In July 2018, the film Dying to Survive premiered in China and quickly became a nationwide sensation.
Adapted from the real-life story of Lu Yong, a chronic myeloid leukemia patient who helped others obtain low-cost generic drugs from India, the film told the story through the perspective of Cheng Yong, an ordinary man caught between survival and morality. It laid bare the harsh tension between expensive patented medicines and patients struggling simply to stay alive.
The movie ignited intense public debate and reflection across Chinese society—about innovative drug development, healthcare affordability, and medical insurance policy.
Innovative medicines are not only the core engine driving the upgrade of the biopharmaceutical industry; they are also a critical safeguard for public health.
Yet in the year Dying to Survive was released, China had only nine domestically developed Category 1 innovative drugs approved for market.
By 2024, that number had surged to 40.
From nine to forty, China’s homegrown innovative drugs completed a remarkable transformation.
How, exactly, did domestic innovative medicine break through?
01 Breaking Through
In 2024 alone, 40 domestically developed Category 1 innovative drugs were approved for market.
Looking at a longer timeline reveals an even more striking trend. Since the start of the “14th Five-Year Plan,” a total of 113 domestic innovative drugs have gained approval—2.8 times the number approved during the “13th Five-Year Plan” period.
A surge in quantity naturally raises a question: what about quality?
By August 2024, China had approved a total of 910 new drugs. Within the pharmaceutical industry, one of the most rigorous clinical trial designs is known as the “head-to-head trial,” which directly compares two or more treatments to evaluate efficacy, safety, and tolerability. In simple terms, it is a direct, no-holds-barred contest.
On September 8, 2024, Akeso announced that its independently developed ivonescimab had outperformed Merck’s blockbuster cancer drug pembrolizumab (Keytruda) in a single-agent head-to-head trial.
Ivonescimab thus became the first drug globally to demonstrate significantly superior efficacy over Keytruda in a Phase III single-agent head-to-head study.
This achievement is especially notable given that Keytruda is the world’s best-selling cancer drug, with global sales reaching USD 29.48 billion in 2024—earning it the title of “the world’s top-selling medicine.”
The Wall Street Journal described Akeso’s breakthrough as the “DeepSeek moment of the biotechnology industry.”
Just a few years ago, around 2018, almost no domestic drugs dared to challenge international pharmaceutical giants head-on. In recent years, however, the growing number of head-to-head trials clearly signals a sharp rise in China’s innovative drug capabilities.
Sales performance is another critical indicator of a drug’s success. Internationally, drugs with annual sales exceeding USD 1 billion are known as “blockbusters,” representing the pinnacle of pharmaceutical innovation.
In 2023, China produced its first homegrown blockbuster drug. BeiGene’s zanubrutinib recorded sales exceeding RMB 9 billion, becoming the country’s first domestically developed blockbuster. That same year, 16 domestic innovative drugs achieved annual sales of over RMB 1 billion.
Chinese innovative drugs are not only thriving at home but are also rapidly expanding overseas. Legend Biotech’s cilta-cel received FDA approval in February 2022 and conditional approval from the European Union in May of the same year.
Over the past three years, the majority of cilta-cel’s sales have come from Europe and the United States. By the end of 2024, cumulative sales had reached USD 1.596 billion. Industry forecasts suggest that its 2025 annual sales could exceed USD 1 billion, making it another Chinese blockbuster drug.
Beyond this, Hansoh Pharma licensed its oral GLP-1 drug to Merck with an upfront payment of USD 112 million. Ascentage Pharma signed an exclusive option agreement with Takeda for olverembatinib, receiving RMB 720 million in option fees and RMB 540 million in equity investment. Bluentera reached a licensing deal with Bristol Myers Squibb for BL-B01D1, securing an upfront payment of USD 800 million.
More and more multinational pharmaceutical companies are now actively seeking collaboration opportunities in China.
In 2024, the total value of outbound licensing deals by Chinese pharmaceutical companies exceeded USD 34 billion.
China’s pharmaceutical industry is shifting from “bringing in” to “going global.”
Domestic innovative drugs have, at last, broken through.
02 Forging the Blade
In the pharmaceutical world, innovative drugs are governed by two well-known rules.
The first is the “nine deaths out of ten” rule: roughly 90% of innovative drug projects fail during preclinical or clinical stages, with only a small fraction ultimately gaining approval.
This means that the growth from nine to forty approved drugs is underpinned by a rapidly expanding pipeline of research projects. By August 2024, China had 5,380 innovative drug candidates in development—more than one-third of the global total—covering oncology, metabolism, autoimmune diseases, cardiovascular conditions, and antivirals.
Viewed bluntly, this resembles a “volume strategy”: the more projects in development, the higher the chance of success.
