The reward systems in universities, such as promotion and tenure, accrue from publication of findings that other researchers consider impressive. Academic culture renders influential peer recognition the dominant measure of success. The fact that the peer reviewers of papers submitted for publication are imbedded in the academic culture (as are many of those who review research grant applications) has assured the ascendancy of reductionism. It also ensures that the measure of value of a researcher’s work is not medical innovation, but publication in prestigious journals that, in turn, serve as the currency for obtaining research grant funding.
The essay has a rather innocous-sound title, “Removing Barriers to Medical Innovation.” In fact, it is a highly contrarian take on medical research.
What we are usually told is that the important research is done at universities using government funds, and the drug companies then appropriate this research for private profit. Those same drug companies waste more money on advertising than they spend on research. Stossel argues that the opposite is the case, and that the huge waste is in government-funded research. His description of the sociology of academic medical research sounds plausible, and some of it applies to academic economics as well.
The excerpt is just facts. It is funny how often obvious facts are contrarian.
As I’m working on my NIH grant reviews (some from industry) today, it seems appropriate to chime in. In the previous era, which may be unduly valorized or unduly condemned, it seemed that university work produced all the findings of general or universal impact; the exploratory basic work which underlies everything else. Industry had some of that but also did more of the focused work that didn’t apply to much, but was extremely relevant to the immediate application.
Unfortunately, several things have changed. Applications for NIH funding are very frequently chasing ‘low hanging fruit.’ Attempts to turn all research into ‘low hanging fruit’ requires gross oversimplifications, leaps of faith, and bald assertions about applications of immature research. When every discovery claims to be medically revolutionary, it can be judged on that standard – and most of them naturally fail. Worse, it undermines even the basic scientific value of exploratory research, quite a bit of which gets published too quickly and without appropriate context. A large fraction of published research has been shown to have major flaws, even invalidating the conclusions.
So, now, its harder to lean on research that isn’t directly applied because the presumed quality controls have failed; medical efficacy (post market surveillance) is still a gold standard, however. The majority of the research that leads quickly to post market surveillance will be industry research. This puts university research either in a bad light, or outside the circle of light, depending on your perspective.