Benefiting Australia from Medical Research University Governance and Regulations Forum

Professor Warwick Anderson AM

NHMRC Chief Executive Officer

16 September 2014

Health & Medical Research – benefiting Australia

Prevention Treatments, policies

Innovation

“We all want the best health care for ourselves and

our families. But coping with the rising cost of health

care is towards the top of budgetary concerns for

many countries, including Australia.”

Department of the Treasury, 2010. Intergenerational Report

2010. Australia to 2050: future challenges, Australian

Government: Canberra pp. xv-xvi. Accessed on 13 June 2014 at:

http://archive.treasury.gov.au/igr/igr2010/report/pdf/IGR_2010.

pdf

2010 Intergenerational Report, Australian Government

Can research be used more effectively to

restrain/reduce costs ?

“Healthy, wealthy and affordable: How research can improve Australia’s health system”, NHMRC CEO Research Newsletter - 18 June 2014 http://www.nhmrc.gov.au/media/newsletters/ceo/2014/healthy-wealthy-and-affordable-how-research-can-improve-australia-s-healt

Research to reduce costs Buchbinder, R., Osborne, R.H., et alia, A Randomized Trial of Vertebroplasty for Painful Osteoporotic Vertebral Fractures, MJA 361(6) 6 August 2009: 557-568

Found that vertebroplasty (bone “cement” for vertebral fractures) was no better than a sham procedure

Research to reduce costs NHMRC Program Grant: Runciman, W., Hunt, T., et alia, CareTrack: assessing the appropriateness of health care delivery in Australia, MJA 197(2) 16 July 2012: 100-105

Identified many areas of healthcare where there is significant wastage, additional costs and sometimes unnecessary suffering; • Over-prescription of antibiotics, particularly for sinus and

throat infections • Surgical site infections, 84% of cases were administered

antibiotics too late to prevent wound infections.

Research to reduce costs Finfer, S., Bellomo, R. et alia (the SAFE Study Investigators), A Comparison of Albumin and Saline for Fluid Resuscitation in the Intensive Care Unit (NEJM 350(22): 2247-2256) “In patients in the ICU, use of either 4 percent albumin or normal saline for fluid resuscitation results in similar outcomes at 28 days.” If implemented, estimated saving of $700M pa (Access Economics report for VIC Neurotrauma Initiative June 2009)

Research to reduce costs Cooper, D.J., Rosenfeld, J.V., et alia, Decompressive Craniectomy in Diffuse Traumatic Brain Injury (NEJM 364(16): 1493-1502)

“In adults with severe diffuse traumatic brain injury and refractory intracranial hypertension, early bifrontotemporoparietal decompressive craniectomy decreased intracranial pressure and the length of stay in the ICU but was associated with more unfavorable outcomes.”

Change in clinical practice would save more than $100M pa(MJA 194(9): 437-8)

HOMEOPATHY

NHMRC literature review: “the available evidence

is not compelling and fails to demonstrate that

homeopathy is an effective treatment for any of the

reported clinical conditions in humans”

https://www.nhmrc.gov.au/_files_nhmrc/file/your_health/complementary_medici

nes/nhmrc_homeopathy_overview_report_october_2013_140407.pdf

How to gain the health benefits of research> How to use research to restrain costs – in Australia’s largest service “industry”?

Strategic Review of Health and Medical Research | Full Report | February 2013 p17

Australia has around 100 ASX listed biotech companies, with a current estimated value of around $50 billion AusBiotech, 2014. Investment Fast Facts: Investment Opportunities. Accessed on 13 June 2014 http://www.ausbiotech.org/content.asp?pageid=146

Australian Life Sciences Index

• had consistently outperformed (by a large margin) All Ordinaries Index of the ASX, and

• had outperformed the NASDAQ Composite Index

Pricewaterhouse Coopers (2012)

Strategic Review of Health and Medical Research | Full Report | February 2013 p14

Biotech companies in Australia employ

around 13,000 employees (three times as

many as in Canada)

Robins, B. 2014. How biotech finally boomed, The Sydney

Morning Herald, 4 January 2014.

Photo: University of Michigan

Scientific America’s Worldview

Scorecard (2013) ranked Australia:

• 7th in the world in biotechnology, up from 10th the

year before.

• best in world for the “best growth in public markets”

and

• second globally for “greatest public company

revenues”.

An economic analysis found CSL

• contributed over $2.5b to the Australian economy in

2012-13 (direct and multiplier effects)

• employed 1,851 people directly, and supported another

7,819 jobs in other industries which generated $866

million dollars in household income.

• invested around $200 million into R&D in Australia.

Source: Medicines Australia http://medicinesaustralia.com.au/2014/08/05/falling-exports-call-for-new-medicines-

industry-strategy/#more-12287

Development Grants Review

Independent, commissioned assessment of the outcomes from NHMRC Development Grants http://www.nhmrc.gov.au/_files_nhmrc/file/media/media/rel12/nhmrc_development_grants_review_april_public_121122.pdf

40 completed grants surveyed: • 85% reached complete or partial proof of concept at

completion of the grant; • 80% had secured a commercial partner (mostly Australian

biotech firms); • 55% are currently under some form of possible commercial

development; and • 6 have resulted in product to market or are awaiting

regulatory approval

……………and more to be done

• integrity in research

• “irreproducibility”

• women leave health and medical research

• access to the findings of publicly funded research

• build breadth, depth, collaboration, international

AUSTRALIAN MEDICAL RESEARCH QUALITY

“Measuring Up”

NHMRC Bibliometric Report 2005 - 2009

• Analysis of all Australian publications indexed in Thomson Reuters’

Web of Science database

• NHMRC-supported publications

– more than 30% total (26% in 2002-2006)

– relative citation impact 60% higher than the world average

– 40% involved international collaborations

– 2.8% in top 1 % cited papers world-wide.

www.nhmrc.gov.au

nhmrc@nhmrc.gov.au