China's meteoric rise in pharmaceuticals threatens US supremacy but what about patients?

Subscribe to enjoy similar stories.The old pharma order anchored around cutting-edge advances in the West has quietly disappeared. What we have now is a bipolar industry centred on the US and China—with implications for patients and policymakers worldwide. China has closed the gap on the number of research studies being conducted and in certain cases even moved ahead of the West on developing new treatments.

Global drugmakers understand this shift very well—having inked hundreds of billions of dollars in deals over the past five years to license promising Chinese innovations for sale overseas to replenish their coffers. US President Donald Trump, in particular, needs to reconsider the wisdom of demanding another year of cuts to America’s biggest science agencies—which fund research that can eventually seed commercial breakthroughs—and the resulting brain drain of top scientists. Strategic rival China is putting technology, including pharma, front and centre of its economic plan.

It outspent the US on R&D as early as two years ago, according to the OECD.Those investments have fuelled a furious pace of growth. Chinese early-stage drug programmes, which affect future approvals and capital-raising, numbered around 800 in 2015, according to a study published last month by the prestigious Journal of the American Medical Association. By 2024, they exceeded 6,000—up more than 600%.

During the same period, the number of projects in the US grew from around 5,000 to 7,000; however, its global share of such programmes declined from half to a third. That trajectory continued into 2025, according to data crunched by the study’s co-authors So-Yeon Kang and Yunan Ji of Georgetown University. While full-year figures weren’t available,