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A Case for Spinal Cord Injury Research Funding

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    A Case for Spinal Cord Injury Research Funding

    Here is a statement that I recently wrote in support of funding spinal cord injury research:

    The Case for Funding Spinal Cord Injury Research
    by Wise Young, Ph.D., M.D.
    W. M. Keck Center for Collaborative Neuroscience
    Rutgers University, Piscataway, New Jersey, last updated 23 July 2005

    The worldwide economic costs of spinal cord injury probably exceed US$66 billion per year. Estimates of spinal cord injury costs in the United States range from $10-$12 billion per year for the medical care and support costs for about 250,000 people with severe spinal cord injuries. Average medical care costs of people with spinal cord injury average about $22,000/person-year. If we assume that the worldwide prevalence of spinal cord injury is about 3 million people and each cost US$22,000 per year for medical support, this adds up to $66 billion per year.

    These economic costs do not reflect the human cost of spinal cord injury. The modal (the most common) age of spinal cord injury is 19 and the median age of spinal cord injury is 26 (half of spinal-injured people are 26 or less). Due to improved medical care, over 90% of people with spinal cord injury who survive one year or more after injury go on to live over 40 years with sensory loss, paralysis, bowel-and-bladder dysfunction, spasticity, and pain. Although the incidence of spinal cord injury is thankfully low (on the order of 20/100,000), it produces more person-years of disability than other more common diseases.

    We currently spend less than 1% of the costs of spinal cord injury on research that has the potential to restore function. For example, despite the >$10 billion cost of spinal cord injury care and support costs in the United States, the National Institutes of Health (NIH) and private foundations fund less than $100 million of spinal cord injury research to restore function to people with spinal cord injury. In the past decade, many of the world’s best scientists have become convinced that the spinal cord can regenerate. Many therapies have been reported to regenerate and restore function in animal spinal cord injury models.

    Spinal cord injury not only affects those with injury but their families as well. Family members or other caretakers care for most people with spinal cord injury. For every person who is spinal-injured, one or more caretakers are affected. Employment of people with spinal cord injury is hovering about 20% in most countries. Spinal cord injury impoverishes families economically. Therapies that restore function and reduce disability should have substantial salutary effects on the economy not only by reducing expense but also by saving of human resources. These benefits are seldom included in the calculation of the benefits of spinal cord injury research. Restoration of function to even 10% of the people with spinal cord injury has the potential to save many billions of dollars of care costs and human resources over years.

    The human costs of spinal cord injury are incalculable. Spinal cord injury is essentially the disconnection of the brain from the body. While many people think that paralysis is the main consequence of spinal cord injury, other consequences are equally or more devastating. In addition to sensory loss and pressure sores from not being able to feel damage to skin, many people with spinal cord injury suffer from serious pain, including neuropathic pain for which there is currently no effective therapy. Loss of bladder and bowel function not only wreaks havoc with the ability of people to have normal social lives but also is life-threatening. Spasticity, muscle and bone atrophy, high incidences of gallbladder disease, loss of temperature control, compromise of sexual function, and many other complications of spinal cord injury cause much suffering.

    Most scientists agree that it is not a matter of if but when a cure for spinal cord injury will be developed. Dozens of therapies have been shown to regenerate the spinal cord and restore function of animals. Because spinal cord injury is considered a small, low-profit, and high-risk market, few pharmaceutical and biotechnology companies are investing significantly into clinical development of spinal cord injury therapies. Many companies are already making a great deal of money from drugs, devices, and supplies for spinal cord injury. Hence, there is little financial incentive to invest in such restorative therapies for spinal cord injury despite the hope and promise for such therapies. On the other hand, companies are interested in developing therapies for spinal cord injury that can be extrapolated to other medical conditions.

    Who are the main benefactors of curative therapies for spinal cord injury? While most people would name insurance companies as the primary benefactor, this is not true because insurance companies simply pass the costs to people who pay insurance. In most countries, the government pays much of the costs of spinal cord injury care. These costs are rising at the rate of 5-10% every year due to the increasing cost of medical care. The cost of spinal cord injury research is low compared to the cost of care and support for spinal cord injury. Most countries spend less than 1% of the cost of caring for spinal cord injury on research that will provide cures for spinal cord injury. A single curative therapy that restores function to even 10% of people with spinal cord injury would return a savings of more than a billion of medical care and welfare support per year in the United States alone. These are not just one-time savings but continue year after year. Society and taxpayers are thus the primary benefactors of a cure for spinal cord injury. Government and private foundations therefore should support spinal cord injury research.

    Christopher Reeve once said that he could accept it if scientists told him that a cure of spinal cord injury is impossible but he cannot accept it if the main obstacles to achieving a cure are lack of funding and politics. Unfortunately, he died before his goal of curing spinal cord injury was achieved; reminding us that time is of the essence. Every year that we delay our investment in research, many people must suffer and people are dying. People cannot afford to wait. We must invest now and sufficiently to ensure rapid advances and efficient transfer of therapies from laboratory to clinical practice. The lives and hopes of millions depend on this investment.
    Last edited by Wise Young; 23 Jul 2005, 6:47 PM.

    Obvious question, but just want to confirm


    I take it you're happy for this article (attributed to you) to be used and quoted in any discussions with media, politicians etc.



      Yes, it was written off the cuff and I hope that you are happy with it. You are very welcome to distribute it. I wasn't sure that you wanted to be identified as the person who requested it. Every time I look and read it again, I make editing it. For example, I just changed it a bit. So, please use what is posted here rather than what I sent to you by private message. Thanks. Wise.
      Last edited by Wise Young; 21 Jul 2005, 12:19 PM.


        Wise - Perfect, excellent and thank you very much for writing the article.


          Originally posted by Wise Young
          You are very welcome to distribute it.
          Does this mean I can send it to the editorial departments of about four newspapers in Southwestern Ontario?
          Roses are red. Tacos are enjoyable. Don't blame immigrants, because you're unemployable.

          T-11 Flaccid Paraplegic due to TM July 1985 @ age 12


            Originally posted by lynnifer
            Does this mean I can send it to the editorial departments of about four newspapers in Southwestern Ontario?
            Lynnifer, of course, you may. I wrote this statement on request of Tom Barbour. I just edited the statement to include authorship, address, this website's URL, and date. wise.



              When I arrived here four years ago, my head was still struggling to get itself around the enormity of what had just happened to my family and my life. I remember vividly sitting right here at my desk, reading a very similar article and feeling convinced that if only enough people in power could hear your words, Dr. Young, they would be unable to continue to do nothing.

              In an effort to do my part, I made copies of that old piece and sent them out via email and snail mail to everyone I knew--and I have to say, four years later, I want a new plan. What you've said here is mind-bogglingly simple:

              The cure is within reach.
              The cure is far, far cheaper in dollars than the status quo.
              The cure is not going to happen until the research is funded.

              What else do they need to know? Why is it so difficult to get this 28-word message across? Is there disagreement about any of these sentences? Is it just pessimism and ignorance?

              I want a new plan.