Leadership in Decline: Assessing U.S. International Competitiveness in Biomedical Research

NIH Director Francis S. Collins endorses this report.

Advances in life sciences—including pharmaceuticals, biotechnology, and medical devices—were a major driver of global economic growth in the second half of the twentieth century. Since World War II, the United States has stood firmly at the forefront of the life sciences revolution, with this leadership built upon a solid commitment to robust and sustained federal investment in biomedical research and development (R&D), channeled primarily through the National Institutes of Health (NIH).

This public investment laid the foundation for the development of scores of breakthrough pharmaceutical drugs and therapies—from personalized gene therapies to synthetic skin to cures for certain types of cancer—and has catalyzed the development of a globally competitive, high-wage life sciences industry in the United States. Today, the U.S. life sciences industry supports more than 7 million jobs and contributes $69 billion annually to U.S. gross domestic product (GDP). But U.S. leadership in the global life sciences industry is today under threat on two fronts. First, federal investment in biomedical research through NIH has decreased, both in inflation-adjusted dollars and as a share of GDP, nearly every year since 2003. Put simply, the United States is not sustaining the historically strong investment in biomedical research that once propelled it to global life sciences leadership.

At the same time, global competition has intensified, as a growing number of countries, including China, Germany, India, Singapore, Sweden, the United Kingdom, and others have recognized that life sciences represents a high-wage, high- growth industry and have taken measures seeking to wrest life sciences leadership from the United States.

These nations have not only significantly expanded their financial support for biomedical research, they have also implemented a range of policies designed to enhance their biomedical innovation ecosystems, such as tax incentives through “patent boxes,” regulatory reforms to speed drug approvals, and immigration and education policies designed to attract and to educate the best life sciences talent. As this report demonstrates, in an increasing number of indicators—from trade balances in pharmaceuticals to shares of global pharmaceutical-industry output—such policies and investments have enabled several countries’ life sciences industries to become competitive with that of the United States.

China, for example, has identified biotechnology as one of seven key strategic and emerging (SEI) pillar industries and has pledged to invest $308.5 billion in biotechnology over the next five years. This means that, if current trends in biomedical research investment continue, the U.S. government’s investment in life sciences research over the ensuing half-decade is likely to be barely half that of China’s in current dollars, and roughly one-quarter of China’s level as a share of GDP. And China already has more gene sequencing capacity than the entire United States and about one-third of total global capacity. Other countries are also investing more in biomedical research relative to the sizes of their economies. When it comes to government funding for pharmaceutical industry-performed research, Korea’s government provides seven times more funding as a share of GDP than does the United States, while Singapore and Taiwan provide five and three times as much, respectively. France and the United Kingdom also provide more, as shares of their economies.

Yet the challenge to U.S. biomedical research competitiveness is not just that other countries are investing relatively more in biomedical R&D as a share of their economies. Nor is it simply that federal funding for biomedical research peaked in 2003, in both inflation-adjusted dollars and as a share of GDP, and has been slipping since. Another problem is the lack of consistency and predictability in the level of U.S. biomedical research funding. To be sure, the 2009 American Recovery and Reinvestment Act (ARRA) included a welcome, albeit temporary, increase in NIH funding. But the positive impact of that ephemeral surge has not been maintained, and NIH funding is threatened with a drastic rollback by the looming automatic sequestration scheduled to be triggered January 2, 2013 (unless Congress reaches a budget deal in the interim).

The sequestration would slash NIH funding by at least 7.8 percent, leading to a $2.4 billion reduction in 2013, the largest cut in the agency’s history. This whipsaw, boom-bust cycle introduces tremendous uncertainty into the biomedical research enterprise, making it difficult for researchers, research institutions, and businesses to make long-term planning and investment decisions. In such an environment of constrained and uncertain funding levels, private investigators with promising biomedical research proposals who can’t secure funding in the United States will increasingly look to pursue opportunities abroad. In other words, part of the challenge to U.S. international competitiveness in biomedical research stems from uncertainty generated by the inability to sustain robust levels of funding for biomedical R&D on a consistent basis.

It is striking that, while many competing countries, such as the United Kingdom, face the same challenges as the United States in terms of budget deficits and high unemployment in a sluggish global economy, these countries are choosing to secure their future well-being, not by just sustaining, but by increasing their investments in biomedical research. They are doing so because they recognize that the most viable solution to such challenges is to help grow key sectors of their economies, such as life sciences. And they recognize that the only way they can do this is by making the necessary investments in research that provide the fundamental foundation for life sciences innovation and a bio-based economy, including new drugs, diagnostics, therapies, and devices.

This report documents the foundational role public investment plays in underpinning a nation’s competitiveness in the life sciences. It assesses the intensifying competition for global life sciences leadership through case studies of four countries—the United States, China, the United Kingdom, and Singapore—that illustrate the commitments that competitor nations are making to enhancing their life sciences competitiveness through increased public investments and comprehensive policy reforms. It then assesses countries’ performances in the life sciences- industries as measured by a variety of indicators, including countries’ share of total patents granted in biotechnology and trends in countries’ levels of trade balances, employment, and share of global output in the pharmaceutical industry.

Testimony in Support of this Report:

"I've supported additional spending in areas of research. We requested that the Labor H-S-S Committee provide $32 billion for NIH funding which is an increase of $1.4 billion over 2012 funding."

-Congressman Kevin Yoder (R-KS)

“It is my hope that this thoughtful, unflinching report of those [spending] trajectories will attract enough attention to help us realize that our dominance of biomedical research cannot be taken any more as a given."

-Dr. Francis Collins, Director, NIH

"NIH trained researchers are the among the most competitive athletes of their kind in the world..NIH is the lifeblood of the biomedical research community, and without it, our most talented minds will simply gravitate to other fields or leave the country for growing research opportunities in other countries as described by Rob earlier.”

-Dr. Scott P. Bruder, Senior Vice President and Chief Science and Technology Officer of BD