There is little doubt that cost was the key factor when foreign drug companies first shifted their clinical trials to China.
"This is a very active area with a lot of companies going into it, especially for pre-clinical and discovery work. A lot can be done in these areas in China – you get a lot of bang for the buck," said Dr Zhu Shen, head of business development at US pharma company Immusol who formerly worked as a consultant to MNCs in China.
According to Excel China, one of the leading contract research organizations operating in the country, preclinical chemistry and toxicology trials and animal testing work can be carried out in China for up to 30% of the cost of doing it in the West. For phase one, two and three clinical research, the costs are 15-20% those of the West.
Price is not the only attraction of China, though. With skilled staff and an increasingly significant domestic drug market, China offers pharma firms the one thing they need more than anything else at this stage of development – patients.
"One of the big drivers is how fast you can recruit suitable patients," said Ray Hill, general manager of global consulting at health industry consultancy IMS.
With its large urban centers and multi-service hospitals, China is a one-stop-shop for companies seeking to access sizeable patient populations. What's more, certain hospitals have developed strong reputations in particular fields, which means they attract patients with similar conditions from all over the country.
And for pharma firms looking to test their products on a blank canvas, China has a large number of "naïve" patients that have not been exposed to other treatments.
"In the West, it is very difficult to find a patient that has not been treated by other means," said Tony Chen, a pharmaceuticals and biotechnology patent specialist for law firm Jones Day in Shanghai.