In Depth: Cost Concerns Loom Over China’s Growing Market for Liver-Protection Drugs

Experts warn that the medications promising to protect liver function are expensive and may pose health risks to patients

The growing use of drugs promising to protect liver function is fueling a billion-dollar industry in China, along with concerns about their costs to patients, both in terms of their health and pocketbooks.

The domestic market for four common types of these medications — known as liver-protection or hepatoprotective drugs — amounted to 9.5 billion yuan ($1.3 billion) in 2023, with much of the sales coming from public hospitals, according to medical data provider Menet.

Evidence shows it’s a growing market. In 2023, prescriptions for hepatoprotective drugs at liver disease outpatient clinics in 119 hospitals across nine Chinese cities totaled more than 100 million yuan, up from 85.4 million yuan in 2016, according to a study published in 2024 by health care professionals from three Beijing-based medical institutions, including Beijing Friendship Hospital.

In China, hepatoprotective drugs are classified as supplementary medication. That means they do not directly treat a disease, but instead can help a primary treatment work better, reduce side effects, or help prevent illness or complications alongside standard therapy. Common types include ursodeoxycholic acid and glutathione, which promise benefits such as detoxifying the liver, lowering liver enzyme levels, and aiding in the regeneration of liver cells.

The most common conditions for which these drugs are prescribed in outpatient clinics are cirrhosis, fatty liver disease, and hepatitis B — a liver infection caused by the virus of the same name, according to the 2024 study.

Part of the reason for these drugs’ popularity in China is the fact that the country is home to one of the largest populations of hepatitis B patients in the world — around 75 million. Yet researchers