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EAdvancing
InnovationandGlobalReach:TheNextChapter
in
China’sClinicalTrial
DevelopmentPharmaDJx
L.E.K.ClinicalDevelopment
ReportNovember2025ThesematerialsareintendedtosupplementadiscussionwithL.E.K.
Consulting.Theseperspectiveswill,therefore,onlybemeaningfultothoseinattendance.Thecontentsofthematerials
areconfidentialandsubjecttoobligations
ofnon-disclosure.Yourattentionisdrawntothefull
disclaimercontainedinthisdocument.•Overthe
pastdecade,China’s
clinicaldevelopment
landscape
has
undergonea
remarkabletransformation.The
markethasexpanded
rapidly,fueled
byfavorable
policyreformsandsustained
R&Dinvestmentfrom
pharmas.
This
evolution
has
laidastrongfoundationforthenext
phase
ofgrowth,
one
characterized
by
deeper
innovation,
greater
global
integration
of
Chinese
biopharmas/biotechsandthe
increasingadoptionofsmartertoolssuch
as
artificial
intelligence
(AI).
Asthe
industry
continuesto
mature,China
ispoisedtoemerge
as
a
leading
hub
globallyfor
innovation-driven
clinical
development.•
Thisreport,
produced
incollaborationwith
PharmaDJ,
providesacomprehensiveoverviewofthestrategic
trendsshaping
China’sclinicaltrialecosystemtoday.
It
highlights
notonlythe
progressmade
in
innovation,
globalization
andAI/smarter
clinicaltrialtools,
butalsotheopportunitiesfacing
both
multinationaland
Chinesecompanies.•Supportedbyacomprehensivesurvey
of
pharmaceuticalcompaniesand
contract
research
organizations
(CROs),
this
reportservesasastarting
pointformultinational
corporation
(MNC)
pharmas,
Chinese
biopharmas
and
biotechs,
and
CROsto
reassesshowthey
can
better
prepareforthefutureofdrug
R&D,
bydriving
greater
innovation,
efficiency
and
globalcollaboration.Foreword:Thisreportsummarizesthekeystrategictrends
ofclinical
development
in
China,
and
canbereferencedbypharmaceuticalcompaniesand
CROsto
supporttheir
R&D/service
strategies2
©2025L.E.K.ConsultingChina
hasestablishedastrongfoundationforclinicaltrialgrowth,
underpinned
byits
large
patient
base,favorable
policies
and
sustained
R&Dinvestmentfrompharmas.Trialvolume
inChinahasrisen
rapidlyfromroughlyone-thirdoftheU.S.
andone-halfofthe
European
levels
in2019toapproximately0.8×and
1.1
×respectively
by2024,positioningChinaasamajorglobalplayer
inclinical
development.
Asthesectorentersits
nextphaseofgrowth,threestrategictrendsareexpectedtoshapethefuture
ofChina’sclinicaltrial
landscape:•
Developmentofmore
innovativeanddifferentiatedtherapies:Chinese
biopharmas
and
biotechs
are
increasing
investment
in
first-in-classand
best-in-classassets,next-generationmodalities,andnewtechnology
platforms,
gaining
strongerglobal
recognition.The
surge
inPhaseIIand
IIItrials
highlights
China’sgrowingcapability
toadvance
innovationsfromearlyto
late
stages,creating
rising
opportunities
forclinicaldevelopmentindustryparticipants.While
homogeneouscompetition
persists,companiesare
driving
differentiation
through
earlycombination
planning,indicationexpansionandstrategicassetprioritization.•ContinuedglobalizationofChinese
innovation:Globalization
remainsastrategic
imperativeforChinese
biopharmas/biotechs,withrisingChina-to-globaltrialsand
licensingdeals
reachingrecordhighs.Thiscreatesexpandingopportunitiesfor
MNCpharmastoaccessdifferentiated,early-stageChineseassetsthatenhanceglobal
portfolios,andfor
CROsequippedwith
global-standard
quality
systems,regulatoryexpertiseand
multiregionalexecutioncapabilitiestoplaya
pivotal
role
in
supporting
cross-borderclinicaldevelopment.•Adoptionof
AIandsmarterclinicaltrialtools:
AIisemergingas
a
transformative
enableracross
the
drug
R&D
life
cycle.
