The Economic and Human Dynamics of Texas Medical Research
Cover Story - May 2000
By Laurie Stoneham
Just as the science of medicine is promising to change the course of human life, Texas academic health centers are discovering that biomedical research can offer sweet financial rewards for those daring and savvy enough to endure its rigors. The impact of these innovations is felt far beyond the walls of academia and is spawning an increasingly important economic segment for the state. But while this frontier holds enormously important answers for mankind, it is also rugged, unforgiving territory riddled with very real dangers that fewer and fewer physicians are willing to enter and explore.
Speaking before the Senate Health Services Committee, chaired by Sen Jane Nelson (R-Flower Mound), William Neaves, PhD, captured the essence of the state's position in what he calls "the impending genetic revolution." Dr Neaves, executive vice president for academic affairs at The University of Texas Southwestern Medical Center at Dallas, said genetic research is a "development that will mark the beginning of the 21st century so dramatically that people for centuries to come will look back on it as a pivotal moment in human history. The signal event of this revolution -- the sequencing of the human genome -- will trigger the ultimate transformation of medicine. Scientists at Texas institutions are on the vanguard of this revolution."
Leading the world
Texas is indeed recognized throughout the world for its groundbreaking basic and clinical research. The University of Texas M.D. Anderson Cancer Center in Houston has transformed the understanding, detection, and treatment of the world's deadliest disease. The San Antonio Cancer Institute, a consortium of the Cancer Therapy & Research Center and The University of Texas Health Science Center at San Antonio, participates in most of the clinical trials of cancer drugs approved by the US Food and Drug Administration (FDA). Research under way at Texas A&M University System Health Science Center is looking at novel medication delivery methods, including edible plants. Investigations at The University of Texas-Houston Health Science Center focus on unique approaches for detecting, treating, and reversing heart disease. The University of Texas Health Center at Tyler tracks a vaccine for tuberculosis and other acute lung disorders. Baylor College of Medicine is an international leader in the Human Genome Project. (See "Research in Texas.")
The nature of medical research is expanding so rapidly that attitudes and associations have to change for researchers to stay in the game. Scientists can no longer work in ivory tower isolation. Basic research must not only hold hands with clinical research, but the disciplines also must be married in an environment that respects and nurtures both. So medical schools are creating or reengineering infrastructures that enable scientists and clinicians to work together to improve the research efforts and accelerate the commercialization of ideas that have market (revenue-producing) potential.
Multidisciplinary approaches and partnerships are being employed. For example, Texas Tech University Health Sciences Center clinicians are teaming with engineers to develop a virtual computer program to train young surgeons and formulate new biomaterials to use in joint replacement surgeries.
Alliances with other academic institutions and private drug and medical device manufacturers from around the country are increasingly common to support and propel advancements.
If an idea appears capable of bearing commercial fruit, universities can use systems already in place to foster further development. Intellectual property committees weigh the return on investment opportunities and define strategies to either license the invention to an existing company in return for royalties and licensing fees or to let the concept form the basis of an independent spin-off company.
Universities have created so-called "technology transfer organizations" to take research from the laboratory to the marketplace. While such ventures are expensive, the risks can be richly rewarding, generating new sources of revenue desperately needed in light of medical school funding formulas that shift with the continually changing government allocation and private reimbursement patterns.
According to the Texas Healthcare and Bioscience Institute (THBI), income generated from royalties, licensing agreements, and other intellectual property transactions at Texas health-related institutions increased from $4.2 million in 1993 to $12.4 million in 1997. Since then, the revenue stream from medical innovations has become even more impressive. Dennis Stone, MD, vice president for technology development at UT Southwestern, estimates this revenue will reach nearly $10 million this year at Southwestern alone.
Chrysalis BioTechnology, Inc, is the first spin-off company to emerge from The University of Texas Medical Branch (UTMB) at Galveston. Founded in 1995, the company is conducting Phase II clinical trials for its lead product, Chrysalin, for treating diabetic ulcers. UTMB holds an equity position in Chrysalis and will receive royalties based on the company's revenues.
Incubators that focus on biotechnology opportunities are springing up around the state. One such organization, Fort Worth MedTech Center, Inc, offers inventors comprehensive business support. "We provide proactive business assistance through mentoring organizations that help launch the venture with such things as a business plan, accounting, legal guidance, insurance coverage, etc," said Warren H. Webb, the facility's president.
Private organizations around the state, such as The Dallas Plan, also recruit and foster the growth of biotech companies that can create new regional economic structures that promote and support biotechnology in their regions.
The broader economic perspective
Biotechnology offers huge potential for the state. THBI President Tom Kowalski summarized what's on the horizon for Texas. "When you look at what's being captured through technology transfers from our universities, what's currently in the pipeline, and what's flowing into the state, there is no question that we're headed for global destinations."
Senator Nelson echoed that sentiment. "Texas has one of the world's largest economies, a friendly business climate, wonderful universities, a huge pool of medical talent, and perhaps an even larger pool of technology wizards. We can and should be a worldwide player in this industry."
The human price
While the science of medicine is blazing new trails that promise giant leaps for mankind, what's lacking is not technology, it's manpower. Choosing research as a career path is falling out of favor among medical students. The financial realities of medicine make academia a less attractive option.
Robert Gracy, PhD, dean for research and biotechnology at the University of North Texas Health Science Center at Fort Worth, notes that the pressures on these physicians are so great, they can't be as versatile or as effective as they once were. Twenty years ago, he says, a physician could become "a 'triple threat,' someone who had an outstanding research lab, a clinical practice, and teaching position. The practice of medicine has become so complex and each of those areas has become so demanding that it's impossible for any one person to excel in all these areas anymore."
But research is too vital to be allowed to dangle in stagnation or fall by the wayside. "Part of our challenge is to recruit promising physicians onto the pathway and provide mechanisms for the best and brightest to become clinical scientists," said Jim Patrick, PhD, vice president and dean for research at Baylor College of Medicine. (See "Careers of Discovery.")
In his convocation speech earlier this year, John P. Howe III, MD, president of UT Health Science Center at San Antonio and former TMA president, quoted one of medicine's boldest frontiersmen, Dr Albert Schweitzer, who said, "The final decision as to what the future of a society shall be depends not on how near its organization is to perfection, but on the degrees of worthiness in its individual members."
Dr Howe concluded, "This is what the research mission in this decade, for our health science center, is all about."
Those remarks ring true for every medical school in the state.
Laurie Stoneham is a freelance writer in Austin.
Research in Texas
Careers of discovery
Following through: Public health research takes science out of the labs and to the people
The science of success: Research means revenues for Texas
Technology transfer organizations
Research on the Web
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