2026: The Tipping Point for Radiopharmaceuticals – Evolving Deal Logic and Industrial Chain Synergy

In recent years,Nuclear medicine is moving from a niche track to the strategic high ground of the global pharmaceutical industry.With the continued approval of radioligand therapy (RLT) products, the pace of industry development has accelerated significantly. Products represented by Novartis’ Lutathera® (177Lu-DOTATATE) and Pluvicto® (177Lu-PSMA-617) have achieved verifiable commercial success, not only substantially boosting market confidence in radiopharmaceutical therapies but also propelling the global radiopharmaceutical market into a phase of accelerated expansion. Meanwhile, infrastructure-focused acquisitions surrounding radionuclide supply, conjugation platforms, and target resources have emerged in European and American markets, becoming a core strategy for multinational pharmaceutical companies to establish their presence in RLT.

In China, the radiopharmaceutical industry is approaching a critical juncture for systemic competition. On the diagnostic front, with multiple mature products already launched; meanwhile, innovative imaging agents such as fluorine-18 (18F)-labeled cardiac imaging agents have entered Phase III clinical trials, and the registration process for tracers related to prostate cancer and neurodegenerative diseases is advancing steadily;Treatment End, domestically developed innovative radiopharmaceuticals are expected to reach their first commercialization milestone in 2026, making it a pivotal year signaling industry growth.

Against this backdrop, VCBeat and MicroMedicine jointly hosted the 9th session of the "China Innovative Medical Asset Living Room Transaction Roundtable," themed “Breaking Through the Billion-Yuan Barrier: Deep-Diving into the Logic and Investment Value of Radiopharmaceutical Deals.” The live session was moderated by He Jiongling, General Manager of the Pharmaceutical Division at Xinghua Dingli. The panel featured experts covering key sectors including industry, capital, business development (BD), and clinical compliance: Bai Ge, Chief Operating Officer of Guotong New Drug; Cheng Chao, Executive Director of Cold Fir Capital; Xia Long, Managing Director of Yifeng Capital; Yang Guotao, Chief Operating Officer of Quark Medicine; and Zhao Huanyu, Vice President of Business Development at Jinghe Biologics. The guests offered diverse perspectivesShared the Core Considerations and Real-World Logic of Buyers and Sellers in Radiopharmaceutical Transactions, providing the industry with a systematic and practical framework for decision-making reference.

Over the past two years,Mergers and acquisitions in the radiopharmaceutical industry have evolved from bidding on single pipelines to systematic strategic layouts by multinational pharmaceutical companies across supply chains, radionuclide manufacturing, and conjugation platforms.。

Guotong New Drug’s Chief Operating Officer, Bai Ge, defined this as “the first wave of moves by multinational pharmaceutical companies to acquire infrastructure,” he mentionedOverseas Companies Demonstrate Strong Inclusiveness in Technological Exploration, with molecular structures spanning small molecules, peptides, and nanobodies, alongside simultaneous development of beta-emitting radionuclides (such as 177Lu) and alpha-emitting radionuclides (such as 225Ac). Under this “all-encompassing” trial model, companies with rapid validation capabilities have become the core drivers of technology translation.

Cheng Chao, Executive Director at Abies Creek Capital, supplemented the discussion on differences in industrial capabilities from a capital perspective: “Chinese companies demonstrate prominent advantages in early-to-mid-stage R&D. The engineer dividend and the efficiency of advancing Investigator-Initiated Trials (IITs) have enabled us to”Faster optimization of popular targets and exploration of new targets“, but foreign multinational corporations (MNCs) hold significant advantages in global registration following Phase III clinical trials, as well as in the global production, distribution, and commercialization systems for radiopharmaceuticals.” Based on this disparity, Cold Fir Capital also focuses on innovative platform-based radiopharmaceutical projects, providing full-cycle investment coverage.

The differences in transaction valuation logic are equally stark. Zhao Huanyu, Vice President of Business Development at Jinghe Bio, pointed out based on practical experience that while the underlying logic of nuclear medicine transactions between China and the United States (such as patent protection and barrier considerations) is not fundamentally different, the core areas of focus diverge significantly:Overseas buyers place greater emphasis on the first-in-class (FIC) potential of drug pipelines and the alignment of indications; domestic buyers focus on the feasibility of market implementation, showing greater sensitivity to manufacturing support, market access pathways, pricing, and financial terms.. She specifically emphasized that in cross-border transactions, non-financial clauses—such as safeguards for project advancement and voting rights in joint decision-making—are often overlooked yet critical to risk prevention and control.