Within
clinicaldevelopment,industryparticipantsshowgrowing
interest
inadoptingAI,withthehighestnear-termpotentialin
data
analysisandmanagement.PharmasandCROsneedtoproactively
integrate
AI
intotheirclinicaldevelopmentcapabilitiestoenhance
efficiencyand
improvetrialquality.Executivesummary:ThreestrategictrendsareshapingthefutureofChina’s
clinical
trial
landscape3
©2025L.E.K.Consulting4
©2025L.E.K.ConsultingAgenda•
Contextofclinicaltrial
development
in
China•
Futurestrategictrendsofclinicaltrialdevelopment
in
China•
Nextstep
questions•
Resourcesand
references•
AbouttheauthorsPopulation(2024)340m4%450m
6%1.4bn17%
ofglobalAged
population(agedover
65
,2024)60m7%100m
14%220m26%of
globalGDP(Trillions
of
USD,2024)29.226%19.4
17%18.717%of
globalForecastedfive-yearGDPgrowth(percentage,2025-29)2%1.3%4%AverageGNIper
capita
(USD,
2024)83,66044,09013,660Healthspending(percentageofGDP,2023)18%10%7%Pharmaceuticalmarketsize(Billionsof
USD,2024)800450250Numberofglobaltop100biopharmas(2024)253013China
hasastrongfoundationforhealthcaremarket
growth,
basedonthe
key
economic
and
healthcare
indexescomparisonofChina,the
USand
EuropeanUnion
countriesNo.1totalandaged
populationSolidgrowing
economyThird
largestdrug
marketNote:GDP:grossdomesticproduct;GNI:GrossNational
IncomeSource:WorldBank,
USFederal
ReserveSystem,
EuropeanCommission,
International
MonetaryFund
(IMF),
IQVIA,
GrandView
report,
L.E.K.
analysisKeyeconomicand
healthcare
indexesofChina,
USand
EU5
©2025L.E.K.Consulting●
China U.S
EU. Opportunities
ChallengesChina
hasandwillcontinuetohavethe
largestpatient
poolwith
betteraffordability,thoughfacingseveralchallengessuchaspricepressure
and
lack
of
patientawarenessNote:VBP:value-basedprocurement;
DRG:diagnosis-relatedgroup;
DIP:diagnosis-interventionpacket;
GDP:gross
domestic
product;
QoL:
qualityof
life;
CXOs:
contract
organizations;
CRO:
contract
researchorganization;CMO:contractmanufacturingorganizationSource:WorldBank,
United
Nations,CentreforEconomics
andBusinessResearch,
L.E.K.
analysisMorehealthcarefront-tier
R&DStreamlined
registrationandaccessWiderhealthcarecoverageSustainedfundingRegulatory
upgradesReimbursement
reformsSteadyincreasein
health
spending
asa
shareofGDPIncreasing
affordabilityWorld’ssecond-largest
economyRisingawarenessonhealth
&
QoL
and
healthcarequalityLargest
patient
baseforlungcancer,
livercancer,diabetes,
hypertension,etc.Regionaleconomydisparities
(flexiblecommercialtacticsare
required)RevaluationofhealthcarecapitalmarketinChinaraiseshurdlesforfinancial
fundingDigital
health
innovationon
the
riseWorldclass
local
CXOs
(e.g.,CRO,
CMO)Upsurge
oflifescience
talentsInfrastructure,dataprivacy
and
paymentmodelfornewtechnologies
areyettobeimprovedLackofpatientdiseaseawareness(pharmasarerequiredto
invest
inpatient
education
and
management)Price
pressurecausedbyVBP,
DRG/DIP,homogeneouscompetition,etc.OpportunitiesandchallengesofChina
healthcare
market6
©2025L.E.K.ConsultingHealthcareremainsastrategicnational
priority
Policy$
EconomyTechnologySocietyChinaclinicaltrialvolume
hasreturnedtogrowthafter
a
dip
in2022,
with
Chinese
pharmas’
in-Chinatrialsaccountingfor~75%oftotalnew
trialstartsNote:*Including
Phase
Ito
Phase
IVtrials
sponsoredbyindustry,excludingbioequivalence
(BE)
trialsand
investigator-initiatedtrials
(IIT);
MNC=multinational
corporation;
CAGR=compoundannual
growth
rateSource:
DXY;Trialtrove;
L.E.K.researchandanalysisChina
newlystartedclinicaltrials
bysponsortype*
(2019-24)ChinaforChinaMNC
in
China21-22(8%)(8%)(7%)(10%)22-2314%(15%)25%(9%)23-2412%2%13%10%3,0002,5002,0001,5001,000500019-2413%8%16%7%19-2127%37%25%24%2,2983231,5484272531,8083512,1242981,44238427%1,6922411,1423092019
20
21
22
23
247
©2025L.E.K.Consulting1,4341729852772,051385TotalChinatoglobal13%2,412Numberoftrials2,694258CAGR
%-8%Numberofnewlystarted
clinical
trials
in
ChinaNumberofnewly
startedclinicaltrials
in
U.S.
