China narrows biotech gap, but US still leads innovation fields

China has overtaken the United States in clinical drug trials, a sign that the biotechnology race is now playing out not just in labs but in the pipelines, factories and financing that move new medicines to patients. A new survey of academics and industry leaders still puts the U.S. ahead in capital, commercialization, talent and technology transfer, but it also shows how fast China is closing in.

The Cure Innovation Index survey found China leading in only two of six areas, clinical development and supply chain, while the two countries were tied in scientific discovery. Seema Kumar, chief executive of Cure, said, "The U.S. is still leading, but confidence is eroding. Most said they see China as an existential threat." The findings were presented at the Biotechnology Innovation Organization’s annual meeting in San Diego, where more than 20,000 industry leaders gathered for a convention running June 22-25.

The numbers behind the shift are stark. Georgetown University researchers found that the U.S. share of early-stage drug-development programs fell from about 48% in 2015 to just over 37% in 2024, while China’s share rose from 8% to just over 32%. Over the same period, the total number of early-stage programs climbed from 10,417 to 18,999, an 82.4% increase. The Georgetown findings were published online in JAMA on March 26, 2026, and the researchers said the United States remained the single largest originator of early-stage programs even as the geographic balance changed sharply.

That shift has sharpened the policy stakes in Washington. The National Security Commission on Emerging Biotechnology delivered its final report to Congress on April 8, 2025, warning that the United States had to act quickly to stay globally competitive. The commission said urgent congressional action was needed, reflecting a broader fear that China’s biotech sector has become vertically integrated and capable of challenging U.S. leadership across research, manufacturing and commercialization.

Congress has already moved once. President Donald Trump signed the BIOSECURE Act into law on December 18, 2025, as Section 851 of the FY2026 NDAA. The law restricts federal procurement and grants involving certain biotechnology products or services from biotechnology companies of concern, and the Office of Management and Budget must publish an initial list of those companies by December 18, 2026.

The contest now looks less like a scientific scorecard than a test of national resilience. The United States still leads in the fields that turn discovery into drugs, but the erosion in early-stage share, the pressure on supply chains and the pace of Chinese expansion leave little room for complacency.