Yang Guotao, Chief Operating Officer of Quark Medicine, added,Multinational pharmaceutical companies place greater emphasis on controlling compliance details., with a particular focus on protocol deviations and the completeness of PED records, while requiring projects to simultaneously comply with regulatory standards in multiple countries and regions, including China, the United States, Europe, and Japan. The 2020 edition of China’s Good Clinical Practice (GCP) clearly defines vulnerable populations, a concept not explicitly described in ICH GCP. Furthermore, while overseas regulations encourage risk-based monitoring plans and Decentralized Clinical Trials (DCTs), current Chinese standards lack explicit provisions in these areas. Nevertheless, both Chinese and international frameworks align on the core principles of protecting subject rights and prioritizing scientific integrity.

Xia Long, Managing Director at Yifeng Capital, combined with investment practice, pointed outThe core challenge of overseas M&A lies in integration management amid cultural differences, while domestic M&A focuses on the struggle for control and benefit distribution.He also emphasized that innovative drug assets undergo rapid technological iteration, and holding them for too long can lead to depreciation. For instance, the kinase inhibitor sector, once highly sought-after, now struggles to attract top-tier investors, highlighting the industry’s high demands on the pace of integration amidst rapid iteration.

He Jiongling, General Manager of the Pharmaceutical Business Division at Xinghua Dingli, concluded that the widening divergence in risk appetite between Chinese and U.S. capital markets has further amplified differences among buyers:The U.S. Market Is Dominated by Long-Term Patient Capital, exhibit a high tolerance for the risks associated with the high barriers to entry and long development cycles of radiopharmaceuticals, and are willing to invest in early-stage pipelines; Chinese capital is more significantly affected by market and policy fluctuations,Prefer to intervene at the stage of technological maturity and clear development paths, with a focus on commercial implementation and stable returns.

The Essence of Buyer Differences Between China and the US Lies in Different Industrial Stages: Overseas markets have entered a phase of integrating engineering systems with production capabilities, while China is transitioning from leveraging R&D efficiency advantages to building comprehensive systemic capabilities. As domestic products approach commercial launch and supply chains take shape, China’s radiopharmaceutical industry is shifting from “project-based competition” to “systemic competition.” The future transaction logic will increasingly center on data, engineering, and regulatory compliance, which has become an industry consensus.

A Clear Consensus on the Global Expansion of Radiopharmaceuticals: Advanced Technology Is a Necessary but Not Sufficient ConditionWhat truly determines the success or failure of global expansion is the persuasiveness of clinical data, the completeness of the engineering system, and the feasibility of replicating and implementing the technology across different regions.。

Bai Ge categorizes the global expansion pathways for radiopharmaceuticals into two types. The first involves the internationalization of de novo innovative pipelines, where global competitiveness must ultimately be validated by clinical data; the novelty of targets or molecular structures holds transactional value only when it demonstrates clear differentiation at the patient level. The second pertains to the export of platform-based technologies, which hinges on engineering efficiency and systemic capabilities. To serve as an entry point for collaboration with multinational pharmaceutical companies, these platforms must outperform their international counterparts in terms of efficiency, cost, or success rate in areas such as cyclic peptides, polypeptides, or AI-assisted molecular design. He revealed that new cross-border collaboration cases are expected to emerge for both models within the next six months.

Zhao Huanyu added an assessment of fit from the buyer’s perspective: When multinational pharmaceutical companies evaluate Chinese radiopharmaceutical assets, they look not only at technological leadership but also at how well these assets integrate with their own CMC systems and commercialization networks, as well as their potential for synergy with existing pipelines in terms of indication selection and combination therapies. As overseas pharmaceutical companies complete their infrastructure deployment in radionuclides and engineering capabilities, they are gradually shifting their focus to pipeline assets with differentiated potential that can be rapidly incorporated into their existing systems.

Yang Guotao emphasized the value of data at the execution level: in cross-border collaborations and due diligence, the value of data lies not only in efficacy outcomes but also in the standardization and traceability of the generation process. Radiopharmaceuticals must navigate multiple regulatory systems, where any deficiencies in protocol execution, record completeness, or compliance details can directly impact the overseas acceptability of the data.

Multiple experts regard radionuclides and their supply systems as key barriers to international expansion. Cheng Chao pointed out that while chelation and supply chains for metallic radionuclides such as Lu-177 are relatively mature, alpha-emitting radionuclides like Ac-225 remain constrained by limited production capacity and high costs. Furthermore, because radiopharmaceuticals possess both biological and physical half-lives, the traditional pharmaceutical model of “centralized production and global distribution” is difficult to replicate. Consequently, continuous, stable production and cross-regional supply capabilities have become core challenges in going global.

