From volume to value: new dry eye drugs challenge the reign of China's low-cost standards

China's dry eye drug therapy landscape is undergoing accelerated transformation.

In 2025, Hengrui Medicine launched "Hengqin" Perfluorohexyloctane Eye Drops for dry eye. Priced at RMB 468 per box on e-commerce platforms, the product achieved sales exceeding 5,000 units (single-box packages) within just over three months of its launch on JD Pharmacy and ranked 8th on the platform's "Dry Eye" medication bestseller list. In late 2024, Grand Pharmaceutical's introduced Varenicline Tartrate Nasal Spray received marketing approval in China. With a retail price of RMB 599 per unit, it became one of the drivers of revenue growth in the company's ophthalmology & otorhinolaryngology (ENT) segment in the first half of 2025.

Compared to traditional dry eye medications, these new mechanism-based drugs are priced several to ten times higher yet achieved immediate commercial success upon launch. Does this suggest that the competitive logic and development landscape of the dry eye drug market may be on the verge of a significant shift?

For a long time, traditional dry eye drugs have primarily focused on symptom relief, with artificial tear solutions represented by sodium hyaluronate eye drops being the mainstream products. On the sales rankings of dry eye medications on pharmaceutical e-commerce platforms, the vast majority of the top ten products are sodium hyaluronate eye drops.

As clinical understanding and new drug research advance, more targeted and efficacious innovative drugs are gradually becoming an industry trend. The Chinese Expert Consensus on the Diagnosis and Treatment of Dry Eye (2024) has also updated the pharmacological treatment approach. It not only emphasizes the selection of ocular secretagogues, ocular anti-inflammatory drugs, and drugs promoting ocular surface repair but also mentions nasal sprays and introduces novel medications such as perfluorohexyloctane, antioxidant eye drops, and small interfering RNA (siRNA) eye drops, providing an authoritative basis for the clinical application of innovative drugs.

In the Chinese ophthalmology market, a group of new dry eye drugs that have already been launched are beginning to make their mark, addressing gaps in traditional therapy.

Meibomian Gland Dysfunction (MGD) is a chronic, non-specific inflammation of the meibomian glands, characterized by obstruction of the meibomian gland ducts or abnormal secretion, and is the primary cause of evaporative dry eye. Clinical studies indicate that 69–86% of people with dry eye have MGD. Therefore, treatment targeting MGD is crucial in dry eye management. However, foundational treatment for MGD in China has historically focused on physical therapies, with few drug treatments directly addressing the underlying cause of MGD.

This changed in July 2025 with the approval of "Hengqin" Perfluorohexyloctane Eye Drops, introduced internationally by Hengrui Medicine. This is currently the only drug globally approved specifically for treating MGD-related dry eye.

Introduced from Novaliq, this drug is developed based on the anhydrous drug delivery technology platform EyeSol and consists of a single component, perfluorohexyloctane (F6H8), containing no oils, surfactants, preservatives, or other excipients. It possesses extremely low surface tension, allowing rapid spread across the ocular surface. It can improve the lipid layer grade, inhibit tear evaporation, and promote corneal epithelial repair. Furthermore, perfluorohexyloctane eye drops can supplement non-polar lipid components, increase tear film thickness, unclog meibomian glands, and improve meibum secretion.

Earlier, in November 2024, Grand Pharmaceutical's introduced Varenicline Tartrate Nasal Spray received marketing approval in China. As a highly selective cholinergic receptor agonist, this product works by activating the trigeminal parasympathetic pathway to increase natural tear secretion, enhance tear film stability, and break the pathophysiological vicious cycle of dry eye.

These novel mechanism drugs, by virtue of their clinical value in addressing the root causes of dry eye, have gained initial market recognition, as evidenced by their market performance.

In August 2025, "Hengqin" Perfluorohexyloctane Eye Drops was launched online on JD Health. The product page shows a price of RMB 468 (for 3ml x 1 vial/box), which is several to ten times higher than most dry eye eye drops commonly priced at tens of RMB. Despite this, according to data displayed on the JD Pharmacy product detail page, as of December 2nd, the product (single-box package) quickly surged to rank 8th on the "Dry Eye" medication bestseller list and had achieved sales exceeding 5,000 units. (Note: This data reflects only the single-box package sales displayed on JD Pharmacy and does not include sales from other pharmacies on the JD Health platform or multi-box packages.)

The retail price for Varenicline Tartrate Nasal Spray is RMB 599 per box (60 sprays). In its H1 2025 financial report, Grand Pharmaceutical disclosed that revenue from its Ophthalmology & ENT segment grew by 22.6% year-over-year, primarily driven by sustained clinical demand for core products and growth from new product sales.

The landscape for new dry eye drugs developed more rapidly overseas. Notably, Perfluorohexyloctane Eye Drops and Varenicline Tartrate Nasal Spray were approved in the United States in 2023 and 2021, respectively, accumulating clinical data and market experience for their subsequent introduction in China. In 2025, the FDA further approved Alcon's innovative dry eye drug Tryptyr ophthalmic solution for marketing. Tryptyr is a TRPM8 receptor agonist (neuromodulator) that stimulates corneal sensory nerves to rapidly increase natural tear production. In a pivotal Phase 3 trial, Tryptyr demonstrated rapid natural tear production as early as Day 1.

