The majority of medical research and investment currently centers on adults’ diseases — but that often comes at the expense of children’s health, according to an essay by Dr. Matthew Davis in the Journal of the American Medical Association (JAMA) Pediatrics. Working to change that could not only help safeguard kids’ health, but could actually lead to scientific breakthroughs for adults, too.
Karan Chhabra, a co-founder of the Millennial Project and medical student who researches certain pediatric specialties, outlines the major issues holding back pediatric specialty research. Most of the setbacks are rooted in an incentive structure that favors adult drugs, medical devices, and research over similar investments in child care — a consequence of the disproportionate level of health care services consumed by adults. Adults use 80 to 90 percent of all hospital resources versus the 10 to 20 percent utilized by children, according to government data.
Since the American health care system is one that rewards the bulk of services provided, the higher market share for adults’ treatment trickles down to the medical education field itself, sapping prospective students’ incentive to enter a child care specialty. As Chhabra notes, that issue could be addressed through a combination of actually funding Obamacare’s pediatric specialist loan repayment program, offering cash incentives for the production of children’s drugs (which currently tend to be watered-down versions of adult drugs that may not be right for them), and increasing NIH funding for clinical trials involving children.
This discrepancy between children’s and adults’ health research manifests itself in other areas of the medical industry that prove less lucrative than top-billed items. For instance, “orphan drugs,” which are medications tailored towards diseases that affect less than 200,000 Americans, are often passed over by the pharmaceutical industry due to their high investment costs and lower profit margins.
However, the preference for short-term profitability over long-term potential in both child specialty services and orphan drugs ignores one of the driving forces of medical progress: discovery. Last September, Merck developed a drug called Ionafarnib that was originally aimed at treating cancer. Instead, Merck realized its product was more effective at combating the rare disease progeria, a fatal affliction that causes rapid aging in children. That research then led scientists to better understand a protein that accumulates as people age — including its role in causing arterial stiffness and heart problems in the general population — and therefore may lead to future breakthroughs that benefit many more people with cardiovascular diseases.
But without more robust resources such as medical loan repayment programs and incentives for drug and device development, millions of Americans may be left without recourse for their specialized health care needs — even if doing so could also help a much larger swath of the population.