The market for erectile dysfunction (ED) treatments in China is undergoing significant transformation after more than two decades of development. The landscape, once defined by a small blue pill, continues to evolve with new challenges for established players.
Pfizer's Viagra (sildenafil citrate), the world's first oral ED treatment, launched globally in 1998 and entered China in 2000, making "Wei Ge" (the Chinese term for Viagra) synonymous with the category. Eli Lilly's Cialis (tadalafil), with its differentiated 36-hour efficacy claim, later entered the market, creating a tripartite dominance with Viagra and Bayer's Levitra. In 2014, BaiYunShan's Jinge arrived as the first domestic generic version, leveraging a significant price advantage to reshape the market into one led by local brands.
However, by 2026, the narratives for these three key products are being rewritten. Viagra faces continued contraction post-patent cliff, Cialis is being progressively divested by its parent company, and Jinge, once a high-growth product, is confronting its own challenges.
These drugs all belong to the PDE5 inhibitor class, sharing a mechanism of action but differing in origin, composition, and market position. Viagra, with its active ingredient sildenafil, was the category pioneer and dominated the global market for over a decade. Cialis, containing tadalafil, differentiated itself with a 36-hour duration and is approved for both ED and benign prostatic hyperplasia. Jinge, a generic version containing the same sildenafil as Viagra, entered the market in 2014 with a strategy of a 30% lower price per dose and a halved single-use dosage, reducing patient cost by 60% compared to the originator.
The past two decades have seen the market shift from foreign dominance to domestic substitution, and now to intense competition. Viagra, the innovator, has fallen from a high-priced product to a participant in price wars, though it maintains a presence in the retail pharmacy channel based on brand recognition. Cialis, the differentiated competitor, transitioned from a core Lilly asset to a divested business. After its ED patent expired in China in 2020 and it failed to win inclusion in the national drug procurement program, its hospital sales plummeted. Lilly sold its mainland China rights for Cialis to Menarini in 2021. In March 2026, Zuellig Pharma announced the acquisition of Cialis rights for Hong Kong, Macau, and South Korea. Despite minimal hospital sales, Cialis maintains a presence in retail and online pharmacies, with 2024 sales totaling approximately 935 million yuan.
The decline of Jinge reflects the collective challenges of the generic drug market. As a core product for BaiYunShan, Jinge saw rapid success after its 2014 launch, capturing 49% market share by 2016 and surpassing Viagra to become the industry leader. Its market share rose to 55% in 2017. By 2019, Jinge led in both sales revenue and volume. It reached a peak in 2023 with sales of 1.29 billion yuan and sales volume exceeding 100 million tablets, maintaining gross margins above 90%. However, a turning point came in 2024. BaiYunShan's annual report showed Jinge's sales revenue fell by nearly 20% year-on-year, with sales volume down over 10% and inventory surging nearly 50%. The decline continued into 2025, with annual sales volume dropping to approximately 79.87 million tablets, nearly 8 million fewer than the previous year, and revenue falling 26.18% year-on-year. This marks the second consecutive year of decline for Jinge.
This downturn is driven by intense market competition. By March 2025, nearly 50 domestic companies had received approval for sildenafil generic drugs, with 137 generic drug applications filed. Over 70 companies had approvals for tadalafil generics. This influx has triggered price wars. In 2020, Qilu Pharmaceutical's sildenafil citrate won exclusive inclusion in the national procurement program with a 92% price cut, at 2.08 yuan per tablet, eliminating Jinge and Viagra from the bid. By the first half of 2023, Qianwei's market share in public hospitals was nearly double that of Viagra, while Jinge's sales in that channel were nearly zero. Even in the retail market, prices have fallen drastically.
Jinge's challenges are essentially the result of diminishing generic drug红利 (benefits). As the first-mover advantage fades, price wars intensify, and competition in a saturated market reaches its limit, sustaining growth becomes difficult. Nevertheless, Jinge remains BaiYunShan's highest-revenue product.
Beyond supply-side competition, changes in demand represent a deeper undercurrent. Companies are exploring new avenues for growth. Formulation innovation is one path, with new options like orally disintegrating tablets, dry suspensions, and oral soluble films emerging, offering benefits like no need for water and discreet use. Furthermore, 2025 saw the arrival of domestic Class 1 innovative drugs. Within a half-month period in July 2025, two new domestic ED drugs were approved: Wangshan Wangshui's Angweida (semenafine hydrochloride tablets) and Yangtze River Pharmaceutical's Taitoutuo (tonodafine hydrochloride tablets). These new drugs aim to challenge the existing PDE5 inhibitor landscape with improved side-effect profiles and higher selectivity.
The era of the "little blue pill" is entering a new phase. Originator drugs are being divested, generics are engaged in fierce competition, new formulations are emerging, and consumer demands are evolving. As these ED treatments face a collective challenge, the central question may not be about who wins, but about what new stories this market can generate.