Hamilton Moses · JAMA 2005 · descriptive economic trend analysis · n=?

Financial Anatomy of Biomedical Research

Cited 450 times in the scientific literature.

Level 4 - case-series / case-control

Descriptive economic trend analysis using compiled public and proprietary databases (graded by design analogy, not clinical CEBM)

OpenAlex W2152158712 · doi:10.1001/jama.294.11.1333 · record verified 2026-08-30

What was done

Publicly available and proprietary databases were compiled to quantify US basic, translational, and clinical biomedical research funding trends from 1994 to 2004 across federal, state, and local governments, foundations, charities, universities, and industry. Main outcomes included total actual spending, inflation-adjusted growth rates, and allocation across research types.

What was found

Biomedical research spending increased from $37.1 billion in 1994 to $94.3 billion in 2003, doubling when adjusted for inflation. In 2003, the principal sponsors were industry (57%) and the National Institutes of Health (28%), with relative proportions from public and private sources remaining unchanged. Industry funding of clinical trials grew from $4.0 billion to $14.2 billion in real terms, while federal allocations to basic versus applied research remained flat. Biomedical research accounted for 5.6% of US total health expenditures, but less than 0.1% was spent on health services research. New product productivity per research dollar was highest for biotechnology and medical device firms, but declined for pharmaceuticals.

Why it matters

This paper provides a comprehensive macroeconomic baseline of US biomedical research investment, documenting a massive expansion in industry-sponsored trials alongside a documented drop in pharmaceutical R&D productivity.

Limits

The study is based on secondary compilations of public and proprietary datasets, which may have inconsistent accounting methodologies across sectors. It is restricted to US sponsors from 1994 to 2004 and does not evaluate clinical outcomes or specific project-level efficacy.

Cited by