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Research at U.S. academic medical centers faces threats to sustainable support

May. 28, 2015, 9:02 AM

Unstable federal research funding and reductions in health care revenue for academic medical centers threatens to undermine the nation’s biomedical research enterprise, and in turn clinical medicine, which the nation needs now more than ever.

This is the conclusion of an analysis written by top officials of some of the nation’s leading academic medical centers, including Vanderbilt, and published this week by the American Association for the Advancement of Science journal Science Translational Medicine.

The publication is titled, “Research in academic medical centers: Two threats to sustainable support.”

“Biomedical research is crucial to the U.S. national agenda,” said Arthur Levine, M.D., of the University of Pittsburgh, and 18 co-authors including Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of Vanderbilt University School of Medicine.

“We cannot meet the health care challenges of an aging and increasingly diverse population without acquiring new knowledge about human health and disease to support the development of creative therapeutic strategies,” the authors asserted.

The authors, who also included medical school deans from Duke, Iowa, University of Texas Southwestern, Yale and 13 other top academic medical centers, called for a “stable economic platform” to support the “full spectrum” of biomedical and engineering research, so that discoveries are translated into tangible benefits for patients.

Such a platform is spelled out in the 21st Century Cures Act now being considered by the U.S. Congress.

“The authors are all concerned about the ability of the U.S. to remain the world’s leader in biomedical research and the engine of innovation for advancements in patient care,” Balser said. “The failure of federal research funding to grow, even at the rate of inflation, at a time when revenue for patient care services is falling, places our nation’s dominance in biomedical science at risk.

“Long-term return on investment, made possible through federally sponsored research, has been a core driver of our economic growth as a nation over the last 50 years. Biomedical research has been, and must remain, foremost among these investments,” Balser said.

The article suggests that the trend of declining research funds through the federal government, concurrent with declining revenues from health care services, are already negatively impacting the discovery infrastructure at our nation’s leading academic centers. If left unchecked, the scope of U.S. biomedical research will decrease, resulting in less new knowledge and technology development, impairing the nation’s ability to address current and future health needs, while adversely impacting U.S. economic growth.

Legislation included in the 21st Century Cures Act, introduced by a bipartisan group of representatives, would increase appropriations to the National Institutes of Health (NIH) and other federal research sponsors and would establish an NIH “Innovation Fund” of $2 billion per year for fiscal years 2016 to 2020.

The study’s authors say that recommendations to stabilize the biomedical research enterprise must identify new resources, policies and business models for sustaining such research.

Without such an investment, biomedical research will shrink. And that, the authors cautioned, “will slow progress in our ability to address the health of our patients and lessen our contribution, through new knowledge and technology development, to the growth of the nation’s economy.”

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