Department of Neurology, University of Rochester Medical Center, Rochester, New York, United States of America.
PLoS One. 2009 Sep 11;4(9):e7015. doi: 10.1371/journal.pone.0007015.
We estimated U.S. biomedical research funding across therapeutic areas, determined the association with disease burden, and evaluated new drug approvals that resulted from this investment.
METHODOLOGY/PRINCIPAL FINDINGS: We calculated funding from 1995 to 2005 and totaled Food and Drug Administration approvals in eight therapeutic areas (cardiovascular, endocrine, gastrointestinal, genitourinary, HIV/AIDS, infectious disease excluding HIV, oncology, and respiratory) primarily using public data. We then calculated correlations between funding, published estimates of disease burden, and drug approvals. Financial support for biomedical research from 1995 to 2005 increased across all therapeutic areas between 43% and 369%. Industry was the principal funder of all areas except HIV/AIDS, infectious disease, and oncology, which were chiefly sponsored by the National Institutes of Health (NIH). Total (rho = 0.70; P = .03) and industry funding (rho = 0.69; P = .04) were correlated with projected disease burden in high income countries while NIH support (rho = 0.80; P = .01) was correlated with projected disease burden globally. From 1995 to 2005 the number of new approvals was flat or declined across therapeutic areas, and over an 8-year lag period, neither total nor industry funding was correlated with future approvals.
CONCLUSIONS/SIGNIFICANCE: Across therapeutic areas, biomedical research funding increased substantially, appears aligned with disease burden in high income countries, but is not linked to new drug approvals. The translational gap between funding and new therapies is affecting all of medicine, and remedies must include changes beyond additional financial investment.
我们估算了美国各治疗领域的生物医学研究经费,确定了其与疾病负担的关联,并评估了由此投资产生的新药批准情况。
方法/主要发现:我们主要使用公共数据计算了 1995 年至 2005 年的资金,并汇总了食品和药物管理局在八个治疗领域(心血管、内分泌、胃肠道、泌尿生殖、艾滋病毒/艾滋病、传染病(不包括艾滋病毒)、肿瘤学和呼吸)的批准情况。然后,我们计算了资金、疾病负担的已发表估计值和药物批准之间的相关性。1995 年至 2005 年,所有治疗领域的生物医学研究资金都增加了 43%至 369%。除艾滋病毒/艾滋病、传染病和肿瘤学领域外,工业界是所有领域的主要资金来源,这些领域主要由美国国立卫生研究院(NIH)资助。总资金(rho = 0.70;P =.03)和工业资金(rho = 0.69;P =.04)与高收入国家预计的疾病负担相关,而 NIH 支持(rho = 0.80;P =.01)与全球预计的疾病负担相关。1995 年至 2005 年,各治疗领域的新药批准数量持平或下降,在 8 年的滞后期间,总资金和工业资金均与未来的批准无关。
结论/意义:在各治疗领域,生物医学研究资金大幅增加,似乎与高收入国家的疾病负担一致,但与新药批准无关。资金与新疗法之间的转化差距正在影响整个医学领域,补救措施必须包括除了额外的财务投资之外的变革。