Resolution criteria

This is an independent multiple-choice market. Each year will resolve independently as YES or NO based on whether China registers more Phase 3 clinical trials than the United States during that calendar year.

• Primary Source of Truth: The database compiled by the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), specifically accessed via the WHO Global Observatory on Health Research and Development dashboard for "Number of clinical trial registrations by year, location, disease and phase of development".

• Resolution Rules:

  • YES: If the final count of Phase 3 clinical trial registrations for China (as the trial location) is strictly greater than the count for the United States (as the trial location) for the given calendar year.

  • NO: If the final count of Phase 3 clinical trial registrations for the United States is greater than or equal to China's count for the given calendar year.

• Data Lag / Resolution Window: Because clinical trial registries experience reporting and registration delays, the creator will wait at least 6 months after the end of the target calendar year (e.g., until July 1 of the following year) to allow the WHO database to stabilize before resolving the corresponding option.

• Fallback Sources: If the WHO Observatory dashboard is unavailable, discontinued, or not updated within 9 months after the end of the target year, the market creator may resolve the market using:

  1. Direct queries of the WHO ICTRP Search Portal.

  2. Aggregated official data from the primary national registries feeding into the ICTRP: ClinicalTrials.gov (for the US) and the Chinese Clinical Trial Registry (ChiCTR) (for China).

  3. Reputable, peer-reviewed academic publications (such as The BMJ or Journal of Clinical Epidemiology) or leading industry analyses (such as L.E.K. Consulting or Fierce Pharma) that explicitly compile WHO ICTRP data for that year.

Background

China’s clinical trial ecosystem has undergone massive expansion. Driven by streamlined regulatory pathways (including a 60-day implied-approval system), high patient density, and heavy domestic R&D investment, China’s overall clinical trial volume surpassed that of the United States in the early 2020s. According to WHO ICTRP data, China registered over 7,100 total trials in 2024 compared to roughly 6,000 in the US.

However, historically, the US has maintained a strong lead in late-stage development, particularly pivotal Phase 3 trials which require multinational sites and significant capital. While China has drastically closed the gap in early-phase (Phase 1) initiations, whether and when its domestic biopharma industry will officially outpace the US in large-scale, pivotal Phase 3 trials remains a key indicator of global biotech leadership.

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