While the U.S. excels at high-risk 'zero to one' innovation, Chinese biotechs are mastering 'me-better' optimization. This is where significant commercial value is captured, as opposed to the initial, riskier discovery phase, posing a new competitive threat.
To compete with China's rapid 'me-better' development, U.S. innovators should proactively partner with Chinese firms to create improved versions of their own drugs. This self-cannibalization strategy is necessary to stay ahead before competitors do it for them.
Dr. McCary's tenure is criticized not for specific drug decisions, but for failing at the core duties of the Commissioner: supporting staff, protecting the agency from political influence, and being a leader. Publicly debating individual drugs undermines the agency's process and morale.
The controversial approval of Elevidys has 'boxed in' the FDA. Now, when reviewing similar drugs like Regenexx Bio's, the agency must contend with its own precedent, making it difficult to apply a consistent standard and creating regulatory uncertainty for the entire field.
Beyond innovation or speed, the key structural advantage for the U.S. biotech ecosystem is its deep, unparalleled capital market. This financial moat makes it difficult for Chinese firms to access the scale of funding needed to truly dominate the global landscape.
Unlike past deals where Chinese firms kept only regional rights, new partnerships, like Hengri's with Bristol Myers, include options for co-commercialization globally. This signals a strategic shift from being regional R&D partners to becoming global commercial entities.
Isomorphic's massive funding from tech investors contrasts sharply with how biotech specialists value companies. Biotech VCs prioritize tangible assets over platforms, having been burned by past platform plays that failed to translate into commercial products, signaling a fundamental market disconnect.
Once profitable, biotechs should transition from a high-risk R&D culture to a more business-oriented model. Biogen's persistent, high-risk pursuit of Alzheimer's drugs demonstrates a common failure to make this strategic shift, wasting capital and acting more like a startup than a mature business.