9 ms·

China's Clinical Trial Boom

160 points by surprisetalk 2y ago

Veedrac 2y ago
So much of policy success comes down to doing obvious and reasonable things, and most of the problem is how to incentivize making those choices. For all China's flaws, they've figured this out. The best news here is that we might finally have a prosaic means to escape our modern-era applied biotech stagnation, the same way solar has appeared as a means to kick the feet out of traditional energy sources. China is pretty new to being an R&D powerhouse, but there are few more worthy causes.
- deleted 2y ago
  [deleted]
- narrator 2y ago
  The best outcome for the current China/U.S conflict is lots of peaceful competition that forces each society to innovate.
  - kccqzy 2y ago
    Well during the Cold War with U.S./USSR conflict there was a lot of competition that heralded many new technologies, especially the dual use technologies that are good for both civilian and military uses. I can imagine something happening again if the U.S. had good leadership.
    - boplicity 2y ago
      The problem is that the U.S. has bad media focused on being "right" over actual truth. (See Fox News and the many far-right "alt news" organizationns.) This lack of care for the truth is the foundation the U.S. political system rests on top of. Without fixing that foundation, U.S. leadership will continue to either be terrible, or terribly constrained. Add in unlimited political funding from anonymous people/organizations, and the situation is only more impossible to fix. Good U.S. leadership is a pipedream, unfortunately.
  - henry2023 2y ago
    One of the parties involved already decided they don't event wanna try to compete.
- tway223 2y ago
  China’s success is not because of the policies but rather despite of them. Though not sure how sustainable these successes would be.
  - tehjoker 2y ago
    How on earth can you possibly claim that when China was a peasant society that was dicked over for a hundred years by western powers addicting them to opium? Obviously their careful planning and industrialization strategy is working.
    - tway223 2y ago
      There is no careful planning. Just take a look at the waste, the debts and the rapid policy changes. It is more like industrial Darwinism at scale. The main fuel was mainly WTO , export and slavery labor. The industrialization in my opinion is a by product of that process.
      - tehjoker 2y ago
        This is a highly propagandized view of China. Their industrial strategy was to get western capitalists to support industrializing the country by offering cheaper labor, but without surrendering control of the country to them, but now wages have risen quite substantially and their country is industrialized. The western capitalists are now pissed that china didn't "liberalize" and let them take control of the country and are attempting to retaliate. This is why you have imbibed this propaganda that they created.
        corimaith 2y ago
        >The western capitalists are now pissed that china didn't "liberalize" and let them take control of the country and are attempting to retaliate. This is why you have imbibed this propaganda that they created. And this is surely a well balanced opinion and not one shaped by highly ideological forces... There is nothing particularly wrong with what OP is saying, with the deflationary price wars happening it's very clear they rely on open exports markets to stave off unemployment against their insufficient domestic demand. That itself is only a possibility in a world of free trade fostered in USA, not in a world of mercantalism pre 1945. The ironic thing is that they themselves are trying to suppress the development of India next up in the value-chain. Anyways, Chinese economists themselves agree for the urgent need to shift to consumption today rather than double down on manufacturing, something that should have done decades ago like Western economists have been urging.
munchler 2y ago
Meanwhile DOGE has cancelled more than $2 billion in federal research grants. The US is shooting itself in the foot when it should be competing at its best. https://www.cbsnews.com/amp/news/nih-layoffs-budget-cuts-medical-research-60-minutes/ https://www.cbsnews.com/amp/news/nih-layoffs-budget-cuts-med...
- eastbound 2y ago
  [flagged]
  - munchler 2y ago
    Give me a freaking break. One side is carrying on the Enlightenment ideals of rationality and secular humanism, while the other is trying to drag us back to the dark ages of superstition and fear. It has nothing to do with political “left” and “right” anymore. It’s just sane vs. insane.
    - dingnuts 2y ago
      your comment would have a lot more weight if the grandparent hadn't been flagged and removed by people who don't like to read things they disagree with! How am I supposed to know what arguments to expect from MAGA if you people censor what they have to say? Censorship isn't helping your cause! It just makes your side look weak and scared.
      - gherkinnn 2y ago
        You can adjust the HN settings to show flagged and dead comments. It was a rubbish comment.
        codybontecou 2y ago
        TIL. Thanks for this.
        lurk2 2y ago
buyucu 2y ago
China is having a boom in everything, not just in clinical trials.
- deleted 2y ago
  [deleted]
- kudalf 2y ago
  There’s no evidence that “Chinese trials” or intentional testing on humans caused the outbreak. Investigations by the World Health Organization and independent scientists have not found proof of deliberate origin.
  - goalieca 2y ago
    You seem like a bot given 1 comment in 3 years and it was about this. Your AI misinterpreted the GP and responded to something not asked.
- refurb 2y ago
  If you follow the economic news China has some severe structure problems that it’s going to have to solve. Huge debt overhang, much of it “hidden” that is dragging down growth The real estate problem still isn’t solved and a big reset of prices is going to have a big impact on the economy China placed a big bet on “key industries” under the theory “supply first then we find demand” which isn’t panning out well with tariffs This is showing up in the stock market which rent saw a 50% decrease And economic growth has been a weak 5% when they need 9-11% if they hope to avoid the middle income trap All while the population is rapidly aging and shrinking at the same time
