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Comment & Response |

Reductions in Funding for Medical Research

Steven S. Ma, BS1,2
[+] Author Affiliations
1Vaccine Research Center, National Institutes of Health, Bethesda, Maryland
2Mr Ma is now an MBA student at Duke University Fuqua School of Business
JAMA. 2013;310(8):854-855. doi:10.1001/jama.2013.170804.
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To the Editor Dr Emanuel’s recent article1 brought awareness to the decline in NIH funding. However, the conclusion that the NIH must focus research only on cost-lowering, quality-improving interventions was based on flawed premises. This conclusion, if accepted, may obscure the true reasons for increased health care spending, higher federal deficits, and lower NIH budgets.

Emanuel’s first premise was that the main source of advancement in biomedical technology is the NIH. Research activities at universities rely on NIH funding; however, this only accounts for approximately 27% of total medical research funding in the United States.2 The majority of medical research funding (approximately 61%) is from private industry.2 Fully or partially NIH-sponsored clinical trials account for only 9.3% of all US-based clinical trials registered on Clinicaltrials.gov (6466 of 69 372 studies).3 Phase 3 clinical trials sponsored by the NIH accounted for only 4.9% of the US total (472 of 9630 studies), whereas only 1.8% (174 of 9630 studies) had the NIH acting as the lead sponsor.3 These data show that NIH research is actually part of a much larger picture and that its contribution to increased health care costs due to technology advancement is overstated.

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August 28, 2013
Ezekiel J. Emanuel, MD, PhD
1Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia
JAMA. 2013;310(8):856. doi:10.1001/jama.2013.170807.
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