A recent study in the New England Journal of Medicine suggests that the U.S. is slipping when it comes to biomedical research.
The study found the U.S.'s share of global biomedical research spending fell from 51 percent ($131 billion) in 2007 to 45 percent ($119 billion) in 2012. During the same time period, European spending held steady. Asia, however, experienced significant growth in biomedical R&D spend. Its share grew from 18 percent to 24 percent, and both China and Japan increased spending — by $6.4 billion and $9 billion, respectively.
Previously, the U.S. share of research spend was as high as 80 percent. Asia's apparent commitment to biomedical R&D growth could be a threat to the U.S.'s longstanding prominence in the area.
According to one of the study's authors, Reshma Jagsi, MD, DPhil, an associate professor of radiation oncology at the University of Michigan Health System, "The United States has long been a world leader in driving research and development in the biomedical science. It's important to maintain that leadership role because biomedical research has a number of long term downstream economic benefits, especially around job creation."
When adjusting for inflation, the fiscal year 2013 NIH budget is 22 percent lower than it was in 2003. Additionally, the number of research project grants funded by the NIH has also dropped from 10,393 in 2003 to 8,232 in 2013.
Despite this decline, the study found that the U.S. spending decline was driven largely by declines in industry spending, not declines government funding.
The authors suggest this is because government regulations in the U.S. drive up the time and expense associated with R&D of biomedical innovations.
Dr. Jagsi says there are fewer regulations and less expense to conduct research in Asia. Labor costs less, the research infrastructure is not as bureaucratic and Asian governments may be offering subsidies.
"We were surprised the impact of industry funding was that dramatic, but it's key to note that government funding is equally important to maintain or grow. Research funded through the National Institutes of Health helps scientists understand how diseases work — this will happen slower as NIH funding continues to be cut," said study author Justin Chakma, a venture capital investor with Thomas, McNerney & Partners in La Jolla, Calif.
In fact, roughly half of the drugs approved by the U.S. Food and Drug Administration have some federal government funding.
History shows that government funding for science research leads to the development of new technology and jobs, and can lead to significant innovations. The graphic to the right, provided to me by the University of Michigan Health System, shows how the U.S. significantly raised its profile in scientific research after the creation of the National Science Foundation in 1950.
Asia's currently influx of dollars into biomedical R&D could lead to a similar linear result, with Asia experiencing the uptick and the U.S. looking more like Europe's red line.
Such a change could mean less innovation, and fewer jobs, for the U.S. Not to mention reduced access to clinical trials and other cutting-edge technology for the many Americans who could benefit.
Ora Pescovitz, MD, CEO of UMHS argues declining research funding threatens the medical innovation pipeline. "We can decide to reduce support for medical research and that science is not a national priority, but that means we must also accept what it means. It means fewer discoveries and a decrease in the development and production of new drugs, therapies and treatments that improve and save lives."
So how can we stem the retreating tide? Advocacy for science funding and research reform. The federal government not only controls NIH funding, but it also control the many regulations that slow the bringing to market of new technologies. While the role of the FDA to protect patients is absolutely critical, some reforms could reduce what many argue are "unnecessary barriers" that slow the number and speed at which new discoveries are brought to market.
For an excellent discussion of potential reforms and the potential impact, check out this Bloomberg piece byTomas J. Philipson of the University of Chicago and Andrew von Eschenbach, commissioner of the FDA from 2006 to 2009. They argue significant changes within Phase 3 clinical trial regulations could bring more innovation to market, which keeping patients safe.