Table Of Content

Measuring Expenditure R&D >n Health-related CepvngniMl ©OECD,2001. ©Software:1987-1996,AcrobatisatrademarkofADOBE. Aallenlnddriiangnhgyt,sherilreeisnmeger,vntetdrs.antOshmEeirCsesDoifognlriakonertsdainysyoturoittbhhueterirocingohoptfyartoingyuhsdteaetdoanmoeartcesoroipfaytlw.oafrethiisspPrroohgibriatmedf.orYyoouurmupsertstorneaalttuhseePornloyg.raUmnaauntdhoarsissoecdiarteepdromdautcetriioanl,s Allrequestsshouldbemadeto; OHeEaCdDoPfuPbulbilciactaitoinosnSserSveircvei,ce, 27,57r7ue5APnardirse-CPeadsecaxl,16,France. Measuring Expenditure on Heaith-reiated R&D OECD((9 ORGANISATIONFORECONOMICCO-OPERATIONANDDEVELOPMENT ORGANISATIONFORECONOMICCO-OPERATION ANDDEVELOPMENT forcePounrs3u0atnhtSteopArtteimclbeer1oif9t6hl,eCthoenvOerngtainoinsastiigonnedforinEPcaorinsomoinci4Ctoh-oDpeecreatmiboenra1n9d60D,eavnedlwohpimcehncta(mOeEiCnDt)o shallpromotepoliciesdesigned: -toachievethehighestsustainableeconomicgrowthandemploymentandarisingstandardof livinginMembercountries,whilemaintainingfinancialstability,andthustocontributetothe developmentoftheworldeconomy; -tocontributetosoundeconomicexpansioninMemberaswellasnon-membercountriesinthe processofeconomicdevelopment;and -tocontributetotheexpansionofworldtradeonamultilateral,non-discriminatorybasisin accordancewithinternationalobligations. TheoriginalMembercountriesoftheOECDareAustria,Belgium,Canada,Denmark,France, Germany,Greece,Iceland,Ireland,Italy,Luxembourg,theNetherlands,Norway,Portugal,Spain, Sweden,Switzerland,Turkey,theUnitedKingdomandtheUnitedStates.Thefollowingcountries became Members subsequently through accession at the dates indicated hereafter: Japan (28thApril1964),Finland(28thJanuaryJ969J,Australia(7thJuneI97J),NewZeaJand(29thMayI973J, Mexico(18thMayI994J,theCzechRepublic(21stDecemberI995J,Hungary(7thMayI996J,Poland C(2o2mnmdisNsoivoenmbofetrhe199E6uJr,oKpoeraenaC(1o2mtmhuDneictieemsbetrak1e9s96pJaratnidntthheeSwloorvkakoRfetphueblOiEcC(1D4t(hArDtieccleem1b3eorft20h0e0JO.ETChDe Convention). ©OECD2001 Permissiontoreproduceaportionofthisworkfornon-commercialpurposesorclassroomuseshouldbeobtained throughtheCentrefran^aisd'exploitationdudroitdecopie(CFC),20,ruedesGrands-Augustins,75006Paris, pp2F7ee2r5ra2r7mn7mcRi5iesos,Psssaiitreoeoiwlnsn.otC(oose3dh3rd-oee1upD)xlrr4ido1v4d6e,ub0,c7eFerD4aooa7nrbnc7ttve0ra.e,airnfsnsa,elxadt(M3et3Aa-hl1rl}o0ou14rg69ph2a33r4tt6hUo7efSAt1Ch,9io,spfoyborrroioeCgkvChestCrhyoCOuclnoleludainrnbtaeern:ycmeewaxwdcwCe.eecpntottopeytOrrh,iEegChCUtDun.iscPtotumeob.dlmieSActrlaalttiSeooesnt,rshv,eiIc2rn,et,rahupee(p5lUA0inn8cid)atr7tee5i-d0Po-anS8sts4ca0atf0leo,,sr FOREWORD Thisbookoriginatesfromanexerciseundertakeninco-operationbetweenStatisticsCanadaand theOECDWorkingPartyofNationalExpertsonScienceandTechnologyIndicators.Itsobjective wastobuildontheexistingworkattheOECD,supportedbytheFrascatiManual,toimprovethe coverage,qualityandcomparabilityofdataavailableonhealthR&Dforinternationalcomparison.As partofthisexercisetencountries[Australia,Austria,Canada,Denmark,France,Israel,Norway, Spain,theUnitedKingdom(England)andtheUnitedStates]providedpapersontheirnationalhealth R&Dsystemsandfundingdataandareviewofthemaininternationalsourceswasundertaken.An