China's booming biotech, from a brain implant to drug discovery

China's biotech industry is on a rapid rise, with the first approved brain-computer interface and massive growth in drug discovery.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:02Ira Flatow?

  Hi, I'm Ira Flatow, and you're listening to Science Friday. In March, China became the first country to approve an invasive brain-computer interface beyond clinical trials. The implant, called NEO, is made by the Chinese company Neuralink Technology. It's now available to some patients with limb paralysis due to a spinal cord injury. So how soon will it be available worldwide? And is this the start of a major new industry? Joining me now to help answer some of the unknowns is Emily Mullen, a staff writer at Wired, who's been covering the brain-computer interface industry in China and the US. Welcome to Science Friday.

• 0:43Speaker 01

  Thanks for having me.

• 0:45Ira Flatow?

  So Emily, just how significant is this milestone for brain-computer interface technology?

• 0:50Speaker 01

  I would say this is a pretty significant milestone, you know, not only for China, but also for the worldwide brain-computer interface field. It shows that China has caught up with the US in terms of BCI technology, and it also shows that these devices are commercially viable.

• 1:12Ira Flatow?

  Huh. Tell me a bit about the implant. Can you describe it for us, how it works?

• 1:17Speaker 01

  Yeah, so as you said, this device is called the NEO, and it doesn't go into the brain directly. It actually rests on top of the brain's protective membrane called the deramater, and it pairs with a soft robotic glove to enable a gripping action for people who have lost the use of their hand. The system was tested on about three dozen people in trials, and China has now started incorporating it into the country's health systems. So we could see this rolled out soon to patients.

• 1:56Ira Flatow?

  How similar is this to other BCI's that other companies are currently developing?

• 2:02Speaker 01

  Yeah, so one of the companies you might have heard of in the US is Elon Musk's Neuralink, and Neuralink is developing this coin-sized implant with thin electrode threads that actually reach into the brain tissue. So that's a little bit different than this device that China has just approved. Now, there are other companies... Such as Synchron, for instance, they're based in New York. They are developing a little stent-like tube that actually fits into a blood vessel and is pushed up through the blood vessels so that it rests actually against the brain.

• 2:42Speaker 01

  So there are all sorts of designs that are being developed and being investigated for different uses.

• 2:49Ira Flatow?

  Yeah, that's interesting. Could we see a bunch of more similar devices approved in China soon?

• 2:55Speaker 01

  There are several companies in China that are now developing brain-computer interfaces. So I think we are probably likely to see, over the next couple of years, more approvals like this. The government officially designated brain-computer interfaces as a strategic industry, and the country's latest five-year plan lists BCI, or brain-computer interface, as one of six key industries that are important to China's future tech competitiveness. So this is China saying, you know, we are serious about the field, we are investing

• 3:37Speaker 01

  in it heavily, we're really staking it out as an area we feel like we can be competitive in.

• 3:44Ira Flatow?

  And this is an important statement, China saying, "We have arrived."

• 3:47Speaker 01

  Yeah, absolutely. Here in the US, there are a handful of companies that are testing these devices in clinical trials, but that process here in the US is a little bit slower. It seems like there are some talks between the FDA and device companies that are still ongoing, but certainly Neuralink and then Synchron, another company developing a brain-computer interface. Those companies are really poised to go into these bigger trials. I think, you know, this will be an interesting test case for not just the US, but also globally

• 4:29Speaker 01

  in terms of how viable this technology is commercially, but also from the patient perspective.

• 4:37Speaker 01

  You know, how useful are these devices in everyday life?

• 4:42Ira Flatow?

  It's interesting you say, how useful are these devices in everyday life? What kinds of everyday life applications are we talking about here?

• 4:51Speaker 01

  Yeah, so most companies are focusing on applications for individuals with paralysis who have lost the use of their limbs. And Neuralink, for instance, they are developing a BCI to allow people to type on a computer, play video games with just their thoughts alone. So these devices, at least right now, are being imagined as an assistive device, tools for people to get back some of their independence.

• 5:23Ira Flatow?

  You know, we always hear about stuff that works really well in the laboratory situation, right? How will we know if it really works out there in the real world for patients?

• 5:36Speaker 01

  So one of the things about these devices is that most of them have to be calibrated before each use. I have visited a BCI trial participant and actually a field engineer comes to visit him every week and sets up the system so that he's able to use it. He can't actually turn it on and off by himself and he can't do the calibration himself. So I think that's going to be one of the things that is going to need to be figured out in this process of trials and in the commercial spaces. Will patients really be able to use them independently?

• 6:18Speaker 01

  How much are they going to need to rely on somebody else to use a device that's meant to restore independence?

• 6:27Ira Flatow?

