President Donald Trump’s drug pricing policy has two China blind spots. The first is that Washington is pressing other developed economies to pay what it calls their fair share for pharmaceutical innovation, while China remains largely outside that burden-sharing effort, even as Chinese drug developers increasingly benefit from the high-priced American market through licensing and direct commercialization. The second is more fundamental because China had already built the drug development capabilities that now attract American and other Western pharmaceutical companies, before the current licensing boom, and without American levels of medicine pricing at home.

The burden-sharing argument behind Trump’s policy is understandable. Developing medicines is expensive, risky, and prone to failure, while Americans have long paid substantially more for innovative drugs than patients in many other wealthy countries. Washington can reasonably ask why U.S. patients should provide such a large share of the revenues that sustain global pharmaceutical research and development.