Small markets must inevitably etch out a niche positioning for themselves, and for Hong Kong, its world-class medical infrastructure, world-renowned academics and clinicians as well as high population density make it a strong contender in clinical research.


Hong Kong is an important piece of our global R&D landscape

Scott Curley, AstraZeneca

One of Hong Kong’s strongest advantages when it comes to clinical research is the fact that the two main clinical trials centers, the Clinical Research Management Office at the Chinese University of Hong Kong (CUHK CRMO) and the Clinical Trials Center at the University of Hong Kong (HKU-CTC), have Chinese FDA accreditation, meaning that their clinical trials data can be used for the registration process in mainland China.


This is why global pharma companies choose Hong Kong to conduct a significant amount of trials, like Roche, who does around 28 to 30 clinical trials across all stages in Hong Kong every year, and AstraZeneca, which has around five ongoing global clinical trials and five ongoing externally-sponsored research programs in Hong Kong at the moment, “testament both to the strength of the clinical research environment here and the high regard our global organization has for Hong Kong. AstraZeneca is … embedded in Hong Kong’s healthcare and medical environment and … vice versa: Hong Kong is an important piece of our global R&D landscape”, stresses general manager of AstraZeneca Hong Kong, Scott Curley.


As Professor Juliana Chan, Executive Director at CRMO CUHK and a leading global diabetes expert, summarizes, “Hong Kong is an excellent test-bed and we have a special role to play in the drug development cycle. The density of the ecosystem and the support of all relevant stakeholders enable us to come up with ideas, answers and innovations in a very short time frame. Once an idea has been tested successfully in Hong Kong, it is easier to roll it out in other markets. We must not forget that we are also a part of China – and the China market is gargantuan. Hong Kong is a place where both discovery and application happen.”


Most leading clinicians in Hong Kong would have spent at least part of their education and career abroad, developing not only a keen awareness of the particularities of global disease patterns but also an extensive professional network. Chan highlights her own background: “I was born and raised in Hong Kong but studied and trained in the UK.


When I came back, I noticed that people with diabetes in Asia exhibit slightly different patterns than patients with diabetes in Europe: they are more prone to certain complications, tend to be younger and have a higher incidence of kidney disease. I set up a couple of clinical trials with leading pharma companies, they saw firsthand the high clinical standards and speedy patient recruitments in Hong Kong, and subsequently set up big research programs targeting niche areas!”


As the largest clinical trial center in Hong Kong, the University of Hong Kong Clinical Trials Center (HKU-CTC), is at the core of Hong Kong’s clinical research proposition. “We conduct all sorts of clinical studies in terms of clinical trial phases and disease areas but in line with international trends, we have seen a surge in the number of oncology, cardiology and hepatology clinical trials.


Since the setting up of our Phase 1 Center in 2014, we are now starting to conduct more and more phase 1 and clinical pharmacology trials, especially in the most popular areas like cancers, hepatitis, cardiovascular and immunological diseases. We expect this trend to continue. Many of such studies finally led to high-impact publications in international scientific journals and even contributed to the launch of new treatments and new healthcare strategies,” Henry Yau, managing director and honorary assistant professor, says.


Managing Director at CRMO CUHK Louisa Tsang elaborates: “Pharma companies assess sites for clinical trials based on speed, quality and the availability of qualified persons. To be competitive against more established environment, we need to guarantee the highest standards relating to patient safety and patient care.”


Even within clinical research, Hong Kong has a particular affinity for early-stage clinical trials. Tsang explains, “The trend is that pharma companies allocate early-phase studies to external partners, and then continue to work with the same partners if the results and experience prove to be good. For that reason, it is important to get in early, not just for CUHK but Hong Kong as a whole! Having more early-phase studies coming in would increase the number of late-phase studies as well, and also mean that Hong Kong doctors will already be familiar with innovative drugs by the time they are available on the market.”


Dr. Sian Ng from Novartis Oncology concurs: “It was recognized that, as a small city, it would be harder for Hong Kong to run late-stage clinical studies that would require the recruitment of hundreds of patients as well as frontline staff. Early-phase clinical studies would be a better fit for Hong Kong as we also boast high-quality laboratory facilities and staff.”


As a company, Novartis is rather unique in being active to conduct phase I trials outside of the US and Europe, she adds, so it was “a very good fit”. Furthermore, “Hong Kong is fortunate to have many excellent, world-class investigators. For instance, recently, Associate Professor Stephen Chan Lam was able to bring a first-in-human study to Hong Kong, which is a huge achievement, as Novartis typically only conducts such complex studies in the US.”


Hong Kong’s research potential is not only limited to clinical trials, however. Its privileged position on the border between China and the international community gives it a unique value proposition to contribute to the global research ecosystem. This was a principal motivation behind the decision of Karolinska Institute (KI) to select Hong Kong as the location for its first international branch in over two centuries of academic and research excellence, the Ming Wai Lau Center for Reparative Medicine.


Executive Director Dr. Ronald Li articulates the overarching mission, which is to “position the Center as an embassy of sorts to connect firstly, Sweden and Hong Kong (as a part of China), and then through that, to contribute to building partnerships between China, the EU and North America via our vast networks so as to facilitate R&D, commercialization and innovation, and translation for the public community to benefit.”


After all, historically, “Hong Kong has been a trading port for centuries, and this is something Hong Kong can continue to leverage in the science and technology fields. We see investing in Hong Kong as a starting point – because we have the international standards and systems that the international community is more familiar with. This is exactly how we would like to position the Center as an embassy, to link Hong Kong, China and Asia to the rest of the world.”


Despite Hong Kong’s robust academic research tradition, Li admits that this model of a dedicated research institute outside of universities, with a strong focus on downstream commercialization of innovation, is “a first for Hong Kong” whereas other countries in the region – notably Singapore – have advanced significantly “when it comes to the downstream development and commercialization of upstream research”. This is why another task for Li is to “adapt this international research institute model to the Hong Kong context and needs.”