Measuring the Impacts of Federal Investments in Research A Workshop Summary (2011) / Chapter Skim
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APPENDIX D THE IMPACT OF PUBLICLY FUNDED BIOMEDICAL AND HEALTH RESEARCH: A REVIEW1 Bhaven N Sampat Department of Health Policy and Management Columbia University I
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154 MEASURING THE IMPACTS OF FEDERAL INVESTMENTS IN RESEARCH Donald Stokes (1997) observes that the public values science "not for what it is but what it is for." A perennial question in U.S.
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APPENDIX D 155 Fundamental New Drugs, Knowledge Devices 1 Instruments and Techniques Health Publicly Private Sector Outcomes Funded R&D 2 R&D (Costs?
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156 MEASURING THE IMPACTS OF FEDERAL INVESTMENTS IN RESEARCH channel, since public agencies may also be important in training doctoral and post-doctoral students who move on to work for private sector firms (Scherer 2000)
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APPENDIX D 157 for example, by changing their prescribing habits (e.g. "beta-blockers after heart attacks improve outcomes")
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158 MEASURING THE IMPACTS OF FEDERAL INVESTMENTS IN RESEARCH more) , even very costly medical technologies pass the cost-benefit test.4 Nordhaus (2003)
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APPENDIX D 159 III. THE EFFECT OF PUBLICLY FUNDED RESEARCH: A REVIEW OF THE EVIDENCE Health Measuring the health returns to publicly funded medical research has been a topic of interest to policymakers for decades.
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160 MEASURING THE IMPACTS OF FEDERAL INVESTMENTS IN RESEARCH Numerous prominent academic studies (Weisbrod 1983, Mushkin 1979) aim to examine the health effects of biomedical research, and the economic value of this impact, in a cost-benefit framework.
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APPENDIX D 161 sponsoring large epidemiological trials and holding consensus conferences. This may reflect a traceability and attribution problem, which is common to the evaluation of fundamental research: It is difficult to directly link improvements in outcome indicators to public sector investments in basic research, even in a study as detailed as this one.
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162 MEASURING THE IMPACTS OF FEDERAL INVESTMENTS IN RESEARCH the important role of public sector research in the development of HIVAIDS drugs, which is observed in several of the empirical studies discussed below. A recent paper by Lakdawalla et al (2011)
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APPENDIX D 163 correlation, but find weaker evidence for cancer and diabetes. Several issues arise here that will re-emerge in other quantitative analyses discussed below.
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164 MEASURING THE IMPACTS OF FEDERAL INVESTMENTS IN RESEARCH private sector R and D within that same disease area over the next seven years. Surveys of firm R and D managers have also been used to gauge how public sector research affects private sector R and D
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APPENDIX D 165 measured by publications and other measures of scientific productivity) working in that area.
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166 MEASURING THE IMPACTS OF FEDERAL INVESTMENTS IN RESEARCH examines the importance of academic research for industrial innovation for firms across a range fields. In this work, as in the Carnegie Mellon Survey discussed above, the biomedical industries are outliers.
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APPENDIX D 167 places of employment, and applies his analysis to 252 drugs approved by the FDA between 1998 and 2007. Using these measures, Kneller finds a larger public sector influence than the previous studies.
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168 MEASURING THE IMPACTS OF FEDERAL INVESTMENTS IN RESEARCH diseases based on funding Institute using information in Congressional budget requests for those institutes. They find that despite a sharp rise in NIH funding over this time period, drug approvals remained flat overall.
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APPENDIX D 169 this device, including the NIH's sponsorship of conferences and centers to spread best-practice, funding of trials and development of important component technologies, and contracts to spur firm formation. Health Costs Despite longstanding concerns about the effects of new biomedical technologies on healthcare costs, and speculation that public sector research may be implicated in spurring this cost spiral, there has been surprisingly little empirical research on this topic.
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170 MEASURING THE IMPACTS OF FEDERAL INVESTMENTS IN RESEARCH estimate the health and economic effects of publicly funded biomedical research. Here, we will highlight several that stand out.
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APPENDIX D 171 The bibliometric approaches discussed above, linking grants to publications to citations to patents to drugs may overcome these traceability challenges, relying on paper trails between research and outcomes, and avoiding the need to associate public sector funding with particular diseases. However, the validity of these analyses rest on a number of assumptions, e.g.
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172 MEASURING THE IMPACTS OF FEDERAL INVESTMENTS IN RESEARCH observed were causal. These too represent promising research approaches going forward.
