The Shift in Global Drug Development

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The a16z Show 57 min 4 speakers 8 chapters transcribed 4 months ago
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What is the significance of China's rise in global clinical trials?

Unknown 0:00
America is 4% of the world's population. It's about 13% of all the drug buying, but it's also more than half of the sales in terms of dollar amounts. So it's huge. And this is a big advantage because like, you know, innovation does respond to the money and it has to. Thank you for having me.
Cremieux 0:41
What happens when the United States is no longer the leader in biomedical innovation? For decades, the U.S. dominated drug development, producing a large share of the world's new therapies and setting the pace for clinical research. But over the last few years, that's started to change. China has rapidly expanded its clinical trial system, accelerated approvals, and is now leading in both volume and novel drug development. This shift isn't about scale. It's about systems. Regulatory design, trial structure, funding models, and incentives all shape how quickly new treatments reach patients and where innovation happens. The question now is whether the U.S. can adapt or whether the center of gravity for biotech continues to move.
Cremieux 1:28
Theo Jaffe and Gabriel Dickinson speak with CREMIU.
Gabriel Dickinson 1:34
Welcome to MTS. How do you pronounce it in the French? That was pretty good.
Theo Jaffee 1:42
We're going to add you. You had a slight Canadian accent there.
Gabriel Dickinson 1:46
To the tweet wall.
Theo Jaffee 1:47
Uh-oh. Straight on the tweet wall. Let me make this bigger so I can look at it. Nothing ever happens. That's what it says. That's the watchword of MTS. Welcome to MTS. Nothing ever happens. Here are the situations. Great. So are we live right now? We are. We are live right now, Krem. We are live on MTS. It's so good to have you on the show. Thank you so much. I'm saying Krem because Kremo, those last like four vowels there, three vowels are just like, they're scaring me. And Australians, we already struggle with vowels.

How have regulatory reforms impacted drug development in China?

Theo Jaffee 2:24
it's already a challenge for my people so um so cremo i mean great to have you on theo and i very pleased to have you on and we were just like come on the show let's let's chat and you were like i'm going to come on the show and i'm going to talk about clinical trials We were like, sure, sure, let's learn. We're all going to learn a little bit. We're all going to learn a little bit. So, I mean, why don't we start, Krem, do you want to just give us, I suppose in a way, what is the best way to describe Kremo? It's you're kind of like this independent researcher. You have this kind of breadth of interest.
Gabriel Dickinson 2:58
On genetics, metrics, and demographics. Yeah.
Theo Jaffee 3:03
Oh, yeah. Genetics, metrics, and demographics. Metrics comes a lot. It fits a lot under metrics.
Gabriel Dickinson 3:07
What's the apostrophe before metrics? What does that mean? You say, I write about genetics, metrics, and demographics in your Twitter bio.
Unknown 3:14
I'm really glad you asked. So I use it to refer to both that I do psychometrics and I do econometrics and sometimes pleometrics as well, which is, you know, basically the same thing for history, not just economics or genetics or psychology.
Theo Jaffee 3:29
Let's plant the plyometrics. Pleometrics, you said? Yeah, plyometrics.
Unknown 3:33
I like to do, you know, jumping jacks and stuff.
Theo Jaffee 3:35
It's pretty. Yeah. Yeah. Well, fantastic. Well, so, I mean, it looks like you've got a, you've got a deck to take us through. We're about to get the deck, but feel free to call. We can kind of riff. We're just interested to hear what you have to say, Theo. I mean, you know, so, so Krem, do you want to, do you want to take us off? What is it? I mean, maybe start by contextualizing it for us. What is, what's the context here? What's the background?
Unknown 3:58
Yeah, so in recent years, ever since 2016, China has been just up and away the big, big leader in biopharmaceuticals, biotech, and producing new drugs, even producing new medical devices. They're getting way ahead of the U.S. For decades, the U.S. has been the top dog by a huge margin. We produce something like 40% of all of the world's medical innovations when you talk about things that are approved and things that actually work.

What are the differences in clinical trial processes between the US and China?

Unknown 4:26
And that is no longer the case. China is actually ahead of the US now. And I'm going to show you some documentation of that. Some people haven't realized it yet. It hasn't really leaked to the press at this point.

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