Financial anatomy of biomedical research
Financial anatomy of biomedical research
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DOI：
10.1001/jama.294.11.1333
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发表时间：
2005-09-21
影响因子：
120.7
通讯作者：
Thier, SO
中科院分区：
文献类型：
--
作者：
Moses, H;Dorsey, ER;Thier, SO
在过去十年中，公共和私人对生物医学研究的财政支持有所增加。对资金来源和使用情况的全面分析很少。这导致投资决策所依据的信息不足，因为并非所有来源都允许平等的自由来探索具有科学或临床重要性的假设，并为判断研究对社会的价值创造了障碍。设计为联邦、州和地方政府;基金会;慈善机构;大学;和行业专有（订阅，但公开）数据库被用来补充public sources.Main结果Measures实际研究支出总额，增长率，和类型的研究与inflationadjustment.Results生物医学研究经费增加了从1994年的371亿美元，以94.3亿美元，在2003年翻了一番，通货膨胀调整后。2003年的主要研究赞助者是工业界（57%）和国立卫生研究院（28%）。所有公共和私人来源的相对比例没有变化。临床试验的行业赞助从40亿美元增加到142亿美元（按真实的计算），而用于基础和应用研究的联邦比例没有变化。据估计，美国将其卫生总支出的5.6%用于生物医学研究，比其他任何国家都多，但用于卫生服务研究的比例不到0.1%。从经济角度来看，生物技术和医疗设备公司的生产率最高，这是以每美元研发成本的新诊断和治疗设备来衡量的。结论提高科研生产率和效益评估是迫切的挑战，需要（1）更有效地将基础科学知识转化为临床应用;（2）对快速发展的科学领域进行严格的评估，以指导临床需求最大的领域的投资，而不仅仅是目前认为有商业机会的领域;以及（3）比一般可获得的更具体的关于研究资金来源和使用的信息，以便做出明智的投资决策。福尔斯的责任落在了产业、政府和基金会身上，他们要从更长远的角度来看待研究价值，从而实现这些变化。
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 States.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 sources.Main Outcome Measures Total actual research spending, growth rates, and type of research with inflation adjustment.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 value.