China Out-Licensing & US CROs: Spending Rerouted, Not a Wholesale Disruption

Research evidence excerpt

China Out-Licensing & US CROs: Spending Rerouted, Not a Wholesale Disruption

Health Care | Healthcare Technology & Distribution

May 26, 2026

Elizabeth Anderson China Out-Licensing & US CROs: Spending

212-446-5632

elizabeth.anderson@evercoreisi.com Rerouted, Not a Wholesale Disruption

Joanna Zhou CRO stock performance has been hampered by investor

212-446-5659 uncertainty around go-forward growth rates, with a number

joanna.zhou@evercoreisi.com

of known unknowns — biotech funding, pharma R&D Amir Farahani, CFA

646-551-8518 spend, AI threats, China out licensing, etc. — driving group

Amir.Farahani@evercoreisi.com multiple compression to low-to-mid teens P/E over the

Ayush Vyas past 18-24 months (vs. a 5-yr average in the low 20s). The 646-551-8512

Ayush.Vyas@evercoreISI.com plan here is to dig into each in turn; this note starts with the

globalization of R&D spend and China's role. Overall, the

impact on Western CROs with late-stage scale and

specialty positioning should be modest, and we are more

cautious on non-differentiated preclinical exposure.

The China CXO sector, now a ~$30-40 Bn export-led

market growing DD, has captured ~250 bps of cumulative

global CXO share over 2020-2025, helped by lower costs,

pipeline density, and integrated CRDMO platforms.

Through 2030, we see scope for another ~150-250 bps of

total share capture if the cost gap remains intact.

One of the main drivers of this share gain is Chinese out-

licensing, which has scaled to $136 Bn in 2025, with

another >$60 Bn in 1Q'26 (~30% of global pharma BD

deals and ~54% of deal value). The shift to Chinese

sourced assets looks more substitutive than additive as

China-originated assets are displacing what would

historically have been ex-China deals, and ex-China deal