Neurology · Memory · 2026
Oligomannate (GV-971),
China-only access for AD.
Sodium oligomannate, conditionally NMPA-approved in 2019 for mild-to-moderate Alzheimer’s disease. Marketed only in China. Memory-clinic workup at the country’s reference neurology centres, with bilingual report and structured home-neurologist handover.
Nov 2019
Conditional NMPA approval
Mild-to-moderate Alzheimer’s — China only
NMPA register
$130–180
Oligomannate / month
NMPA-listed post-NRDL pricing
Hospital pharmacy quotes
Cell Res 2019
Pivotal phase 3
n=818 · 36 weeks · ADAS-Cog12 endpoint
Wang et al.
Not FDA / EMA
China-only access
International phase 3 (GREEN MEMORY) discontinued
Public registry
Memory clinic
Workup pathway
MRI · MMSE/MoCA/ADAS-Cog · reversible-cause labs
NIA-AA standard
Combinable
With ChEI / memantine
Anti-amyloid mAb selection by MDT
Local clinical guidance
Tiers & pricing
Six pathways, transparent pricing.
Memory-clinic workup + cycle 1
Neurology consult, MRI, cognitive battery, reversible-cause labs, first month oligomannate, bilingual report.
$1,200–1,800
Refill / month (oral)
Oligomannate at hospital-pharmacy NMPA-listed price. Optional remote 3-month neurology follow-up.
$130–180
CSF biomarker panel
Lumbar puncture with Aβ42, Aβ40, p-tau181, t-tau. Diagnostic refinement before therapy.
$450–950
Amyloid PET
Florbetapir / florbetaben PET where available. Helps select anti-amyloid mAb candidates.
$1,800–2,800
Anti-amyloid mAb pathway
Lecanemab / donanemab for biomarker-positive early AD. ARIA monitoring required. Separate package.
$3,500–6,500 / month
Annual re-evaluation
Cognitive battery, neurology consult, MRI if indicated, medication review.
$650–1,100
Top centres
Where international patients
access AD care.
Huashan Hospital, Fudan 华山医院神经内科
Class A · National neurology reference centre · large memory-disorder clinic · biomarker depth
Xuanwu Hospital, Capital Medical University 宣武医院
Class A · National geriatric neurology and memory disorders centre · cognitive trial site
Peking Union Medical College Hospital 北京协和医院
Class A · diagnostic excellence · atypical dementia phenotyping · CSF biomarker availability
Ruijin Hospital, SJTU 瑞金医院神经内科
Class A · strong cognitive disorders programme · co-management with psychiatry
FAQ
Oligomannate in China — answered.
- What is oligomannate (GV-971) and why is it China-only?
- Sodium oligomannate (商品名 九期一, GV-971, manufactured by Shanghai Green Valley) is an oligosaccharide derived from brown algae, conditionally approved by NMPA in November 2019 for mild-to-moderate Alzheimer’s disease based on a 36-week phase-3 trial in Chinese patients. The proposed mechanism is gut-microbiota modulation reducing peripheral and brain neuroinflammation. It is not approved by FDA or EMA — a phase-3 international trial (GREEN MEMORY) was initiated and later discontinued. As of 2026 it remains marketed only in China. Patients seeking access must come to China.
- Is the evidence convincing?
- We present this honestly. The pivotal Chinese phase-3 (Wang et al., Cell Research 2019; n=818, 36 weeks) showed a statistically significant ADAS-Cog12 difference vs placebo at week 36 (around 2.5 points). The trial has been discussed critically in international neurology (concerns about the trajectory of the placebo arm, short duration, and limited biomarker data). The conditional NMPA approval is exactly that — conditional, with post-marketing data requirements. We do not claim oligomannate is equivalent to or superior to FDA-approved AD therapies (donepezil, memantine, lecanemab, donanemab). It is one option, with imperfect evidence, available only in China. Decisions should be made with a treating neurologist after full case review.
- Who is potentially appropriate?
- NMPA label: mild-to-moderate Alzheimer’s disease (MMSE typically 11–26). Standard pre-prescription workup at the partner memory clinic includes: confirmation of clinical AD diagnosis (NIA-AA criteria); structural brain MRI; cognitive battery (MMSE + MoCA + ADAS-Cog); functional / behavioural scales (ADCS-ADL, NPI); rule out reversible causes (TSH, B12, folate, syphilis, HIV, metabolic panel); consideration of biomarker testing (CSF amyloid / tau or amyloid PET where available) for diagnostic refinement. Clear contraindications: known hypersensitivity to component oligosaccharides; severe hepatic or renal impairment; pregnancy.
- What does it cost?
- NMPA-listed price for oligomannate after national reimbursement (NRDL): approximately $130–180/month at hospital pharmacy. International patient package — 3-day memory-clinic workup including neurology consult, MRI, cognitive battery, reversible-cause labs, first month of medication, and bilingual report — $1,200–1,800. Add-ons: CSF biomarker panel (Aβ42, Aβ40, p-tau181, t-tau) where available $450–950; amyloid PET where available $1,800–2,800; APOE genotyping $80–150; caregiver-training session $80–150.
- Can it be combined with donepezil, memantine, or anti-amyloid antibodies?
- Yes for cholinesterase inhibitors and memantine — these are routinely co-prescribed in China per local clinical guidance, and the partner neurologists typically recommend continuing standard-of-care symptomatic therapy alongside oligomannate. Anti-amyloid monoclonal antibodies (lecanemab / Leqembi was NMPA-approved in 2024; donanemab subsequently) are available at select Chinese centres for amyloid-positive early AD, but selection between oligomannate and anti-amyloid mAb is non-trivial and depends on disease stage, biomarker status, ARIA risk and patient preference. A neurology MDT review is recommended for complex decisions.
- Can I bring it home? Refill workflow?
- Yes — oligomannate is a non-controlled prescription medication and most countries permit personal-use import of a 90-day supply with original NMPA labelling and a physician’s letter. We provide bilingual prescription, English drug-information sheet, attending-neurologist letter for customs, and a structured handover document for your home neurologist. Long-term refills can be coordinated with periodic remote follow-up plus annual in-person re-evaluation (cognitive battery, MRI if indicated, medication review).
- What are the side effects?
- From the pivotal phase 3 and post-marketing experience: most common are mild GI symptoms (loose stools, abdominal discomfort) and transient elevations in lipase / amylase. Serious adverse events were comparable to placebo in the phase 3 — but post-marketing data continue to accumulate and are reviewed by NMPA. We provide a 24/7 contact for the first 60 days of therapy and follow-up labs at 3 and 6 months for liver function, kidney function, and pancreatic enzymes.
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For information only. Not medical advice. Oligomannate is conditionally NMPA-approved and is not approved by FDA or EMA. Decisions about Alzheimer’s therapy must be made by a treating neurologist with full case review.