Will dexamethasone prices remain elevated after the antitrust fines and volume-based procurement?

Will dexamethasone prices remain elevated after the antitrust fines and volume-based procurement?
The dexamethasone market is entering a new pricing regime. The 2023 antitrust ruling and inclusion in the ninth national VBP have fundamentally altered the landscape. Hospital sales of dexamethasone sodium phosphate injection reached RMB 916 million in 2023, but this was inflated by cartel-driven prices. Post-VBP, winning bids have fallen dramatically—Xianju, for instance, cut prices by nearly 90% in the first half of 2024, though its prices still exceed those of some competitors' VBP awards. The company reported a RMB 26 million decline in dexamethasone sales revenue during that period, reflecting both lower prices and reduced volumes as hospitals shifted to cheaper alternatives. However, demand fundamentals remain solid: dexamethasone is essential for treating severe COVID-19, inflammatory conditions, and adrenal insufficiency, with WHO listing it as a critical medicine. The key question is whether supply discipline holds—with three major producers now under regulatory scrutiny, the incentive to collude has weakened, but the underlying market concentration persists.