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Cost Conscious

With sequestration-driven budget cuts and waning bipartisan support, the environment for medical research funding in the US is looking bleak and could turn bleaker still unless researchers work to turn things around, the University of Pennsylvania's Ezekiel Emanuel writes in a commentary published this week in the Journal of the American Medical Association. (Emanuel is the brother of Rahm Emanuel, the Chicago mayor and former chief of staff for President Barack Obama.)

Emanuel attributes this fall-off in support for medical research to four factors: the increased politicization of science; the current lack of strong Congressional champions for agencies like the National Institutes of Health; the increased scrutiny large NIH budgets have drawn; and, in an irony worthy of Alanis Morissette herself, the role of medical advances have played in increasing healthcare costs.

Of that last factor, Emanuel writes that roughly half the increase in healthcare costs can be attributed to "technology, that is, advances in biomedical science."

"And a main source — if not the main source — of advances in biomedical technology is the NIH," he notes.

So what's a person to do? Go back to bleeding patients with leeches?

Well, no. But, Emanuel says, NIH and the larger medical research community would be well served by focusing more seriously on developing "technologies that are not just 'incredibly exciting' but also cost lowering and value enhancing."

"Focusing research on cost-lowering, quality-improving interventions has not been an NIH priority," he writes. "This change in focus is vital to the future of both the country and the NIH."

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