informalworkshopwasheldon10March2000todiscussthemainmeasurementissuesrevealedby thesepapersincluding: • Identifyingandcomparinghealth-relatedR&DingovernmentR&Dbudgets. • MeasuringtheresourcesdevotedtoR&Dinhospitals. • IdentifyingtheborderlineissuesofR&Dassociatedwithclinicaltrials. • Measuringandcomparinghealth-relatedR&Dinthegovernment,privatenon-profitand highereducationsectors. • Identifyingandcomparinghealth-relatedR&Dinthebusinessenterprisesector. • OtherclassificationsofhealthR&D. compaTrhabeilifitrystopfarttheofdatthaeobnoohkealidtehn-triefliaetsedanRd&DillucsutrrarteenstlytheavamialianbleprforbolmemsOEoCfDintaenrdnatoitohnaelr internationalR&Dandhealthdatasources.Itincorporatesthediscussionpapersandgivesmany illustrationsfromnationalsources. R&DPairnthIoIscpoitvaelrss,tahendnamteioansaulripanpgerRs&wDhicbhyrpeevresaolnssowmiethcommulmtoipnlepreacotcicvuitpiaetsiosnpsre(andotoavbelyrmveearsyurlionngg hours)andotherscausedbynationalspecificities,suchasemploymentpracticesorcomplexrelations betweentheinstitutionsandteamswhichmakeuptherespectivenationalhealthscienceand innovationsystems. ThereportispublishedontheresponsibilityoftheSecretary-GeneraloftheOECD.Supportfrom theGovernmentofCanadathroughStatisticsCanadaisgratefullyacknowledged. 3 TABLEOFCONTENTS Parti ANASSESSMENTOFNATIONALANDINTERNATIONALPRACTICESFORCOMPILING DATAONHEAETH-REEATEDRESEARCHANDnEVEEOPMENT Chapter1. IAdpepnrtoipfryiiantgioannsdaCnodmpOaurtlianygsHfeoarltRh&-Dre:laGteBdARO&RDDinGovernmentBudget AlisonYoung 11 Chapter2. CompilingPerformer-reportedHealthGERD AlisonYoung 23 Chapter3. CIlmipnriocvalinTgriNaalstiaonndalRS&urDveiynsHoasnpditTahlesirInternationalComparability: AlisonYoung 43 Chapter4. OtherViewsandClassificationsofHealth-relatedR&D AlisonYoung 49 PartII NATIONAI.EFFORTSTOMEASURERESOURCESFDRHEAETH-REEATEDR&D Chapter5. HealthResearchandExperimentalDevelopmentinAustralia DerekByars 79 Chapter6. MeasuringHealthR&DinAustria KarlMessmnnn ...I0!I Chapter7. EstimatesofGrossExpendituresonR&DintheHealthFieldinCanada PaulMcPhie 121 Chapter8. R&DintheDanishHealthSector HenrikTraelsenandKarenSiime 127 Chapter9. EstimatingHealth-relatedR&DExpenditureinFrance MoniqueBonneau 169 Chapter10.MeasuringResourcesDevotedtoHealth-relatedR&DinIsrael SoliPelegandNavaBrenner 175 5 Chapter11.MeasuringHealthR&DinNorway SmanneLehmannSundnes 193 Chapter12.ResearchintheSpanishHealthServices CarlosAngulo 203 Chapter13.MeasuringHealth-relatedR&DintheUnitedKingdom FionaRussellandDerekGardiner 207 Chapter14.EstimatesofHealthR&DExpendituresintheUnitedStates:AnExploratory DataCompilation .fohnE..Jankowski 213 6 PartI ANASSESSMENTOENATIONALANDINTERNATIONALPRACTICES EORCOMPILINGDATAONHEALTH-RELATEDRESEARCHAND DEVELOPMENT by AlisonYoung ConsultanttoStatisticsCanada Introduction Thedemandforinformation Theimportanceofthecontributionofscienceandtechnologytoimprovinghumanhealthiswidely accepted. Science,technologyandhumanhealth cHeanltluroyf.alSlotmheegoafintshesInehguaimnasnhlaifveeerxepseuclttaedncdyiroefctltyhefrpoamstthseeviemrparlotvheomuesnatnsdinyeeacrosnohmaivceaonccdurerdeudcatiniotnhails standardsthathaverecentlytransformedthemateriallivesofmost-butfarfromalloftheworld’s population.Improvementsinincomeandeducationaccount,however,foronlypartofthiscentury’s