title: Burden of disease, research funding and innovation in the UK: Do new health technologies reflect research inputs and need?
abstract: OBJECTIVE
  New and emerging health technologies (innovation outputs) do not always reflect conditions representing the greatest disease burden. We examine the role of research and development (R&D) funding in this relationship, considering whether areas with fewer innovative outputs receive an appropriate share of funding relative to their disease burden.
  
  
  METHODS
  We report a retrospective observational study, comparing burden of disease with R&D funding and innovation output. UK disability-adjusted life years (DALYs) and deaths came from the World Health Organization (WHO) 2004 Global Burden of Disease estimates; funding estimates from the UK Clinical Research Collaboration's 2006 Health Research Analysis; and innovation output was estimated by the number of new and emerging technologies reported by the National Institute for Health Research (NIHR) Horizon Scanning Centre between 2000 and 2009.
  
  
  RESULTS
  Disease areas representing the biggest burden were generally associated with the most funding and innovation output; cancer, neuropsychiatric conditions and cardiovascular disease together comprised approximately two-thirds of DALYs, funding and reported technologies. Compared with DALYs, funding and technologies were disproportionately high for cancer, and technologies alone were disproportionately high for musculoskeletal conditions and endocrine/metabolic diseases. Neuropsychiatric conditions had comparatively few technologies compared to both DALYs and funding. The relationship between DALYs and innovation output appeared to be mediated by R&D funding.
  
  
  CONCLUSIONS
  The relationship between burden of disease and new and emerging health technologies for different disease areas is partly dependent on the associated level of R&D funding (input). Discrepancies among key groups may reflect differential focus of research funding across disease areas.
authors.affiliation: Clinical Senior Lecturer, NIHR Horizon Scanning Centre, University of Birmingham, UK.
authors.forename: Derek
authors.initials: D
authors.lastname: Ward
authors.affiliation: Research Fellow, NIHR Horizon Scanning Centre, University of Birmingham, UK o.i.martino@bham.ac.uk.
authors.forename: Orsolina
authors.initials: O
authors.lastname: Martino
authors.affiliation: Clinical Senior Lecturer, NIHR Horizon Scanning Centre, University of Birmingham, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Packer
authors.affiliation: Research Fellow, NIHR Horizon Scanning Centre, University of Birmingham, UK.
authors.forename: Sue
authors.initials: S
authors.lastname: Simpson
authors.affiliation: Professor of Public Health, Department of Public Health, Epidemiology & Biostatistics, University of Birmingham, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Stevens
mesh_terms: D020811:Biomedical Technology / Q000639:trends*; D017281:Cost of Illness; D006801:Humans; D019057:Quality-Adjusted Life Years; D012106:Research; D012189:Retrospective Studies; D006113:United Kingdom
keywords: burden of illness; funding; innovation