(2019-24)Numberofclinicaltrials
U.S.(2019-24)ChinaCAGR=14%2,3742,0971,7751,41223
245,0004,0003,0002,0001,0000CAGR=(3%)3,8373,5433,0612019
20
21
22
23
245,0004,0003,0002,0001,0000CAGR=(4%)2,9772,446
2,272
2,0872019
20
21
22
23
24
Favorablepolicy
China’sgovernment
has
launchedaseriesofpoliciesto
boostinnovativedrugs,emphasizingfull-chain
integration
andquality
growth
Accelerated
innovationRapid
rise
inearly-phaseand
FIC
trialsshows
China
is
closingthegapwithglobal
innovation
leadersIn-Chinatrialvolume
hasrisen
rapidlycomparedto
U.S.andEurope,
positioningChina
as
a
major
globalplayerin
clinical
developmentNote:Only
including
PhaseIto
PhaseIIItrials
sponsoredby
industry
with
at
least
one
site
in
China
or
U.S
.
orEurope,
excluding
bioequivalence
(BE)trials,
Phase
IVtrials
and
investigator-initiatedtrials
(IIT);
FIC=first-inclassSource:
DXY,Trialtrove,
L.E.K.researchandanalysis5,0004,0003,0002,0001,2341,00002019Numberofnewlystarted
clinical
trials
in
EUR
(2019-24)Number
ofclinicaltrialsEUR●
Continuous
R&D
investmentGrowing
R&Dspendand
patent
output;
China
nowhas
four
ofthetop25
pharmacompaniesby
pipeline
size8
©2025L.E.K.ConsultingKeydriversofChina’sclinicaltrialvolumegrowthNumberofclinicaltrials20
21
222,8492,5393,3103,6183,1461,914Favorablepolicy:
Healthcare
industry
hasbenefitedfromstrongergovernment
policysupportandaprogressivelymaturingregulatoryenvironment,mostnotably
in
pharmaVolumebased
procure-mentNote:
IP:intellectual
property;
NMPA:
NationalMedicalProductsAdministration;
ICH:The
InternationalCouncilforHarmonizationofTechnicalRequirements
forPharmaceuticalsfor
Human
Use;
RWE:
real-worldevidence;CTA:Clinical
TrialApplication;
DRG:diagnosis-relatedgroup;
DIP:diagnosis-interventionpacket;
NRDL:
National
Reimbursement
Drug
List;
GBA:The
GreaterBay
Area;
*
医保简易续约Source:
NMPA,
L.E.K.analysisR&DRegistrationPricingand
market
accessCommercializationManufacturingFull
chainSupport
high-qualityinnovativedrugdev.NRDLupdates(incl.simple
renewal*)Digital-ization
accelerationEarly
accessprograms(GBA,
Bo’Ao)Innovativemedicinefull-
chainsupportKeyregulatory
initiativesimpactingChina’s
healthcaremarket(2017-24)9
©2025L.E.K.ConsultingGenericqualityconsistencyevaluation(GQCE)Positiveforinnovative
drugsTwobatchesof
raredisease
listStreamlinedCTA
reviewtimelineAcceleratedregistrationpathsOpening
upofe-commerceMarketAuthoriza-
tion
HolderUrgently
needed
drug
listClinicaldata
protectionChina
NMPAjoining
ICHIncreased
IP
protectionRWE
for
registrationMedTech
localizationAlternative
paymentAnti-corruptionDRG/DIP•
TherapidgrowthofPhase
IIand
IIItrialsinChinademonstrates
Chinese
pharmas’strongwillingness
and
capabilitytoadvance
innovationsfromearly-tolate-stage
clinicaldevelopment•Phase
IIandIII
nowaccountforover50%oftotaltrials,indicating
rising
opportunitiesfortheclinicaldevelopment
ecosystem
participantsAcceleratedinnovativedrugdevelopment:China
hasbuiltastrong
foundation
