Health

Finding the silver lining amid medical research funding cuts

January 23, 2018

Global, North America

January 23, 2018

Global, North America
Serpil Erzurum

Chair. Lerner Research Institute

Dr Serpil Erzurum is chair of the Lerner Research Institute of Cleveland Clinic and member of the National Academy of Sciences. She has published more than 200 peer-reviewed articles and has been principal investigator on more than 20 federal grants, including multi-investigator programme project grants and network trials.

Some believe—to paraphrase Charles Dickens—that this is the best of times and the worst of times to be a medical researcher. On the one hand, technology is helping medical researchers make leaps and bounds in the areas of surgical procedures and pharmacological advancements. But on the other hand, medical researchers are feeling constrained by an increasingly complex medical insurance system and dwindling government funding for research. Perhaps, those who ascribe to this paradoxical view are half right.

It’s the best of times. Period!

As someone who has worked in science and medical research for the last three decades, I believe that this is absolutely the most exciting and most productive time for research. The things that we do now in just a few hours in the course of a day used to take us months or years in the early 1980s. Everything you access throughout the vast healthcare arena—including for example electronic medical records, magnetic resonance imaging (MRI), nanodevices to precisely treat cancerous cells—began with an idea that sprang to life through diligent, inspired research.

But the medical research landscape has changed. Major pharma companies have de-invested in discovery science. The National Institutes of Health—still the greatest source of research funding in the US—has nevertheless struggled to keep up with the meteoric rise in biomedical research costs. Few medical centres, other than the largest, can afford to emphasise research as part of a physician’s training or career growth.

So why do I remain enthusiastic? The answer is simple: patient care has never been better.

Shifting sources of funding

Breakthroughs in research occur at breakneck speed, driven by explosive growth in data analytics. When I compare what we do today to when I started in this field, the current pace of discovery is unprecedented. Our capacity for acquiring data-driven scientific knowledge is exponentially greater—by order of magnitude of tens of thousands—than what I had as a research fellow.

Yet the challenges we face are substantial because the cost burden for research has slowly shifted away from traditional sources. What that means is that we have had to become more creative in how and from where we acquire the necessary funds.

In bygone days pharma companies would operate their own exclusive research discovery labs, but many of them have closed down. Why? Because the typical investment—start to finish—for a drug to reach the market is US$1bn, often over a 20-year period. So, for many, it makes better business sense to cede early rounds of research to others and then strategically invest in the later stages of development, or even to acquire an emerging bio-tech company.

Further, the ever-changing insurance reimbursement model has left many healthcare organisations scrambling to meet their financial obligations. Thus, the percentage of funding earmarked for research and other once-instrumental initiatives has dwindled.

While some may see these challenges as obstacles, I prefer to view them as opportunities for melding innovative, new funding models that can redefine how research gets done.

Finding new funding methods

From my personal experience, there are three high-level proven methodologies for funding and reconstructing research programmes that institutions would do well to consider:

  • Forge creative partnerships: Many organisations, once at loggerheads in the battle for funding or being first to a discovery, are joining forces and sharing the cost burden—and the rewards—of research. Often, the aforementioned pharma companies are aligning more closely with academic or medical research teams to propel an initiative forward. So, there is a greater focus on public-private alliances.
  • Dive even further into data: In this, the Digital Era, we are increasingly dependent on data. And that includes how we deliver and operationalise healthcare. Every medical organisation has bolstered their IT and data capabilities in recent years, but even more calculated investment in IT will pay dividends in the long run. Think of the possibilities if we were able to use electronic medical records to track what drugs were best treating cancer patients nationwide, segmented by their age, gender, location etc. Digital technology is transformative, and can fuel even greater inroads in healthcare.
  • Leverage your strengths: While headlong dives into uncharted waters can sometimes lead to amazing discoveries, a more prudent approach is to fish in familiar seas. At Cleveland Clinic, we increasingly focus our research dollars on those disciplines we are particularly good at. By prioritising where and how we invest in research, we are more likely to make the most impact.

Conclusion

In this, the greatest time in the history of medical research, funding is changing, rather than going away. If we think and act more strategically, with respect to how we secure and spend research funds, the best of times will most certainly continue.

 

The views and opinions expressed in this article are those of the authors and do not necessarily reflect the views of The Economist Intelligence Unit Limited (EIU) or any other member of The Economist Group. The Economist Group (including the EIU) cannot accept any responsibility or liability for reliance by any person on this article or any of the information, opinions or conclusions set out in the article.

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