The fact that these high-priced new drugs can still achieve rapid sales traction reflects patient recognition of the new technologies and products. It also signifies that the dry eye drug market is accelerating its transition from symptom relief towards intervention targeting the underlying causes of the disease.

The diverse etiologies of dry eye dictate a multiplicity of mechanisms for new drug development. The initial market acceptance of novel mechanism drugs also signifies that dry eye treatment is accelerating into an era of precision and personalized medicine.

The lacrimal glands, ocular surface (cornea, conjunctiva, and meibomian glands), eyelids, and the sensory and motor nerves connecting them form an integrated functional unit. Any alteration within this unit can lead to dry eye. Key contributing factors include various ocular surface epithelial disorders, immune-mediated inflammation, apoptosis of ocular surface or lacrimal gland cells, decreased sex hormone levels, and environmental influences, rendering the pathological process of dry eye highly complex.

Currently, numerous innovative dry eye drugs remain in the global R&D pipeline, targeting different underlying causes of the disease. This effort is propelling dry eye treatment toward an era of highly individualized therapy, poised to gradually transform the current paradigm of using single drugs for all patients.

Figure 1. Dry Eye Innovative Drug Pipelines Under Development in China, Source: NMPA, Pharnexcloud Database, Public Corporate Information

 Figure 2. Part of Global Dry Eye Innovative Drug Pipeline Already in Late-Stage Development, Source: Pharnexcloud Database, Publicly Available Corporate Information

Precise target engagement is a defining feature of innovative dry eye drugs, with multiple agents achieving "precision strikes" against key pathways involved in the disease's pathogenesis.

Within China's R&D pipeline, Viva Vision's VVN-001 eye drops focus on the LFA-1 target, effectively blocking its interaction with the ligand ICAM-1 to control ocular inflammation. The drug has entered Phase III clinical trials. Senju Pharmaceutical's SJP-0132 eye drops, as the world's first drug targeting the TRPV1 receptor, work by blocking abnormal sensory nerve excitation and inhibiting inflammatory mediator release, thereby improving tear film stability and repairing ocular surface damage. This drug has completed a Phase III clinical study for dry eye in Japan, achieving its primary efficacy endpoints, and is now in the marketing application stage.

Furthermore, Ocumension Therapeutics' OT-202 breaks the limitation of single-target approaches. As a dual Syk/VEGFR-2 inhibitor, it represents a novel chemical entity with a novel target mechanism in China, demonstrating significant improvements in both dry eye signs and symptoms. Its Phase II clinical results were recently published in a top-tier international ophthalmology journal.

Internationally, Sylentis' Tivanisiran utilizes siRNA technology to selectively inhibit TRPV1 channel production, precisely blocking pain signal transmission. Palatin's PL-9643 targets the melanocortin receptor, directly activating a natural anti-inflammatory pathway, showcasing unique advantages in precise regulation.

The pathological complexity of dry eye dictates that a single mechanism is insufficient to meet all needs. The current pipeline of innovative drugs already covers multiple directions including anti-inflammation, anti-oxidation, and pro-repair, establishing a multi-dimensional treatment framework.

Inflammation is both a causative factor and a secondary manifestation of dry eye: Ocular damage disrupts tear film homeostasis, triggering a non-specific innate immune response, which leads to chronic ocular surface inflammation—the root of common dry eye symptoms. Persistent adaptive immune responses further exacerbate inflammation, creating a vicious cycle in chronic dry eye. Controlling ocular surface inflammation and breaking this inflammatory cycle is a fundamental principle in dry eye treatment, making anti-inflammatory drugs the most active area in dry eye drug development.

For example, The United Laboratories' TUL12101, as the first-in-class RASP (reactive aldehyde species) inhibitor developed in China, captures harmful aldehydes to break the inflammatory cycle. Puyou Biomedical's CF04 eye drops target denatured proteins, inhibiting their aggregation and cytotoxicity to block ocular surface inflammatory signaling pathways. Additionally, Viva Vision's VVN-001, Ocumension Therapeutics' OT-202, and Palatin's PL-9643 all have anti-inflammatory mechanisms as their core action.

It is worth noting that numerous studies in recent years have shown a close association between oxidative stress and the onset and progression of dry eye. Consequently, antioxidant eye drops have emerged as a new direction in dry eye drug R&D—developing drugs for oxidative stress-driven dry eye that scavenge excess reactive oxygen species (ROS) to alleviate symptoms.

However, the number of currently marketed or in-development antioxidant drugs remains limited, indicating that exploration in this direction is still at a relatively early stage. Among them, Otsuka Pharmaceutical's rebamipide eye drops are a potent antioxidant and free radical scavenger already marketed in Japan. Mitotech's SkQ1 is a mitochondria-targeted antioxidant approved for dry eye treatment in Russia. In 2022, Essex Bio-Technology successfully secured global exclusive rights for SkQ1 in ophthalmology from Mitotech. At that time, SkQ1 had advanced to Phase III trials in the US, but no publicly available information indicates the initiation of clinical studies for SkQ1 in China since then.

