Congress should commit to US biotechnology leadership
The House Select Committee on China is coming to Boston and Cambridge next week for events focused on the life sciences. The Chinese Communist Party is investing big in biotech. Some elements are salutary, like more funding for medical research. Some are nefarious, like the global harvesting of genetic data without consent. The committee wants to study how Congress should respond.
Massachusetts shows us how: by supporting talented people; by passing policy that promotes makers, not takers; and by providing biotech infrastructure.
First, people. The physician-scientist is the catalyst of biomedical innovation. Shuttling between the clinic and the laboratory, the physician-scientist builds practical wisdom by iteratively treating patients and conducting experiments. In the past year alone, therapies for heart disease, sickle-cell disease, and ovarian cancer have been launched by Massachusetts companies led by the “bench-to-bedside” praxis of physician-scientists.
The physician-scientists who founded or lead those three companies — Sekar Kathiresan, Reshma Kewalramani, and Baruj Benacerraf — all immigrated to the United States. This week’s border security backtracking by House Republicans shows they would rather campaign on immigration than govern on it. Washington, though, could still make modest progress in attracting foreign physician-scientists by adding them to the Labor Department’s Schedule A Group I occupations list for expedited visas.
Congress must also fund this talent. Curiosity-driven, peer-reviewed research is a public good that requires public investment. In 2020, House Republicans called to double science and technology funding. Now in the majority, they propose to slash nearly $4 billion from the National Institutes of Health, the world’s biggest supporter of biomedical research. Congress should reject that hypocrisy and instead aim for doubling national research and development intensity.
Two steps in the right direction would be to fully appropriate the basic research provisions of the bipartisan CHIPS and Science Act, which would unlock more public money for science, and reverse the Trump-era amortization penalty on research and experimental expenditures, which would unlock more private money for science and which just passed the House, with my support.
In supporting both public and private backers of R&D through appropriations and tax treatment, Congress should also encourage reforms. In particular, the NIH and nongovernmental institutes like Focused Research Organizations must better support young scientists, mid-career pivoters, and proponents of high-risk or cross-disciplinary ideas, all of whom struggle to get grants in an increasingly competitive but decreasingly productive university funding model. In renewing the Massachusetts Life Sciences Initiative, the state could model talent-boosting tactics by adopting a version of Fast Grants to kickstart talented individuals without a track record.
Talent responds to incentives. Every element of the biomedical ecosystem, from academic medical centers to biopharmaceutical companies to health insurers, features instances of “making” and “taking.” Makers create something new and valuable. Takers extract money without creating value. Congress should incent the makers within each industry and rein in the takers.
Rationalizing the Coordinated Framework for the Regulation of Biotechnology, as recently advised by the National Security Commission on Emerging Biotechnology, is one opportunity to reward biotech makers and discourage snake-oil salesmen, by simultaneously streamlining and toughening regulations. Another example is regulating pharmacy benefit managers, the middlemen of the drug supply chain who decide on behalf of insurance companies which drugs patients can access. The PBMs take billions in profits that should be directed to lowering patients’ out-of-pocket costs.
In addition to supporting talent and passing promaker policy, policy makers should also provide infrastructure and standards for the life sciences. Clinical trials are the most expensive phase of biomedical innovation and are getting costlier. Improving the efficiency and diversity of clinical trials would be a rising tide to lift all biomedical boats, and the Advanced Research Projects Agency for Health, which I helped site in Massachusetts, should make it a priority.
Another way to lift all boats is standardization, especially across bio-manufacturing, a growth sector for Massachusetts. Standardization of conventions, measures, and data reduces friction and amplifies US soft power in international industry, as it did for telecommunications.
Biotechnology is a global enterprise. The United States is leading, but China is catching up. It’s even surpassing us in critical areas like publications and patents. In response, Congress should focus less on China and more on Massachusetts. Life sciences leadership can’t be won through tit-for-tat gamesmanship. It must be earned through the cultivation of a dynamic ecosystem.
US Representative Jake Auchincloss represents the Massachusetts 4th Congressional District and serves on the House Select Committee on China.