By NextBestFitExpand public R&D funding
Increase NIH and public trial funding, especially for late-stage trials, so innovation relies less on high prices.
Offsets some lost private R&D with public funding.
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This path
Expand public R&D funding
Concrete changes if chosen
What would actually have to change in law, agencies, payment rules, or systems.
- Increase NIH and late-stage trial funding
- Create a public clinical-trial network
Effects
Each effect has its own page: the evidence, the case that it is or isn't a real cost, and whom it affects.
What it fixes
- R&D is funded by high prices, which ties innovation to unaffordability
Expanded public research and trial funding, especially for late-stage trials, offsets lost revenue and reduces reliance on high prices while allowing neglected diseases to receive funding.
What it creates or worsens
- Raises spending or loosens control over it
Expanded public research and trial funding costs taxpayers.
- Government chooses which research gets funded
Expanded public research funding puts the selection of research priorities in government hands.
Who's affected
Who gains
- People with ongoing or specialist care needs
- R&D is funded by high prices, which ties innovation to unaffordability: High prices make current treatment less affordable.
- People who will need care in the future
- R&D is funded by high prices, which ties innovation to unaffordability: Price cuts without replacement research funding can reduce the development of new drugs.
- Medical researchers and research institutions
- Government chooses which research gets funded: Well-connected institutions can benefit from politically influenced research funding.
Who loses
- Drug and device makers
- R&D is funded by high prices, which ties innovation to unaffordability: High prices fund research and support expected investor returns.
- Taxpayers and public budgets
- Raises spending or loosens control over it: Public budgets pay the added spending.
- Medical researchers and research institutions
- Government chooses which research gets funded: Government priorities may leave risky or politically disfavored research unfunded.
- People with ongoing or specialist care needs
- Government chooses which research gets funded: People with rare conditions can lose research support for needed treatments.
Where it has been tried
- U.S. NIH, BARDA: Public funding contributed to nearly every new drug approved 2010–2016.
- United States: A 2018 study linked NIH-funded research to all 210 new drugs approved in 2010–2016, with associated NIH project costs exceeding $100 billion.