  - deleted 2y ago
    [deleted]
  - buyucu 2y ago
    [flagged]
    - 2y ago
mmooss 2y ago
Competing with it is a problem for conservativism. Some admittedly loose reasoning: Conservativism preserves currently widely accepted structures, including ideas, by ridiculing and excluding new ones; social structures, by outlawing / persecuting / demonizing new ones as a threat to 'our traditions' and 'way of life'; businesses, through tariffs and other anti-competitive measures - the House GOP is considering a bill that reduces antitrust powers, for example; existing economic sectors, by government picking winners and funding them, limiting the economy to what is popular and that the government already understands, such as manufacturing; etc. Remember the land of the individual, of personal freedom, of opportunity, that by its culture generated invention and innovation that other places, without that culture, couldn't match. What China, which is limited by central control, is doing is copying well-established innovations - a biotech industry that relies on clinical trials. Cutting edge stuff - decades ago. What has made the US successful is creating, innovating, and moving on to the next thing - things the government and most of the public are far behind on. Look at the boom in the IT industry over the last several decades (also no longer cutting edge except in limited ways). How can that happen now? The US has currently embraced relatively extreme conservatism. People are afraid to offer challenging ideas, and make their money from rent and from squeezing revenue from old ideas (the stereotypical private equity model). They can't go anywhere except by pleasing the oligarchy, now including the government.
- vladms 2y ago
  While agree with the whole analysis, I do wonder if most/enough/all the ones supporting the regime change in US are really conservatives ("embraced extreme conservatism") or they just feel/are "left behind" hence they want any change. People might not care who is in power (although they will suffer the consequences), but if after 4 years they do not live better they will say "let's change" - without really checking what is the alternative... In the end, alternation of rulers is probably on average healthier than having the same guys over and over, but it is no guarantee of success.
  - theLiminator 2y ago
    I personally think you're right. I think that in general a lot of people want change for the sake of change if they're unhappy (or often even if they're happy).
486sx33 2y ago
[flagged]
- a2dam 2y ago
  What are you talking about?
miki123211 2y ago
China's population is almost twice that of the US and EU combined. If what you're lacking for is patients, there's no better place to go to. Not only that, but we're also a lot more obsessed with patient privacy. If somebody dies of cancer, there's no headline news about them dying of a cancelled trial, even if that's actually what happened. If patient data leaks, there's both a PR nightmare and legal consequences for the institution. That drives priorities. I wouldn't be surprised if (some) Chinese researches are allowed to SELECT * from citizens where disease = 'bone_cancer', whereas researchers in the US have to send people to waiting rooms in hopes of catching an eligible patient[1]. Unless this gets changed, things won't get better. We really need to start optimizing for min(deaths) instead of min(bad_pr) or min(outrage). That's a genuinely hard problem in a democratic society that respects the right to free speech (which, to be clear, is a very good society to live in IMO). In a way, it's a good problem to have. [1] is a really good and accessible overview of why drug trials are so hard and what could be done to make them easier, it's worth checking out for anybody who wants to dive deeper into the subject. [1] https://www.complexsystemspodcast.com/episodes/drug-development-ross-rheingans-yoo/ https://www.complexsystemspodcast.com/episodes/drug-developm...
- kulahan 2y ago
  I strongly disagree. There is no need for humans to be immortal, and there is nothing wrong with tacking healthcare research to public opinion at a bare minimum. If nothing else, it helps ensure our medical care doesn’t veer too far off track.
  - coderatlarge 2y ago
    please consider revisiting this post when/if you or a loved one are on the receiving end of a terminal illness diagnosis. which i don’t wish on anyone.
    - serf 2y ago
      as someone who lives in that perspective, and has lots many loved ones to such diseases.. I wonder if you have ever really considered the prospect of immortality and the implications. A lot of our worldly meaning is derived from the fact that the clock is ticking. Death of progenitors increases the quality of life for the offspring in almost every single metric, more so for long-lived species that require little protection past a certain growth milestone, and personally I see it as a specific 'human arrogance'; if someone had the idea of "Let's make all the field mice immortal" the first opinion would be "that's ridiculous, the ecosphere would be thrown entirely out of balance, the entire predatory chain would be upheaved."... but when we talk about human immortality it always falls back to "Well, don't you miss dear old Grandma serf?" I miss her dearly, but the fact of the matter is that the world wouldn't survive long without a death/life cycle for its' inhabitants, and I think that should include the ones that are the most dangerous to the world at large. p.s. if you need a laymen excuse : i've read enough scifi dystopia tales that begin with the concept of human immortality and the gradual fall of every single moral barrier or raison d'etre ; I don't think that premise is too far from what may happen if humanity is ever given a choice against death.
holoduke 2y ago
Just a walk in a random big city in China reveals how fast they are progressing. The speed of things changing is ridiculous. In almost every field they are getting better. And fast. Thats what you can achieve when your country has 40 years of mass production experience. The thing I hope most for is that China gets its own high performing chips so that companies like Nvidia really get a competitor.
- bamboozled 2y ago
  Interestingly the allure to visit China and see the progress is becoming more compelling. Meanwhile people are afraid to visit the USA.
