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Rate of US medical research investment drops
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Despite a global increase in the rate of investment in medical research between 2004 and 2012, the rate of research investment has decreased in the United States, according to recent data published in JAMA.
Based on these trends, it is projected that the US will cede its historical lead in medical research innovation over the next decade unless steps are taken to reverse this trajectory, according to researchers.
Hamilton Moses III, MD, of Johns Hopkins School of Medicine, and colleagues collected information from various public data sources for the period of 1994 to 2012 to examine trends in US and international research funding, as well as disease burden by source and industry type. Forty of the world’s largest developed nations were compared on the basis of investment, employment, economic value, patents and publications.
The researchers said that between 1994 and 2004, total US funding for medical research increased by 6% annually. However, this rate dropped to 0.8% per year between 2004 and 2012, at which time it reached $117 billion (4.5%) of total health care expenditures. There was an increase in funding from private sources from 46% in 1994 to 58% in 2012. Early-stage research also was reduced in favor of medical devices, bioengineered drugs and late-stage clinical trials, particularly for cancer and rare diseases.
Investments by the NIH appeared to be disproportionately allocated to cancer and HIV/AIDS research.
Health services research also was underfunded, receiving $5 billion, equaling 0.3% of total health care expenditures, or 1/20th of science funding.
Among the 22 medical industries evaluated for investment in innovation, private insurers ranked last (0.04% of revenue) and health systems ranked 19th (0.1% of revenue). The researchers projected that if service firms were to reach median research and development funding, yearly incremental increases from $8 billion to $15 billion could be achieved.
US government research funding decreased from 57% of the global total in 2004 to 50% in 2012. US companies similarly decreased funding from 50% of the global total to 41% during the same period. Accounting for both public and private research funding, the US dropped from 57% of the global total in 2004 to 44% in 2012.
Elsewhere, investment increased significantly in Asia, particularly in China, where it tripled from $2.6 billion in 2004 to $9.7 billion in 2012. Relative to global rates, the US’ proportion of life science patents declined from 57% in 1981 to 51% in 2011. The US’ contribution to the global total of the most valuable life science patents also decreased, from 73% in 1981 to 59% in 2011.
“The analysis underscores the need for the United States to find new sources to support medical research, if the clinical value of its past science investment and opportunities to improve care are to be fully realized,” the researchers wrote. “Substantial new private resources are feasible, though public funding can play a greater role. Both will require nontraditional approaches if they are to be politically and economically realistic.”
In a related editorial, Victor J. Dzau, MD, of the Institute of Medicine in Washington, D.C., and Harvey V. Fineberg, MD, PhD, of the University of California, San Francisco, emphasized the need to continually reassess priorities in medical research in the US.
“To achieve a new strategic vision for research, the United States will need a roadmap that sets priorities, describes needed structural and organizational changes, and creates an environment that enables innovation,” Dzau and Fineberg wrote. “The needed changes include better coordination across funders and research institutions, development of new funding sources, improved grant evaluation processes, changes in education and training, rationalization of capital investments, and improved operational efficiencies.”
For more information:
Dzau VJ. JAMA. 2015;313:143-144.
Moses III H. JAMA. 2015;313:174-189.
Disclosure: See the study for a full list of relevant financial disclosures. Dzau and Fineberg report no relevant financial disclosures.