Furthermore, InnoBM Pharmaceuticals' JN002 eye drops adopt a treatment strategy that specifically, continuously, and efficiently clears upstream products of oxidative stress in dry eye (i.e., ROS), persistently alleviating the oxidative stress response. It intervenes in and blocks various stages of the dry eye inflammatory cascade to break the vicious cycle of the disease.

Pro-repair drugs focus on repairing damage to ocular surface tissues and nerves, providing solutions for moderate-to-severe dry eye. For instance, Sinobioway Medicine's SMR001 eye drops, centered on recombinant human nerve growth factor, offer a novel treatment option for moderate-to-severe dry eye by repairing corneal nerves and promoting epithelial regeneration. Its Phase III trial has received ethical approval. Xingqi Pharmaceutical's SQ-22031 targets neurotrophic keratitis, aiming to restore the function of damaged neurons and improve corneal sensitivity and tear production. BRIM's BRM-421 eye drops (introduced in China by Grand Pharmaceutical as GPN00136) work by accelerating limbal stem cell proliferation and promoting goblet cell differentiation to improve tear quality. Zhaoke Ophthalmology, in collaboration with ReGenTree, is developing RGN-259, which leverages the protective and reparative properties of thymosin beta-4 to achieve dual effects of corneal repair and anti-inflammation.

The new generation of drugs also aims for rapid onset, addressing the long-standing industry challenge of patient adherence by improving patient trust and experience.

Historically, aside from artificial tears that provide immediate "hydration-on-demand," many dry eye drugs have suffered from slow onset of action, typically measured in weeks or even months. This directly contributed to insufficient patient trust and poor adherence, representing a major pain point in dry eye treatment. Therefore, "rapid onset" has become a key breakthrough goal for new dry eye drugs. Simultaneously, companies are continuously optimizing delivery methods, leveraging the dual advantages of fast action and user convenience to improve patient adherence.

Among the previously mentioned marketed drugs, Alcon's Tryptyr eye drops demonstrate efficacy starting on the first day, while Varenicline Tartrate Nasal Spray can promote tear secretion almost instantaneously.

Among drugs in development, clinical studies of VVN-001 eye drops indicate characteristics such as low irritation and fast onset. RGN-259 eye drops, across three Phase III clinical trials involving over 1,600 patients, showed statistically significant improvements in dry eye signs and symptoms in different patient populations after 1 and 2 weeks of treatment. PL-9643 directly addresses the core mechanism of harmful inflammation, avoiding the delayed onset associated with traditional drugs.

In summary, the R&D landscape for new dry eye drugs has formed a multi-target, multi-mechanism layout. This will drive the evolution of dry eye treatment from superficial hydration to promoting tear secretion, and ultimately to comprehensive maintenance of a healthy tear film "ecosystem." As these precision therapies become available in the future, they will provide more personalized treatment options for dry eye patients with different etiologies and varying degrees of severity.

With the advent of the precision treatment era for dry eye drugs, the long-standing market dynamic dominated by single blockbuster products may undergo reconstruction, gradually evolving into a diverse landscape with multiple contenders.

Among currently approved dry eye medications, artificial tear solutions directly increase tear volume and lubricate the ocular surface, providing temporary symptomatic relief and are suitable for mild dry eye. Anti-inflammatory eye drops act on inflammatory mediators to reduce ocular irritation and inflammation, while glandular secretagogues stimulate secretion from the lacrimal and meibomian glands. These latter two categories are primarily used for moderate-to-severe dry eye.

For a long time, artificial tears, primarily sodium hyaluronate eye drops, have been favored as a "one-size-fits-all" remedy by patients with various types of dry eye due to their rapid perceived effect, over-the-counter (OTC) availability, and easy accessibility. This contributed to a market structure dominated by single blockbuster products. To this day, leading sodium hyaluronate brands continue to experience sales growth.

As the mechanisms of action for dry eye drugs diversify, the market structure is poised for a shift. On one hand, innovative drugs each focus on specific etiologies and patient subgroups, such as Meibomian Gland Dysfunction (MGD), neurogenic dry eye, or severe dry eye. Each drug can establish its own advantage in its corresponding niche, fostering a scenario where multiple drugs occupy distinct, specialized segments. On the other hand, the "treating the root cause, not just symptoms" nature of these innovative drugs means they are not reliant on competing primarily on low price to capture market share. Instead, their core competitiveness is built upon efficacy and targeting precision.

Of course, opportunities still exist for the emergence of new blockbuster products within certain sizable patient subgroups. For instance, MGD, as a major cause of dry eye, involves a large patient population whose treatment needs remain insufficiently met.

In summary, the transformation of the dry eye drug market is gathering momentum, with precision treatment and personalized adaptation becoming the prevailing trend. Which product or brand will emerge as the fastest-growing under this new paradigm? The answer is highly anticipated.