China didn't become a drug-making powerhouse through lab breakthroughs—they did it just by changing one government insurance list.
March 25, 2026
Original Paper
From Free Rider to Innovator: The Rise of China's Drug Development
SSRN · 6456963
The Takeaway
While many assume China's rise in pharma is due to state-sponsored research or talent flows, this paper shows that a single reform to the National Reimbursement Drug List (NRDL) accounted for nearly half of the growth. By simply expanding the guaranteed market size for new drugs, the policy incentivized domestic firms to innovate more effectively than traditional industrial subsidies.
From the abstract
This paper examines China’s transition from pharmaceutical “free rider” to global innovator over the last decade. In 2010, China accounted for less than 8% of global clinical trials; by 2020, it had surpassed the US in annual registered clinical trial volume. To study this transformation, we compile a comprehensive, synchronized database spanning the pharmaceutical drug development supply chain, covering scientific publications, clinical trials, drug development milestones for China, the U.S., a