Biomedical research and broken clocks: All the parts, but no instructions

The day-to-day rigors of academic biomedical research are difficult to appreciate, and it is necessary that scientists share their perspective of the knowledge market with politicians and government representatives who are burdened with making difficult decisions on our behalf. Unlike the airline industry that also does research and development (R&D) to create safer, lighter and more efficient airplanes, academic medicine does not build R&D into the pricing of its services. This is because biomedical research is a surprisingly random process that depends on chance observations, unexpected results, and seemingly unrelated outcomes. As a result, downstream applications of research are almost impossible to predict at the outset, and necessitate an altogether different model of cost recovery.

Imagine a broken a clock with all of its parts, and no operator’s manual to describe how any of them fit together—let alone what they do. Clearly the most cost-effective way to fix this clock is to locate the malfunctioning component(s), presumably by comparing it to an identical functioning model, but where do we start? Without a comprehensive understanding of a clock’s inner workings no one place is better than another, and assuming time is of the essence, we might want to employ multiple investigators, each starting at a different point, to come to a conclusion faster. Biomedical research results in improved models of human biology (blueprints) that scientists use to understand how systems fall out of alignment (disease), and establish targeted therapies to correct them. Compared to the clock, the human body contains many orders of magnitude more parts (all of them smaller), and given the expense of the highly specialized equipment required to study it, establishing a solid understanding of pathology to direct drug development becomes cost-prohibitive.

To subsidize national biomedical research endeavors, projected costs are spread among citizens in the form of taxes, and distributed to multiple academic institutes as operating grants. Investments in research lead to licensed technologies that create jobs and revenues far in excess of the grants that support them, with every dollar invested in chemical research and development producing, on average, $2 in corporate operating income over 6 years – an average annual return of 17% after taxes (Measuring Up: Research & Development Counts for the Chemical Industry). In this economic climate, you would be hard-pressed to find a better deal!

How then do we fund it?