  - aurareturn 2y ago
    If you check my post history, I kept encouraging HN posters to go to China to see for themselves. The vast majority of commenters here have never been to a China or have never been recently. It’ll change how they see China instantly. The problem with many HN commentators on China is that they view China through a western news propaganda filter. Therefore, they think China must be stealing or cheating to get ahead. If they go see for themselves, the moment they step off the plane, they’ll see that major Chinese cities are 5-10 years ahead of any US city. In other words, China is leading in many areas, not stealing or cheating. They have no reason to steal when they’re leading already.
    - sien 2y ago
      This video by a guy who used to live in China and returned to Shenzhen really surprised me . It's incredible to see how some Chinese cities are today. So many electric cars, incredible metros, drone delivery and more. https://www.youtube.com/watch?v=VItBlmlWE4U https://www.youtube.com/watch?v=VItBlmlWE4U (20 min ) I have no connection with this person at all. Just to make that clear.
      - aurareturn 2y ago
        I was in Shenzhen in 2018. I returned in 2023. I was absolutely shocked at the difference. It truly felt like China was 5-10 years ahead of any US city.
monero-xmr 2y ago
If China actually makes pharmaceutical breakthroughs, the West should immediately steal them and invalidate any claims of patents. They do not respect US intellectual property rights
- tway223 2y ago
  The west actually had quite some deals with them recently. If not for the trade war there could’ve been a lot more. To some extent it is like the Temu vibe.
- litbear2022 2y ago
  [flagged]
- WorldPeas 2y ago
  ..with what industrial scale? It would work for internal markets maybe but I figure the Chinese industrial base applies to more than plastic toys
  - monero-xmr 2y ago
    Copying pharmaceuticals is ridiculously easy. Only patents protect them
    - WorldPeas 2y ago
      I guess the open nature of theft would make it harder to do artifical scarcity so many manufacturers are prone to
nujabe 2y ago
What’s new? America is cooked.
pappyvanwinkle 2y ago
Interesting piece, but I think it is helpful to highlight some points not addressed that provide meaningful context. Though the US system is not perfect, I think we need to acknowledge the US does have a robust, enviable biomedical / regulatory ecosystem, and lots of thought and effort have gone into curating the system that we all enjoy today. To engage with a select few of the points made: 1) Author cites that China introduced priority review mechanisms, conditional approvals, and accelerated timelines to streamline approval pathways. They fail to mention that the US helped pioneer these same mechanisms and that they are currently, actively, in use. We DO have priority review vouchers to incentivize investment in orphan disease, conditional approval pathways, and breakthrough designations for drugs addressing unmet needs to name a few. The US has been, and continues to be an innovator on these topics and credit should be given here - this stuff isn't new to us and there is a rich history of attempts to incentivize innovation ranging from offering prizes for cures to disease, to purchasing experimental therapeutics in advance of approval to ensure sponsors have the cashflow to continue development. 2) Regarding acceptance of foreign data, whose data do you think the rest of the world wants to use by designing their policies the way they have? Many countries are willing to accept foreign data because that includes data generated in the US, where historically and presently, standards are very high and the research infrastructure is well-supported (recent events notwithstanding). One need only look at the story of Dr. Frances Kelsey and thalidomide to understand why the US has gone to great lengths to ensure a high bar that is carefully maintained by its own FDA's standards. This is NOT to say great data isn't generated elsewhere and there are examples where ex-US data has been used to support US approval of promising drugs (particularly in areas of significant unmet need, for example, neurodegenerative disease), but there is rhyme to the reason that goes beyond the argument that the US is antiquated in its approach. That said, one can acknowledge there is a geopolitical component that may wax and wane in relative importance depending on the current political climate. 3) Citing the Lunar trial actually highlights the robustness of the US biomedical enterprise rather than detracts from it - that trial was conducted in patients with stage IV NSCLC after they progressed on platinum therapy. In the US during the enrollment period, ICIs like pembro were being approved as first-line monotherapy displacing platinum-based therapies. So the problem there is when practice changes, you're going to 1) have a harder time finding patients that are progressing on the thing that is no longer first line and 2) remember the intervention arm was ICI + TTF...so you can't intervene when people have already received the drug class that is part of your intervention. Saying they couldn't enroll because of bad infrastructure is like saying the apple store is bad at enrolling customers with dead Iphone 10s to trial your combo therapy when most of the people they see have Iphone 15s. You need to enroll then where most people coming through have iphone 10s and this is precisely why they enrolled a significant proportion of patients ex-US because the standard of care elsewhere had not yet changed. Props to the author for bringing up the important question of US competitiveness in drug development. But let us not forget that we have an enviable biomedical apparatus for a reason - the US has a strong track record of high standards and innovation because we have a good many rigorous, scientifically-minded folks who work on improving it all the time. It's not perfect, but if we don't call out the good, pioneering work that has been done here, then people may feel justified in questioning if anything has been done at all. One should not get the impression we're just waiting around to get hyperdunked or just lucked into the good things we do have.
MartinGAugustin 2y ago
[dead]

