Zaquvo surges past Fexuclue while K-CAB holds dominant lead; indications and global reach emerge as next battleground
The market for next-generation acid suppressants known as P-CABs — potassium-competitive acid blockers — is being rapidly reshuffled, driven by new drugs developed independently by South Korean pharmaceutical companies.
HK Inno.N's K-CAB continues to hold an overwhelming lead as the market's dominant player. But Zaquvo, a late entrant jointly backed by Dong-A ST and Jeil Pharmaceutical, has climbed to second place by monthly prescription revenue, setting off an intensifying battle with Daewoong Pharmaceutical's Fexuclue for the runner-up spot. All three products are widely cited as milestones demonstrating the maturity of South Korean pharmaceutical companies' independent research and development capabilities.
The most striking development is Zaquvo's rapid ascent. The drug posted 7.55 billion won (about $4.97 million) in out-of-hospital prescription revenue in May, securing second place in the P-CAB market.
Zaquvo received Ministry of Food and Drug Safety approval in April 2024 — designated as the country's 37th domestically developed new drug — and launched commercially on Oct. 1 of that year. It took the drug just 19 months to overtake Fexuclue for second place. On an annual basis, Zaquvo ranked third in 2025 with 44.3 billion won in out-of-hospital prescription revenue, but this year it has staged a complete monthly reversal.
K-CAB, the undisputed market leader, continues to raise the bar on the strength of its first-mover advantage. The drug recorded 217.9 billion won in annual prescription revenue in 2025 and commands more than 50 percent of the P-CAB market, maintaining a position no rival has come close to challenging.
K-CAB also leads on approved indications, holding five compared with four for Fexuclue and two for Zaquvo.
K-CAB has also accumulated 159 clinical research datasets — the largest body of evidence among domestic P-CAB drugs — a key factor reinforcing prescribing habits among physicians.
Daewoong Pharmaceutical is pushing back with differentiated clinical data behind Fexuclue. On May 4, the company received final Ministry of Food and Drug Safety approval for a new indication for Fexuclue 40 mg tablets: combination antibiotic therapy for the eradication of Helicobacter pylori.
Fexuclue now carries a total of four indications — treatment of erosive gastroesophageal reflux disease, improvement of gastric mucosal lesions in acute and chronic gastritis, prevention of nonsteroidal anti-inflammatory drug-induced peptic ulcers, and the newly added H. pylori eradication regimen.
silverpaper@heraldcorp.com
