Canadian funding for health research has varied over the last few decades. Our work focused specifically on the magnitude of public/charitable funding on cardiovascular disease (CVD)-related research from 1975 to 2005. These sectors’ spending have increased over this 20-year period but mostly in the last decade. In particular, public/charitable sectors expenditures first rose after 1998, from $39 million to $48 million, and then again from 2000 onwards, from $72 million to just over $90 million.
A closer look at the composition of the public/charitable sectors expenditure trends over time show that the H&SF of Canada and the MRCC have been the main funders and drivers of CVD research in Canada during our analysis period (Figure
3). From 1975 to the mid-80s, the H&SF of Canada and the MRCC funded the majority of CVD-related research. After that, provincial agencies, such as the AHFMR and the FRSQ, started to gain importance. The ICRP and CFI became major funders in the later years of our analysis, after their creation.
This first major increase in CVD funding can be attributed to several factors. In 2000, the MRCC transitioned to the CIHR with a broader mandate and endowed with a larger budget
. In addition, after 1999 the H&SF of Canada started funding research chairs in cardiovascular and stroke research, providing additional funding for researchers
. Finally, the creation of both the CFI and the CHSRF in 1997 contributed to an increase in overall funding. The second major increase in funding can be explained, in part, by the creation of several other organizations. Genome Canada was established in 2000 to develop and implement a national strategy to support large-scale genomics and proteomics research. The ICRP followed in 2003.
Over our analysis period, public/charitable sectors expenditures increased by a factor of almost 7.5. However, compared to the UK, Canada has spent far less on total public/charitable cardiovascular-related research over the last 30 years. In particular for the public/charitable sectors, Canada spent almost $13 million on cardiovascular-related research in 1975 for a population of about 23 million – roughly $0.60 per person. The UK spent about $4.50 per person, 8 times the Canadian value for a population twice as large
. In 1992, seventeen years later, Canada spent about $1.42 per person on cardiovascular-related research, while the equivalent UK value was $4.23. The UK has traditionally spent more on research-related activities than Canada
, which largely explains this difference. Furthermore, this result may be due to different approaches in estimating expenditure data. Nonetheless, the gap in research expenditures between the two countries has decreased in the last years, attributed largely to creation of the CIHR and other research-funding organizations.
Other research reports that overall biomedical and health services research spending per capita in Canada in 1985 ($17) was slightly more than half that of the US ($30)
. More recent data also show that Canada spends substantially less on CVD-related research than the US. Data from the NIH (using the RCDC method) shows that for 2008 about $4.6 billion dollars (USD) were spent on CVD-related research (this includes atherosclerosis, cardiovascular, heart disease, heart disease – coronary heart disease, hypertension and stroke)
. (Unfortunately, we do not have the figures for 2005; however, it is likely that this value has not changed much.)
By international standards, the evidence suggests Canada spends less on health-related research than the UK and the US, at least in terms of absolute values; however, to fully gauge the impact of Canada’s research investment would require understanding how CVD research expenditures lead to changes in health. From 1994 to 2004, we witnessed a drop in the adult CVD-attributable death rate of about 30%
. The extent to which this is attributable to new research is unclear and beyond the scope of this analysis; these health gains are likely a result of not only research undertaken in Canada but also research undertaken elsewhere. However, new discoveries have undoubtedly played some role. An important area for further research is to quantify the relationship between expenditures and health gains, through a formal return on investment analysis
. Other jurisdictions, such as the UK, have undertaken such analyses and found that for every $1 spent on public/charitable CVD-related research, UK citizens would receive an income stream of about £0.09 per year in perpetuity. While this type of analysis would allow us to ascertain whether Canada is spending too much or not on research, this too is beyond the scope of this paper.
These estimates provide policy makers and the CEOs of granting agencies a depiction of funding trends in CVD research from not-for profit organizations; that is, it sheds some light on how public/charitable money has been spent on CVD-related research and where the funds have come from. There is an ongoing debate among policy makers regarding the government’s role in producing scientific and technical knowledge. One of the main issues concerns how much public money should be spent on scientific research and which areas of research should receive funding
. These figures can serve as important inputs in planning future research budgets and setting priorities for resource allocation in CVD research. Factors such as public health needs, scientific opportunities, the quality of research proposals, and the maintenance of staffing and infrastructure all need to be taken into account when deciding how to allocate funds
. Efforts to plan disease-oriented research activities are also influenced by projections of future patterns of disease and the effects of demographic changes (such as aging) and personal habits (such as tobacco use)
Several limitations of our analysis merit discussion. We attempted to estimate all cardiovascular research-related expenditures for public/charitable sectors. Although we may not have accounted for all expenditures, we captured most of them. More importantly, for most organizations we were able to account for all cardiovascular research-related activities, which enhanced the precision of our analysis. Our analysis also required making some assumptions in a few instances (such as linear interpolation) to reach our final estimates.
Notwithstanding these concerns, we believe that we have reached plausible estimates that not only improve our understanding of this topic but also provide substantial improvements over previous work. Buxton et al.’s time series of estimated public/charitable UK expenditures on medical research in cardiovascular disease was pieced together from a variety of sources and incorporated multiple assumptions and interpolations
. We believe that our estimates are more reliable for several reasons. First, we included a review of all grants, awards, fellowships and scholarships. Second, since the majority of our data were from the same source,c we can assume that the data used in our analysis have been reported consistently over time. Third, we employed few linear interpolations in our analysis. Finally, we also made fewer assumptions
. Thus, this study’s contributions to the field are two-fold: a detailed description of the health care funding landscape for not-for profit organizations in Canada and a consistent time series of public and charitable sectors expenditure estimates for Canadian CVD-related medical research from 1975 to 2005.