Spending More On U.S. Medical Research Hasn’t Led To New Cures. What’s Going Wrong?

CREDIT: SHUTTERSTOCK
CREDIT: SHUTTERSTOCK

Despite increased federal funding for medical research, life expectancy hasn’t changed much and scientists have made little headway in producing new treatments, a recent study suggests. Researchers point to a lengthy approval process and pressure to get published in prestigious journals as among the reasons for such lethargic changes.

The study, published in the Proceedings of the National Academy of Sciences, analyzed National Institutes of Health (NIH) funding, the number of published scientific studies, changes in life expectancy in recent decades, and the number of new drug approvals. Findings showed that while the number of scientists in the U.S. increased more than nine-fold since 1960s and NIH’s budget quadrupled, life expectancy remained constant and the number of new Food and Drug Administration (FDA)-approved drugs only doubled.

“We are spending more money now just to get the same results we always have and this is going to keep happening if we don’t fix things,” co-author Arturo Casadevall, professor of molecular microbiology and immunology at Johns Hopkins University’s Bloomberg School of Public Health, told Yahoo News.

These findings come more than a month after lawmakers in the U.S. House of Representatives approved the 21st Century Cures Act, a law that aims to streamline the drug approval process and spur the creation of thousands of FDA-approved drugs and medical devices. Under the law, an Innovation Fund would also allocate $1.75 billion to the FDA and $110 million to NIH for five years — money that will be used to invest in younger scientists.

At a time when federal funding for biomedical research has dropped 44 percent in the last decade, 21st Century Cures’ supporters say future federal funding could help the United States maintain its place as a leading research hub. But, as the findings of the recent study show, more money may not make a difference if institutional changes don’t follow.

For instance, a previous study showed that more than $28 million in public and private funds spent on research — which accounts for half of the content published — cannot be reproduced, perhaps because of what Casadevall and his colleague Anthony Bowen describe as a culture that allows scientists to oversimplify their studies so their work gets published in leading scientific journals. In recent years, scientists have grown frustrated with the trajectory of content, saying greater priority is often given to what may be considered “less important” work.

Casadevall said such relaxed standards often preclude researchers from dealing with the complexity of today’s ailments, including Alzheimer’s disease and cancer, which require time and effort. They also endanger patients, as noted in another recent study that found dozens of instances when the FDA failed to disclose scientific fraud to the detriment of consumers. The FDA, which has faced scrutiny in the past, has since attempted to strengthen its standards, including the passage of a law that requires researchers to register clinical trials on a government website.

While additional regulations could help increase product quality and track spending, scientists still crumble under the pressure of making sure they’re reporting back to their funders — a dilemma that further complicates the balancing act between efficiency and spending.

Administrative tasks, for example, often account for more than 40 percent of the time that researchers devote to federally funded research projects. Requirements often include preparing grant proposals, tabulating a scientist’s time on a grant, documenting conflicts of interest, institutional review boards, and animal care and use committees. Teams may also spend more time reconciling conflicting demands from different entities. While adhering to these rules takes funding away from universities and other research, there’s some reluctance to revamp the system because of the chance that may create room for more errors.

Bowen, a visiting scholar at the Hopkins School of Health, alluded to these challenges. “There is something wrong in the process, but there are no simple answers. It may be a confluence of factors that are causing us not to be getting more bang for our buck,” Bowen told Yahoo News.

But that hasn’t stopped the National Science Board (NSB) from attempting move forward. In a 2014 report entitled “Reducing Investigators’ Administrative Workload for Federally Funded Research,” the group recommended limiting proposal requirements to metrics that determine merit of findings — including upkeep of reports, conflicts of interest, and safety requirements.

“Regulation and oversight of research are needed to ensure accountability, transparency and safety,” Arthur Bienenstock, chair of the NSB task force that examined the issue, said in a statement. “But excessive and ineffective requirements take scientists away from the bench unnecessarily and divert taxpayer dollars from research to superfluous grant administration.”

“This is a real problem, particularly in the current budget climate. Streamlining research regulations and making requirements more consistent across federal agencies is in the best interest of scientists and taxpayers,” he added.