About The Study: Global early-stage drug development has nearly doubled over the past decade, shifting from a system dominated by the U.S. toward a 2-hub structure centered on the U.S. and China. Because early-stage drug candidates shape future drug approvals and investment, these shifts may have downstream implications for regulatory coordination, scientific workforce development, and patient access to new therapies. Continued monitoring will be essential for policymakers to understand these consequences and to design appropriate financial and regulatory incentives.
Corresponding Author: To contact the corresponding author, So-Yeon Kang, PhD, MBA, email soyeon.kang@georgetown.edu .
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(doi:10.1001/jama.2026.1962)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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