Alzheimer’s disease is the most common type of dementia, accounting for 60-80% of dementia cases. It is a progressive disease beginning with mild memory loss and could end up with the loss of conversational ability and unable to respond to happenings in the surroundings.

China has 17mn of dementia patients, accounting for ~30% WW. Its aged 60+ Alzheimer’s patients has reached ~10mn and is expected to triple by 2050E. Besides urbanization and pollution, the key driver to the rise is driven by the aging population, where we expect 24% of the vast population will be aged 60+ by 2030E and 28% by 2040E.  We estimate the Alzheimer’s drug market was ~US$300mn in 2023 and to be more than double reaching over US$650mn by 2030E. In addition to drugs, more investment is needed in improving diagnosis given current under-diagnosis and improving current fragmented senior care. Though China’s healthcare system struggles with limited dementia specialists and drug access, initiatives like the National Dementia Prevention and Treatment Plan and AI diagnostics aim to improve screening. Domestic pharma/biotech are actively advancing therapies (such as GV-971), as China’s vast patient pool offers unique opportunities for global Alzheimer’s developers.

Today, there is a worldwide effort underway to find better ways to treat the disease, delay its onset and prevent it from developing. US FDA has approved three amyloid-targeting therapies for Alzheimer’s – aducanumab, lecanemab and donanemab, all demonstrating clinical efficacy in slowing cognitive decline in early-stage patients. Both lecanemab and donanemab have been approved in China, though their high cost of about US$26k each per year and lack of NDRL coverage limit access to patients in China. Local biotech Green Valley’s sodium oligomannate (GV-971) was approved in China in 2019 as the world’s first Alzheimer’s drug targeting the gut-brain axis. Priced at US$1 per capsule (NDRL inclusion in 2022), its annual cost is ~US$2,000 with an annual out-of-pocket expense of ~US$1,000, making it more affordable than imported drugs.

Although existing therapies can modestly slow progression, none have shown disease reversal. Emerging approaches – including GLP-1-based therapies, tau-targeting drugs, therapeutic vaccines, and innovative technologies such as focused ultrasound, deep brain stimulation, stem cell therapy, and gene editing – may offer transformative strategies. In China, Alzheimer’s drug pipeline features a mix of amyloid-targeting biologics, tau-based therapies, TCM derivatives, and innovative small molecules. Notable pipelines include biologics such as SHR-1707 (Hengrui, anti-Aβ mAb, Ph II) and CM383 (Keymed, anti-Aβ mAb, Ph I), as well as small molecules such as varoglutamstat (Simcere/Vivoryon, QPCT inhibitor, Ph II), RP-902 (Risen Pharma, anti-Aβ small molecule, Ph II) and flunopirine (Kanion, AChE inhibitor, Ph II) which aim for oral convenience. There are also TCM-inspired candidates, such as KH-110 (Kanghong, Ph III) and Sailuotong (Shineway, Ph III).