[belorn]

It should also be mentioned (since we are talking about statistics here), that 1/3 of the total US medical research spending is from taxes (congress) and has been consistently been so for 20-30 years. That money has no connections with the current health care system, or insurance companies and is just pure tax money sent into research.

From those 1/3, about 95% of all core research is supported, and around 80% of all research into medical conditions that are life threatening.

Health care system, insurance companies and patents are for everything else...

*The 95% and 80% is number from a talk, and for the moment I can't find references. What I could find is statements about majority funding is used on basic research (http://jama.jamanetwork.com/article.aspx?articleid=205216 and http://www.nsf.gov/statistics/seind12/c5/c5s1.htm). In the future I will hold off on those number in comments until I got direct sources to use with them.

[kingkawn]

If true these stat provide a compelling point of argument for expanded government research funding and less protection for the private insurance system. Do you have a source for it?

[belorn]

Mostly those was taken from a talk, but here is the data I could find: (https://en.wikipedia.org/wiki/Nih): for the total % of funding and where that money come from. (http://report.nih.gov/categorical_spending.aspx): For different Categorization.

I would also add a bit old paper about cancer research (http://www.iom.edu/~/media/Files/Activity%20Files/Disease/NC...), through they include all various stages of development. They attribute a 31% to industry.

[criley]

I'd be interested as well, because if he's trying to label all NIH-bound funds as imperative to this process, I think he's overstating his case.

Yes, academic institutions do a lot of low level work that pharma companies build on top of, but you'd be surprised how often potential new molecular entities (truly new drugs) do not originate from government sponsored academic sources.

(However, the tools, understanding and/or methodologies that made that new NME possible did likely come from those labs!)

[belorn]

One can read the data in different ways, and I don't think anyone doubt that pharma companies do contribute to the investments into new medical innovations. One interpretation that I listen/read about is that NiH and pharma operate on different levels, and thus sadly, NiH's contribution tend to be forgotten because they aren't the people with that pop out the pills bought in the store, even if the pills would not have existed if it hadn't been for the NiH funded research that made the new innovation possible.

Then we add patents and insurance companies into the mix, and some people want to paint a picture how innovation gets created. My comment was thus mostly to inform that the largest single funder to medical research is not some for-profit company like Pfizer, but rather tax supported NiH.

[kingkawn]

"I don't think anyone doubt that pharma companies do contribute to the investments into new medical innovations."

Every aspect of this system has to be questioned relentlessly, because each of them requires huge investments of social and financial capital. I am happy to doubt the value of the private drug companies' contributions. Many of their discoveries are reformulations of older drugs meant to allow a repatenting and re-marketing of old ideas. Many of the new supposedly breakthrough drugs do not provide significant improvements in mortality, but do cost huge amounts of money so that they can recoup their investment.

There are of course important developments that come from everywhere, but the question is about signal to noise. If, as these statistics imply, you can show that the drugs and other changes in medical care that provide positive changes to quality of life and mortality are coming from government research significantly more so than other sources then why subsidize private research, why protect the private drug development system that results in outrageously priced drugs, why waste 2/3rds of research money to produce such a disproportionately small portion of the advancements in medical knowledge?

Again, I would like to see sources for the numbers, but regardless, there should be no assumptions made about the value of private or public investment because that's the way it has been.

[criley]

> Many of their discoveries are reformulations of older drugs meant to allow a repatenting and re-marketing of old ideas.

I think you're confusing evergreening, which is a real problem, with the number of NME's that are being generated. NME's are "new molecular entities", or totally new formulations.

>Many of the new supposedly breakthrough drugs do not provide significant improvements in mortality, but do cost huge amounts of money so that they can recoup their investment.

Low hanging fruit has been taken and newer methods of discovering safe and effective drugs are needed.

You might find this shocking, but pharma is a dying business. Companies are divorcing their drug development departments into separate businesses so they can fail gracefully. The blockbuster drugs that can recoup the investment of looking for a needle in a haystack aren't coming any more.

