The decision last week to freeze our government’s healthcare agencies is obviously a political one. It’s not the first time that the NIH has been the object of partisan argument. In 2003, an attempt to cut specific grants was defeated, with Congressman David Obey saying “the day we politicize NIH research … that is the day we ruin science research in this country.”
I’m afraid, while this is common sense, it may not speak to those who were making the decisions last week. As a doctor turned healthcare innovator, I want to try and explain this in terms of pure economics. As President Trump would have most certainly learned on his first day at Wharton, you really have to spend money to make money. If you want to make America truly a world leader, why on earth would you stifle the institution that contributed an estimated $92.89 billion to the US economy in 2023 alone and has produced over 170 Nobel Laureates since its inception?
I am the co-founder of a women’s health care company. I didn’t leave clinical medicine for the reasons many physicians are opting out of direct patient care. I loved being a doctor. I still love being a doctor. But I saw an opportunity to bring my skill set to patients in a different way. Now most of my days are spent fundraising, filling out grant applications, schmoozing investors and fretting about our runway. Many healthcare innovations are digital. Ours is not. We have seven PhD’s on staff and they expect to eat. I know, they drive a hard bargain.
Let me tell you something about healthcare start-up fund-raising. It’s like chewing glass. Thick shards of sharp sand that you wash down with a bitter glass of “try again tomorrow.”
Innovation equals money. The average cost to bring a drug to FDA approval using clinical data is now at $4.3M. Don’t need clinical data? Great, that’s a super bargain at $2.2M. It only costs a few hundred bucks to file a patent with the US patent office. But I can tell you with great authority that it doesn’t come close to covering the actual cost, which includes pre-filing advice and legal fees, additional rights in other countries and ongoing maintenance fees. We’re talking tens of thousands of dollars. And then there are those pesky PhDs at my office who demand things like heat, electricity and access to clean toilets. Changing the world costs money. Money most researchers, innovators, and scientists don’t have.
On a more personal note, I want to share what last week was like for me. I had spent over a month drowning in pitch decks and market analyses, heading toward a virtual grant application pitch with an NIH agency. My co-founders (a couple of amazing academics who have dedicated their lives to bettering the health of women for the sake of science, not their own egos) and I practiced every day. I made arrangements for my kids to be somewhere else, lest my son think my NIH meeting was a great time to ask for a bowl of cereal and extra screentime. By the way, you don’t get to “choose” your appointment time. The NIH is a big, busy place. If they tell you your appointment is Thursday at 11am, then your appointment is on Thursday at 11am.
Three hours before our meeting, I checked my email and saw the notice that all grant communications were cancelled until further notice.
I was disappointed. Very. This was a big deal for my company. It wasn’t a lot of money at all, but it would have been a springboard for us to further investment. An NIH grant would have given us credibility and a leg up. For other scientists, last Thursday was more than a leg up. These grants fuel incredible research, much bigger than what I’m trying to do. It’s estimated that for every $100M in NIH funding 76 patents are awarded and nearly $600M in additional R&D funding is achieved. NIH grants aren’t just handed out on a whim. Applicants spend months to years preparing. Grant cycles open and then close again. Your appointment is on Thursday at 11am. Be there or be square. My heart goes out to those who have even more at stake than we do.
On average the NIH gives 83% of its $47.1B budget to fund research, with over 11,000 awards per year. Last year, NIH funding went to a brain-computer interface that allowed a man paralyzed with ALS speak to his family. My mom died of ALS. I am so happy for that man and his family that they could speak to each other once more. Another NIH highlight was a blood test for Alzheimer’s. More funding went to preventing and treating peanut allergies in kids. This is amazing stuff. And stuff costs money.
Doctors don’t go to medical school because they think it will make them rich. Scientists certainly don’t go into research because they prefer private air travel. We do it because we want to make the world a better place. We want to reduce suffering and help people. However, my task here is to translate how good science makes for good business. It is estimated that for every $1 invested in just women’s health, there is a $3 return on investment. If you put your money into the S&P, you might make 10% a year. Put it into women’s healthcare and you might make 300%. Do the math. (Obviously, the S&P is a slightly safer bet. Everyone has their own risk aversion to investment. Please consult your own financial advisor, don’t just listen to me. I’m talking to our government.)
The United States is an undeniable world leader in science and technology. But when it comes to healthcare, we could do a little better. Last year the US ranked #7 in the World Index of Healthcare Innovation. We were #2 when it comes to access to new treatments. We spend nearly 20% of our GDP on health yet our healthcare quality ranks 14th around the world. We are number 22 in the world for disease prevention.
We could do better. How can we beat those pesky Swiss? Through innovation. Let’s advance science. Let’s reduce costs. Let’s allow innovation to thrive.
Mr. President, if you want to cut wasteful government spending, great. Start by investing in innovation. If you want America to be a world leader in healthcare, start by investing in innovation. We are not your enemy. Freezing the very organizations that have helped make the United States a world leading research kingpin is like shooting off your nose to spite your face.
I’m a doctor. I can tell you with authority that is a pretty bad idea.
Editor’s note: As of the time of publication the freeze has been temporarily paused by a federal judge.
Photo by Chip Somodevilla/Getty Images
Dr. Lara Zibners, MD, MMEd, MBA, is a visionary entrepreneur, board-certified pediatric emergency physician, educator, published author, and businesswoman dedicated to transforming women’s healthcare. Based between Vienna and London, she brings a global perspective to healthcare innovation.
With a medical degree from The Ohio State University College of Medicine, a Master’s in Medical Education from the University of Dundee, and an MBA from UNC-Chapel Hill, she has a career spanning the U.S., UK, and Europe, Lara’s expertise bridges clinical practice, executive leadership, and healthcare innovation.
Her journey took a personal turn after enduring seven rounds of IVF, where she experienced the severe discomfort and emotional toll of drug delivery for fertility and miscarriage prevention. Struck by the anxiety and trauma many women face during these treatments, Lara co-founded Calla Lily Clinical Care to develop innovative solutions for management of a variety of gynecological conditions.
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