orufenmdUaeSrrkDa5b50l0eye0ia0rmspp;rerotvoceadmpaeiyntattsh(ieninpnhuueramclbtheha.rsiAntisgthcpeloowtsueerrntaoodf7jt5uh.seteWcdehnyftourrthyiinsftlhaeetinpoone)rompwlooeuuslodfdaihfacfvoeeurnethnrcayedwaaifttlheifreanceoxinptnercocoltmlaienncglyevfeoolrf income?Importantasincomeandeducationundoubtedlyare,anotherfactor-advanceinscientific knowledgeanditsapplicationbothincreatingpowerfulinterventionsandinguidingbehaviour-has, perhaps,becomemoreimportant. Source:WHO(1996),InvestinginHealthResearchandDevelopment notaTnheesatdabvlainscheedinsestcieonftiifnitcekrnnaotwiloneadlgleymceonmtpiaornaebdleabhoevaelthr-esruelltastefdroRm&RD&Ddataac,tivwihtiiecsh.Tcoandabtee,utsheerdetios describeandunderstandthisphenomenonandtoaidpolicymakersinprioritysetting.Thisfirstpartofthe bookreviewstheexistinginternationalsourcesandongoingplansinordertoidentifywhatinformationon R&Disalreadyavailableorinthepipelineandexaminesthemainproblemsofinternationalcomparability withillustrationsforselectedcountries. 7 Itreviewsthreeframeworksandsourcesofdataonspendingonhealth-relatedR&D: • Scienceandtechnologypolicy,indicatorsandunderlyingsurvey. • Healthpolicy,indicatorsandunderlyingsurvey. • Specialstudiesofhealthresearch. ofheaIlntht-hreefliartstedtwRo&cDasewsitthhienmtohsetsttahtaitstciacanlbfereaxmpeewcotrekdcisontcoegrenteda.geInnetrhaeltphiicrtdurceasoeftahegrleeavteelraantdtesmtprtucmtuarye bemadetoobtainfullcoverageandtousespecificclassifications. Aframeworkforinternationalcomparisons firmSdeifnicneittihoensreovfiheewalitshofRe&xDistainngdniatstimoanialnacnodmpionnteernntast.ioWnahlasturavreeynseaenddedsoaurrecegsauogneescfaornnmoetasbeugriinngwitthhe coverageandcomparabilityofthedataavailable. TheNationalHealthScienceandInnovationSystem FirstitisusefultostartwithanoverallviewofthewayhealthR&Disorganised.Eachcountrymay besaidtohaveaNationalHealthScienceandInnovationSystem(NHSIS),i.e.thesetofinstitutions,teams andindividualswho,jointlyandindividually,create,storeandtransfertheknowledge,skillsandartefacts whichdefinenewandimprovedhealthproductsandinterventionsandmoreefficientwaysofdelivering them?Thissystemoperatesattwolevels,thedistinctinstitutionsandmajorprogrammesandbelowthema complexnetworkoftopics,teamsandprojectswhicharetheactual“elementsinacollectivesystemof creation,transfer,anduse”^ofhealthrelatedknowledge. Thesame“core”typesofinstitutions(medicalresearchcouncils'*,medicalfaculties,hospitals, pharmaceuticalcompanies,health-relatedcharitiesetc.)existinmostcountries.However,thewaytheyare oi“nprsegtraiintpiuhtseierodanlsahnwedhailtcthhheiRrf&urnDedlaitonirsvtepiteiurtmfipooonrrsmt”asmnocaemyevbaehreimaealstihnflrRyo&imnDvcoolauvlnettdhroyiungthhoeatclhotiushnctairsrye.noatFnudrthdteohier(rommroaraireneteahxcetprieevcittayer.detToohtedhsoee)r relativelylittleR&D(non-universityhospitals).TheymaydosomehealthrelatedR&Dinconnectionwith tdhoeibrasmiacirnesaectairvcihtywh(ihecahltmhaayndhasvaefehteyalatthnaupcplleiacrateisotnasbl(igsehnmeernatls,remsielairtcahrycomuendciilcsi)n.eRb&yDthesuarrvemyesdmfaorycecso)veorr onlythecoreinstitutions,oralsotheperipheralones.Someverydetailedonesmayreach“topics,teams andprojects”. 