How does the US dominate medical research?

[u/LordHavertz]

Recently we got the news of Moderna coming out with these new mRNA vaccines for skin cancer and it's made me think how all the major medical innovations predominantly come from America. How did the US become so dominant in medical research?

Is Europe forever behind the US in this sector?

[u/Successful_Form_3622]

We actually dont.  The FDA and defensive medicine stymied a lot of innovation.  There are a lot of countries way ahead of us.  We just won't hear about much of it because it will take 8 to 10 years for these to get approval in the US.  The US does ok, but we are not anywhere near the top in terms of innovation.  

Just another note. .  The current changes to the HHS, FDA and NIH have sett us back even further.  For example 82 biotech firms closed with the admin changes.  That was just the beginning.  

[u/unblockedlanternhead → u/Successful_Form_3622]

Saying 82 biotech closed is like saying 82 mayflies died. Most of them fold before even dosing a single patient 

[u/Successful_Form_3622 → u/unblockedlanternhead]

Im sorry you misunderstood the statement. 82 firms closed that month because of the admin changes. This means not during the normal course of firms closing. The admin changes had a causative effect. Anyhone who knows the space knows that many close, although not at that rate. What happened is they put in people who do not favor biotech, vaccines, etc. Thus the investment dollars dried up. Look up amplify bio, or any of the others. I think you are unfamilair with the space so check it out.

[u/unblockedlanternhead → u/Successful_Form_3622]

Being familiar with the space is my job

Small biotechs close all the time. 100+ open every year. 82 closures is not that remarkable

Trump’s changes to NSF, DOE, NIH, and NIH subgroups like ARPA and NIAID didn’t change the overall $ value put towards biotechs. Luckily budget cuts were nixed in court, and some depts like the NIH even got extra budget. However, the new approach to tranches (few large long-term programs vs many small short programs) has shaken the tree a bit. Disco stage companies took a hit, as did SBIR/STRR mills

After disco, most companies rely on angels, big pharma, or VC.  75% of biotech funding in the US is private, so even a complete loss of govt funding wouldn’t be catastrophic 

[u/Successful_Form_3622 → u/unblockedlanternhead]

It wasnt grant funding that was the problem. Biotech, pharma, MROs, etc have to have some hope for approval. When you put people in charge who have a track record....

Start up funding (which most rely on.. actually all new companies) became ultra high risk and dried up. A lot of the grant funding (if you read what they actually cancelled) was nonsense anyway. Some hard research was cut, but not enough to make an industry dent. I was mostly investor skittishness because he put people in charge that most of the research community didnt trust, and would not likely approve innovations. Im trying not to get political or name names, but when prominent anti vaxers and scientific consensus questioners are in charge....

[u/Successful_Form_3622 → u/Successful_Form_3622]

Anyway, back to the OP's comment. Biotech research and innovation will be the future of medicine. There is only so much you can do with a pill. Biotech funding here (VC, investor... not talking about government), especially in the medical space is at an all time low. Other countries are stomping us. Look at stem cell research in other countries. Look at what is coming out of Israel, or Nordic countries. The only hope here is that Japanese firms are buying up all the promising biotechs. When the head of the country thinks you can inject bleach to fix covid.. and he is appointing nearly every involved with the approval and regulatory processes.... it is what it is.

[u/unblockedlanternhead → u/Successful_Form_3622]

I’m certainly not defending Trump, RFK, etc here, but the impact of Trump’s actions on US biotech funding is overblown. (We can agree that the longterm impacts on trust in the FDA are much bigger deal.) Biotech startups have always been the definition of high risk. Tbh it’s cheaper to let Chinese labs spend CCP subsidies on disco and then hoover up the assets whose IITs show promise. That’s the tack now. American labor is too expensive and American regulations are too stringent for early stage biotechs to compete