Faster, Cheaper Drugs: China’s Biotech Impact
A fundamental shift in the biotech ecosystem globally is rewriting that the cost and time to market equation for drug develoment, according to Appel. Fueled by fast regulation reforms, large scale in clinical trials, and lower development costs across Asia, particularly China, an increase of next-gen therapies is making its way to Western markets at unprecedented speed.
Appel explained that in just five years, China has executed one of the most dramatic transformations in pharmaceutical history. The country has surged from representing a mere 2% of global biotech deal flow to commanding 50% of the market—effectively making it a larger force in drug innovation than the US itself.
“This is a hard thing for a lot of people to grasp,” Appel said. “How do you go from being a very small amount of the market to being the majority of the market?”
Marc Appel, founder of Pacific Bridge
The answer lies in changes that have been building for decades—and they’re helping patients far beyond China.
Appel says this shift is actually good news for American healthcare. Instead of being a competition where one side wins and the other loses, working together is creating more drugs, lowering costs, and reducing prices for US patients.
“Patients in the US benefit in a major way,” Appel said.
“Making better versions of existing drugs has a huge amount of value because if you make a drug less toxic or longer acting, you should get better adherence, with people on drugs for more time or experiencing fewer side effects, and that has a huge impact on overall patient outcomes.”
From manufacturing hub to innovation powerhouse
China’s biotech evolution spans two decades, beginning in the early 2000s as a generic drug manufacturing hub with growing preclinical and clinical research capabilities. The transformation accelerated when US-trained Chinese scientists returned home over the past decade, bringing advanced drug development expertise. Combined with aggressive government support, venture capital funding, cost-effective skilled labor, and established infrastructure, these scientists created a thriving biotech ecosystem. Chinese companies initially produced drug copies, then advanced to “best-in-class” versions with improved characteristics, according to Appel.
The results are already visible in the US market, he told us. BeiGene’s Brukinsa now competes directly with Johnson & Johnson’s drug in the hematology space. Legend Biotech developed Carvykti, a CAR-T cell therapy approved in the US for multiple myeloma. Summit Therapeutics is advancing a groundbreaking PD-1/VEGF (ivonescimab) combination molecule that targets two major cancer pathways simultaneously—originally developed by Chinese company Akeso—that shows better efficacy than either of its predecessor drug types.
“These are having a big impact on patients because these are leading therapeutics. These are not small market drugs,” Appel emphasized.
Looking ahead, he noted that the trend will only accelerate. “You look five years out from now, and a large percentage of the new drugs coming on the market will have originated in China.”
Speed and cost advantage
China’s competitive edge stems from two key factors: speed and cost. The country’s large population provides access to significantly more patients than the US, enabling faster clinical trial recruitment. With fewer existing lines of therapy as standard of care, drugs can reach patients more quickly, he stated.
“You have that many more people with a particular disease,” Appel said. “As a result of that speed and frankly abundance, you get things done at much lower cost as well. That’s really helped to propel the industry forward and turn them into a major hub for biotech innovation.”
This efficiency doesn’t just benefit Chinese patients—it creates a win-win scenario for the global healthcare system. “Speeding up drug development and lowering the cost means more drugs getting to patients,” Appel explained.
A two-way street
The collaboration between Chinese and US biotech takes multiple forms. Chinese companies frequently out-license molecules to large US pharmaceutical companies or venture capital firms that build new companies around them. On the other hand, Western companies increasingly partner with Chinese firms to run clinical trials, leveraging faster recruitment and lower costs.
“There’s capabilities that the US has, there’s capabilities China has,” Appel said.
“Working together just means we’re able to help more patients globally. Everybody sort of wins from that collaboration.”
Pacific Bridge itself exemplifies this bridging role, investing in Asian biotech assets for Western development while also helping Western companies accelerate their studies in Asia.
The regulatory evolution
A critical enabler of China’s rise has been its regulatory growth, according to Appel. The country has significantly increased oversight to match global standards, implementing orphan drug acts, clear commercialization rules, and stringent safety requirements.
“If anything, there are things that the US could probably learn from the Chinese regulatory structures now,” Appel said. “The Chinese rules are global standards, but have come about much more recently, so they’re much easier to follow and almost clearer than the US rules.
“So that’s obviously very important for China. Until China had quality of clinical development that sort of matched global standards, you really couldn’t necessarily rely on data, and I think that in recent years there’s been major shifts to come up to that global standard.”
Competitive pressures
Despite the benefits, this new landscape presents challenges. Geopolitical tensions complicate cross-border collaboration, and cultural differences can create barriers for companies without local expertise.
More fundamentally, increased competition is changing the economics of drug development, Appel noted. “The world’s become much more competitive, which means you have to move much faster just to stay afloat as a drug company,” he warned. “There’s more pricing pressures if more companies can get an approval more quickly.”
For pharmaceutical companies, distributors, and pharmacy benefit managers, this shift could reshape profit centers and commercialization strategies. “More rapid drug development and more competition in these spaces means there’s certainly going to be some major changes,” Appel said. “Those who figure out how to adapt to that changing landscape will be successful.”
Appel remains optimistic about continued US-China collaboration, provided geopolitical tensions don’t worsen. “China will continue to gain more capabilities and become more sophisticated in biotech development,” he said. “At the same time, I’m hopeful that the US will continue to advance new medicines and continue to be a center of innovation.”