160 points by surprisetalk 2y ago

So much of policy success comes down to doing obvious and reasonable things, and most of the problem is how to incentivize making those choices. For all China's flaws, they've figured this out. The best news here is that we might finally have a prosaic means to escape our modern-era applied biotech stagnation, the same way solar has appeared as a means to kick the feet out of traditional energy sources. China is pretty new to being an R&D powerhouse, but there are few more worthy causes.

deleted 2y ago
[deleted]
narrator 2y ago
The best outcome for the current China/U.S conflict is lots of peaceful competition that forces each society to innovate.
- kccqzy 2y ago
  Well during the Cold War with U.S./USSR conflict there was a lot of competition that heralded many new technologies, especially the dual use technologies that are good for both civilian and military uses. I can imagine something happening again if the U.S. had good leadership.
  - boplicity 2y ago
    The problem is that the U.S. has bad media focused on being "right" over actual truth. (See Fox News and the many far-right "alt news" organizationns.) This lack of care for the truth is the foundation the U.S. political system rests on top of. Without fixing that foundation, U.S. leadership will continue to either be terrible, or terribly constrained. Add in unlimited political funding from anonymous people/organizations, and the situation is only more impossible to fix. Good U.S. leadership is a pipedream, unfortunately.
- henry2023 2y ago
  One of the parties involved already decided they don't event wanna try to compete.
tway223 2y ago
China’s success is not because of the policies but rather despite of them. Though not sure how sustainable these successes would be.
- tehjoker 2y ago
  How on earth can you possibly claim that when China was a peasant society that was dicked over for a hundred years by western powers addicting them to opium? Obviously their careful planning and industrialization strategy is working.
  - tway223 2y ago
    There is no careful planning. Just take a look at the waste, the debts and the rapid policy changes. It is more like industrial Darwinism at scale. The main fuel was mainly WTO , export and slavery labor. The industrialization in my opinion is a by product of that process.
    - tehjoker 2y ago
      This is a highly propagandized view of China. Their industrial strategy was to get western capitalists to support industrializing the country by offering cheaper labor, but without surrendering control of the country to them, but now wages have risen quite substantially and their country is industrialized. The western capitalists are now pissed that china didn't "liberalize" and let them take control of the country and are attempting to retaliate. This is why you have imbibed this propaganda that they created.
      - corimaith 2y ago
        >The western capitalists are now pissed that china didn't "liberalize" and let them take control of the country and are attempting to retaliate. This is why you have imbibed this propaganda that they created. And this is surely a well balanced opinion and not one shaped by highly ideological forces... There is nothing particularly wrong with what OP is saying, with the deflationary price wars happening it's very clear they rely on open exports markets to stave off unemployment against their insufficient domestic demand. That itself is only a possibility in a world of free trade fostered in USA, not in a world of mercantalism pre 1945. The ironic thing is that they themselves are trying to suppress the development of India next up in the value-chain. Anyways, Chinese economists themselves agree for the urgent need to shift to consumption today rather than double down on manufacturing, something that should have done decades ago like Western economists have been urging.

