽以365.07亿美元销售额登顶，诺和诺德司美格鲁肽361亿美元紧随其后，连续两年夺冠的默沙东K药退居第三。两款GLP-1药物包揽冠亚军，标志着治疗时代的权力交接，从肿瘤免疫主导转向代谢疾病领域崛起，本质是不同治疗领域市场潜力的直接体现，全球医药产业格局迎来历史性重构。1决战2025年四季度，新“药王”实现反超礼来公司的GLP-1/GIP双靶点激动剂替尔泊肽以365.07亿美元的年销售额，从诺和诺德和默沙东手中夺走了“药王”头衔。诺和诺德的司美格鲁肽仅以4亿美元微小差距位列第二。实际上，2025年上半年的销售数据显示，司美格鲁肽以超166亿美元销售额暂时领先，而替尔泊肽则以近150亿美元位居第三。转折点出现在第四季度。礼来财报显示，替尔泊肽在2025年第四季度大卖116.70亿美元，实现了对司美格鲁肽的最终反超。这种剧烈变化反映了GLP-1市场的竞争激烈程度。细分来看，替尔泊肽的两个版本都表现出色：降糖版Mounjaro销售额229.65亿美元，同比增长99%；减重版Zepbound销售额135.42亿美元，同比激增175%。而司美格鲁肽家族则包括降糖注射版Ozempic、减重注射版Wegovy和降糖口服片剂Rybelsus三个版本，合计贡献了361亿美元销售额。连续两年占据榜首的默沙东的K药退居第三，在2025年创造了316.8亿美元的销售纪录，同比增长7%。“药王”的迭代速度正在加快。回顾历史，辉瑞的降脂药立普妥、艾伯维的修美乐曾各连续10年稳坐“药王”宝座；而默沙东的K药仅在这个位置上停留了不到3年。这一趋势折射出医药行业创新节奏的提速。当领跑者以“两年翻倍”的速度扩张，追赶者的差异化竞争窗口正持续压缩。2更迭本质是市场需求和增长潜力的不同“药王”的更迭，本质是不同治疗领域市场潜力的直接体现。行业分析人士指出，GLP-1药物替尔泊肽、司美格鲁肽能超越K药等肿瘤药，核心在于患者群体、市场模式与竞争格局的根本差异。GLP-1主打“重磅慢病药”模式，针对2型糖尿病、肥胖等生活方式相关代谢病，潜在患者数以亿计，依赖长期用药，且持续拓展心血管获益等新适应证，市场天花板极高。而K药等PD-1肿瘤药仅服务已患病人群，市场总量和用药时长受疾病谱、病程限制。市场属性上，GLP-1面向广阔增量市场，仅国内减重适应证处方率不足1%，从降糖到减重再到心血管获益，持续开辟新增长曲线。K药则处于成熟存量市场，虽靠新适应证和联合疗法维持增长，但单药已进入成熟期，增长渐缓。竞争层面，GLP-1当前由礼来、诺和诺德双寡头主导，市场远未饱和，销量增长足以抵消价格竞争影响。K药则直面专利到期前的激烈竞争，后续还将承受更大的专利悬崖压力。这种差异直接推动了全球“药王”权杖从肿瘤领域向代谢疾病领域的转移。3GLP-1赛道激战正酣新“药王”的诞生正在改变全球药物研发的资金流向和战略重点。GLP-1赛道的爆发不仅吸引了诺和诺德和礼来加大投入，也促使更多企业进入这一领域。GLP-1药物赛道惊人的吸金速度令其他领域望尘莫及。替尔泊肽达到100亿美元销售额用了不到3年，而突破300亿美元大关仅用了1年。相比之下，K药从2019年突破100亿美元到2025年突破300亿美元，用了6年时间。2025年初数据显示，全球GLP-1管线数量达179个，同比增长40%；跨国药企在减重领域的研发投入占比从2020年的12%提升至2025年的35%。礼来、诺和诺德、辉瑞等巨头均将减重列为核心战略，仅辉瑞就计划2026年启动10项超长效GLP-1的Ⅲ期研究，还有礼来的奥氟格列隆等新药。国内企业也有新品待上，包括恒瑞医药的HRS-7535、闻泰医药的VCT220等。据《世界肥胖图谱2025》预测，全球GLP-1市场规模从2024年的534.6亿美元向2030年的1500亿美元迈进，年复合增长率（CAGR）预计超过20%。分析师指出，GLP-1药物创新正朝着多靶点、更长效、更便捷给药的方向深度发展，口服剂型已成为行业下一个核心竞争焦点。这种研发转向反映了对患者需求的更深入理解。减肥药防止体重反弹、减少肌肉流失等临床需求尚未被充分满足，这为差异化创新提供了空间。礼来在研的瑞他鲁肽（GLP-1/GIP/GCGR三靶点）、诺和诺德的CagriSema（GLP-1/胰淀素双靶点）均被视为下一代潜在“药王”。4肿瘤免疫赛道寻求转变曾蝉联“药王”宝座的K药尽管增速放缓，但仍在肿瘤领域保持着不可撼动的地位。2025年，K药虽然跌下“药王”宝座，但销售额首次冲破300亿美元大关，贡献了默沙东近半的营收。在这之前，2023年，K药全球销售额为 250.11亿美元 ，首次超越修美乐，成为全球最畅销药品；2024年全球销售额294.82亿美元 ，同比增长18%，蝉联全球“药王”。