Recent analysis of the biopharmaceutical industry in Japan has emphasized that the lack of a thriving biotech ecosystem in that country is largely due to tight controls on drug pricing1. However, this is only one part of the explanation, and any strategy to promote Japanese biotech must acknowledge the full complexity of the problem. Japan has long punched above its weight in innovative research in biochemistry and medicinal chemistry despite relative government underinvestment compared with the United States and Europe. In the United States, 363 new drugs were approved by the Food and Drug Administration between 2011 and 2021 (ref. 2). The leading country of origin of these approvals was the United States, with 223 drugs, but Japan was the second-leading country of origin, with 33 drugs. Drugs first developed in Japan include statins (Sankyo) and the cancer immunotherapy Opdivo (nivolumab; Ono Pharmaceutical), based on the discovery of programmed death inhibitor proteins by Nobel prize recipient Tasuku Honjo. In the field of biotechnology, Japanese successes include BioWa (acquired by Kirin), a producer of monoclonal antibodies, and Chugai Pharmaceutical, which has the largest bioreactor capacity in Japan and has been fed a steady stream of new drugs from its majority owner Roche.

Yet Japan lacks a home-grown biotech ecosystem. Even the discovery of induced pluripotent stem cells by Kyoto University researcher Shinya Yamanaka has not translated into Japanese leadership in cell therapies. Several factors beyond drug price controls are involved. Although many Japanese pharmaceutical companies have corporate venture capital arms and invest in biotech startups, these investments are mostly in the United States and other regions outside Japan. The same is true of Japanese venture capital investing as a whole. In 2022, this sector invested 120 times more in the United States than in Japan3,4. Japan has simply failed to develop a startup ecosystem, especially in biotech. According to the Global Startup Ecosystem Report 2021 from Startup Genome, Tokyo ranked ninth in the world as a startup hub, below other cities in East Asia, including Beijing and Shanghai4.