Recently, many community health service centers in various locations have encountered the phenomenon of “flu vaccines hard to get with a single shot.” The main reason may be that the dominant influenza strain has shifted from A(H1N1)pdm09 to A(H3N2), driving a clear upward trend in influenza outbreaks. According to the latest weekly influenza report released by the National Influenza Center, the percentage of influenza-like illness (ILI) cases reported by sentinel hospitals in northern provinces has reached 5.1%, significantly higher than the level in the same period of 2022–2024.
China’s 2025 Winter Flu Trend: An Early Peak and a Strain Shift
After October 2025, as temperatures fell, influenza cases in various regions showed a clear upward trend. Compared with previous years, this year’s influenza season may not only arrive earlier, but the circulating strain also differs noticeably from last year.
Surveillance data from the National CDC show that in Week 44 of 2025, the percentage of ILI cases reported by sentinel hospitals in southern provinces was 4.6%, and it was as high as 5.1% in northern provinces, significantly higher than the level in the same period of 2022–2024.
Etiological surveillance results indicate that current influenza-positive specimens are dominated by A(H3N2), which differs from last year’s mainly circulating A(H1N1) strain. The change in strain means that population immunity is relatively weak, increasing the risk of breaching the herd immunity barrier; 2025 may be a “big flu year.”
Experts predict that the peak of China’s influenza epidemic this autumn and winter may appear in mid-to-late December and early January. Professor Li Tongzeng of Beijing You’an Hospital pointed out that Japan has entered the flu season since October, more than a month earlier than usual, which may be a signal that China’s flu season will arrive early.
From clinical visits, Dr. Huang of the pediatrics department at a hospital in Sichuan disclosed: “The number of flu patients coming for consultation has obviously increased, mainly concentrated among primary-school students.”
Flu Vaccine Market: Transformation and Upgrade Amid a Price War
a. Quadrivalent vaccines hold a dominant position
China’s flu vaccine market is undergoing rapid transformation. Currently, the market is primarily divided into trivalent and quadrivalent vaccines, which are further subdivided into various technical routes, including split-virion vaccines and subunit vaccines.
Quadrivalent vaccines have become mainstream in the market, with their batch-release volume accounting for more than 60%. Major manufacturers include Hualan Biological, Beijing Sinovac, Shanghai Institute of Biological Products, and CanSinoBIO’s subsidiary Cansino (Jindike). Among them, as a leading enterprise in China’s influenza vaccine field, Hualan Biological has had 54 batches of flu vaccines batch-released so far in 2025, of which the quadrivalent split-virion influenza vaccine accounts for 48 batches.
By contrast, trivalent vaccines have almost disappeared from the self-pay market and have mainly shifted to government procurement channels. Government procurement prices have continued to decline, and there has even been a “floor price” of only 5.5 yuan per dose (approx. USD 0.77) for the trivalent influenza vaccine by the Shanghai Institute of Biological Products.
b. Subunit vaccines are gathering momentum
As a representative of the next-generation technical route, subunit vaccines, although priced higher, are gaining increasing recognition from consumers due to better safety and immunogenicity. Zhonghui Bio’s independently developed “Hui’erkangxin” is the first approved product in this category, with a supply price of 319 yuan (approx. USD 44.66).
The core advantage of subunit vaccines lies in their precise antigen-extraction technology. Through further purification processes, they precisely extract the key antigens on the virus surface that most strongly trigger the human immune response—haemagglutinin (HA) and neuraminidase (NA)—and remove other internal viral proteins, nucleic acids, and impurities.
This precise design brings significant safety improvements. Because unnecessary internal viral components are removed, subunit vaccines fundamentally avoid adverse reactions such as fever and local redness that impurities may cause. Clinical data confirm that in infants and young children, the incidence of local adverse reactions after vaccination is 54% of that of traditional split-virion vaccines, and the fever reaction rate in children aged 3–8 is as low as 46% of that of split-virion vaccines.
c. Volume-based procurement has significantly lowered flu-vaccine market prices
Government procurement prices for trivalent vaccines have continued to fall, dropping from tens of yuan in the past to single digits today. Quadrivalent vaccines have not been spared either. In May 2024, the Jiangsu Provincial Public Resources Trading Center issued a notice that three institutes under China National Pharmaceutical Group (Sinopharm) would adjust the price of quadrivalent influenza vaccines from 128 yuan per dose (approx. USD 17.92) to 88 yuan per dose (approx. USD 12.32), opening the curtain on a “price-cut wave” for quadrivalent vaccines. Subsequently, Hualan Biological, Beijing Sinovac, and others quickly followed, with Beijing Sinovac further lowering the price to 78 yuan per dose (approx. USD 10.92).
The price cuts directly compressed the profit margins of vaccine companies. CansinoBIO’s affiliate (Jindike) stated that the company lowered the price of quadrivalent flu vaccines starting in June 2024; in the first half of 2025, revenue increased slightly by 7.18%, but the net loss reached 39.6531 million yuan (approx. USD 5.55 million). Hualan Vaccine reported a situation of “higher revenue without higher profit” in the first half of this year, with its gross margin falling by more than 10 percentage points year-over-year to 86.63%.
