Summary of Key Points
This news article highlights the unique challenges in China's new drug development process, particularly the lack of innovation from scratch: **There is a low correlation between the discovery of new drug targets in China and hospitals (compared to 60% of targets identified in the United States coming from hospitals), the number of clinical trial institutions has doubled, but there is a significant shortage of physician scientists who have both clinical expertise and research capabilities), and although there are many basic research papers, few high-quality original achievements. Experts point out that the root of these issues lies in an imperfect training system for physician scientists and a research evaluation framework that prioritizes paper publication over clinical needs. To overcome these challenges, it is necessary to improve the training mechanisms and adjust the research evaluation criteria.
I. The Difference in the Origin of New Drug Targets: Why Don't More Targets Come from Hospitals in China?
The first step in new drug development is identifying targets—specific proteins or genes that cause diseases. In the United States, 60% of targets are discovered in hospitals, but in China, this connection is virtually non-existent. The reason is that there are a large number of physician scientists in the U.S.: they see patients during the day and conduct research at night, allowing them to directly identify unmet clinical needs from patient cases (for example, diseases for which existing drugs are ineffective) and then turn these into research topics. In China, such professionals are scarce; doctors either focus solely on patient care or on basic research, creating a gap in the process of translating clinical needs into viable research targets.
II. Despite Doubling the Number of Clinical Trial Institutions, Why Is There Still a Lack of Key Personnel?
From 2020 to 2025, the number of clinical trial institutions in China increased from 975 to 1834, but there is still a significant shortage of physician scientists who can drive research translation. There are three main reasons for this:
1. Insufficient Representation: Internationally, physician scientists should account for about 5% of the total number of doctors, but this ratio has not been reached in China.
2. Lack of Training Systems: Top medical schools in Europe and America have departments dedicated to clinical research, while only a few Chinese institutions (such as Peking Union Medical College and Peking University Health Science Center) offer relevant programs, with very limited enrollments.
3. Small Pool of Potential Candidates: Physician scientists are typically selected from eight-year medical programs, but the combined annual enrollment at Tsinghua University, Peking University, and Peking Union Medical College is less than 100, compared to the 300 enrolled at the National University of Singapore—this small base results in a limited number of qualified candidates.
III. China Has the Second-Highest Number of Papers Worldwide, but Why Are There So Few Original New Drugs?
China ranks second globally in the number of biomedical papers published in top journals (Cell, Nature, Science), yet there is a scarcity of original achievements that can be translated into new drugs. The core problem is an editorial-driven research evaluation system: Scholars often pursue hot topics in journals to publish papers and conduct “hypothesis-based” research, only to change their focus after publication without verifying the validity of their hypotheses. As a result, there are many potential targets, but few that are reliable, making it difficult for pharmaceutical companies to invest in their development.
On the other hand, China’s translational platforms (such as CROs) are well-developed; what is lacking is a supply of high-quality research results that are suitable for drug development. If the research truly addresses clinical problems, pharmaceutical companies will be willing to invest.
IV. The Key to Overcoming These Challenges: Training Physician Scientists and Adjusting Research Evaluation
Experts propose the following solutions:
1. Improve the Training of Physician Scientists:
- Establish selection mechanisms to identify doctors with potential for translation research, aiming for a 5% representation.
- Provide systematic training, drawing on models like the U.S. “Yellow Beret Program” (which allows doctors to study at research institutes full-time).
- Promote integrated programs combining MD (Doctor of Medicine) and PhD degrees, and remove restrictions that prevent doctors from pursuing master’s degrees after obtaining a PhD.
- Integrate medical schools with hospitals, such as the new campus being built by Tsinghua University School of Medicine, to provide necessary support for physician scientists.
2. Adjust Research Evaluation Criteria:
- Give scientists enough time and freedom in basic research; avoid forcing them to follow preset research agendas (e.g., developing new drugs).
- Shift the focus of evaluation from the number of papers published to the clinical problems solved by the research.
V. In Summary: The Core of New Drug Innovation Lies in Transforming Clinical Needs into Research
For China to make breakthroughs in new drug development, it is essential to bridge the gap between doctors and scientists—doctors should identify clinical issues, and scientists should transform these issues into viable research topics for new drugs. This requires training more physician scientists who can both treat patients and conduct research, as well as reorienting research towards solving real clinical problems, rather than solely focusing on paper publication.