Xiao Wang, the patient has hemorrhagic shock with a blood pressure of 40/20mmHg and a lactate concentration of 10.2mmol/L. Immediately prescribe 500ml of Sodium Lactate Ringer for rapid intravenous infusion! ”In the operating room, the emergency department director Li Jianguo's voice was urgent. This scene is repeated every day in nearly 30000 secondary and above hospitals across the country - as the most commonly used balanced salt solution in clinical practice, Sodium Lactate Ringer Injection (hereinafter referred to as "Ringer Injection") has long become the "life supplement" for emergency, surgery, and intensive care. This article will systematically analyze the value and industrial development logic of this classic injection from an industry perspective, combined with clinical data and market dynamics.
--1、 Industry Overview 1 According to the requirements of the National Medical Products Administration's "Classification and Application Materials for Chemical Drug Registration", Rulin Liquid belongs to the category of "electrolyte balance regulating drugs" (classification code: H05B), with the core function of supplementing extracellular fluid, regulating electrolyte and acid-base balance. Its composition strictly follows the standards of the Chinese Pharmacopoeia (2020 edition): it contains 3.10g of sodium lactate, 6.00g of sodium chloride, 0.30g of potassium chloride, and 0.20g of calcium chloride (anhydrous) per 1000ml, with an osmotic pressure similar to plasma (272-295mOsm/L) and a pH value of 6.0-7.5. It is one of the most clinically recognized isotonic equilibrium solutions.
The industry segmentation areas mainly include: ① Conventional large volume injections (500ml, 1000ml); ② Pre filled small volume injections (50ml, 100ml); ③ Modified type for special indications (such as children's specific type without preservatives). two The industrial chain structure of the dairy industry presents a three-level structure of "raw materials formulation terminal": - Upstream: raw material suppliers, including sodium lactate (25% of cost), sodium chloride (15%), potassium chloride (10%), and packaging materials (glass bottles/soft bags/PP bottles, 30%). Key enterprises include Shandong Luxi Chemical (Sodium Lactate), China National Salt Corporation (Sodium Chloride), and Cangzhou Mingzhu (Medicinal Soft Bags).

-Midstream: Formulation production enterprises, the core barrier is sterile filling technology and quality control (requiring GMP

certification). Leading enterprises include Kelun Pharmaceutical (32% market share), China Resources Shuanghe (25%), and Zhengda Tianqing (18%), with CR3 reaching 75%.

-Downstream: Terminal medical institutions (accounting for 85%, mainly tertiary hospitals), retail pharmacies (accounting for

10%, mainly used for home fluid replacement), and pre hospital emergency system (accounting for 5%, such as 120 emergency vehicles on standby).

---2. Market Status Analysis 1 According to the "2024 China Large scale Infusion Market Research Report" by MiNet, as the core category of balanced salt solutions, Rulin Liquid's market size reached 8.26 billion yuan in 2024, with a compound annual growth rate of 8.7% from 2020 to 2024 (the overall growth rate of large scale infusion during the same period was 5.2%). The main reasons for the growth are the increase in surgical operations (National Health Commission data: the number of surgeries in China reached 72 million in 2024, an increase of 35% compared to 2020) and the expansion of intensive care units (ICUs) (the number of ICU beds in tertiary hospitals exceeded 400000 in 2024, doubling from 2020).

Year
2020, 2021, 2022, 2023, 2024

Market size (in billions of yuan)
56.3, 61.2, 66.5, 73.1, 82.6

Year on year growth rate
-8.7%, 8.7%, 9.9%, 13.0%

2. The competitive landscape is highly concentrated in the industry, with a CR5 of 88% and leading enterprises relying on production capacity and quality advantages:

- Kelun Pharmaceutical: has the world's largest large infusion production base (with an annual production capacity of 1.5 billion bottles), reducing the bag breakage rate to 0.01% (industry average 0.03%) through "upright soft bag" technology, and a market share of

32% in 2024.

.

-China Resources Shuanghe: Focusing on the "precise fluid replacement" scenario, we have launched the "low-dose lactam solution for children" (100ml/bag), which will account for 45% of the segmented market by 2024. -Zhengda Tianqing: Expanding into overseas markets, with a total export value of 120 million US dollars for dairy products in 2024 (mainly to Southeast Asia), a year-on-year increase of 40%. three User Profile: The terminal usage is mainly focused on medical institutions. According to the hospital procurement data of Yaozhi Network in 2024, the departments used are emergency (35%), surgery (30%), ICU (25%), and obstetrics (10%); -Hospital level: Third level hospital (accounting for 60%, with an annual procurement volume of over 5 million bags), second level hospital (30%), primary medical institution (10%, with the fastest growth rate in recent years); -Usage scenarios: Perioperative fluid replacement (55%), shock resuscitation (25%), correction of metabolic acidosis (15%), and others (5%). --3、 Technology and Trend Analysis 1 The core technology evolution of Rulin Liquid focuses on "formulation process optimization" and "quality control upgrade": - Aseptic assurance technology: Traditional glass bottles require high-pressure sterilization at 121 ℃, which can easily lead to the decomposition of sodium lactate (degradation rate of about 2%); The "nitrogen filled soft bag" technology launched by Kelun Pharmaceutical in 2023 reduces the degradation rate to 0.5% through nitrogen protection, and is listed as a recommended process in the "Chinese Infusion Treatment Guidelines (2024 Edition)". -Precise control of osmotic pressure: CR Shuanghe adopts an "online osmotic pressure monitoring system" to reduce the fluctuation range of product osmotic pressure from ± 5% to ± 2%, which is closer to human plasma (285mOsm/L) and reduces the infusion reaction rate (from 0.1% to 0.03%). two Future trend prediction - policy driven: In 2023, the National Health Commission's "Emergency Capacity Building Standards for Grassroots Medical Institutions" require "all community health service centers to be equipped with balanced salt solutions". It is expected that the grassroots market size will increase from 830 million yuan in 2024 to 1.5 billion yuan by 2025 (CAGR 34%).

