On September 12, a research team from the Chinese Academy of Sciences published a result in the journal Cell, titled "Metformin decelerates aging clock in male monkeys." After eight years of in-depth research, its findings were confirmed in primates. Metformin can significantly delay aging, especially protecting the brain cognitive function of elderly animals.

This study found that the protective effect of metformin on primate aging does not depend on its traditional blood sugar and metabolic regulatory functions, but will reset the intrinsic program of cellular aging, thereby delaying cellular aging.

Previously, in a research report titled "Metformin facilitates viral reservoir reactivation and their recognition by anti-HIV-1 envelope antibodies" published in the international magazine iScience, scientists from the University of Montreal and other institutions found through research that metformin may help HIV-infected people who are receiving treatment clear the reservoir of the virus in their bodies and eventually eliminate the virus.

An incomplete review found that metformin’s past potential effects include: weight loss, anti-aging, reversing biological age, preventing haze, assisting in smoking cessation, anti-inflammation, improving polycystic ovary syndrome, cardiovascular protection, improving intestinal flora, etc.

However, most of these potential effects are still under further study, and some studies may not be very mature yet, so the real effects of some of the effects of metformin may be limited.

So far, metformin has been around for more than a hundred years and has more than 30 years of clinical application experience in my country.

In addition to the update of the mechanism of action, the dosage forms of metformin are constantly changing, including ordinary tablets, enteric-coated metformin, metformin extended-release tablets, etc. to meet the needs of different patients. In addition, fixed compound preparations composed of metformin and other drugs are also being launched.

On September 16, Cyberline searched the official website of the State Food and Drug Administration using the keyword "metformin" and found that there were 367 relevant approvals, involving a large number of well-known pharmaceutical companies.

At present, there is a large number of drugs competing for some of the mechanisms of action of metformin, such as hypoglycemic and weight loss, and the market is hot.

Among all drugs for the treatment of diabetes, metformin is the first choice and full-course drug for the treatment of type 2 diabetes, and it is also the first choice drug for the combined treatment of type 2 diabetes.

According to Minenet data, metformin has become the top non-insulin hypoglycemic drug in China's public medical institutions in 2020, with sales exceeding 6.2 billion yuan.

my country is the world's largest country with diabetes, with the number of patients ranking first in the world. The incidence of diabetes continues to increase and is trending at a younger age. According to Minai.com data, metformin hydrochloride tablets have the highest degree of competition, with more than 100 domestic and foreign manufacturers, and nearly 60 have entered the clinical stage.

In the weight loss market, metformin has the effect of reducing weight in patients with type 2 diabetes. Its weight loss effect is mainly attributed to its pharmacological effects of suppressing appetite and improving insulin resistance.

However, compared with the weight loss effect of metformin, in the current drug market, the effects of weight loss drugs GLP-1 receptor agonists, such as semaglutide and tilpotide, are more prominent.

As a first-line drug for the treatment of diabetes, metformin was included in the third batch of national procurement in August 2020. At that time, 8 domestic generic pharmaceutical companies were selected for the oral constant-release and sustained-release dosage forms.

The price of oral sustained-release dosage form of metformin (0.5g specification) has dropped from 0.4 yuan per tablet before the centralized procurement to about 6 cents, and the average daily cost has dropped from 1.6 yuan to 0.24 yuan; the price of sustained-release dosage form has dropped from 0.7 yuan per tablet. to about 0.1 yuan, and the average daily cost dropped from 2.8 yuan to 0.4 yuan.

The National Medical Insurance Administration stated that after the centralized procurement, 11.4 billion tablets of metformin were used by medical institutions across the country in 2023, of which 4.6 billion tablets were used in the 0.25g specification and 6.8 billion tablets were used in the 0.5g specification. The amount of selected metformin accounted for 11.4 billion tablets. 84% of the total drug consumption.

For a large number of unselected companies, both the price and market size of metformin are no small challenges.

The renewal of national procurement standards is being carried out one after another, and metformin is still one of the important "players" in centralized procurement.

In the recent drug procurement of the Thirteen Provinces (Districts, Corps) Alliance, the renewal price of metformin for national procurement has been increased (for details, click "Metformin, Centralized Procurement Renewal Price Increase").

However, the overall price of metformin is not high. For pharmaceutical companies, competition for metformin raw materials is already very fierce.

According to Yaorongyun data, 25 domestic companies, 7 Indian companies, and 5 European companies have converted metformin raw materials to A (raw materials/excipients/packaging materials that have been approved for use in marketed preparations). With simultaneous control of preparation and API production lines, pharmaceutical companies can increase prices through large-scale competition and seize more markets.

For most companies that do not have API production lines, as more and more pharmaceutical companies pass consistency evaluation, competition for large products such as metformin is still intensifying.

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