munchler 2y ago

Meanwhile DOGE has cancelled more than $2 billion in federal research grants. The US is shooting itself in the foot when it should be competing at its best. https://www.cbsnews.com/amp/news/nih-layoffs-budget-cuts-medical-research-60-minutes/ https://www.cbsnews.com/amp/news/nih-layoffs-budget-cuts-med...

eastbound 2y ago
[flagged]
- munchler 2y ago
  Give me a freaking break. One side is carrying on the Enlightenment ideals of rationality and secular humanism, while the other is trying to drag us back to the dark ages of superstition and fear. It has nothing to do with political “left” and “right” anymore. It’s just sane vs. insane.
  - dingnuts 2y ago
    your comment would have a lot more weight if the grandparent hadn't been flagged and removed by people who don't like to read things they disagree with! How am I supposed to know what arguments to expect from MAGA if you people censor what they have to say? Censorship isn't helping your cause! It just makes your side look weak and scared.
    - gherkinnn 2y ago
      You can adjust the HN settings to show flagged and dead comments. It was a rubbish comment.
      - codybontecou 2y ago
        TIL. Thanks for this.
      - lurk2 2y ago

buyucu 2y ago

China is having a boom in everything, not just in clinical trials.

deleted 2y ago
[deleted]
kudalf 2y ago
There’s no evidence that “Chinese trials” or intentional testing on humans caused the outbreak. Investigations by the World Health Organization and independent scientists have not found proof of deliberate origin.
- goalieca 2y ago
  You seem like a bot given 1 comment in 3 years and it was about this. Your AI misinterpreted the GP and responded to something not asked.
refurb 2y ago
If you follow the economic news China has some severe structure problems that it’s going to have to solve. Huge debt overhang, much of it “hidden” that is dragging down growth The real estate problem still isn’t solved and a big reset of prices is going to have a big impact on the economy China placed a big bet on “key industries” under the theory “supply first then we find demand” which isn’t panning out well with tariffs This is showing up in the stock market which rent saw a 50% decrease And economic growth has been a weak 5% when they need 9-11% if they hope to avoid the middle income trap All while the population is rapidly aging and shrinking at the same time
- deleted 2y ago
  [deleted]
- buyucu 2y ago
  [flagged]
  - 2y ago

mmooss 2y ago

Competing with it is a problem for conservativism. Some admittedly loose reasoning: Conservativism preserves currently widely accepted structures, including ideas, by ridiculing and excluding new ones; social structures, by outlawing / persecuting / demonizing new ones as a threat to 'our traditions' and 'way of life'; businesses, through tariffs and other anti-competitive measures - the House GOP is considering a bill that reduces antitrust powers, for example; existing economic sectors, by government picking winners and funding them, limiting the economy to what is popular and that the government already understands, such as manufacturing; etc. Remember the land of the individual, of personal freedom, of opportunity, that by its culture generated invention and innovation that other places, without that culture, couldn't match. What China, which is limited by central control, is doing is copying well-established innovations - a biotech industry that relies on clinical trials. Cutting edge stuff - decades ago. What has made the US successful is creating, innovating, and moving on to the next thing - things the government and most of the public are far behind on. Look at the boom in the IT industry over the last several decades (also no longer cutting edge except in limited ways). How can that happen now? The US has currently embraced relatively extreme conservatism. People are afraid to offer challenging ideas, and make their money from rent and from squeezing revenue from old ideas (the stereotypical private equity model). They can't go anywhere except by pleasing the oligarchy, now including the government.

vladms 2y ago
While agree with the whole analysis, I do wonder if most/enough/all the ones supporting the regime change in US are really conservatives ("embraced extreme conservatism") or they just feel/are "left behind" hence they want any change. People might not care who is in power (although they will suffer the consequences), but if after 4 years they do not live better they will say "let's change" - without really checking what is the alternative... In the end, alternation of rulers is probably on average healthier than having the same guys over and over, but it is no guarantee of success.
- theLiminator 2y ago
  I personally think you're right. I think that in general a lot of people want change for the sake of change if they're unhappy (or often even if they're happy).

