The Rush To Test Drugs In China is in full swing — a peculiar form of labor arbitrage, n’est-ce pas?:
China’s immense patient populations suffering from cancer, diabetes, cardiovascular illnesses, and a whole range of infectious diseases have captured the attention of drug and medical device companies across Europe and America. They are expanding research and testing facilities in China, not only because costs are low and it is relatively easy to recruit patients, but also because Beijing insists new drugs be tested locally before going on sale.Many Western drug companies have had research bases in China since the 1990s. But the past 12 months have seen a flurry of new activity. In May of last year, AstraZeneca PLC committed $100 million in new research spending, much of it earmarked for cancer. In November, Novartis announced plans for a $100 million research and development center in Shanghai. And Eli Lilly & Co. has 35 trials under way involving thousands of patients. The company will enroll twice as many patients this year as in 2006—some in trials that would be hard to fill in the U.S., says Dr. Steven M. Paul, Lilly’s executive vice-president for science and technology. “We can do these very safely and quickly in China.”
Trials run by western companies bring big benefits to China. Patients gain access to “cutting-edge medical products,” says Beat Widler, head of clinical quality at Swiss pharma giant Roche, which invested more than $50 million on its Chinese operations last year. At the same time, he adds, Chinese doctors, nurses, and research staff “improve their understanding of trial methodology.”
Yet working inside China’s sprawling, often under-supervised health-care system may raise complex ethical questions. In the past, Chinese medical authorities have greenlighted risky experiments, including stem cell injections and treatments that involve altering the patient’s genes. Moreover, people recruited into trials don’t always understand what they have signed up for, but they rush to join because it may be their only chance to see a doctor.