From the perspective of industrial synergy, Xia Long noted that the core strength of domestic nuclear medicine biotech companies lies in early-to-mid-stage R&D, enabling rapid technological breakthroughs in target identification and molecular design. However, it is difficult to independently establish the production networks, cross-regional compliance frameworks, and commercialization channels required for global deployment in the short term. Furthermore, constrained by the dual half-lives of radioisotopes and radiopharmaceuticals, cross-border supply chains and localized services entail high complexity, making it easy for individual enterprises to deplete their resources if they pursue international expansion alone. Therefore, going global requires a strategy of “technology export plus leveraging established systems,” whereby companies capitalize on their innovative strengths to integrate with the mature global ecosystems of overseas multinational corporations (MNCs), thereby rapidly addressing gaps in commercial execution.

From a capital and transaction perspective, He Jiongling pointed out that domestic enterprises should leverage their innovation advantages in early-to-mid-stage R&D, while proactively aligning with mature overseas compliance systems and commercialization resources. In particular, they should plan ahead for pricing strategies, health insurance reimbursement pathways, and supply chain adaptation, ensuring that technological innovation is matched by implementation capabilities, thereby realizing value in the global market.

In the field of radiopharmaceuticals, deal completion is merely the starting point; what truly determines success or failure is the capability for systematic post-transaction integration.The value realization of radiopharmaceuticals is highly dependent on the synchronized advancement of three pillars: R&D, manufacturing, and regulatory compliance., any bottleneck in one link will amplify the overall risk.

From the perspective of investment screening logic, Cheng Chao pointed out that capital is not focused on a single technical highlight,Greater attention should be paid to the “scalability” of radiopharmaceuticals at the engineering and supply chain levels.Whether the target mechanism possesses differentiated potential, whether the conjugation technology can support scalable manufacturing, and the stability of radionuclide supply coupled with cost-control capabilities will all directly impact the pace of clinical development and commercialization.

Once truly entering the integration phase, challenges rapidly shift from “technical assessment” to “execution and implementation.” Drawing on his practical experience in radiopharmaceutical companies, Bai Ge pointed out that the integration complexity of radiopharmaceutical projects is significantly higher than that of traditional drugs, with core pressures concentrated in two key areas: CMC scale-up and clinical advancement. These involve extensive and detailed tasks such as technology transfer, validation of data consistency, and regulatory communications. “This is not an issue that can be resolved through processes or routine meetings,” he emphasized. The key to alliance management lies in whether teams genuinely achieve synergy. Whether it involves forward integration following the in-licensing of overseas assets or reverse collaboration after mergers and acquisitions, human factors always take precedence.

From clinical and compliance perspectives, Yang Guotao further pointed out that radiopharmaceuticals are constrained by both biological and physical half-lives, imposing higher requirements on production, transportation, and usage. In cross-border transactions, due diligence does not necessarily entail stricter standards, but rather demands greater rigor in execution details and data integrity. The replicability of projects across different regulatory frameworks will directly influence the depth of subsequent collaborations.

Regarding the alignment between transaction structure and execution, Zhao Huanyu pointed out from a business development (BD) perspective that as the market matures, buyers’ assessment of assets is shifting from “technological potential” to “system compatibility.” Key factors influencing deal closure now include whether the asset can be integrated into existing CMC and commercialization systems, whether risk-sharing mechanisms are clearly defined, and whether project advancement remains controllable.

At the post-investment management level, He Jiongling further pointed out that the role of capital is not to directly intervene in R&D decision-making, but to help companies address capability gaps in non-R&D areas, including regulatory registration, supply chain management, and systematic preparations for commercialization, thereby facilitating the team’s gradual transition from an R&D-centric model to a product- and market-oriented organizational structure.

Xia Long cautions that the core of post-transaction integration in nuclear medicine lies in “synergy efficiency” and “risk control.” The industry’s characteristics of high capital investment and stringent regulation dictate that integration should not blindly pursue full value-chain coverage, as this may easily lead to capital stagnation, delayed progress, or even cash flow breaks. Integration must focus on core synergies, ensuring consistency in R&D data and scalability of manufacturing processes, while rapidly aligning with compliance standards and securing a stable supply chain. Only by forming a closed loop among R&D, production, and compliance can asset value be fully realized.

In summary, the panelists have reached a clear consensus:The True Barrier to Nuclear Medicine Deals Lies Not in Signing the Contract, but in Post-Transaction Execution CapabilityOnly by simultaneously strengthening all three pillars—R&D, production, and compliance—can transaction value be truly transformed into long-term competitiveness.

