China conducts more clinical drug trials than the US and leads in clinical development and supply chain, according to a recent survey presented June 22 at the Biotechnology Innovation Organization annual meeting in San Diego [1, 2, 3]. The country's drug regulator reported a record 5,215 clinical trials registered in 2025, marking the first time the annual total exceeded 5,000 [3]. Cost advantages, regulatory reforms, and government support have contributed to this growth in clinical trials [1, 3].
The US remains strong in biotechnology quality, capital, commercialization, scaling experimental products to large production, and talent, the Cure Innovation Index survey of 117 senior industry and academic leaders found [1, 2, 3]. However, the US share of early drug development programs fell from 48% in 2015 to about 37% in 2024, while China’s share rose sharply from 8% to over 32% in the same period [1]. Both countries were tied in scientific discovery according to respondents [1, 2, 3].
Seema Kumar, CEO of Cure Innovation Index, said, "The US is still leading, but confidence is eroding. Most said they see China as an existential threat" [1]. Eighty-five percent of respondents expect the US lead in biotech to last 10 years or less [1, 2].
China's rise is attributed in part to lower costs, regulatory reforms, and strong government backing, aiding its clinical trial volume and supply chain capabilities [1, 3]. Meanwhile, the US retains an edge in commercializing new biotech innovations and mobilizing capital [1, 2, 3].
The survey results highlight a narrowing gap between the two countries as China rapidly increases its footprint in early drug development programs and clinical trials. The next update on these trends is expected after future Cure Innovation Index surveys, with attention on how the US responds to the shifting competitive landscape [1, 2, 3].