- Technological iteration: Pre filled milk forest liquid (50ml/vial) has replaced 20% of traditional large packaging in some tertiary hospitals since its launch in 2024, as it does not require compatibility and reduces pollution risks. It is expected that the penetration rate will reach 30% by 2025, promoting a 15% increase in unit price (traditional 500ml bags cost 4.5 yuan, pre filled 50ml vials cost 8 yuan).
-Change in demand: With the increasing aging population (15.6% of the population aged 65 and above in 2024), the number of patients with chronic kidney disease (requiring correction of metabolic acidosis) has increased to 130 million, and the use of Rulin liquid in nephrology is expected to increase by 20% by 2025. three Analysis of Emerging Scenarios - Pre hospital Emergency Care: Beijing Emergency Center will pilot the "Pre filled Milk Forest Fluid Equipping for Emergency Vehicles" in 2024, which will shorten the first dose of fluid replacement for shock patients from 30 minutes after admission to 5 minutes on site, and increase patient survival rate by 8% (based on 1200 case statistics).
-Sports Medicine: Medical facilities for marathon events have started using low-dose lactam solution (100ml) for correcting sports induced dehydration. In 2024, the national procurement volume for large-scale events reached 500000 units, an increase of 100% compared to 2023.
--4、 Challenge and Opportunity 1 Existing challenges - Fluctuations in raw material prices: Sodium lactate raw materials are affected by corn prices (with an 18% increase in corn prices in 2023), resulting in a 5% increase in production costs for dairy forest liquid. The industry average gross profit margin has decreased from 52% in 2020 to 45% in 2024.
-Policy pressure risk: In the seventh batch of national drug procurement in 2024, the bid price of Rulin liquid decreased by 12% compared to the benchmark price (from 5.2 yuan/bag to 4.6 yuan/bag), and it is expected that the profits of leading enterprises will decrease by 3-5 percentage points by 2025.
-Alternative product competition: The new sodium acetate Ringer's solution has a faster metabolism (lactate needs to be metabolized by the liver, while acetic acid can be directly utilized by muscles), and its penetration rate in the ICU has increased from 5% in 2020 to 15% in 2024, diverting some of the demand for Ringer's solution.

2. Development Opportunities - Deepening Domestic Substitution: Although Rulin Liquid has been 100% domestically produced, packaging materials (such as high-pressure resistant PP bottles) still rely on imports (Asahi Kasei of Japan accounts for 60% of the market share). In 2024, the "domestically produced high-pressure resistant PP bottles" developed by Cangzhou Mingzhu will pass the drug packaging material certification. It is expected that the import substitution rate will reach 30% by 2025, reducing packaging material costs by 10%.
-Green Production Dividend: The energy consumption of the infusion industry accounts for 8% of the pharmaceutical manufacturing industry (according to data from the National Bureau of Statistics in 2023). Kelun Pharmaceutical's "steam waste heat recovery system", which will be put into use in 2024, can reduce energy consumption by 25% and receive a government subsidy of 20 million yuan per year. It is expected that the industry's green process penetration rate will exceed 50% by 2025.
-Consumer upgrade demand: The proportion of high-end preparations (such as non pyrogen milk forest solution) used in neonatology has increased from 10% in 2020 to 35% in 2024, with a unit price twice that of ordinary preparations (9 yuan/bag) and a gross profit margin of 60%, becoming a new profit growth point.
--5、 Suggestions and Prospects 1 Enterprise strategy suggestion - Leading enterprises (such as Kelun and Shuanghe) should accelerate the layout of high-end dosage forms such as pre filled and non pyrogen formulations, while expanding overseas markets (with an annual increase of 12% in demand for large infusion solutions in Southeast Asia and the Middle East). Referring to Kelun Pharmaceutical's 2024 strategy: investing 300 million yuan in the research and development of pre filled production lines, achieving a revenue of 280 million yuan that year, increasing the proportion to 15%.
-Small and medium-sized enterprises: Focus on segmented markets, such as developing "100ml simple packaging" for primary healthcare institutions (reducing costs by 30%), or collaborating with chain pharmacies to launch "home rehydration kits" (including lactam solution and rehydration knowledge manual). A regional pharmaceutical company will increase its market share at the grassroots level in Henan from 5% to 12% through this strategy in 2024. two Investment Risk Warning - Technological Iteration Risk: If Sodium Acetate Ringer's Solution is negotiated through medical insurance in 2025, it may result in a loss of 10% of the market share of Rulin's Solution, corresponding to an investment loss of approximately 800 million yuan (calculated based on the scale of 2024).

- Policy change risk: If the country includes Rulin liquid as a "key monitored drug" by 2025, it may restrict its use in non essential scenarios, and the market size is expected to decrease by 15% (about 1.2 billion yuan).
-Market competition risk: New entrants (such as some raw material pharmaceutical companies transforming into formulations) may seize the market through low price strategies. It is expected that the industry CR3 will decrease from 75% to 70% by 2025, and the profits of top companies will be compressed by 5%.
--This seemingly ordinary liquid connects the entire life chain from the raw material workshop to the operating room. ”The head of the infusion division of Kelun Pharmaceutical expressed his emotions at the 2024 industry summit. With technological upgrades and demand differentiation, the dairy industry is shifting from "scale expansion" to "quality and scenario innovation". Whoever can take the lead in high-end formulations, grassroots penetration, and green production in the future will continue to lead in this "life supplement" track.