# Behind the Rise of Imported Antibiotics to Over 1,000 Yuan After Delisting Two Years Ago: Who's Driving Up Prices? Why No Need to Hoard?

How to Avoid Regulatory Scrutiny Behind the Speculation on Imported Drug Price Hikes?

“Imported Ceftriaxone Prices Soared 52 Times!”

“Original price over 30 yuan, now up to 1,600 yuan per box!”

……

Recently, news of the price increase of the antibacterial drug Cefuroxime Axetil Tablets (brand name: Xilixin) has sparked widespread discussion on social media platforms. On the morning of March 19, a reporter from The Paper saw on an e-commerce platform that some pharmacies were selling the 0.25g*12 tablet box at a maximum price of 2,000 yuan, with some indicating an expiration date of June 2026. The price hike of this drug at the end of 2025 also drew attention, when the online price was still around four or five hundred yuan.

Screenshot of Xilixin’s price on an e-commerce platform

What’s going on with “Xilixin”?

Xilixin is a brand name for Cefuroxime Axetil Tablets, an antibiotic produced by the multinational pharmaceutical company GSK, used to treat various bacterial infections. According to the National Medical Products Administration (NMPA) database, the approval number for this drug is valid until November 15, 2027. Data from Minai.com shows that in 2019, Xilixin’s sales in China (including urban public hospitals, county-level public hospitals, city pharmacies, online pharmacies, urban communities, and township health centers) reached nearly 160 million yuan. Sales plummeted 75% in 2020, but in the first three quarters of 2025, sales still amounted to 44.27 million yuan.

Sales of “Xilixin” in the Chinese market Source: Minai.com

As early as the beginning of 2025, a widely circulated letter from GSK stated that Xilixin tablets would no longer be supplied to the Chinese market starting July 2024. GSK confirmed this to The Paper on the evening of March 19: “According to GSK’s global product strategy adjustment, after terminating its commercial cooperation with domestic partners, GSK notified distributors in July 2024 that it would cease supplying Xilixin tablets to China. Partners may continue to sell existing stock until the product expires or is sold out.”

GSK said they are aware of public concern regarding the supply of Xilixin tablets. They strictly follow Chinese laws and regulations for prescription drug sales and management, and actively cooperate with relevant authorities to respond to abnormal situations. “We advise consumers to use medications under the guidance of healthcare professionals and purchase through legitimate channels.”

It’s worth noting that according to the September 2020 prospectus of Yiteng Pharmaceutical, which was listed in Hong Kong, the company has been the exclusive promoter of Xilixin in China since 2008, including injections and tablets, with tablets mainly used in hospital respiratory, ENT, and pediatric departments. On December 30, 2025, Yiteng Pharmaceutical merged with the Hong Kong-listed Jiayou Bio. On February 6, 2026, Jiayou Bio announced a name change to Yiteng Jiayou. The prospectus published in December 2025 states that “the exclusive marketing and distribution agreements for the original cefuroxime product Xilixin expired in December 2023, and sales ceased due to increased market competition.”

Professor Lu Yun from the School of International Pharmaceutical Business at China Pharmaceutical University believes that many manufacturers produce generic Cefuroxime Axetil, and many hospitals report good efficacy with generics. The original branded drug cannot maintain high prices in hospitals or gain more market share, and is unwilling to lower prices to compete with generics. Delisting is a business strategy and a normal commercial behavior.

A domestic pharmaceutical industry insider pointed out that in recent years, the rapidly changing Chinese pharmaceutical market has seen multinational companies shift their focus to high-value new drugs. Some older or generic drugs have been either transferred market rights or exited the Chinese market altogether, based on market conditions. From the consumer side, due to the higher recognition of some foreign-branded original drugs, patients tend to have an inertia in their medication habits. When news of delisting or supply shortages emerges, some less price-sensitive groups may panic and stockpile high-priced drugs.

Doctor’s Reminder: No Need to Stockpile, Follow Prescriptions

Although Xilixin is an imported original drug, it has long since lost patent protection, and many generics are available on the market. The NMPA database shows that there are 24 approval numbers for Cefuroxime Axetil Tablets, produced by well-known companies such as United Laboratories, China National Pharmaceutical Group, and Betapharm.

Approval numbers for Cefuroxime Axetil Tablets Source: NMPA database screenshot

Cefuroxime Axetil Tablets were included in the “4+7” city drug procurement in 2018, with Betapharm as the winning bidder at a price of 6.16 yuan. By 2019, following the implementation of the “4+7” procurement and provincial follow-up, the government organized regional alliances for cross-area procurement, including Cefuroxime Axetil Tablets. The final winners were China National Pharmaceutical Group, Baiyunshan Tianxin Pharmaceutical, and Jingxin Pharmaceutical, with Jingxin and China National Pharmaceutical Group winning bids for 250mg*12 tablets at 4.28 yuan and 5.79 yuan respectively.

