Why dismantling America’s biomedical innovation engine is a long-term threat to the very industry staying quiet about it.
A recent piece by Steven Usdain, which was also highlighted by Holden Thorp, got me thinking: are Big Pharma executives truly complacent regarding the continuous stream of unwise administrative and political decisions impacting the US biomedical innovation engine? While some believe innovation happens primarily within Big Pharma, the reality is that the industry has always dependend on academic research to inform in-house discovery. Furthermore, over the past decade, it has become increasingly reliant on absorbing medical innovations from emerging biotechs. A notable exception is the development of GLP-1 weight-loss medications by Novo Nordisk, but generally, small biotechs out-license technologies that originate and are patented at academic institutions. Thus, the true engine of biomedical innovation remains US academic institutions. That is where groundbreaking discoveries are made using taxpayer money administered by federal agencies like the National Institutes of Health (NIH) and National Science Foundation (NSF). While there is certainly room to improve how research is conducted and translated in the US, I believe many of the measures implemented since 2025 fail to address the core issues. Instead, they are likely to create new problems that hinder discovery at a time of heightened international competition.
“The biomedical industry does not begin in pharmaceutical companies. It begins in federally funded academic laboratories, where discoveries become patents, startups, and eventually medicines. Weakening that system weakens the entire drug development ecosystem.”
Why Big Pharma is silent
The biomedical industry’s silence is likely driven by two primary factors:
First, pharmaceutical companies are currently navigating significant policy changes that threaten their return on investment for drugs in or nearing approval. Specifically, the “Most Favored Nation” policy, which aims to align US drug prices with the lowest in other developed countries, could reduce revenues nearly two-thirds, given that US prices were estimated to be 3 times the global average in 2022. Additionally, the Inflation Reduction Act, is, by some estimates, projected to reduce global revenues by 12% ($2.9 trillion) by 2039. As a result, it is not surprising that Big Pharma executives are prioritizing using their political capital to manage the impact of these policies. Whether or not these policies are themselves misguided is up for debate, but suffice to say the transition to AI-based drug discovery and development requires a significant investment and internal restructuring, a challenging feat during a period of significant revenue loss.
Second: While the government is currently focused on maintaining US dominance in quantum computing and AI, China is making significant strides towards displacing the US as the world leader in biomedical research, an area in which the US has historically been unrivaled. By leveraging a robust biotech ecosystem, cutting-edge facilities, and top-tier scientific talent, China is offering innovative solutions and faster turnaround times at lower costs than currently possible in the US. Consequently, many Big Pharma companies are increasingly turning East to populate their drug discovery pipelines. From their perspective, as long as their pipelines are flush with promising drug candidates, the call for the long-term preservation of the US biomedical innovation engine can wait.
The outsourcing trap
Perhaps there is a strategic logic in allowing early-stage, high-risk R&D to occur internationally while US-based companies focus on the complexities of bringing products to the US and global market. This approach mirrors strategies seen in other industries, such as sports apparel. Nike successfully did this with sneakers, and dominated sports apparel for years. Though a brilliant strategy, it arguably reflects a short-termism mindset. We have also seen this with Tesla who, by taking their manufacturing to China, blessed the world with cheaper battery-operated cars from Chinese competitors that remain largely inaccessible to American consumers due to heavy tariffs and regulatory protections that favor domestic products. It remains to be seen if similar measures would be implemented should non-domestic entrants bring cheaper biomedical products to market. Over time, the moat Big Pharma has built through expertise in US-specific regulatory affairs and clinical development may diminish as international competitors learn to navigate these same hurdles at lower costs.
While rising international competition in the biomedical industry is welcome by virtue of the promise of more therapeutic and diagnostic options at lower prices, outsourcing biomedical innovation poses a compounding threat to public health in America.
This is particularly concerning given a climate that is increasingly making American patients invisible to researchers. Data obfuscation, potential funding cuts to researchers and their institutions, and the centralization of funding decisions under misinformed officials who may lack domain expertise all threaten the generation and accessibility of critical health data. These factors likely result in in poor decision-making and delays in research essential to Americans health. Furthermore, indiscriminately cutting off access to existing data for international researchers, even through formal agreements, further isolates our clinical realities. The net effect is that we are losing visibility into the health challenges facing American patients. If we cannot identify these problems, they cannot be solved, which ultimately leads to fewer medical breakthroughs for patients in America and, eventually, across the globe.
If the current innovation landscape shifts, pharmaceutical executives may find it difficult to pivot to other markets. Historically, no other country matches the United States in terms of population size and willingness to pay for advanced medical technology. As the world’s biggest revenue-generating market, America remains central to the industry’s viability.
“If the next generation of biomedical breakthroughs is increasingly discovered, developed, and funded elsewhere, what happens when America needs those innovations most?”
What Americans stand to lose when innovation leaves home
Dismantling the US biomedical innovation system is a significant threat to every American patient. If the local innovation ecosystem is compromised, resulting in top talent and private investment flowing elsewhere, access to essential medicines could become a bargaining chip in diplomatic negotiations amid rising geopolitical tensions. We saw this dynamic play out with COVID-19 vaccines, where many nations struggled for access while Americans benefited from local development and deployment. The prospect of these roles being reversed is a serious concern, especially given the shift toward more isolationist policies.
The window to act is closing
For Pharma Executive with long-term vision, I encourage you to leverage your influence in Washington to advocate for the industry’s future by advocating for increasing research funding, and measures that preserve independent research and innovation at American Universities in alignment with the medical and public health needs of the American public. Specifically, please consider submitting a public comment on the Office of Management and Budget’s latest proposal regarding federal funds and grants in support of research and discovery. You can find an accessible breakdown of the implications here. Comments are due before July 13th, 2026.
For Patients and Families who are concerned about the future of healthcare for your children and grandchildren, here are several ways you can help prevent further damage to our scientific enterprise:
- Familiarize yourself with how drugs are developed and priced through the “Biotech Unveiled” asynchronous crash course.
- Contact your representatives and ask them to stand AGAINST the dismantling of US biomedical innovation by opposing:
- Budget cuts to the NIH, NSF, and CDC.
- Political interference in the day-to-day operation and responsibilities of these institutions.
- The appointment of inadequate leadership without community consultation.
- The 15% cap of federal grant overheads, which are vital for research operations and talent training.
- Be an advocate by joining and or supporting organizations like Stand up for Science or the Global Alliance for Open Science.
- Leave a public comment on the Office of Management and Budget’s (OMB’s) latest proposal regarding federal research funding. Learn more by reading this accessible breakdown of some of the implications.
“The greatest threat is not losing scientific leadership. It is becoming dependent on others for the therapies, diagnostics, and health technologies that define modern medicine.”
Douaa Mugahid – enlightenbio guest blogger
Douaa Mugahid (aka Doaa Megahed) is a Research Scientist at the Harvard School of Public Health where her work focuses on enabling interdisciplinary, decentralized infectious disease research and early-stage technology development. She is also a part-time Senior Consultant at myEUconsulting and the founding COO of the Scientific Arab Forum.
“The views expressed here are my personal views and do not reflect those of my employers.”
