More than 2/3 of new medicines are created by biotech and in-licensed by pharma, and nearly every innovative biotech comes from academia. That’s because it takes years and years of sustained and consistent focus and perseverance on a basic biological problem to lead to innovative drugs. This is not something that pharma can usually support. Youtube Jim Allison and checkpoint blockade.
Yes, we can improve efficiency, but IMHO the NIH should come up with creative solutions to expand the pipeline and participate in the upside of medicines that it helps create, rather than severely cutting infrastructure for a key industry and opportunity for US growth.