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    Original Investigation
    Health Policy
    March 27, 2020

    Comparison of US Federal and Foundation Funding of Research for Sickle Cell Disease and Cystic Fibrosis and Factors Associated With Research Productivity

    Author Affiliations
    • 1Deparment of Pediatrics and Medicine, Stony Brook University Hospital, Stony Brook, New York
    • 2Division of Pediatric Pulmonology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
    • 3Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
    • 4Berman Institute of Bioethics, Johns Hopkins University School of Medicine, Baltimore, Maryland
    • 5Division of Hematology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina
    • 6Division of Pediatric Hematology/Oncology, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina
    JAMA Netw Open. 2020;3(3):e201737. doi:10.1001/jamanetworkopen.2020.1737
    Key Points español 中文 (chinese)

    Question  Are differences in disease-specific funding between sickle cell disease and cystic fibrosis associated with variations in drug development and research publications?

    Findings  This cross-sectional study of research funding and outputs for cystic fibrosis and sickle cell disease found that both federal funding and foundation expenditures were greater for cystic fibrosis compared with sickle cell disease. Significantly more research articles and drug approvals were found for cystic fibrosis compared with sickle cell disease, but the total numbers of clinical trials were similar.

    Meaning  The findings show that disparities in funding exist between sickle cell disease and cystic fibrosis and that these disparities may be associated with decreased research productivity and novel drug development for sickle cell disease.

    Abstract

    Importance  Sickle cell disease (SCD) and cystic fibrosis (CF) are severe autosomal recessive disorders associated with intermittent disease exacerbations that require hospitalizations, progressive chronic organ injury, and substantial premature mortality. Research funding is a limited resource and may contribute to health care disparities, especially for rare diseases that disproportionally affect economically disadvantaged groups.

    Objective  To compare disease-specific funding between SCD and CF and the association between funding and research productivity.

    Design, Setting, and Participants  This cross-sectional study examined federal and foundation funding, publications indexed in PubMed, clinical trials registered in ClinicalTrials.gov, and new drug approvals from January 1, 2008, to December 31, 2018, in an estimated US population of approximately 90 000 individuals with SCD and approximately 30 000 individuals with CF.

    Main Outcomes and Measures  Federal and foundation funding, publications indexed in PubMed, clinical trial registrations, and new drug approvals.

    Results  From 2008 through 2018, federal funding was greater per person with CF compared with SCD (mean [SD], $2807 [$175] vs $812 [$147]; P < .001). Foundation expenditures were greater for CF than for SCD (mean [SD], $7690 [$3974] vs $102 [$13.7]; P < .001). Significantly more research articles (mean [SD], 1594 [225] vs 926 [157]; P < .001) and US Food and Drug Administration drug approvals (4 vs 1) were found for CF compared with SCD, but the total number of clinical trials was similar (mean [SD], 27.3 [6.9] vs 23.8 [6.3]; P = .22).

    Conclusions and Relevance  The findings show that disparities in funding between SCD and CF may be associated with decreased research productivity and novel drug development for SCD. Increased federal and foundation funding is needed for SCD and other diseases that disproportionately affect economically disadvantaged groups to address health care disparities.

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