In the first quarter of 2026, potassium-competitive acid blockers (P-CABs) continued to reshape Korea’s peptic ulcer treatment market, rapidly closing the long-standing gap with esomeprazole, a proton pump inhibitor (PPI) that has traditionally led outpatient prescription sales among single-ingredient drugs.
According to Hit News, citing data from pharmaceutical market research firm UBIST, outpatient prescription sales for 1,324 products in the “peptic ulcer agents” category (MFDS code 232) reached $283 million in the first quarter, up 6.3% from $266 million a year earlier.
Tegoprazan Gains Ground on Esomeprazole
Beyond overall market growth, the most notable shift lies in ingredient rankings. Esomeprazole maintained the top position with $38.6 million in prescriptions, up 4.1% year over year.
However, HK inno.N’s P-CAB drug K-CAB (tegoprazan) is rapidly closing in. It recorded $39.6 million in prescriptions—up 13.9% year over year—capturing a 14% market share. The gap with the top ingredient has narrowed significantly.
Rabeprazole dropped to third place despite solid 8.7% growth to $38.2 million, as it failed to keep pace with the accelerating adoption of P-CABs. Rebamipide followed in fourth place with $28.3 million (4.9% share).
Fifth place went to Daewoong Pharmaceutical’s P-CAB drug Fexuclue and its generics, which together generated $18.8 million in prescriptions, up 16.5% year over year. At this pace, the ingredient category is projected to reach $68 million annually.
In contrast, Artemisia extract products fell to sixth place, declining 18.7% to $17.1 million amid reevaluation-related challenges.
Meanwhile, Onconic Therapeutics’ Za Q Bo (zastaprazan) posted the most striking growth. Ranking seventh, it recorded $14.4 million in prescriptions—more than doubling year over year—highlighting its rapid market uptake.
Source: UBIST / Chart by Reporter Woojin Lee, Translated by Reporter Sodam Park
One in Four GI Prescriptions Now P-CAB
With K-CAB, Fexuclue, and Za Q Bo all ranking within the top 10, P-CABs have significantly expanded their market presence. Their share rose from 17.26% to 25.74% year over year, surpassing the 25% threshold.
This growth reflects intensified commercial strategies. HK inno.N and Jeil Pharmaceutical (Onconic Therapeutics) are actively expanding market penetration to establish flagship products, while Daewoong Pharmaceutical has strengthened promotion efforts. Its affiliate Daewoong Bio alone generated $1.69 million in prescriptions despite targeting a limited number of institutions.
In contrast, the PPI class declined to 44.57%, while H2 receptor antagonists fell to 10.16%. Other categories, including mucosal protective agents, also decreased from 23.66% to 19.52%.
Among the fastest-growing products, zastaprazan led with a 219.2% increase year over year. Calcium carbonate/rabeprazole rose 118% to $744,000, followed by calcium carbonate/esomeprazole at $1.62 million, up 22.3%. Despite smaller base sizes for combination products, zastaprazan’s growth stands out.
Source: UBIST / Chart by Reporter Woojin Lee, Translated by Reporter Sodam Park
P-CAB Momentum Reshapes Company Rankings
The rise of P-CABs is also driving shifts in company rankings. HK inno.N ranked first with $40.3 million in prescriptions, followed by Daewoong Pharmaceutical at $19.1 million. Jeil Pharmaceutical climbed to third place on strong growth.
Hanmi Pharmaceutical, previously third, fell to fourth as prescriptions declined 8% year over year to $11.2 million. Il-Yang Pharmaceutical, known for its blockbuster Noltec (ilaprazole), slipped to fifth despite growth to $8.72 million, as competitors expanded more aggressively.
The trend toward consolidation and widening gaps is becoming more apparent. HK inno.N remains the only company to surpass $135 million annually, reaching $150 million last year. Daewoong Pharmaceutical is the only other company exceeding $68 million. Jeil Pharmaceutical recorded $46.6 million in annual prescriptions, closely trailing Hanmi Pharmaceutical at $49.3 million.
At the current pace, Jeil Pharmaceutical is expected to solidify its position in third place and widen the gap further.
In short, the first-quarter data underscores a clear trend: the rapid expansion of P-CABs is accelerating and shows no signs of slowing.
Note:
As this analysis is based on a sample survey, results may differ from actual company sales. Different salt forms of the same active ingredient were aggregated under a single ingredient category, and all Artemisia extract products were combined regardless of extraction solvent.
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