但是，K药的核心化合物专利将于2028年12月到期，但另外两项方法专利的保护期可能延长至2029年5月或11月。据了解，默沙东正在积极推动皮下注射剂型申报上市，以应对专利悬崖。有临床专家表示，皮下注射剂型操作相对简便，临床使用更加广泛，或许可以延续K药在PD-1市场的统治地位。默沙东预计，其皮下注射制剂在2028年的渗透率或达30%～40%，整个K药产品家族有望冲击350亿美元的销售峰值。同时，默沙东也在通过并购和研发，丰富肿瘤乃至其他疾病领域的产品管线，以降低对单一产品的依赖。从更广的范围来看，K药的增速放缓，给PD-1等肿瘤药物的未来发展提供了重要启示，即以精准分层为基础、联合疗法为核心、全病程管理为方向。而对国内企业来说，须通过差异化创新和全球化布局，在肿瘤免疫治疗的下半场占据一席之地。5中国市场成为“药王”重要战场在全球“药王”更迭的背景下，中国市场正在成为GLP-1药物竞争的重要战场。诺和诺德在中国用于糖尿病治疗的GLP-1市场和胰岛素市场处于领先地位。价格竞争在中国市场尤为激烈。自2025年11月起，诺和诺德与礼来相继下调司美格鲁肽与替尔泊肽的价格，以抢占市场。数据显示，司美格鲁肽降糖注射版Ozempic中国区销售额为53.99亿丹麦克朗（约合人民币59.39亿元）；降糖口服版Rybelsus中国区销售额约为6.2亿丹麦克朗（约合人民币6.82亿元），同比增长27%；减重注射版Wegovy中国区销售额约为7.96亿丹麦克朗（约合人民币8.76亿元），同比增长314%。分析师认为，当前GLP-1赛道已从早期的“蓝海市场”步入“群雄逐鹿”的竞争新阶段。对于中国药企而言，这既是挑战也是机遇。国内企业需要加速创新，在GLP-1领域寻找差异化优势，才有可能在全球市场中分得一杯羹。而对K药来说，中国这个全球第二大肿瘤药物市场非常关键。2025年默沙东中国市场总收入为18.16亿美元（约128亿元人民币），K药作为默沙东在中国市场唯一的增长支柱，2025年中国销售额为11亿～13亿美元（约77亿～91亿元人民币），占K药全球销售额的3.5%～4.1%，占默沙东中国总营收的60%～72%。62026年“药王”已被提前锁定替尔泊肽已提前锁定2026年销量冠军。随着替尔泊肽登上2025年度“药王”宝座，2026年的竞争格局已初现端倪。礼来为2026年给出了800亿～830亿美元的全年营收指引，尽管增速相比2025年的41%有所放缓，但依然是一条颇为陡峭的增长曲线，同时这一数字将再创制药企业年营收的新纪录。这也预示着，替尔泊肽已提前预订了2026年全球“药王”的宝座。Nature子刊《Nature Reviews Drug Discovery》曾在2024年底发布的对2025年全球十大畅销药的预测中，预计礼来的替尔泊肽（包括降糖版Mounjaro和减重版Zepbound）合计销售额将达到 311亿美元 ，实际达365亿美元，远超预期。其预测2026年替尔泊肽销售额455亿美元、司美格鲁肽351亿美元、K药338亿美元，仍看好替尔泊肽蝉联“药王”。业内人士认为，全球“药王”的权杖交接不会停止，在医药创新进入“加速时代”的今天，没有永恒的王座，只有永恒的创新竞赛。","kind":"news","is_publish_news":true,"is_publish_highlight":false,"is_publish_live":false,"is_publish_wemedia":null,"editions":null,"column":"","sentiment":"0","news_tag":"productRelease","news_rank":0,"isVideo":false,"video":null,"symbols":[],"gpt_button":1,"need_auth":false,"need_login_tip":false,"code":"91000000","status":"200"},"commentList":[],"isCommentEnd":true,"newsSizeData":{"likeSize":1,"commentSize":0,"repostSize":0,"favoriteSize":0,"likeStatus":false,"favoriteStatus":false},"APP":{"userAgent":"Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; 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