The second is the “ten-year, ten-billion-dollar rule,” which states that developing an innovative drug typically requires around ten years and USD 1 billion in investment.
A 2020 analysis by Evaluate Pharma showed that oncology drugs cost an average of USD 2.6 billion to develop and take 13 years to reach market. BeiGene’s zanubrutinib, for example, took eight years and more than RMB 1.5 billion to develop. Even at lower costs than Western peers, such investments remain beyond the reach of most companies.
Beyond cost, China also enjoys significant efficiency advantages in drug development. From mechanism validation to preclinical candidate selection, domestic timelines typically range from 12 to 20 months, compared with 24 to 36 months overseas.
In innovative drug development, time is money. Faster timelines allow companies to seize critical market windows and capture 70–90% of market share in winner-takes-all scenarios.
The return of overseas talent and the adoption of AI and big data technologies have further accelerated China’s drug innovation.
Policy support has also been indispensable. Few industries are as dependent on policy backing as innovative pharmaceuticals, due to their high costs, long cycles, high risks, and strict regulation.
As early as 2008, China launched the “Major New Drug Creation” national science and technology program, committing substantial central and local government funding to innovative drug research.
The true policy inflection point came in 2015, widely regarded as the inaugural year of China’s innovative drug era. Key measures included expedited approval channels for innovative and urgently needed drugs, tax incentives for R&D spending, dedicated government funding programs, and expanded reimbursement coverage for high-cost innovative medicines.
Together, these policies formed a closed-loop ecosystem of “encouraging R&D, accelerating approvals, and ensuring market returns,” injecting powerful momentum into the industry.
From 2015 onward, China’s breakthrough journey in innovative medicine took a full decade.
Ten years of quiet sharpening, followed by a single strike that astonished the world.
03 Strategy
Progress should be acknowledged, but gaps must also be recognized. Compared with global pharmaceutical giants, Chinese drugmakers still have significant room to grow in both scale and innovation strength.
The world’s top ten pharmaceutical companies—Pfizer, Merck, Johnson & Johnson, AbbVie, AstraZeneca, Roche, Novartis, Bristol Myers Squibb, Eli Lilly, and Sanofi—invest heavily in R&D. Even Sanofi, ranked tenth, spends nearly USD 8.7 billion annually.
China’s highest-revenue pharmaceutical company, Sino Biopharmaceutical, reported revenue of RMB 28.87 billion in 2024, with R&D intensity reaching 17.6%, close to international levels. Yet in absolute scale, it still trails far behind global leaders.
The global pharmaceutical landscape continues to favor incumbents. In this industry, R&D spending is not merely a cost—it is a strategic investment. International giants build formidable moats through sustained innovation, patent portfolios, and global commercialization capabilities, reinforcing a virtuous cycle of “R&D–technology–patents–market.”
For Chinese pharmaceutical companies, there are no shortcuts, but there are strategies. In R&D, a combination of “efficiency first” and “ecosystem collaboration” offers a viable path.
China’s advantages in cost and speed should be amplified through institutional innovation, technological advancement, and market scale. AI, in particular, deserves heightened attention. With its powerful data processing capabilities, AI can act as an accelerator in drug development—shortening target discovery from years to months.
Insilico Medicine, for instance, used its integrated AI platform to move a candidate drug from project initiation to preclinical nomination in just 18 months—roughly one-third the time of traditional development.
China’s strengths in AI technology are set to become a decisive weapon in innovative drug research.
Ecosystem collaboration means building integrated innovation networks among government, enterprises, and research institutions—breaking away from the traditional model of isolated R&D, reducing costs, and improving success rates.
In December 2024, Xianbixin sublingual tablets, the world’s first emergency stroke drug, were approved for market. The drug was jointly developed by Simcere Pharmaceutical and Ningdan New Drug, with support from national key laboratories and Beijing Tiantan Hospital.
The project also benefited from national funding programs, expedited regulatory review, and inclusion in major public health initiatives—making it a textbook example of ecosystem collaboration.
04 Looking Ahead
Over the past decade, China’s innovative drug development has achieved a qualitative leap. From imitation to innovation, from weakness to strength, this progress has been driven by the combined efforts of government, enterprises, and research institutions.
In 2024, “innovative drugs” appeared in China’s government work report for the first time. In 2025, policy support was further reinforced, with commitments to improve pricing mechanisms, establish innovative drug catalogs, and strengthen long-term support.
National backing for innovative medicine continues to intensify.
“They’re not taking medicine—they’re taking hope.”
This iconic line from Dying to Survive resonates deeply today.
With continued breakthroughs in innovative medicine, there is every reason to believe that more hope will reach more patients in the years ahead.