486sx33 2y ago

[flagged]

a2dam 2y ago
What are you talking about?

miki123211 2y ago

China's population is almost twice that of the US and EU combined. If what you're lacking for is patients, there's no better place to go to. Not only that, but we're also a lot more obsessed with patient privacy. If somebody dies of cancer, there's no headline news about them dying of a cancelled trial, even if that's actually what happened. If patient data leaks, there's both a PR nightmare and legal consequences for the institution. That drives priorities. I wouldn't be surprised if (some) Chinese researches are allowed to SELECT * from citizens where disease = 'bone_cancer', whereas researchers in the US have to send people to waiting rooms in hopes of catching an eligible patient[1]. Unless this gets changed, things won't get better. We really need to start optimizing for min(deaths) instead of min(bad_pr) or min(outrage). That's a genuinely hard problem in a democratic society that respects the right to free speech (which, to be clear, is a very good society to live in IMO). In a way, it's a good problem to have. [1] is a really good and accessible overview of why drug trials are so hard and what could be done to make them easier, it's worth checking out for anybody who wants to dive deeper into the subject. [1] https://www.complexsystemspodcast.com/episodes/drug-development-ross-rheingans-yoo/ https://www.complexsystemspodcast.com/episodes/drug-developm...

kulahan 2y ago
I strongly disagree. There is no need for humans to be immortal, and there is nothing wrong with tacking healthcare research to public opinion at a bare minimum. If nothing else, it helps ensure our medical care doesn’t veer too far off track.
- coderatlarge 2y ago
  please consider revisiting this post when/if you or a loved one are on the receiving end of a terminal illness diagnosis. which i don’t wish on anyone.
  - serf 2y ago
    as someone who lives in that perspective, and has lots many loved ones to such diseases.. I wonder if you have ever really considered the prospect of immortality and the implications. A lot of our worldly meaning is derived from the fact that the clock is ticking. Death of progenitors increases the quality of life for the offspring in almost every single metric, more so for long-lived species that require little protection past a certain growth milestone, and personally I see it as a specific 'human arrogance'; if someone had the idea of "Let's make all the field mice immortal" the first opinion would be "that's ridiculous, the ecosphere would be thrown entirely out of balance, the entire predatory chain would be upheaved."... but when we talk about human immortality it always falls back to "Well, don't you miss dear old Grandma serf?" I miss her dearly, but the fact of the matter is that the world wouldn't survive long without a death/life cycle for its' inhabitants, and I think that should include the ones that are the most dangerous to the world at large. p.s. if you need a laymen excuse : i've read enough scifi dystopia tales that begin with the concept of human immortality and the gradual fall of every single moral barrier or raison d'etre ; I don't think that premise is too far from what may happen if humanity is ever given a choice against death.

holoduke 2y ago

Just a walk in a random big city in China reveals how fast they are progressing. The speed of things changing is ridiculous. In almost every field they are getting better. And fast. Thats what you can achieve when your country has 40 years of mass production experience. The thing I hope most for is that China gets its own high performing chips so that companies like Nvidia really get a competitor.

bamboozled 2y ago
Interestingly the allure to visit China and see the progress is becoming more compelling. Meanwhile people are afraid to visit the USA.
- aurareturn 2y ago
  If you check my post history, I kept encouraging HN posters to go to China to see for themselves. The vast majority of commenters here have never been to a China or have never been recently. It’ll change how they see China instantly. The problem with many HN commentators on China is that they view China through a western news propaganda filter. Therefore, they think China must be stealing or cheating to get ahead. If they go see for themselves, the moment they step off the plane, they’ll see that major Chinese cities are 5-10 years ahead of any US city. In other words, China is leading in many areas, not stealing or cheating. They have no reason to steal when they’re leading already.
  - sien 2y ago
    This video by a guy who used to live in China and returned to Shenzhen really surprised me . It's incredible to see how some Chinese cities are today. So many electric cars, incredible metros, drone delivery and more. https://www.youtube.com/watch?v=VItBlmlWE4U https://www.youtube.com/watch?v=VItBlmlWE4U (20 min ) I have no connection with this person at all. Just to make that clear.
    - aurareturn 2y ago
      I was in Shenzhen in 2018. I returned in 2023. I was absolutely shocked at the difference. It truly felt like China was 5-10 years ahead of any US city.

