Pundits have long predicted that biology would dominate the twenty-first century, just as physics dominated the twentieth century.
But biomedical research has yet to achieve the kind of productivity increases that accompanied the industrialization of combustion, electricity, and electronics. Will the "century of biology" turn out to be little more than a fantasy?
The problem largely comes down to a decrease in biomedical research-and-development expenditure. As it stands, roughly
The discrepancy between spending and output adheres to what has come to be known as "
This phenomenon is rooted in high rates of drug failure and lengthening technology cycles. The probability that a drug entering clinical trials will gain approval from the
So far, pharmaceutical and biomedical research firms have responded to
The industry's ability to support R&D budgets has already led to the closure of more than 30 major research sites.
Moreover, biomedical research firms are abandoning certain diseases in order to avoid the large-scale trials that they require, focusing instead on "orphan diseases" like cystic fibrosis, which demand smaller clinical trials that have a higher probability of success, leading to drugs that can cost more than
Finally, while drugs are increasingly produced by small companies that larger pharmaceutical firms then acquire, funding for these start-ups is drying up. Likewise, universities - the main source of biomedical innovation - are facing dwindling budgets. This year, funding for the
Restoring funding for basic biomedical research appears to have lost favor with policymakers, because it does not offer immediate self-sustaining economic returns. And funding for basic research remains a low priority in emerging economies like
With no panacea in sight, several other solutions are gaining traction. To maximize investment, the public and private sectors are increasingly pooling resources. For example, under the
These pooled resources will be directed to a few high-priority diseases, identified through an evaluation of the marginal benefit of additional R&D.
At the same time, governments will have to implement policies aimed at guiding investment toward specific diseases. For example, increased NIH funding, extended market exclusivity, and relaxed regulatory hurdles in the US resulted in a renaissance in antibiotic drug development.
Society will also have to share the cost of drug development. Regulatory agencies worldwide may follow the
Whether these efforts will succeed in putting biomedical research on a more sustainable footing remains an open question. This could still turn out to be biology's century. But it is not a sure thing.
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