Multiple experts concurred that 2026 will mark a significant watershed for China’s radiopharmaceutical industry. The significance of this milestone lies not only in the advancement of individual products, but more importantly in the emergence of a replicable, integrated framework encompassing radionuclide supply, engineering systems, clinical pathways, and commercialization conditions, thereby shifting the industry from “feasibility validation” to “systematic competition.”

From the perspective of capital and valuation, Xia Long pointed out that 2026 will be a critical year for the market validation of the nuclear medicine business model. Apollomics and Grand Pharma are advancing their core pipelines centered on Lutetium-177 to the New Drug Application (NDA) and Phase III stages, respectively. Factors such as approval progress, operational efficiency of the nuclear medicine supply chain, and future commercial performance will directly impact the valuation framework of nuclear medicine companies. Market feedback following Apollomics’ listing on the Hong Kong Stock Exchange is also regarded as a key barometer.

In terms of medium- to long-term strategic planning, Cheng Chao believes that new targets, alpha-emitting radionuclides (such as At-211 and Ac-225), low-cost scalable radionuclide production technologies, and conjugation platforms with scale-up potential will remain key focus areas over the next three to five years. As some projects reach critical clinical milestones, 2026 is expected to witness a surge in data-driven business development (BD) transactions.

From an engineering and commercialization perspective, Yang Guotao views radionuclide supply as one of the most critical variables in 2026. He noted that the stabilization of Lutetium-177 (Lu-177) supplies and the gradual emergence of domestic suppliers for radionuclides such as Actinium-225 (Ac-225) will reduce uncertainties surrounding clinical initiation and volume scale-up. However, companies must simultaneously meet regulatory requirements imposed by drug administration and ecological environment authorities, with compliance capabilities directly impacting the pace of progress.

Regarding pipeline evolution, Bai Ge predicts that 2026 will mark an accelerated phase of indication expansion: overseas, diagnostic radiopharmaceuticals for Alzheimer’s disease (AD) have entered the New Drug Application (NDA) stage, while similar products in China are advancing to Phase III trials; in the field of cardiac nuclear medicine, fluorine-18-labeled PET imaging agents are poised for breakthroughs; and in solid tumors, the focus is expanding from neuroendocrine tumors and prostate cancer to liver, gastric, and esophageal cancers, which are prevalent in China.

Zhao Huanyu added from a business development perspective that radiopharmaceuticals possess integrated theranostic properties, with significant potential for expanding indications in the diagnostic field; on the therapeutic front, oncology remains the primary strategic focus. Drawing on overseas transaction cases such as Novartis’s acquisition of DLL3 assets and BMS’s in-licensing of ACP3 assets, radiopharmaceuticals demonstrate unique advantages in targeting HER2 and other markers, capable of addressing unmet needs not covered by existing drugs, with more novel target layouts expected to emerge in the future.

He Jiongling added that the radiopharmaceutical trading market in 2026 will be more mature and refined, with a greater emphasis on strategic synergy. Future competition in the radiopharmaceutical industry will shift comprehensively from previous comparisons of single pipelines to ultimate contests at the level of the entire industrial chain.

In the outlook session, panelists offered relatively consistent judgments from various perspectives: Bai Ge believes that the capital market will exhibit a distinct tiered structure with more flexible investment approaches, and business development (BD) is poised for a breakthrough year; Zhao Huanyu assesses that domestic radiopharmaceuticals remain in an early stage but are expected to accelerate over the next one to two years; Yang Guotao emphasizes that radionuclide supply and integrated diagnosis and therapy will see significant improvement; Xia Long anticipates that radiopharmaceuticals will gradually succeed antibody-drug conjugates (ADCs) as the new focal point of BD; and Cheng Chao summarizes the industry’s pace as “nurturing hope and awaiting harvest.”

2026 May Become the Tipping Point for China’s Radiopharmaceutical Industry: The Focus Shifts from Single-Pipeline Competition to Supply Chain Collaboration, and from Project-Based Exploration to Systematic Development.As some products enter the phase of commercialization exploration, pricing, medical insurance inclusion, and commercial performance are expected to undergo intensive validation, providing clearer benchmarks for subsequent industrial and capital decisions.

China Innovative Healthcare Assets Lounge – "Deal Roundtable" Episode 12

Roundtable Theme: Technological Breakthroughs Leading Transformation—The Path to Domestic Substitution of Core Components in Medical Imaging

Inviting key representatives from Chaoqun Testing, Xinsheng Jiechuang, Shenzhen Capital Group, Yueyin Medical Fund, and Tainuo Fund to discuss new trends in the domestic substitution of core components for medical imaging!

Scan the QR code on the poster to book your free appointment!