Medical research
Typically, the work requires no ethical approval, is supervised by scientists rather than physicians, and is carried out in a university or company, rather than a hospital.
It is generally supervised by physicians and conducted by nurses in a medical setting, such as a hospital or research clinic, and requires ethical approval.
Public contributors can also ensure that the research is presented in plain language that is clear to the wider society and the specific groups it is most relevant for.
[7] In the United States, data from ongoing surveys by the National Science Foundation (NSF) show that federal agencies provided only 44% of the $86 billion spent on basic research in 2015.
[9] One method proposed to maximize the return on investment in medicine is to fund the development of open source hardware for medical research and treatment.
Since the establishment of the National Institutes of Health (NIH) in the mid-1940s, the main source of U.S. federal support of biomedical research, investment priorities and levels of funding have fluctuated.
[12] The National Institutes of Health (NIH) is the agency that is responsible for management of the lion's share of federal funding of biomedical research.
[14] Since 1980 the share of biomedical research funding from industry sources has grown from 32% to 62%,[15] which has resulted in the development of numerous life-saving medical advances.
The 1980 Bayh–Dole Act was passed by Congress to foster a more constructive relationship between the collaboration of government and industry funded biomedical research.
[20] According to Ariel Katz on average after a patent application is submitted it takes an additional 8 years before the FDA approves a drug for marketing.
[19] The Hatch-Waxman Act was passed with the idea that giving brand manufacturers the ability to extend their patent by an additional 5 years would create greater incentives for innovation and private sector funding for investment.
This publication included 37 different studies that met specific criteria to determine whether or not an academic institution or scientific investigator funded by industry had engaged in behavior that could be deduced to be a conflict of interest in the field of biomedical research.
Survey results from one study concluded that 43% of scientific investigators employed by a participating academic institution had received research related gifts and discretionary funds from industry sponsors.
[15] Another participating institution surveyed showed that 7.6% of investigators were financially tied to research sponsors, including paid speaking engagements (34%), consulting arrangements (33%), advisory board positions (32%) and equity (14%).
[26] The NIH provides more financial support for medical research than any other agency in the world to date and claims responsibility for numerous innovations that have improved global health.
Innovations such as the polio vaccine, antibiotics and antipsychotic agents, developed in the early years of the NIH lead to social and political support of the agency.
Political initiatives in the early 1990s lead to a doubling of NIH funding, spurring an era of great scientific progress.
[23] Despite an overall increase of investment in biomedical research, there has been stagnation, and in some areas a marked decline in the number of drug and device approvals over the same time period.
[23] The stock performance, a measure that can be an indication of future firm growth or technological direction, has substantially increased for both predominantly medical device and biotechnology producers.
Federal agencies have called upon greater regulation to address these problems; a spokesman from the National Institute of Neurological Disorders and Stroke, an agency of the NIH, stated that there is "widespread poor reporting of experimental design in articles and grant applications, that animal research should follow a core set of research parameters, and that a concerted effort by all stakeholders is needed to disseminate best reporting practices and put them into practice".
National regulatory authorities are appointed in most countries to oversee and monitor medical research, such as for the development and distribution of new drugs.
A major flaw and vulnerability in biomedical research appears to be the hypercompetition for the resources and positions that are required to conduct science.
[29][30][31][32][33] Other risky trends include a decline in the share of key research grants going to younger scientists, as well as a steady rise in the age at which investigators receive their first funding.
Intense competition for funding and publication pressures fosters a climate of secrecy and self-protection, stifling creativity and collaboration.
The power imbalance in academic hierarchies exacerbates these issues, with junior researchers often subjected to exploitative practices and denied proper recognition for their contributions.
In the United States, one estimate found that in 2011, one-third of Medicare physician and outpatient hospital spending was on new technologies unavailable in the prior decade.
For example, proton therapy was approved by the FDA, but private health insurers in the United States considered it unproven or unnecessary given its high cost, although it was ultimately covered for certain cancers.
