Industry likely to expand role in funding neurosurgery research

With federal funding increasingly restricted, industry will play a critical role in funding neurosurgery research, according to a report by three prominent neurosurgeons in the journal World Neurosurgery.

"It is likely that the role of industry in research funding in neurosurgery will continue to expand, whether by individual grants or by organizations such as the Neurosurgery Research and Education Foundation," Loyola neurosurgeons Vikram Prabhu, MD, Russ Nockels, MD, and Douglas Anderson, MD, wrote. "We should nurture this relationship, regulating it carefully without stifling it."

Drs. Prabhu, Nockels and Anderson are professors in the Department of Neurological Surgery of Loyola University Chicago Stritch School of Medicine. Dr. Anderson is department chair.

Industry has funded neurosurgery research for decades. "Through the years, it has brought advances to the medical field benefiting countless patients and the population at large," Drs. Prabhu, Nockels and Anderson wrote.

Industry funding also has resulted in periodic ethical lapses. ''But these are the exception rather than the rule and they are constantly being addressed and rectified - at a local and national level and with ever-increasing scrutiny," the authors wrote.

The National Institutes of Health is the world's leading underwriter of biomedical research, but obtaining NIH funding is an arduous process. A researcher must have an extensive track record, robust research facilities and a thriving program. Most grant applications are rejected, and most physicians do not have the time or training to master the art of grant writing.

Industry has superseded the NIH as the primary sponsor of clinical research. A 2015 study published in the Journal of the American Medical Association found that between 2006 and 2014, the number of industry-funded clinical trials increased by 43 percent, while the number of trials funded by the NIH decreased by 24 percent.

A July 2017 study in World Neurosurgery that examined industry funding of neurosurgery research found that full professors on average received more than four times as much funding as assistant professors. Vascular neurosurgeons on average received more money than other neurosurgery subspecialists. Seventy-seven percent of male neurosurgeons received industry funding, compared with 59 percent of female neurosurgeons. Among those who did receive funding, 23 percent of men received more than $10,000, compared with 11 percent of women.

Such funding disparities should be addressed, Drs. Prabhu, Nockels, and Anderson wrote. "Academic rank and gender should not be factors, and other neurosurgical disciplines, such as oncology, critical care and neurotrauma, functional and peripheral nerve, deserve an equal share of the pie."

The authors conclude: "Logistical and financial support for research from private organizations or industry should be welcomed, if the source is properly vetted and the proposed work is within the scientific and ethical confines of neurosurgery. Careful oversight and appropriate disclosure to avoid conflicts of interest are mandatory and physicians have to maintain the highest ethical standards. Organizations, such as the Neurosurgery Research and Education Foundation, play a key role; it may actually be best to steer precious research money through such entities."