CLINICAL NEWS
Big Names, Big Bucks
Large universities with prestigious reputations (based on U.S. News & World Report rankings) receive a
large portion of grant funding from the National Institutes of Health (NIH), but less-prestigious institutions
represented greater returns on investment.
In an analysis of research productivity (i.e., number of publications or citation impact per dollar of NIH
funding) between 2006 and 2015:
Per dollar of funding, prestigious institutions (including the University of California
San Francisco, Johns Hopkins University, and Harvard Medical School) had:
Unhealthy Competition
65 % higher grant-application success rates
A review of records from an administrative claims data-
base revealed that, from the time the first generic version
of imatinib entered the market in 2016, there was only a
small decrease in the price of the generic drug relative to
the brand-name version:
50 % larger award sizes
PRESTIGIOUS
• 8 % reduction during
the first year
• 10 % reduction during
the second year
Less-prestigious institutions (like the University of South Dakota, West Virginia
University, and the University of Mississippi) had:
65 % more publications
citation
35 % higher
impact
Meanwhile, the branded drug’s price continued to rise,
totaling about $146,000 per year.
LESS-PRESTIGIOUS
The smaller-than-expected price reduction is likely due to
slow uptake of generic versions of these drugs: In 2010,
brand-name imatinib was the drug of choice for 75% of
patients with chronic myeloid leukemia who were starting a
tyrosine kinase inhibitor. Seven years later, generic imatinib
still made up only 28% of new treatments.
“Scientific output is not a linear function of amounts of federal grant support to individual investigators,”
the author concluded. “Giving the lion’s share of grant dollars to a small minority of institutions seems
counterproductive and wasteful – whether or not the disparities in funding are driven by bias.”
Source: Cole AL, Dusetzina SB. Generic price competition for specialty drugs:
too little, too late? Health Aff (Millwood). 2018;37:738-42.
Source: Wahls WP. High cost of bias: diminishing marginal returns on NIH grant funding to institutions. bioRxiv. 2018 July 13.
Medicare for All?
Surveys suggest that most Americans support a “Medicare-for-all” plan
that was spearheaded by Sen. Bernie Sanders (VT-I), but a new report
about the cost of the plan could temper that enthusiasm.
A report from the Mercatus Center at George Mason University estimated that
the plan would boost government spending on health care by
32.6
trillion
over 10 years.
$
His plan calls for opening up Medicare (the program for U.S. seniors) to
all citizens, eliminating copays and deductibles for medical services, and
reducing the insurance industry’s role in the U.S. health-care system.
The authors argued that, as demand for services drives up spending,
people will see enormous tax hikes. However, Sen. Sanders called the re-
port grossly misleading, stating that, “If every major country on Earth can
guarantee health care to all, and achieve better health outcomes, while
spending substantially less per capita than we do, it is absurd for anyone
to suggest that the U.S. cannot do the same.”
Source: Associated Press, July 30, 2018.
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