What answer to biomedicine’s declining R&D productivity?
Massive investments in biomedical research on mental health over the past decades have not led to added clinical benefits or improved health outcomes, argues Professor Nikolas Rose in his Volterra lectures given in Oslo and Trondheim. A recent Nesta report on the UK research system extends this conclusion to the entire field of biomedicine and recommends to diversify funding for health research to escape a ‘biomedical bubble’.
Over the years multi-billion sums have been invested into biomedical research designed to tackle mental health. But as Professor Nikolas Rose of King’s College London argued in two public talks he gave in Oslo and Trondheim on invitation of the Centre for Digital Life, this investment has not paid off thus far. There is no breakthrough on the pharmacological front and there is no evidence that existing drugs, as important as they are for medical practice, do more than address symptoms. Similarly, whole genome association studies and neuro-imaging have not led to disease models from which therapeutic benefits could be derived.
Professor Rose is not alone in calling out a mismatch between the current strategy of health research funding and the expected benefits for society. The innovation foundation Nesta has recently published the report ‘Escaping the Biomedical Bubble: Why UK research and innovation needs a greater diversity of priorities, politics, places and people’. Its authors, Professors Richard Jones and James Wilsdon, carefully document the declining productivity of investments into health-related R&D that underwrites phenomena like the rising cost to bring a new drug to the market. Their analysis further diagnoses a mismatch between disease burden and research efforts, for instance in the area of cardiovascular disease.
Jones and Wilsdon are keenly aware that both health and industrial policy are at stake. On one hand, new innovation models are required.
“The emerging lesson is that for many areas of new technology in the material and biological world, where expensive research needs to be sustained over many years to produce a return, the venture capital supported spin-out simply doesn’t make economic sense.” p.32
On the other hand, health research requires diversification.
“[T]here’s more to biology than the biomedical life sciences – and the sciences that underpin health go well beyond the biomedical life sciences. Healthcare innovations in future will come as much from the physical, the digital, the social and the environmental as from the biomedical.” p.53
Neither Jones and Wilsdon, nor Rose argue against biomedical health research; it is an important part of health research. The question is one of balance. And they agree that currently too little is invested in approaches that start with people’s current health needs and then translate these into diverse investigation pathways. Biomedicine may be one pathway amongst others. But the status quo of ‘give biomedicine more time and money and it shall deliver’ is an unsustainable promise. It is also an undemocratic one, so the Nesta report, as funding strategies are still developed by too small and too homogenous group of people.