Flu Drug Market: Old and New Alternating and Competition Escalating
a. From Roche’s dominance to a pack of domestic rivals
Anti-influenza antiviral drugs are mainly categorized into three groups: neuraminidase inhibitors (oseltamivir, peramivir, zanamivir), RNA polymerase inhibitors (baloxavir marboxil, favipiravir), and haemagglutinin inhibitors (arbidol). Among them, oseltamivir, as a classic antiviral, still accounts for more than 85% of the anti-influenza drug market.
Dongyangguang Pharma’s Kewei (oseltamivir phosphate) dominates the oseltamivir market; in 2023, it accounted for 64.8% of China’s oseltamivir phosphate market and 50.5% of China’s anti-influenza drug market.
However, competition in the oseltamivir market has become increasingly fierce, with nearly 50 pharmaceutical companies obtaining production approvals for oseltamivir phosphate capsules.
The next-generation anti-influenza drug baloxavir marboxil was approved for marketing in China in 2021 and was included in medical insurance the same year. Baloxavir marboxil has the advantage of convenient administration—the entire course requires only a single dose, reducing viral load in one day to aid recovery. In recent years, its market sales have grown rapidly, rising from 300,000 yuan (approx. USD 42,000) in 2021 to surpass 1.5 billion yuan (approx. USD 210 million) in 2024. At present, baloxavir tablets in China form a “one originator + two domestics” pattern: in addition to the originator Roche, products from CSPC and Taifeng Pharma were approved in October 2022 and January 2025, respectively.
b. Innovative products keep appearing
Since 2025, breakthroughs in innovation in the anti-influenza drug market have been particularly notable, with multiple innovative drugs targeting new mechanisms approved for marketing:
- Angladiwe tablets (Zhongsheng Pharma): the world’s first inhibitor targeting the PB2 subunit of influenza virus RNA polymerase, blocking replication from the very initial stage.
- Maseloxavir tablets (co-developed by Jichuan Pharma and Zhengxiang Pharma) and Mashulaxavir tablets (Qingfeng Pharma): as RNA polymerase PA inhibitors, they exert strong antiviral effects by inhibiting viral mRNA transcription.
These innovative drugs share a common feature of breaking through the mechanisms of traditional medicines and providing new solutions to the problem of viral resistance. By inhibiting different targets within the virus’s core replication engine (RNA polymerase), they not only act faster but also offer alternative therapies for strains resistant to traditional neuraminidase inhibitors.
c. Volume-based procurement accelerates the reshaping of the competitive landscape
Volume-based procurement policies have profoundly affected the anti-influenza drug market. As one of the first varieties under volume-based procurement, oseltamivir has been included in the seventh national centralized procurement batch (2022). Centralized procurement has intensified market competition, forcing companies to adjust product strategies. With oseltamivir’s patent having long expired (2016), a large number of generics have flooded the market, causing oseltamivir prices to drop sharply.
Meanwhile, next-generation drugs have quickly entered the market through medical-insurance negotiations. Baloxavir marboxil was included in the reimbursement list the same year it was approved in 2021. In 2025, Mashulaxavir tablets and Angladiwe tablets passed the preliminary review of the National Basic Medical Insurance Catalog negotiations; if ultimately included, this will further accelerate the reshaping of the market structure.
Future Market: Opportunities and Challenges Coexist
Following the COVID-19 pandemic, the continued high incidence of influenza is driving rapid growth in China’s flu vaccine and drug markets: according to Huaxing Securities’ estimates, China’s flu-vaccine market is expected to grow from 6.4 billion yuan (approx. USD 0.90 billion) in 2020 to 19.7 billion yuan (approx. USD 2.76 billion) in 2025; the anti-influenza drug market is also growing rapidly—according to Top-View Research Institute, from 2024 to 2028 China’s anti-influenza drug market size is expected to grow at a compound annual rate of 20.2%, reaching 26.9 billion yuan (approx. USD 3.77 billion) in 2028.
Future market development will show three major trends:
- Product innovation and upgrades: China’s current flu-vaccine market is still dominated by inactivated vaccines, while next-generation platforms such as subunit vaccines are gradually emerging. In the drug field, innovative therapies targeting key links in viral replication continue to appear, providing more options for clinical use.
- Increasing market segmentation: The flu-vaccine market will gradually differentiate—regular split-virion vaccines will meet basic public-health needs; high-end products such as subunit vaccines will target children and high-end consumer groups with higher safety requirements.
- Rising vaccination rates: At present, China’s flu-vaccine penetration remains low—the full-population vaccination rate is only 4.08%, far from the WHO-recommended target vaccination rate of 75% and that of developed countries.
Conclusion
With the arrival of the high-incidence flu season in autumn and winter 2025 and the immune-escape risk brought by strain variation, demand for flu vaccines and medicines may continue to strengthen this year. While the market heats up, policy tools such as the reimbursement catalog and centralized procurement negotiations are continuously changing the competitive landscape. To cope with extremely fierce market competition, manufacturers are pinning their hopes on innovative products to break the deadlock.
[Disclaimer]: The above content reflects analysis of publicly available information, expert insights, and BCC research. It does not constitute investment advice. BCC is not responsible for any losses resulting from reliance on the views expressed herein. Investors should exercise caution.