Dr. Zhou Xin, director of the Department of Pulmonary Medicine at Shanghai Jiao Tong University School of Medicine’s First Affiliated Hospital, told The Paper that Xilixin is a very old oral cephalosporin antibiotic, and there are many similar oral drugs in China. Speculating on its price is unnecessary. Beijing You’an Hospital infectious disease specialist Dr. Li Tong also said that Xilixin is the brand name of Cefuroxime Axetil, whose generic name is Cefuroxime Axetil Tablets. Many high-quality, affordable generics are available domestically, with no significant difference in efficacy, safety, or side effects compared to the original. Stockpiling is not recommended.

“There are many antibiotics for respiratory infections, including imported and domestic products, which can fully meet clinical needs,” Zhou Xin reminded. Currently, some imported oral antibiotics are still available in hospitals, but each hospital’s situation varies. Antibiotics are prescription drugs and should be used under medical guidance, not purchased or taken based on personal feeling.

Who Is Inflating the Prices of Generics?

Price speculation is not limited to Xilixin. In 2025, the price of Levothyroxine Sodium (brand name: Relethys), used to treat hypothyroidism, also surged from about 30 yuan to over a hundred yuan.

赵衡, founder of the healthcare consulting firm LatitudeHealth, told reporters that although Relethys is produced by a foreign company, it is not an original patented drug and can also be subject to price speculation. This indicates that price hikes are not necessarily centered on original drugs; “bounty hunters” or scalpers may be behind the manipulation, exploiting public trust or enthusiasm for imported or original drugs to stockpile and artificially inflate prices. Addressing this phenomenon mainly depends on regulatory intervention.

Some industry insiders share similar views. They believe Cefuroxime Axetil Tablets are just common antibiotics, not miracle drugs, and many domestic generics are available. Many people do not understand the difference between the generic name and the brand name, which can be exploited to artificially raise prices of certain drugs. Improving public trust in domestic generics requires long-term education and publicity.

“Regulatory authorities have statutory powers to oversee drug pricing violations. They can proactively detect and investigate through price monitoring, data analysis, and public opinion monitoring,” said lawyer Zhang Yong, founder of Yifa Legal. “While drug prices are market-determined, this does not mean unlimited price increases. Short-term supply and demand imbalances are one thing, but if there is hoarding, collusion, or malicious price gouging, it violates regulatory red lines. Authorities can take action based on the Price Law, Anti-Monopoly Law, and other relevant regulations.”

In June 2022, the State Administration for Market Regulation issued the “Guiding Opinions on Investigating Price Gouging” (referred to as the “Opinions”). The document states that market regulators at all levels should establish emergency mechanisms for abnormal price fluctuations, improve contingency plans, strengthen monitoring and early warning, closely track price trends, analyze market dynamics, and enhance the sensitivity and effectiveness of regulation.

The “Opinions” also specify that if operators engage in or potentially promote rapid or excessive price increases, regulators can determine such behavior as illegal price gouging under Article 6, Item 1 of the Price Law, including fabricating or spreading information about tight supply or surging demand.

How to Improve Public Trust in Generics?

Despite the availability of generic options, some patients still express distrust of domestic generics. A chronic disease patient told reporters that their medication used to cost about 1,000 yuan per month out-of-pocket, but recently switched to a domestic generic costing only about 80 yuan. Although they haven’t experienced any issues so far, they remain worried about quality due to the price difference. “Mainly concerned about quality.”

Industry insiders believe that respecting the preferences of those who favor imported or original drugs is important. As domestic brands of generics develop, more consumers will recognize that affordable, high-quality generics are available.

Liao Minjia, deputy director of research at Shanghai Chuangqi Health Development Institute, said that the root causes of issues in the generic drug industry—such as quality and shortages—are closely related to drug regulation, pricing, and reimbursement policies. The FDA’s drug shortage reports highlight that the main reasons include insufficient financial incentives for manufacturers to produce low-margin drugs and the failure of market mechanisms to effectively recognize and reward high-quality manufacturing practices.

To promote high-quality development of generics, Liao suggests incorporating quality and price considerations into pricing and reimbursement policies, including multiple indicators such as manufacturing capacity, supply stability, and market price differences into decision-making systems. Additionally, regulatory and insurance authorities should collaborate to establish a comprehensive evaluation system for generic suppliers, covering quality management, raw material traceability, production and supply stability, inventory capacity, and market pricing. The insurance department can then implement differentiated economic incentives based on this assessment, prioritizing manufacturers with high-quality production capabilities and stable supply records, thus ensuring drug accessibility and supporting sustainable high-quality growth of the generic industry.