in
early-phase
clinicaldevelopmentandis
nowrapidlyexpandingits
late-phase
development
capabilitiesCAGR%(2019-24)1433445%55%2019Phase
I
11
14%86%20192,5002,0001,5001,234Numberofnewlystartedclinicaltrials
in
China
by
phase*
(2019-24)NumberofclinicaltrialsCAGR%
(2019-24)15820CAGR%
(2019-24)201221Note:*Onlyincluding
Phase
Ito
PhaseIIItrials
sponsoredbyindustrywith
at
least
one
site
in
China,
excluding
bioequivalencetrials,
Phase
IVtrialsand
investigator-initiatedtrialsSource:
DXY,
L.E.K.analysisTotalPhase
III15Phase
II
20NewlystartedPhaseIIclinical
trials
in
China*
(2019,
2024)
NumberofclinicaltrialsNewlystartedPhaseIIIclinical
trials
in
China*
(2019,
24)
NumberofclinicaltrialsMNCsponsoredCNcompanysponsored10
©2025L.E.K.Consulting2,37428%28%27%22%51%20191,0005000Total6688004000800400043%24CNcompanysponsored
11%89%33%67%MNCsponsoredTotal27667624241086420CAGR=12%7.3
6.9CAGR=25%4.73.93.12018
19
20
21
22
23
24•
Underencouragingpolicy,Chinesepharmasaredevotingmoreeffortstodrugdevelopment,supportedbyrising
topbiopharmaR&Dspendingwitha
12%CAGRfrom2021to2024•ContinuousR&D
investmenthas
driven
steady
patentgrowthforChinese
pharmas,withtheirshareofpublishedpharmaPCT(PatentCooperationTreaty)applicationsrisingfrom7%in2015to22%
in2024ContinuousR&Dinvestment:
Robust
pharma
R&DexpenditureamongChinese
pharmashas
alsosustainedthe
underlying
growthofChinaclinicaltrials
inthepastR&Dpercentageofrevenue3.7%4.1%4.7%5.4%5.7%6.0%7.1%TotalR&DspendingofChinesetop50
biopharmaby
pharmaceutical
revenue(2018-24)Billions
of
USDSource:
DXY,Trialtrove,Wind,
L.E.K.analysis11
©2025L.E.K.Consulting6.08.5
Growthdrivers•ContinuedChinesegovernmentsupportingpolicytowardinnovativedrug
R&Dandcommercialization•Chinesebiopharmas’continuously
increasing
R&Dspending•Strongout-licensing
momentumto
provideChinesebiotechswithfundingto
reinvestininnovation•Continuous
MNC
pharmainvestment
in
ChinaHeadwinds•
RationalizationanduncertaintyofPE/VCfunding•Stricter
regulatory
requirementson
clinicaltrialsLookingforward,~80%ofsurveyrespondentsshowapositiveattitudetowardfuture
trial
number
growth
in
ChinaNote:*Surveyquestion:
Inthenextfiveyears(2025-30),
what’syour
viewonChina’sclinicaltrialgrowthratecomparedwithhistorical
growth
(2019-24)?您认为未来5年,即2025年至2030年,中国临床试验数量的增速相较于历史增长将会如何改变?**Includesninerespondentsfromfinancial
investors,employeesfrommedicaldevicecompanies,hospitals
andregulatoryagencies,
in
additionto
pharma
and
CRO
respondentsSource:
L.E.K.surveyandanalysisPerspectiveson2025-30growthoutlookofclinicaltrialvolumeinChina*Percentageofrespondents12%41%47%MNC
pharma(N=17)Unsure/cannotcommentLowerthanhistoricalgrowthSimilartohistoricalgrowthHigherthanhistoricalgrowth5%
8%51%36%Chinesebiopharma(N=39)7%12%42%39%Total**
(N=89)8%21%21%50%CRO
(N=24)12
©2025L.E.K.Consulting10080604020013
©2025L.E.K.ConsultingAgenda•
Contextofclinicaltrialdevelopment
in
China•
Futurestrategictrendsofclinicaltrialdevelopment
