The era of lifelong medication for hepatitis B ends, as Chinese and foreign pharmaceutical companies launch a billion-dollar battle for dominance

Hepatitis B cure is no longer a dream.

In January 2026, GSK (Stock code: GSK.N) dropped a heavy bombshell: its investigational hepatitis B drug Bepirovirsen successfully completed two global Phase III clinical trials. In February, Japan was the first to accept its marketing application. In March, China’s drug regulatory agency announced plans to prioritize review. This new drug, which could allow patients to “stop medication,” is reshaping a $129.4 billion market.

GSK’s decade-long layout reflects a fundamental shift in hepatitis B treatment—moving from “long-term virus suppression” to “finite course cure.” Behind the spotlight, a group of Chinese pharmaceutical companies are racing to outpace others through combination therapies.

As approximately 254 million hepatitis B patients worldwide begin to seriously discuss ending lifelong medication, a competition over the redistribution of hundreds of billions in market value has already begun. Who can develop combination therapies in the next three years that enable more people to “stop medication” will be the next winner.

What makes this drug so impressive?

Let’s look at some data. Currently, China has about 75 million hepatitis B virus carriers, with over 27 million diagnosed. But the diagnosis rate is only 22%, and treatment rate just 15%. What does this mean? The vast majority of patients either don’t know they have the disease or, if they do, aren’t properly treated.

Why isn’t treatment adequate? Because current drugs only suppress the virus. The mainstream treatment now is nucleos(t)ide analogs (like Entecavir, Tenofovir), which can suppress the virus to undetectable levels but cannot eliminate hepatitis B surface antigen (HBsAg)—which acts as the virus’s “invisibility cloak.” As long as it remains, the immune system cannot recognize the virus, preventing natural clearance. The result: medication must continue, and if stopped, the virus often rebounds. Long-term medication patients still face risks of cirrhosis and liver cancer.

Market research firm MarketResearchFuture projects that by 2032, the global hepatitis B treatment market will reach $129.4 billion, with a compound annual growth rate (CAGR) of 4.5% from 2023 to 2032. Such a large market is missing a drug that allows patients to stop medication.

Bepirovirsen aims to fill this gap. It doesn’t “hold down” the virus but strips away its “invisibility cloak.”

Hepatitis B virus (HBV) causes infected liver cells to wear a “cloak” (surface antigen), which the immune system cannot recognize. Bepirovirsen is a “molecular scissors” that precisely cuts the “blueprints” used for viral replication. Without these blueprints, the virus cannot produce new components or produce its invisibility cloak. Once the disguise disappears, the immune system can identify and clear infected cells.

GSK announced in January 2026 that Phase III trials showed Bepirovirsen achieved the primary efficacy endpoint in over 1,800 patients. Based on earlier Phase IIb data, about 10% of patients achieved “functional cure”—no detectable virus or cloak after stopping medication. Although this rate still needs improvement, it’s a breakthrough from zero. For those successful, it means ending lifelong medication.

GSK’s six-year strategic move

In 2019, while global pharma companies were still chasing cancer drugs, GSK paid $25 million upfront to Ionis Pharmaceuticals (IONS.O, NASDAQ) for the rights to Bepirovirsen. Few paid attention at the time, but looking back, it was a smart move.

GSK is a well-established British pharmaceutical giant, one of the world’s leading drugmakers, with operations in respiratory, vaccines, HIV, and more. As of March 2026, its market cap is about $107.6 billion.

Source: Baidu Stock Market Express

Why focus on hepatitis B? The logic is clear: core HIV drugs will face patent cliffs starting in 2028, creating urgent demand for new growth points. Market expectations are that if Bepirovirsen gets approved, it could become a key revenue pillar for GSK. Under the licensing agreement, Ionis could receive up to $150 million in milestone payments and 10-12% tiered royalties on net sales.

