Challenge and opportunity pg. 2
For the next fiscal year (2009), the national research community is calling for a budget increase of 6.7 percent for NIH, which would keep pace with inflation plus provide an additional 3 percent to begin to make up for recent years in which funding has fallen relative to inflation. Such an increase ($1.4 billion) would translate into approximately $60 million in business activity gains in Tennessee alone, and over 200 new jobs with more than $20 million in wages.
Nationwide, we would see approximately $3 billion in new business activity and over 9,000 additional jobs with $1.1 billion in new wages, according to the Families USA report. This is a minimum economic return of three-to-one even if NO health care benefits resulted from our investment in biomedical science!
But of course the health benefit of biomedical research also can yield an impressive return on investment.
In 2006, University of Chicago economists Kevin Murphy, Ph.D., and Robert Topel, Ph.D., estimated that increases in life expectancy between 1970 and 2000 “added about $3.2 trillion per year to national wealth, with half of these gains due to progress against heart disease alone.” While it is difficult to determine exactly how much of this progress can be attributed to medical research, it is well accepted that the dramatic drop in heart disease mortality in recent decades is due to improved understanding of the role of cholesterol, and resultant changes in diet, interventional procedures and new pharmaceuticals.
Currently there are more than 500 potential drugs for complex diseases in clinical trials in the United States, yet only about 50 percent of the patients enrolled in these trials will experience a positive result, and fewer than 20 new drugs make it to the marketplace every year.
Why is the success rate so low? One reason is that genetic variation has a huge impact on our individual responses to medications. Because of this variability, pharmaceutical trials must be conducted in very large patient populations, at considerable cost (approximately $1 billion per drug), and over a long period of time (it can take a decade to complete some studies). As a result, few novel therapeutic agents make it through the pharmaceutical pipeline. If one could define, in advance, which individuals or populations would be most likely to benefit from a specific therapy, smaller studies at substantially less cost would be required, and the constricted pipeline of new drugs would literally burst open.
Vanderbilt Medical Center is investing heavily in personalized medicine -- that is, identifying and characterizing the molecular diversity among individuals through test results, tissue samples, and an electronic database of health and genetic information. Our “DNA databank” now contains over 60,000 samples, and is among the fastest growing DNA repositories worldwide. Thanks to large-scale, global investments in biomedical informatics over the past decade, information gleaned from samples can be stripped of identifying information to protect patient privacy. This work is laying the foundation for the identification of biomarkers that will dramatically improve the output of new diagnostics and drugs, and at a fraction of the cost.