A research team led by Dr. Hamilton Moses III of the Alerion Institute in North Garden, Va., found biomedical-research funding increased by 254 percent, from $37.1 billion in 1994 to $94.3 billion in 2003, which still amounts to a doubling when inflation is taken into account.

Industry provided 57 percent of the funding in 2003, with the National Institutes of Health accounting for 28 percent.

"The doubling over a decade of total spending by U.S. public and private research sponsors in real, inflation-adjusted, terms should be reassuring to those who fear that financial sponsorship for research is not paralleling scientific opportunity," Moses and colleagues write in the Sept. 21 issue of the Journal of the American Medical Association.

Another study in the Journal, however, concludes that cuts in the NIH's budget may be limiting the research done at academic medical centers.

Dr. Jordan Cohen and Elisa Siegel, both of the Association of American Medical Colleges, wrote that the NIH budget has grown by less than the rate of inflation in recent years and, combined with the increasing costs of conducting research and the need to comply with new governmental regulations, the trend could force some academic centers to close programs.

"The White House Office of Science and Technology Policy and Office of Management and Budget have undertaken a cross-agency initiative to identify more efficient business models and to streamline agency requirements for federally sponsored research, giving rise to some hope that the federal government will at least partially restore the balance of responsibility that formerly characterized the historic federal-academic partnership in the country's research enterprise," Cohen and Siegel wrote.

"If some relief is not forthcoming, some institutions may find it impossible to sustain their sponsored research programs," they added.

Cohen and Siegel recommended the research community endeavor to maintain the public's understanding of the importance and integrity of medical research.

"The ability to sustain financial support for medical research in the face of constrained federal and state budgets is heavily dependent on managing unrealistic public expectations and on maintaining public trust," they wrote.

Cohen and Siegel also advised being more open with research results and ensuring that standard research precautions remain in place when collaborating with industry.

"The ability to benefit optimally from the growing relationships with industry is heavily dependent on remaining true to fundamental academic values, including the safety of human subjects research, the integrity of the scientific process, and the free exchange of research results," they wrote.

Moses and colleagues urged all funding parties - government, industry and foundations - to approach biomedical research from the perspective that it "is an inherently high risk and lengthy process" that can take decades to reach fruition to clinical applications.

The team also noted that the productivity of pharmaceutical companies in recent years has fallen, as measured by a decline in new molecular entities approved by the Food and Drug Administration.

This may be due in part to companies not pursuing areas where there are few effective treatments. This may limit their productivity because these are areas rich with opportunities to develop treatments that are new classes of drugs or that work by novel mechanisms.

"The willingness of biotechnology companies to do this may, in part, account for their greater relative productivity," Moses and colleagues wrote.

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