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APPENDIX D 173 research was responsible for only a small share of this gain, it delivers high returns on investment (Murphy and Topel 2003) .11 More work is needed directly examining the role of the public sector per se, and especially public sector basic research, in affecting these health outcomes.
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174 MEASURING THE IMPACTS OF FEDERAL INVESTMENTS IN RESEARCH Ballar, J and Gornick, H
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APPENDIX D 175 Dorsey, E.R, Thompson, J.P., Carrasco, M., de Roulet, J., Vitticore, P., Nicholson, S., Johnston, S.C., Holloway, R.G., Moses, H III.
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176 MEASURING THE IMPACTS OF FEDERAL INVESTMENTS IN RESEARCH Lichtenberg, F
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APPENDIX D 177 Philipson, T., and Jena , A.B.
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178 MEASURING THE IMPACTS OF FEDERAL INVESTMENTS IN RESEARCH Zucker, L., Brewer, M., and Darby, M
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Table D-1 Public Funding and Health Outcomes: Summary of Selected Studies Authors Question Empirical Approach Measures/Data Results Cutler and What is the role of biomedical Detailed case study of Economic value of Returns to basic research Kadiyala research in reduction in CVD the roles of high tech clinical benefits of 30-1 (2007) mortality?
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Authors Question Empirical Approach Measures/Data Results 180 Weisbrod What was rate of return on Detailed case study Economic value of Rate of return 11-12% (1983) public investments in polio Counterfactual: what clinical outcomes research?
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Authors Question Empirical Approach Measures/Data Results Manton et al How do U.S. health dynamics Correlate 10 year NIH funding overall Temporal correlation (2009)
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Authors Question Empirical Approach Measures/Data Results 182 Comroe and What types of research Interviews, expert Top 10 clinical advances 41 percent of all work Dripps (clinical vs. basic)
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TABLE D-2 Public Funding and New Drugs, Devices: Summary of Selected Studies Authors Question Empirical Approach Measures Results Cockburn and How does public Case studies of 15 clinically Qualitative Of 15 drugs, public sector Henderson sector research affect important drugs determinations of roles research made key enabling (1996) pharmaceutical of public sector in drug discovery for 11 innovation?
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Authors Question Empirical Approach Measures Results 184 articles acknowledging public sector funding Sampat (2007) On how many drugs Examine share of drug FDA approved NDAs 72 of 1546 NDAs have an do academic approvals where academic 1988-2005 academic patent institutions own and public sector Orange Book patents 10.3 percent of NMEs patents?
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Authors Question Empirical Approach Measures Results Stevens et al On how many drugs Examine number of drug FDA data on drug and 153 FDA-approved drugs (2011) and vaccines approvals in-licensed from biologic approvals discovered by public sector emanate from public PSRIs (excluding licenses Orange Book data on institutions over past 40 years sector research to platform technologies)
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Authors Question Empirical Approach Measures Results 186 employment Morlacchi and What were the Longitudinal case study of Interview data NHLBI contracts important in Nelson (2011) sources of innovation the development of the Information from key spurring firm formation and behind development LVAD patents and evolution in 1960s/1970s of the left-ventricular publications on LVAD NHLBI important in assist device sponsoring conferences, (LVAD)
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Dorsey et al Are new drug Correlations of NIH 1995-2000 FDA drug Despite a rise in NIH (and (2009) approvals by funding data with future and approvals, mapped other funding)
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TABLE D-3 Public Funding and Private R and D, Patenting: Summary of Selected Studies 188 Authors Question Empirical Approach Measures Results Ward and How does industry Panel regressions PhRMA data on R and A 1 percent increase in NIH Dranove funded R and D relating private R and D D by field research associated with .76 (1995) respond to NIH R in a disease area to NIH NIH data on R and D by percent increase by private sector and D?
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Authors Question Empirical Approach Measures Results R and D investment? funding across disease therapeutic classes, research funding associated with a areas, over time 1972-1996 1.7 percent increase in private PhRMA data on private sector R and D sector R and D in these A 1 percent increase in clinical classes, 1980-1999 research funding associated with a .40 percent increase in private sector R and D Azoulay, Do elite life scientists Panel regression models Data on 10,450 elite life Professional transitions lead to a Graff Zivin, benefit local firms?
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Authors Question Empirical Approach Measures Results 190 (1998) biotech firms?
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Authors Question Empirical Approach Measures Results and D in medical instruments industry: Medicine, Materials Science, Biology Mansfield How important is Survey Survey results from 77 Percent of new products that could (1998) academic work for firms not have been developed (without industrial substantial delay)
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