Consistent funding the right prescription for biomedical research

The effectiveness of biomedical research in the United States is undermined by an inconsistent “bust-boom-bust” funding cycle, according to an editorial written by Thomas F. Boat, M.D., a physician in the Department of Pediatrics at Cincinnati Children’s

Appearing Jan. 13 in the Journal of the American Medical Association (JAMA), the editorial offers commentary on an accompanying article in the same issue of JAMA by E. Ray Dorsey, M.D., University of Rochester Medical Center, and colleagues. Both items raise an important question as to whether inconsistent funding for medical research holds back efforts to make U.S. citizens healthier.

Looking at all U.S. funding sources of biomedical research from 1994-2003, and from 2003-2007, the authors point to an annual 7.8-percent-increase during the first period and a 3.4-percent-increase in the subsequent four years. A look at inflation-adjusted funding from just the National Institutes of Health over the two comparison periods shows an even more dramatic boom-bust scenario. NIH funding essentially doubled during the first nine years (most of that increase occurring 1998-2003), then dropped to a negative annual rate of 2.2 percent during 2003-2007.

The hardest hit, institution wise, are likely to be academic research institutions that depend heavily on federal funding for biomedical research, according to Dr. Boat.

“Variable research funding has been an obstacle for research programs and research faculty development, as well as sustainability, in medical schools and biomedical research institutions,” writes Dr. Boat, who is also executive associate dean for Clinical Affairs at the University of Cincinnati College of Medicine.

Dr. Boat points to a somewhat alarming finding mentioned in Dr. Dorsey’s JAMA article, one that underscores a critical piece of the overall dilemma. Although an estimated 70-80 percent of total global biomedical research is sponsored by U.S. sources, there are multiple health outcomes in the U.S. that lag behind those of other countries.

“Ultimately, biomedical research productivity must be assessed against individual and population health,” Dr. Boat writes.

So, what’s the fix? Dr. Boat recommends national research policy that addresses funding of “adequate, stable and productive biomedical research” and “adequate funding of research that addresses interventions designed to improve the delivery of a broad range of health services at an affordable cost.” He also advocates for “balanced funding for investigative efforts across the entire spectrum of health care needs….”

JAMA’s website can be found at http://jama.ama-assn.org/.