Sinocelltech Faces Crisis: Flagship Product Implicated in Medical Insurance Fraud as Innovation Drug Companies Navigate Healthcare Policy Challenges

A criminal judgment has exposed the hidden corners of innovative pharmaceutical company Sinocelltech Group Limited.

A recent judgment (No. 2025 Zhe 038 Criminal First Instance 676) published by the Ruian People's Court revealed that the Zhejiang sales team of Sinocelltech Engineering Co., Ltd., a controlling subsidiary of Sinocelltech Group Limited, formed a complete medical insurance fraud chain with local medical institutions and hemophilia patients. Sales representatives induced patients to fabricate medical conditions and seek treatment without actual bleeding episodes, providing 4% rebates after obtaining medications through medical insurance.

One illiterate patient born in 1979 directly handed over their medical insurance card to sales representatives. Without undergoing any bleeding examinations, this patient obtained medications 41 times through three institutions, defrauding 1.19 million yuan from the medical insurance fund while personally profiting 35,000 yuan.

The core drug in this fraud case is Sinocelltech's "lifeline" product - Anjiayin.

As China's first domestically produced recombinant factor VIII product, Anjiayin rapidly became Sinocelltech's revenue engine after its 2021 launch. In 2024, out of the company's total revenue of 2.5 billion yuan, Anjiayin alone accounted for 1.89 billion yuan, representing over 75% of total revenue. Behind the remarkable growth story of sales surging from 134 million yuan to 1.89 billion yuan over three years, sales expenses skyrocketed simultaneously - the company's "external donations" expenditure surged from 24.77 million yuan in 2021 to 456 million yuan in 2024, an increase of nearly 20-fold.

As medical insurance regulatory enforcement intensified, the success story began to fade. In the first quarter of 2025, Sinocelltech's revenue declined 15.15% year-over-year, with net profit dropping 14.06%. The company acknowledged in investor communications: "Due to the impact of centralized procurement price reductions and medical insurance cost controls, the recombinant factor VIII market has contracted, leading to declining sales revenue for Anjiayin."

A brutal price war has already unfolded in the Guangdong Alliance's centralized procurement - Anjiayin's winning bid price dropped to around 2,000 yuan, approaching the price level of plasma-derived factor VIII. The deeper contradiction lies in the misalignment between medical insurance policies and clinical needs: the National Medical Insurance Catalog clearly stipulates that adult patients can only receive reimbursement when "limited to use during bleeding episodes," while preventive treatment is clinically crucial for avoiding joint damage.

As medical insurance fund supervision becomes increasingly sophisticated, Sinocelltech's predicament reflects the collective anxiety of innovative pharmaceutical companies: how to maintain boundaries between commercial expansion and medical insurance compliance? Whether Anjiayin can unlock medical insurance reimbursement coverage for adult preventive treatment will determine its ability to weather the current challenges. Regardless of the outcome, this case has sounded an alarm for the industry - any attempt to test the boundaries of medical insurance regulations will ultimately result in severe consequences.