In 2025 it seemed the only certainty for biotech was more uncertainty. Biotech leaders conducted business as usual against the background of ongoing funding challenges and ever-increasing drug development complexity. During the year ICON Biotech surveyed 163 biotech leaders in North America, EMEA and APAC to see how they are responding to the headwinds. The survey was a repeat of one conducted in 2023 and comparing the results illustrates how the sector has changed. A supplemental survey of 100 biotech leaders in China provides perspective from the country overtaking the US for new drug development. The results of both surveys provide insights into what biotech leaders anticipate in the coming two years, the therapies and modalities they’re focused on now and what macro and micro factors are impacting their operations.
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The rise of China as a biotech powerhouse
Arguably the biggest biotech news story in recent years has been China’s consolidation as a leading nation for life science and biotech. China’s focus has shifted from pharmaceutical manufacturing of existing treatments to innovation and research. Since 2023 China has conducted more trials for innovative drugs than the US.1 By 2040 assets originating from China are estimated to represent 35% of US FDA approvals.2 EU and US policymakers have expressed concerns about the implications for their regions’ competitiveness and biosecurity. While both regions’ policymakers have recommendations to address these issues, implementing possible solutions will take time and rely on government support even when administrations change. Favorable long-term national and regional government policies in China support biotech and pharma in four regional hubs. A large treatment-naïve patient population ensures that clinical trials and investigation sites have the participants needed to conduct their research.
More for less: Funding challenges persist
Funding continues to be a cause for concern for biotechs, globally and within China. The good news for biotechs is that funding is available, the bad news is that today it is more likely to be concentrated in fewer, but bigger deals. For the lucky few benefitting from these mega rounds means a longer runway to develop their drugs without a further funding round. However, for the majority of biotechs competition to secure funding is fiercer than ever. Adding to this is the almost 40% reduction of funding from the National Institutes of Health, the world’s largest health and life sciences funding body. Notwithstanding these challenges 75% of respondents expect to increase their R&D spending in the next one to two years. To do so, 41% intend to seek additional funds – almost trebling 2023’s 14%. Global biotech leaders cited current funding sources as partnerships with large pharma (48%), venture capital firms (32%) and government grants or public funding (28%).3 The picture in China is similar, with the same top three funding sources: large pharma partnerships (59%), venture capital firms (49%) and government grants/public funding (36%). A higher percentage (83%) of Chinese biotech leaders expect to increase R&D spending with 45% planning to seek additional funding.
Modalities and therapeutic research trends
Questions about modalities and therapeutic areas revealed some changes since the 2023 survey. In the earlier global survey, the prominent modality was small molecule (35%) followed by cell therapy (31%) and monoclonal antibodies (mAbs) (29%). In 2025’s survey the top three modalities were cell therapy (40%), antibody drug conjugates (ADCs) (31%) and microbiome therapies (31%). Pipeline mAbs activity dropped by 8% and small molecule by 7%. Meanwhile, China is conducting around double the number of cell and gene therapy (CGT) studies as the US.4 Survey respondents in China reflect this with the top three most active modalities being cell therapy (53%), microbiome (45%) and ADCs (39%).
The therapeutic activity areas shifted since 2023 also; oncology was overtaken by neurology as the most active area. Other therapeutic areas increased since 2023 including cardiovascular (39% vs 29% in 2023) and immune disorders (32% vs 26%). While oncology declined from 42% to 30% it remains a competitive but challenging research area, especially when treatments are delivered via novel mechanisms or combinations. For early stage biotechs oncology may seem a riskier proposition. Oncology clinical trials often have to reach a later stage than other therapeutic areas before they can attract financial partners. The difference between China and the rest of the world was evident in the survey results. China biotech’s active therapeutic areas were cardiovascular (58%), oncology (53%) and neurology (37%).
Geopolitical uncertainty and regulatory complexity
More than 70 countries held national elections in 2024 and a quarter of the world’s population were eligible to vote in countries where over half the world's population lives. Perhaps unsurprisingly, concerns about geopolitical uncertainty doubled since the 2023 survey: from 26% to 53%. Changing regulatory requirements were also front of mind among global biotech leaders, with 66% (vs 2023’s 56%) listing it as a macro element impacting their operations. The survey ran within months of the Trump administration’s tariffs announcement and the order of investigations on the import of pharmaceuticals. With ongoing court challenges and countries negotiating trade deals with the US uncertainty persisted. At the same time leadership and staffing changes in the new administration’s Department of Health and Human Services and the FDA added further ambiguity. In China, biotech leaders seem less concerned about geopolitical uncertainty with just 37% citing it as a factor in their future operations.
Accessing talent to cope with drug development complexity
Drug development complexity remains the biggest operational issue for biotechs and ensuring that organizations have the right people to manage thatcomplexity is essential. There were geographic differences on whether talent shortages were likely to impact operations. APAC respondents were three times more likely to be concerned about talent shortages than North America or Europe. In the supplemental survey of 100 China biotech leaders, 34% of respondents expect access to talent with scientific and digital skillsets to impact their future organizational operations. In both the global and China surveys, respondents felt that their existing workforces were too stretched to consider innovating processes (China 19%, Global 21%). This reinforces the potential impact that talent shortage could have on biotech organizations.
Biotech beyond 2026
Biotech leaders are adept at working through ambiguity. A desire to overcome challenges is one of the factors that attract many to a career in science. Problem solving within the lab to provide solutions to patients in the wider world motivates biotech leaders to carry on. Despite the recent turbulence there are reasons for optimism for biotech leaders. In fact, in both surveys, the vast majority of leaders were confident about reaching their next investment milestones (Global: 92%, China: 95%) and that their product would be successful (Global: 91%, China: 94%). For the biotech leaders who overcome these challenges rewards await. Ultimately, the people with the most to gain are always the patients, it is their lives that will be transformed, even saved, by innovative treatments.
Citations
- Eleanor Olcott, Haohsiang Ko, Sandlund W. The relentless rise of China's biotechs. Financial Times. https://www.ft.com/content/c0a1b15b-84ee-4549-85eb-ed3341112ce5. Published 2025. Updated 27 October. Accessed 10 November 2025.
- China Biotech: Innovation Dawn. New York, USA: Morgan Stanley 26 August 2025.
- Many of the survey questions allowed respondents to select more than one answer.
- Beaney A. China takes lead in CGT trials amid Western funding challenges. Clinical Trials Arena. https://www.clinicaltrialsarena.com/features/china-takes-lead-in-cgt-trials-amid-western-funding-challenges/?cf-view&cf-closed. Published 2025. Updated 27 August 2025. Accessed 13 November, 2025.