{"id":30541,"date":"2026-09-19T04:48:00","date_gmt":"2026-09-18T20:48:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=30541"},"modified":"2026-09-19T07:37:28","modified_gmt":"2026-09-18T23:37:28","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%97%a9%e6%9c%9f%e7%94%9f%e7%89%a9%e5%88%b6%e8%8d%af%e5%88%9b%e6%96%b0%e7%9a%84%e5%9c%b0%e5%9f%9f%e6%94%b9%e5%8f%98","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=30541","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u65e9\u671f\u751f\u7269\u5236\u836f\u521b\u65b0\u7684\u5730\u57df\u6539\u53d8"},"content":{"rendered":"\n

Research Letter <\/p>\n\n\n\n

Geographic Shifts in Early-Stage Biopharmaceutical Innovation<\/h1>\n\n\n\n

So-Yeon Kang, Yunan Ji<\/h3>\n\n\n\n

JAMA Published Online: March 26, 2026<\/h3>\n\n\n\n

doi: 10.1001\/jama.2026.1962<\/h3>\n\n\n\n

Biopharmaceutical innovation is increasingly viewed as a source of national economic and strategic advantage, prompting public investment in domestic drug research and development.1<\/a><\/sup> At the same time, large pharmaceutical firms now perform a shrinking share of research and development in-house, relying more on external start-ups, academic spin-offs, and cross-border collaborations.2<\/a><\/sup> As a result, the geography of scientific discovery increasingly diverges from the geography of drug marketing, limiting the ability of analyses focused on approved products to capture where innovation originates. A growing literature documents growth in China\u2019s biopharmaceutical sector using downstream indicators such as licensing activity or regulatory approvals.3<\/a>-6<\/a><\/sup> However, these country-specific analyses may not fully capture relative global shifts in innovation distribution or the geographic origins of early-stage drug development, despite its critical role in shaping future approvals and investment. This study examines changes from 2015 through 2025 in the country of origin of early-stage biopharmaceutical development programs worldwide.<\/p>\n\n\n\n

Methods<\/p>\n\n\n\n

We conducted a retrospective analysis using the Clarivate Cortellis Drug Development Database, which tracks global pharmaceutical research and development activity across public and private entities. The unit of analysis was early-stage drug development program, defined as development of a specific drug for a specific indication. Programs at the discovery, preclinical, or early clinical testing stages (phase 0-2) between January 1, 2015, and September 30, 2025, were included. Discovery and preclinical programs were categorized as preclinical programs. The sample selection flow is detailed in the eAppendix in Supplement 1<\/a>. We conducted repeated cross-sectional analyses both overall and stratified by development stage (preclinical vs early clinical testing), examining programs observed in each year, with 2024 used as the most recent year for annual counts. Programs were assigned to a country of origin based on the global headquarters of the originator company and were not reassigned following licensing or acquisition.<\/a><\/p>\n\n\n\n

We examined counts and shares by country, development stage, drug modality, and therapeutic area using Stata version 18 (StataCorp). Countries outside the top 5 were grouped as all other countries. This study was exempt from institutional review board oversight and followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE<\/a>) reporting guidelines.<\/a><\/p>\n\n\n\n

Results<\/p>\n\n\n\n

The annual number of drug development programs increased from 10\u202f417 in 2015 to 18\u202f999 in 2024 (an 82.4% increase) (Table<\/a>), with preclinical programs accounting for nearly two-thirds (from 7084 [68%] in 2015 to 11\u202f422 [60.1%] in 2024). Growth was observed in the US (from 5024 to 7107 [41.5%]) and all other countries (from 4564 to 5747 [25.9%]) and was most pronounced in China (from 829 to 6145 [641%]).<\/a><\/p>\n\n\n\n