inChina
‒Developmentofmore
innovativeanddifferentiated
therapies
‒ContinuedglobalizationofChinese
innovation‒
Adoptionof
AIandsmarter
clinicaltrial
tools•
Nextstep
questions•
Resourcesand
references•
Abouttheauthors02Continued
globalization
of
Chineseinnovation03
ol
tion
of
AI
and
smarter
clinical
trial
spodtoA++Weanticipatethreestrategictrendsshaping
clinicaltrialdevelopmentasthe
sector
continues
its
shifttowardinnovationand
globalizationDevelopmentof
moreinnovative
and
differentiatedTherapies14
©2025L.E.K.Consulting01++15
©2025L.E.K.Consulting•
Contextofclinicaltrialdevelopment
in
China•
Futurestrategictrendsofclinicaltrialdevelopment
in
China‒Developmentofmore
innovativeanddifferentiated
therapies
‒ContinuedglobalizationofChinese
innovation‒
Adoptionof
AIandsmarter
clinicaltrial
tools•
Nextstep
questions•
Resourcesand
references•
AbouttheauthorsAgenda850200150100500838Non-listedListedcompanies19965271891-1011-2021-3031-4041-5051-6061-7071-8081-9091-100101+Numberofinnovative
drugassets*^
per
company10050053
50372019
20
21
22
23
241005008474452019
20
21
22
23
24Chinese
pharmasareactively
participatingininnovation,with
progress
made
inrecent
years
tosurpass
FDAannual
newdrugapprovalsandreachingarecord-high
numberofapprovals
in2024Note:*Innovativepharmasdefines
asinnovativedrugprogramsaccountfor50%+oftotaldrugprograms;
**ExcludingTCMs;
*^
Including
both
active
and
inactive
innovative
assets,
and
self-developed
and
licensed-inassets;^IncludesdrugsapprovedbyCenter
for
Drug
Evaluationand
Research(CDER),whilethe
biologics
approvedsolelybyCenter
for
Biologics
Evaluationand
Research
(CBER)are
not
included;
FDA:
Foodand
DrugAdministration;
NMPA:
NationalMedicalProductsAdministration;TCMs:traditionalChinesemedicinesSource:
NMPA,
FDA,
DXY,
Pharmcube,
L.E.K.analysisDistributionofChinese
innovative
pharmas
by
numberof
innovativedrugassets*
(2024)Numberofcompanieswith
innovativedrugassetsNMPA
newdrug
approvals
inChina**
(2019-24)NumberofdrugsFDA
newdrug
approvals
inU.S.^
(2019-24)Numberofdrugs16
©2025L.E.K.Consulting3
0
84548505550714283202
4•
FDAhasdevelopedfour
programstofacilitateandexpeditethe
developmentofnew
drugs•Around40%ofChinese
biopharmas’productswithFDAdesignationareglobalorChinafirst-in-classMany
innovativeassetsalsomanagedtoobtainFDAspecial
designation
throughfilling
unmet
needsforseriousconditionsorsignificant
improvementoneffectivenessNumberofChinese
biopharmas’productswithFDAspecialdesignation(notexhaustive*)
(2019–1H25)NumberofproductsNote:*IncludingproductsdevelopedbyChinese
pharmas,globallyenteringclinicaltrial(Phase
I
and
beyond),
NDAorbeing
approved
after
2019,thatwere
granted
FDA
special
designation;
**Based
on
DXY
analysis,
FICis
determinedbasedonhighestdevelopmentstageand
pipelinetiming;
NDA:
New
DrugApplicationSource:
DXY,
L.E.K.analysis17
©2025L.E.K.ConsultingOthersChina
FIC**Global
FIC**AcceleratedPriorityreview