GSK’s Chief Scientific Officer Tony Wood explained plainly: Bepirovirsen is not just a drug but the foundation of future “sequential therapy” for hepatitis B—using drugs to strip away the virus’s disguise first, then combining with other mechanisms to potentially increase cure rates from 10% to 30% or 50%.

Who is leading, who is chasing?

Bepirovirsen is currently leading, but many competitors are closing in, especially Chinese pharmaceutical companies actively positioning themselves in this round of hepatitis B innovation.

GSK’s core advantage is its global lead in progress: Bepirovirsen was submitted for approval in Japan in February 2026 and in China to the NMPA on March 11, 2026 (which granted priority review). Plans are underway to submit to the US FDA in late 2026. It is expected to be the world’s first approved functional cure for hepatitis B, with commercial prospects looking optimistic. However, the drug has notable limitations: it requires weekly subcutaneous injections for 24 weeks, which significantly impacts patient compliance compared to oral medications; and current efficacy data are based on combination with nucleos(t)ide analogs, with single-drug efficacy still undisclosed, and applicable patient groups limited.

Guangsheng Tang (300436.SZ) is a domestic frontrunner, focusing on a differentiated approach with oral and combination therapies. In February 2026, its core product GST-HG141 completed all Phase III trials with 578 subjects. This drug is the world’s first hepatitis B core protein inhibitor to reach Phase III, alongside another oral surface antigen inhibitor GST-HG131, which has completed Phase II. Both belong to innovative mechanisms, with no similar products on the market yet, and both are included in the national breakthrough drug list, highlighting strong development potential.

Source: Baidu Stock Market Express

More critically, Guangsheng Tang launched the “Dengfeng Plan,” combining two innovative drugs: GST-HG141 targets the core protein to inhibit the virus, while GST-HG131 aims to reduce surface antigen, working synergistically to tackle clinical cure challenges. By the end of 2025, Guangsheng Tang’s participation in the national major science and technology project “Research on new combined treatment protocols for clinical cure of chronic hepatitis B” was approved, with both drugs and the combination therapy included in sub-projects. Riding the “trillion-dollar market potential” of hepatitis B cure, Guangsheng Tang’s stock price surged about 173% in 2025.

Despite rapid progress, challenges remain: compared to GSK’s earlier development stage, its combination therapy’s final efficacy still requires further validation through Phase III trials. CIC Zhuoshi Consulting notes that the future of hepatitis B cure will likely be dominated by multi-mechanism combination therapies—single-drug cure rates of 10% are just the starting point for the industry.

Beyond Guangsheng Tang, other companies are accelerating: Haobo Pharma’s AHO-137 ASO therapy showed promising results in Phase IIa, with a 30% clinical cure rate at 72 weeks in specific patient groups (HBeAg-negative, NA-treated, HBsAg 100–1000 IU/mL), and has completed Phase III enrollment; Tiansheng Bo Pharmaceutical (02137.HK) is expanding but had a market cap of only HKD 945 million as of March 2026; Gilead Sciences (01672.HK) is exploring a different path with PD-L1 antibodies; Kaiyan Technology (688687.SH) recently withdrew its application for interferon α-2, needing more clinical data, which caused its stock to drop sharply.

Complete hepatitis B industry chain map

Upstream: Technology sources

Midstream: New drug R&D

Downstream: Basic treatment + diagnostics

Upstream relies on technology licensing fees, midstream depends on clinical trial progress and approvals, downstream benefits from existing market and screening dividends.

CIC Zhuoshi Director Lu Likang pointed out that hepatitis B drug development is shifting from “long-term viral suppression” to “clinical cure” with a focus on multi-mechanism synergy. The clear future path involves: on top of nucleos(t)ide analogs, adding RNA interference to lower antigen levels, then using immune enhancers to consolidate treatment response.

By 2026, hepatitis B treatment stands at a historic crossroads. For patients, the hope of ending lifelong medication is finally tangible; for the industry, the trillion-dollar market is being revalued; for investors, GSK is temporarily leading, but domestic companies are fiercely chasing.

What will the outcome be?