Issue #25·

China now runs more CAR-T trials than the country that invented CAR-T

America created one of the most transformative cancer therapies ever made, then watched China build more kitchens, hire more cooks, and serve more patients. Today we unpack how the global biotech balance of power is shifting, plus a century-old syringe maker that just paid $200 million to become something else entirely.

Top Story Today

America Invented CAR-T. Now It's Playing Catch-Up.

China now runs more CAR-T clinical trials than the United States, with over 300 registered as of early 2024, and it enrolls patients faster thanks to structural advantages. The cost gap is staggering: a CAR-T treatment runs north of $370,000 in the U.S. versus $70,000 to $200,000 in China. Meanwhile, NIH grant approval rates dropped to about 13% in FY2025 (down roughly 30% from prior levels), and the number of funded investigators fell by nearly 2,000. With China's total R&D spending reaching 96% of the U.S. level in purchasing power parity terms, the gene therapy market projected to hit $78 billion by the mid-2030s, and Asia-Pacific growing at 29% annually, the innovation center of gravity is shifting faster than most realize.

Why it matters: This isn't just a scorecard. If U.S. research funding stalls while China accelerates, American patients could end up waiting longer for therapies that Chinese patients already have access to, reshaping the strategic calculus for biotech investors and R&D leaders worldwide.

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Deals and Strategy

The Syringe Giant That Just Bet $200M It Can Outgrow Needles

Embecta, the century-old insulin syringe maker, is acquiring UK auto-injector company Owen Mumford for up to $200 million. The real prize is Aidaptus, a next-gen auto-injector platform that adapts to variable syringe fill levels. With the auto-injector market growing at 13% to 16% annually and GLP-1 injectables booming, Embecta is pivoting from flip-phone-era syringes to the drug delivery devices pharma actually wants.

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Devices and Regulatory

MiniMed's New Insulin Pump Ditched Its Screen Entirely

Half the size of its predecessor and completely screenless: that's MiniMed's Flex insulin pump, which just scored FDA 510(k) clearance. The device runs entirely through a smartphone app and still holds a full 300-unit reservoir. Launching weeks after MiniMed's Nasdaq IPO, the Flex intensifies its fight with Insulet's Omnipod in a $7 billion pump market where discretion is becoming the deciding factor.

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