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Moses H, Dorsey ER, Matheson DHM, Thier SO. Financial Anatomy of Biomedical Research. JAMA. 2005;294(11):1333–1342. doi:10.1001/jama.294.11.1333
Author Affiliations: The Alerion Institute,
North Garden, Va (Dr Moses); The Boston Consulting Group, Bethesda, Md (Dr
Moses and Mr Matheson); Department of Medicine and Health Policy, Massachusetts
General Hospital and Harvard Medical School, Boston (Dr Thier); Department
of Neurology, University of Rochester Medical Center, Rochester, NY (Dr Dorsey).
Dr Dorsey performed most of his work while at the Hospital of the University
Context Public and private financial support of biomedical research have increased
over the past decade. Few comprehensive analyses of the sources and uses of
funds are available. This results in inadequate information on which to base
investment decisions because not all sources allow equal latitude to explore
hypotheses having scientific or clinical importance and creates a barrier
to judging the value of research to society.
Objective To quantify funding trends from 1994 to 2004 of basic, translational,
and clinical biomedical research by principal sponsors based in the United
Design Publicly available data were compiled for the federal, state, and local
governments; foundations; charities; universities; and industry. Proprietary
(by subscription but openly available) databases were used to supplement public
Main Outcome Measures Total actual research spending, growth rates, and type of research with
Results Biomedical research funding increased from $37.1 billion in 1994 to
$94.3 billion in 2003 and doubled when adjusted for inflation. Principal research
sponsors in 2003 were industry (57%) and the National Institutes of Health
(28%). Relative proportions from all public and private sources did not change.
Industry sponsorship of clinical trials increased from $4.0 to $14.2 billion
(in real terms) while federal proportions devoted to basic and applied research
were unchanged. The United States spent an estimated 5.6% of its total health
expenditures on biomedical research, more than any other country, but less
than 0.1% for health services research. From an economic perspective, biotechnology
and medical device companies were most productive, as measured by new diagnostic
and therapeutic devices per dollar of research and development cost. Productivity
declined for new pharmaceuticals.
Conclusions Enhancing research productivity and evaluation of benefit are pressing
challenges, requiring (1) more effective translation of basic scientific knowledge
to clinical application; (2) critical appraisal of rapidly moving scientific
areas to guide investment where clinical need is greatest, not only where
commercial opportunity is currently perceived; and (3) more specific information
about sources and uses of research funds than is generally available to allow
informed investment decisions. Responsibility falls on industry, government,
and foundations to bring these changes about with a longer-term view of research
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