approvalFasttrackBreakthroughtherapy1008060402001,0066326
17
2124Chinese
pharmasareactively
investinginFICandfast-followerbeyond
me-too
development,venturinginto
nextgenerationmodalities
including
CGT,
ADCsandbi-/multispecificantibodiesOverviewofthe
investigationaldrugpipeline
inChinaofChinesecompaniesbyinnovationleveland
producttype(2021-24)Numberofinnovativeproducts
inthe
pipelinesNote:*IncludingCGT,bi-/multispecificantibodies,ADCs,nucleic-acid-baseddrugs,vaccines,
PROTACs
andoncolyticviruses;
CGT:cell
and
gene
therapies;ADCs:
antibody-drug
conjugates;
PROTACs:
proteolysis-targetingchimerasSource:
Nature
Reviews
Drug
Discovery,
L.E.K.analysis418836518
14321921
242,251613First-in-classFast-followerMe-tooClassificationnotavailable5,0004,0003,0002,0001,000018
©2025L.E.K.ConsultingCelltherapies
Bi-/multispecificantibodies1,0531,80335235929524AllNext-generation2073272104243419711612721ADCs
Genetherapies473923117473124367
23212513
7212021
248044215535254,3911,709
1643039677Inadditionto
newmodalities,companiesarealsoworkingto
discover
newtargets,
improve
drugfeaturesand
invest
incutting-edgetechnologyplatforms“
…Ratherthanreplacinghumans,AIwillextendour
reach,creatingmore
opportunities
andvalueinnewdrugdevelopmentand
igniting
the
next
phase
of
growth
for
Chinese
innovativedrugs.
The
future
of
biomedical
breakthroughs
will
be
forged
jointlybyhumaningenuity
andmachineintelligence
…
”-Partner,a
Chinesebiopharma,Jun.2025“
…
Todrivesustainedinnovationinthefuture,wemustleveragecutting-edgetechnologiestoexploreinnovations
indrugformulationanddelivery.
Thisincludesinvestigatinghowtoextendamolecule’shalf-life,reducedosingfrequency,or
developanoralformulationto
replaceaninjectableone
…”-SVP,aleadingMNCbiopharma,
Sep.
2024“…A
drug’s
differentiated
advantage
is
a
key
determinant
ofitsdevelopment
pace.Successinahighlycompetitivemarkethingesondrugsthatofferuniquetherapeutictarget,favorablesafety,andtrueinnovation
…”-
Chief
MedicalOfficer,aChinesebiopharma,Jul.2025Improvedrugfeatures(e.g.,dosageform,routeofadministration,safety,indicationexpansion)Investin
cutting-edgetechnologyplatformsDiscover
newdrugtargetsforTAswithunmetneedsLaunched
Erzofrianddifferentiatedamongexistingoralantipsychoticdrugs
byprovidingalong-actinginjectableoptiontoimprovepatientadherence
inschizophreniaLeveraging
AI-poweredantibodytechnologyplatform,Adagenehelpscreatenovelantibodiesthatovercomesafetyissues
andimproveefficacyforoncologydrugsIfupinostat(BEBT-908)for
lymphomaERZOFRI(paliperidonepalmitate)for
schizophreniaDynamicPrecision
Libraryincl.NEObody,
SAFEbody,
POWERbodyplatformsNote:TAs:therapeuticareas;
DLBCL:diffuselargeB-celllymphoma;
NMPA:
National
MedicalProducts
AdministrationSource:Companywebsites,
PubMed,press
release,
L.E.K.analysisTheworld’sfirstdualPI3K/HDAC
inhibitorforDLBCLwithNMPAapprovalinJul.2025ADA
GENEAplatform-driven,
clinical-
stagebiopharma19
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