  Emily Mullin, staff writer at Wired. After the break, a look into what's driving China's biotech industry boom. Stay with us.

• 6:41Speaker 02

  Support for Science Friday comes from the William K. Bose Junior Foundation.

• 6:50Ira Flatow?

  Now, it's not just China's brain-computer interface sector that's growing. The country's entire biotech industry has skyrocketed in recent years. A decade ago, about 8% of new drug molecules were discovered in China. Now, it's over 40%, and more clinical trials are now being conducted in China than in the US or Europe. And most recently, pharma juggernaut Bristol Myers Squibb signed a $15 billion deal with a Chinese company to acquire several early-stage drug candidates. Has the center of gravity in biotech moved from the US to China?

• 7:32Ira Flatow?

  My next guest has been following the Chinese pharma industry's meteoric rise. Dr. Siyuan Kang is an assistant professor of health management and policy at Georgetown University in Washington, DC. Welcome to Science Friday.

• 7:45Speaker 03

  Thank you for having me.

• 7:47Ira Flatow?

  Nice to have you. Tell us, what is driving this enormous growth of the Chinese biotech industry?

• 7:54Speaker 03

  That's a great question. And China's rise in biotechnology is not just a random or overnight event. It's the sort of result of more than a decade of coordinated investment in science, research, regulation, and biotechnology industry. And I think it's really a two-part story. First is that the way that pharmaceutical companies develop drugs has changed a lot. So our traditional image of big pharma companies is like Pfizer, like hire an army of PhDs from biology or chemistry PhD and run their own lab, discover drugs, and patent them, develop the drugs, and commercialize them, right? So like a one-stop-shop model. But it changed a lot.

• 8:38Speaker 03

  And they now, of course, do have their own laboratories, but also to search for the neurotoxin candidates. So they send these people to China, Singapore, South Korea, to find the promising drug candidates. And second part is, again, China's investment in this drug industry and the transformation of their ecosystem toward more innovation from manufacturing.

• 9:01Ira Flatow?

  Are there specific parts of the biotech industry where Chinese companies are excelling, so to say?

• 9:09Speaker 03

  Right, so China is known for its sort of a factory of the world in a concept, right? So that's primary supplier of generic drugs. But now they are really doing well in early-stage drug development. When you say early-stage drug development, it means that it includes the early-stage drug discovery and also the preclinical research and the phase one and phase two clinical trials.

• 9:34Ira Flatow?

  Why are they better at doing that?

• 9:37Speaker 03

  That's another important area that we need to explore and investigate further. But what you hear a lot is about their speed and cost. So startup companies, as you can imagine, like in the small startup companies, they run on the very limited funding that they raised from venture capital firms. So they have limited time and limited amount of money, for example, like a $20 million for 20 months, you know, something like that. And time is money, and they have to show the promise within that sort of 20 months of the timeline. And if they fail, then they cannot actually survive, because it's kind of binary nature, you know, for the biotech companies, survive or fail.

• 10:19Speaker 03

  And China now offers very cost-efficient models, like it's a lot easier to recruit, you know, the patients in clinical trials, and also they offer sort of very favorable regulatory environment, and also they have built some sort of, you know, very effective clinical trial infrastructure. So that combination of this pool of patients and it's efficiency around the clinical trials and also the money involved in that really make attracting a lot of startup companies to run these clinical trials in China.

• 10:51Ira Flatow?

  Yeah, so that's an important point, companies getting additional money from the government even if they fail at first.

• 10:57Speaker 03

  Exactly.

• 10:59Ira Flatow?

  So how common is it for American or European companies to source early-stage drug candidates from China?

• 11:08Speaker 03

  Increasingly, more and more drugs are coming from these Chinese companies. So about half of the new drug licensing deals were about these drugs developed in startup companies in China. And also, like you just mentioned, the Bristol-Myers Scoops, the license licensing deal, they signed this licensing agreement with Henry Pharma in China for about $15 billion for 13 drug candidates across different therapeutic categories. So it's a huge deal, $15 billion for 13 candidates.

• 11:43Ira Flatow?

  With the Chinese government willing to fund these companies and with the companies themselves, like Bristol-Myers, making deals with China, how disruptive could China's ascent in the biotech industry be to the global pharmaceutical industry?

• 12:03Speaker 03

  That's a million-dollar question, I'd say.

• 12:06Ira Flatow?

  Not more than a million, isn't it?

• 12:07Speaker 03

  Yeah, billion-dollar question, might be. Yeah. Because that's a kind of the topic debated a lot recently. Pharmaceutical companies, so they send people not because the drug is in China, but because that's where science is, right? Where the innovation is. They want to maximize their profit, also maximize efficiency. They are naturally just pursue the sort of, you know, the where the opportunities where the promising candidates are developed. But for the big picture, like as you mentioned, the global pharmaceutical industry, we don't know how the other countries and our companies can survive with this intensifying competition. But now, we cannot ignore some sort of geopolitical issues.

