An analysis of trials registered in ClinicalTrials.gov shows that the private sector is doing a lot more to advance pharmaceutical science than the government.

Don't be alarmed by that. Before a product can go to market, the manufacturer is required to prove safety and efficacy whereas government-funded trials are picked by a government committee and therefore not based on what may benefit the public. For that reason, it's not only good that the NIH is not funding a lot of trials, it's essential. Pharmaceuticals are one area of medicine that has not been taken over by government tinkering and if we look at the solar and wind industry, it is easy to see why it is better for everyone that the NIH stick to basic research.

The paper in JAMA was based on downloaded data from ClinicalTrials.gov. The authors searched for "interventional study" and obtained counts of newly registered trials by funder type: "NIH," "industry," "other U.S. federal agency," or "all others (individuals, universities, organizations)."

Examining data according to the first received date, the number of newly registered trials doubled from 9,321 in 2006 to 18,400 in 2014. The number of industry-funded trials increased by 1,965 (43 percent). Concurrently, the number of NIH-funded trials decreased by 328 (24 percent). During this period of relatively few trials being funded by other U.S. federal agencies, funding from the all others category increased by 7,357 (227 percent). In a random sample of 500 trials in this category, a majority (353; 71 percent) did not have U.S.­ based funders. From 2006 through 2014, the total number of newly registered trials increased by 5,410 (59 percent) and that of industry-funded trials increased by 758 (17 percent). The number of NIH-funded trials declined by 316 (27 percent).

The authors speculate that the decrease in NIH-funded trials may have resulted from a decline in discretionary spending by the U.S. federal government. "The 2014 NIH budget is 14 percent less than the 2006 budget (when adjusted for inflation). An expanding portfolio of NIH research with a flat budget may also have contributed to the decline in NIH-funded trials." 

Academia lobbied aggressively against the Bush administration from 2001 to 2008 - but he doubled funding for the NIH whereas the current administration has focused on appealing to middle-of-the-road voters and neglected constituencies that are never going to vote for the opposing party. Scientists and union workers have been penalized the most for loyalty to the point of defying their own interests and in the case of science, the repercussions for the future remain unknown.