>If, as these statistics imply, you can show that the drugs and other changes in medical care that provide positive changes to quality of life and mortality are coming from government research significantly more so than other sources then why subsidize private research, why protect the private drug development system that results in outrageously priced drugs, why waste 2/3rds of research money to produce such a disproportionately small portion of the advancements in medical knowledge?

This is absolutely, 100% totally and COMPLETELY false.

The government IS NOT INVOLVED IN DRUG RESEARCH. Honestly, period. They can't afford it! It costs a billion dollars to whittle 10,000 drug candidates into 1 FDA approved drugs. NIH grants aren't even 1% of that cost.

The government is not responsible for very much actual drug development at all. They don't own or fund the labs. They fund the schools that do the work on the lower level theory, on the tools and concepts that will one day be commercially viable.

Private labs handle the vast majority of all new molecular entity discovery, pre-trial, trial, etc. They have the money, labs and teams capable of handling it -- NIH funded labs often don't!

Here's a list of NME's for 2013 so far: http://www.fda.gov/drugs/developmentapprovalprocess/druginno...

Remember, the FDA is the gatekeeper and these companies research thousands and thousands of candidates looking for something that they can statistically prove safety and efficacy of to the FDA, and the FDA gets to decide.

As you can see from that list, the FDA doesn't allow new molecules out very often.

[belorn]

1/3 is the number, and while they do spend some on clinical trials, the vast majority goes to applied and basic research (their wording). That means 2/3 of the total R&D of medical innovation (US) need to go somewhere which is the drug development you are talking about.

Some people have argued that maybe those 2/3 should be tax money too. Its a bit weird situation where the state already pays for 1/3 of the R&D, and then on top of that give state enforced monopoly in 20 years periods for those who invest in the other 2/3 (additional monopoly period is also granted by the FDA after an successful drug trial). State enforced monopoly is often describe as tax raised outside congress control, and has its history and name (letters patent = royal decree) from that purpose.

One question we should ask is what the industry brings to the table if we took away all state funded involvement. Is it more efficient to bring competition through patent grants rather than direct research and development grants? Do we get larger and more spread out pool of investment that could not happen without a few blockbuster drugs to get gambling money? We should ask for data which prove that the current method (1/3 of the funding and granted state monopolies) is the best use of tax money. Maybe at least demand some kind of high standard when a company take research supported by the 1/3, and claim a new invention based on already known and disclosed techniques. The India model is to demand an increased efficiency, beyond showing that the modification of the old drug is novel.

[kingkawn]

And who said there was no need for caps lock?

We could get into a back and forth of yelling, but you are also it seems 100% wrong. Government funding underlies the vast majority of advances in basic science understanding, what you referred to as lower-level theory, that then is utilized by drug companies to direct their new drug development. A good example is the relatively recent isolation of the Angiotensin II receptor, which in turn is leading to drug development. The basic science and years of research underpinning that discovery is not a byproduct of private investment. Lower-level theory is not lower at all, and is of no less value or less important to the person who is at the receiving end of this entire system; the patient.

The FDA doesn't allow new molecules out very often because most of them are useless, harmful, or redundant. I think that their standards for redundancy should be tightened. Low hanging fruit have not all been taken, its just that pharma doesn't invest enough in basic research because they're trying to pick all the low-hanging fruit from other people's work.

Going back to my original reply; I objected to the unquestioned acceptance of the value of private research. I would also object to the unquestioned acceptance of government research as being inherently valuable. While I think it is fairly clear that I believe that the government funded research gives far more value per dollar for society as a whole, it doesn't mean that I will blindly accept either form as the right one. I asked for references to backup stats that reinforce what I believe, rather than just run with it as a bludgeon against your argument.

game recognize game, son.

[anoncow]

Would love a source on the 95% figure.