monero-xmr 2y ago

If China actually makes pharmaceutical breakthroughs, the West should immediately steal them and invalidate any claims of patents. They do not respect US intellectual property rights

tway223 2y ago
The west actually had quite some deals with them recently. If not for the trade war there could’ve been a lot more. To some extent it is like the Temu vibe.
litbear2022 2y ago
[flagged]
WorldPeas 2y ago
..with what industrial scale? It would work for internal markets maybe but I figure the Chinese industrial base applies to more than plastic toys
- monero-xmr 2y ago
  Copying pharmaceuticals is ridiculously easy. Only patents protect them
  - WorldPeas 2y ago
    I guess the open nature of theft would make it harder to do artifical scarcity so many manufacturers are prone to

nujabe 2y ago

What’s new? America is cooked.

pappyvanwinkle 2y ago

Interesting piece, but I think it is helpful to highlight some points not addressed that provide meaningful context. Though the US system is not perfect, I think we need to acknowledge the US does have a robust, enviable biomedical / regulatory ecosystem, and lots of thought and effort have gone into curating the system that we all enjoy today. To engage with a select few of the points made: 1) Author cites that China introduced priority review mechanisms, conditional approvals, and accelerated timelines to streamline approval pathways. They fail to mention that the US helped pioneer these same mechanisms and that they are currently, actively, in use. We DO have priority review vouchers to incentivize investment in orphan disease, conditional approval pathways, and breakthrough designations for drugs addressing unmet needs to name a few. The US has been, and continues to be an innovator on these topics and credit should be given here - this stuff isn't new to us and there is a rich history of attempts to incentivize innovation ranging from offering prizes for cures to disease, to purchasing experimental therapeutics in advance of approval to ensure sponsors have the cashflow to continue development. 2) Regarding acceptance of foreign data, whose data do you think the rest of the world wants to use by designing their policies the way they have? Many countries are willing to accept foreign data because that includes data generated in the US, where historically and presently, standards are very high and the research infrastructure is well-supported (recent events notwithstanding). One need only look at the story of Dr. Frances Kelsey and thalidomide to understand why the US has gone to great lengths to ensure a high bar that is carefully maintained by its own FDA's standards. This is NOT to say great data isn't generated elsewhere and there are examples where ex-US data has been used to support US approval of promising drugs (particularly in areas of significant unmet need, for example, neurodegenerative disease), but there is rhyme to the reason that goes beyond the argument that the US is antiquated in its approach. That said, one can acknowledge there is a geopolitical component that may wax and wane in relative importance depending on the current political climate. 3) Citing the Lunar trial actually highlights the robustness of the US biomedical enterprise rather than detracts from it - that trial was conducted in patients with stage IV NSCLC after they progressed on platinum therapy. In the US during the enrollment period, ICIs like pembro were being approved as first-line monotherapy displacing platinum-based therapies. So the problem there is when practice changes, you're going to 1) have a harder time finding patients that are progressing on the thing that is no longer first line and 2) remember the intervention arm was ICI + TTF...so you can't intervene when people have already received the drug class that is part of your intervention. Saying they couldn't enroll because of bad infrastructure is like saying the apple store is bad at enrolling customers with dead Iphone 10s to trial your combo therapy when most of the people they see have Iphone 15s. You need to enroll then where most people coming through have iphone 10s and this is precisely why they enrolled a significant proportion of patients ex-US because the standard of care elsewhere had not yet changed. Props to the author for bringing up the important question of US competitiveness in drug development. But let us not forget that we have an enviable biomedical apparatus for a reason - the US has a strong track record of high standards and innovation because we have a good many rigorous, scientifically-minded folks who work on improving it all the time. It's not perfect, but if we don't call out the good, pioneering work that has been done here, then people may feel justified in questioning if anything has been done at all. One should not get the impression we're just waiting around to get hyperdunked or just lucked into the good things we do have.

MartinGAugustin 2y ago

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