The report in Wednesday's Journal of the American Medical Association comes amid heightened public attention to medical research because of liability lawsuits over the painkiller Vioxx, political debate over stem cell research and the untapped potential of curing or preventing disease through mapping the human genome.
"If we're soon going to be spending $100 billion a year, we'd better have treatments that work over a long period of time against diseases that are important today and will be more important tomorrow," said Dr. Hamilton Moses III, co-author of the study and chairman of the Alerion Institute, which conducts studies on research policy.
"If we don't know those conditions are satisfied, we can't judge whether we're getting our money's worth," he said.
The study is part of a special issue of JAMA devoted to the state of U.S. medical research. What emerges from the issue is a picture of an amorphous, mostly profit-driven system, where industry research focuses on existing drugs and lets discovery-stage research lag behind.
The authors call on the medical industry, government and foundations to do better at investing in research on diseases with fewer effective treatments, such as Alzheimer's, and at translating basic research into new treatments and cures.
The authors have ties to the industry, medical schools and health companies, doing consulting work and sitting on drug company boards, according to financial disclosures published with the study.