Table. \u00a0Changes in the Geographic Distribution of Drug Development Programs by Drug Modality and Therapeutic Area<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
Characteristics<\/th>No. (%)<\/th><\/tr>
2015<\/th>2024<\/th><\/tr><\/thead>
All<\/td>10\u202f417<\/td>18\u202f999<\/td><\/tr>
Drug modalitya<\/sup><\/td><\/td><\/td><\/tr>
Biologics<\/td>4156<\/td>10\u202f299<\/td><\/tr>
US<\/td>1900 (45.7)<\/td>3681 (35.7)<\/td><\/tr>
China<\/td>362 (8.7)<\/td>3611 (35.1)<\/td><\/tr>
All other countriesb<\/sup><\/td>1894 (45.6)<\/td>3007 (29.2)<\/td><\/tr>
Small molecules<\/td>6247<\/td>8664<\/td><\/tr>
US<\/td>3116 (49.9)<\/td>3413 (39.4)<\/td><\/tr>
China<\/td>467 (7.5)<\/td>2522 (29.1)<\/td><\/tr>
All other countriesb<\/sup><\/td>2664 (42.6)<\/td>2729 (31.5)<\/td><\/tr>
Therapeutic area of focus<\/td><\/td><\/td><\/tr>
Cancer<\/td>3720<\/td>11\u202f115<\/td><\/tr>
US<\/td>1811 (48.7)<\/td>4051 (36.5)<\/td><\/tr>
China<\/td>381 (10.2)<\/td>4152 (37.4)<\/td><\/tr>
All other countriesb<\/sup><\/td>1528 (41.1)<\/td>2912 (26.2)<\/td><\/tr>
Infectious diseases<\/td>1311<\/td>854<\/td><\/tr>
US<\/td>672 (51.2)<\/td>317 (37.1)<\/td><\/tr>
China<\/td>118 (9.0)<\/td>220 (25.8)<\/td><\/tr>
All other countriesb<\/sup><\/td>521 (39.7)<\/td>317 (37.1)<\/td><\/tr>
Neurology\/psychiatric conditions<\/td>1070<\/td>1499<\/td><\/tr>
US<\/td>554 (51.8)<\/td>629 (42.0)<\/td><\/tr>
China<\/td>54 (5.1)<\/td>281 (18.8)<\/td><\/tr>
All other countriesb<\/sup><\/td>462 (43.2)<\/td>589 (39.3)<\/td><\/tr>
All othersc<\/sup><\/td>4316<\/td>5531<\/td><\/tr>
US<\/td>1987 (47.0)<\/td>2110 (38.2)<\/td><\/tr>
China<\/td>276 (6.4)<\/td>1492 (26.7)<\/td><\/tr>
All other countriesb<\/sup><\/td>2053 (47.6)<\/td>1929 (34.9)<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

Marked geographic shifts were observed over time. In 2015, 48.2% of programs originated in the US and 8.0% in China (Figure<\/a>, A). By 2024, the US share declined to 37.4%, while China\u2019s share rose to 32.3%, with declining contributions from other high-income countries. Similar geographic patterns were observed for preclinical programs (Figure<\/a>, B) and early-phase clinical trials (Figure<\/a>, C) and across more granular development stages.<\/a><\/a><\/p>\n\n\n\n

Figure. \u00a0Bar and Line Graphs of Global Shifts in Early-Stage Drug Originations, 2015-2025<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n

The bar plots (corresponding to the left y-axes) show the total number of drug development programs globally by quarter between January 1, 2015, and September 15, 2025. The line plots (corresponding to the right y-axes) show the share of drug development programs by country over the same period. All other countries include 82 countries (eg, South Korea, United Kingdom, Japan, Germany, Switzerland, France, Canada, Australia). Panel A includes all drug development programs from discovery to phase 2 clinical trials. Panel B includes only programs in the preclinical stage, which encompasses both drug discovery and preclinical development conducted prior to clinical trials. Panel C includes only phase 1 and 2 clinical trials.<\/p>\n\n\n\n

These shifts were consistent across drug modalities and therapeutic areas. By 2024, biologics accounted for 54.2% of early-stage development globally (Table<\/a>), driven largely by growth in China (from 362 in 2015 to 3611 in 2024). A similar pattern was observed in oncology and endocrine and metabolic diseases, while distributions in other therapeutic areas remained relatively stable.<\/a><\/p>\n\n\n\n

Discussion<\/p>\n\n\n\n

Global early-stage drug development has nearly doubled over the past decade, shifting from a system dominated by the US toward a 2-hub structure centered on the US and China. Because early-stage drug candidates shape future drug approvals and investment, these shifts may have downstream implications for regulatory coordination, scientific workforce development, and patient access to new therapies. Continued monitoring will be essential for policymakers to understand these consequences and to design appropriate financial and regulatory incentives. We could not assess innovation quality or track ownership changes, which suggest important directions for future research.<\/p>\n","protected":false},"excerpt":{"rendered":"

Research Letter  Geographic Shifts in Early-Stage […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30541"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=30541"}],"version-history":[{"count":4,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30541\/revisions"}],"predecessor-version":[{"id":31671,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30541\/revisions\/31671"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=30541"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=30541"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=30541"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}