lots of discourse on here recently on how to get FIH clinical data in US cheaper, faster, and more competitively with China
Chinese biotechs, on average across modalities, generate FIH data with ~ $10M USD in funding total (R&D work, clinical ops, mfg, and pt recruitment)
but how do they do this? and what can the US do?
well first for the US side on how to respond, there's been a few more "obvious" answers offered. Accelerate regulatory reviews on IND faster. Open up an IRB path directly with hospitals a la IITs in China.
another vector might be public-private partnerships in form of tax credits, discounted lab space, or targeted translational grants.
On the China side, I've seen folks answer to how they're able do it being some mix of: accelerated regulatory path (ie IRB), government policy, piggy backing on existing IP (ie fast followers only)
One thing I have not seen folks talk about, which to me is the most obvious, is - wait for it - the intense competition that breeds insane levels of hard work in China.
China's local biotech environment is dramatically more competitive than in the US. Here in the US every target has perhaps 2 or 3 competitors. In China every target has dozens.
Case in point: in vivo CAR-T which has recently become a hot area this year, there are maybe 5-10 reasonable competitors in the West.
In China, there are close to 200. ~10 companies will read out FIH data in immunology this year 2025, and a multiple of that number will do so in oncology (the earliest US companies are expected to read out FIH data is 2026).
This is bewildering to observers in the West. Why would any entrepreneur start a company with ostensibly the same technology, targets, mission, etc as so many others that are already out there?
Well Chinese entrepreneurs are not dumb. They do this because the last 40 years of development in China has shown them it is actually a winning strategy. A hard working, enterprising person in the last several decades in China that went into say, textiles at first, then low cost manufacturing, then solar photovoltaics, then EVs (and so on) on balance generally did indeed WIN when they jumped into the fray. The outcomes have worked out enough to incentivize this behavior.
Through a 40 year long battle royale in the business environment, Chinese entrepreneurs know the truth that the best CEOs here in the West know just as well - the only true moat for a company is consistent, relentless execution.
Back to biotech. Biotech is on the list of "strategic sectors" for China and was named again in the 2026-2030 national 5 year plan.
The Chinese biotechs are only going to keep coming - so how does US biotech work to increase the competitiveness of the industry?
Well, leaders in biotech in the West need to hear this: it's not just regulatory policy, government support, or IP leakage that's leading China to win in biotech.
The uncomfortable truth is it's past time for us in the West to get fit and get in shape.
This is going to sound trite, but leaders need to make hard decisions to prioritize appropriately, to focus ruthlessly on the key value drivers, to make shrewd decisions that extend runway. Leaders need to push *hard*.
Teams need to put in the hours to help make that push. Labs and offices in South SF and Boston should not be empty at 4pm on a Thursday. Or a Friday for that matter. In my last trip to Shanghai, I visited a large R&D lab of a biotech on a Friday afternoon, 5:30pm. Every seat was filled by a scientist *actually executing an experiment*.
Ultimately the path to global primacy in biotech is paved with hard work, smart science, shrewd decisions, and the indomitable will of founders & leaders.
True here in the US, true in China, true wherever new medicines will be created.