1. TRh&erDewahriecohthiesrthientteorpniactioofnaalnostohuerrceSstaatinsdtifcrsaCmaenwoardkas/.OTEhCiDspacatpievirtyd.oesnotexaminedataonbiotechnology 2. BasedonMetcalfe(1995)asquotedinOECD(1999a)andGlobalForumforHealthResearch(1999). 3. Smith(1996)asquotedinOECD(1999a). 4. Givenrecentchanges“HealthResearchCouncils”wouldbemoreappropriate.Forexample,since1992the AustralianHealthResearchCouncil,andin2000theCanadianInstitutesofHealth. 8 DistinguishingbetweenR&Dandnon-R&Dactivities R&DDiafnfderoetnhtersoacutricveitsiepsl.acethebordersofhealthR&Datdifferentpoints.Thefirstboundaryisbetween ThedefinitionofR&DforsurveypurposesdatesbacktotheUnitedStatesinthemid1950’s.Ithas changedlittlesince^.TheversionusedbyOECD/Eurostat/UNESCOisasfollows: Researchandexperimentaldevelopmentcomprisecreativeworkundertakenonasystematicbasein ordertoincreasethestockofknowledge,includingknowledgeaboutman,cultureandsociety,andtheuse ofthisknowledgetodevisenewapplications ofdeVpiarrttuuarlel.yRall&tDhecsaonurcbeesdeixsatmiingnueidshiendthfirsopmapoetrheurseatchtiisvidteifesinictairornieodrsouotmeitnhitnhgevHeeraylltihkeSictiaesncaepoainndt Innovation System. These other activities include: education and training; other scientific and technologicalactivities,(scientificandtechnicalinformationservices;generalpurposedata-collection; testingandstandardisation;feasibilitystudies;patentandlicencework;policy-relatedstudies;routine risaSdeon&egfdnuTttlwoiaaaftrrcyhteemiRrvedid&etsiivuDecepsalpolowonphrlcmtiayeicrnnhewtgh)aae;racrcettieoinvtviehiitteetiirediesses.i.dandSntIuoonsiutbnrrtudcihieeaelplsdecanumacdpstaeieytnvhitoteafiatenctsahteteilmivaeiopltanttyadh,li-trnoocegraldpatimatosacetidytitneyRgccuhot&inovsoDehulrnoRdgibtie&ocrtmatDhulaskRiftenr&nhoaeDomlavslaopattlrhilb-ooerptneehldreaaisntaseedtndidaanRcdtgt&imuhviDioinsts.ihieseestdr,realfmtaritaooeymdn Distinguishingbetweenhealth-relatedR&DandotherR&D InthewidestsenseweareinterestedinallR&Dwhichisrelevanttohumanhealth.Herethereareno generallyacceptedinternationaldefinitionsorguidelinesoncoverage.“Therearefew(ifany)areasof investigationswhichcan“logically”beexcludedfrompossiblerelevancetohealth-perhapscosmology” (Wilk,1996).Coveragediffersbetweensources,dependingontheaimsofthedesigners/usersandalsoon thetypeofsurveyapproachadopted.Theterm“relevance”canbedefinedusingdifferentcriteriaandits coveragecanbeextendedalongseveralaxes. • Howfar“back”upthechainthesourceconcernedgoesforlongtermresearch,whichmayhave healthapplications,notablyinthefieldofbiology. • HowfaritincludesR&Dontheriskfactorsforill-health(smoking,diet,socialexclusion,etc.) • HowfaritincludesR&Donmethodsofmanaginganddeliveringnewandimprovedhealth productsandinterventionsandtheassociatedgovernmentpolicies. Apparentandactualexpenditureonhealth-relatedR&D GiventhelackofanagreedsetofhighqualityhealthR&Ddatatounderpininternational cdaoonmidpnagtrrseiaostoitnnhsge,ytthahreeomsreaesdsuepcerekodixnitgeospfoifrcorksitunhcgehohudetaatltahtehhiaRmv&meeDdtioianctdoeimlcpyaitalovreasitlthahbeelmyewfaornoudmlodbvvarireoailuolusyshleiiankltetehrt-noraetclioaotmneapdlarRseo&ubrDceetsswe.reieIenns countries.Thisreportexamineswhetherthese“apparenthealthR&Dexpenditure”seriesare,infact. 5. ThisgeneraldefinitionfirstappearedinthesecondversionoftheFrascatiManualpublishedin1970. 9