• 12:52Speaker 03

  And also, we have lots of uncertainty about whether to happen if the majority of drugs are coming from China through these licensing agreements, things like that. And also, we don't have the immediate answer to what would be the consequence of this on the US pharmaceutical ecosystem and infrastructure and human capital.

• 13:10Ira Flatow?

  Yeah. Are we going to see less talent coming to the US and just staying in China to develop these new drugs?

• 13:16Speaker 03

  That's an excellent question, too. And for example, previously, when brilliant people came to the United States for their PhDs or training and postdoc fellowship, they tend to stay in the US companies, right? And also US ecosystem. And they re-contribute to the innovation within our country. But now, the China's biopharmaceutical industry and biotech industry itself has the capacity to develop their own talent, and so to retain their talent, and also to feed the next generation of the talents, too. That's another area that we need to pay attention to as well.

• 13:56Ira Flatow?

  So we might soon see drugs that are created from start to finish in China reaching the US market. I mean, not just American companies buying early-stage candidates from Chinese companies.

• 14:09Speaker 03

  Yes, I think that's a fair concern. Because China, as you know, has this amazing manufacturing facilities and infrastructure. And even though it's currently mostly focusing on generic drugs, and down the road, they may want to develop some sort of cell therapies and gene therapies and manufacture them within China, then it means that they may just own this entire ecosystem, from discovery, development, to manufacturing and commercialization, too.

• 14:39Ira Flatow?

  Could the American companies and the American government see that as a threat to the security of American pharmaceutical industry?

• 14:49Speaker 03

  Oh, yes. We increasingly see this kind of policy debates and discussions around the role of China, and also how to handle this kind of investment going to China from the US. And also, there are sort of discussions about banning some licensing deals with Chinese companies or companies in certain markets. But that's not something that any people or the stakeholders in this ecosystem want to see, because, as I mentioned earlier, this is about innovation and science, and completely banning or disrupting this sort of, you know, the natural economy. And Also the economic behaviors that can have sort of unintended consequences on patients' access to needed treatments, right?

• 15:34Ira Flatow?

  Right.

• 15:34Speaker 03

  So that approach should be very, very careful. And we want to approach this as sort of, you know, competitionist perspective, not as sort of, you know, some trade war or any sort of, you know, banning

• 15:46Ira Flatow?

  Right.

• 15:46Speaker 03

  the transactions and yeah.

• 15:49Ira Flatow?

  What about the price of drugs? Could this drive down the price of drugs if, if China gets really to be one of the superpowers in the pharmaceutical industry? Or would it drive the price up because you might have a monopoly?

• 16:03Speaker 03

  In theory, if we obtain the drugs developed in lower cost setting, then we may want to see that the drug actual price lower than in the previous settings, right? But now we don't have any evidence to support each, any direction. And also from the manufacturer's perspective, that may not be the motivation for them to lower the price. Because, as I mentioned, Bristol-Myers�ip's paid $15 billion, right?

• 16:31Ira Flatow?

  Right.

• 16:31Speaker 03

  So it's not, it's no lower than any other deals that they did, made with other American companies too. So for them, lowering the drug price is not, I don't think that that's on their agenda.

• 16:44Ira Flatow?

  Hmm. Is there room then for cooperation between the US and China? Instead of viewing it as, as a competition? Or is it this just how business is done?

• 16:55Speaker 03

  Absolutely. So there's lots of, you know, discussion about how to coordinate and harmonize this regulatory systems and also how to co-develop drugs. So there are ongoing, some parallel discussion about this. But in the meantime, we need to pay attention to how we can make this in the US system stronger. Because, you know, this innovation is a sort of long game. And once we lose the sort of resource and infrastructure, it's really hard to rebuild. So what are the kind of consequences and implications of this shift on the US ecosystem? As well as the local economy supporting this bio-pharmaceutical innovation?

• 17:37Ira Flatow?

  Thank you for being with us today.

• 17:38Speaker 03

  Thank you very much.

• 17:40Ira Flatow?

  Dr. Soo-Yan Kang is an assistant professor of Health Management and Policy at Georgetown University in Washington.

• 17:51Ira Flatow?

  Before we go, we're working on a segment about AI in the doctor's office. And we want to know, are you a doctor? And have you used platforms like Open Evidence? What do you think about other doctors using AI? Or are you a patient whose doctor used AI during your care? Please tell us your story and your thoughts at 1-877-4-CY-FRI. This episode was produced by Shoshana Buxbaum. I'm Ira Flatow. We'll catch you next time.