For most people, medicines are a bottle of pills on a shelf – made by drug companies, stocked by pharmacies, prescribed by doctors. But drugs that people take for serious illnesses – to prevent HIV, shrink tumors and treat seizures – have years-long backstories that often trace to basic science experiments in university laboratories.
That foundation is now under threat. The Trump administration has abruptly frozen billions in research grants to universities it accuses of antisemitism or bias unrelated to the research. Some research is being terminated midstream and further funding cuts loom, jeopardizing the development of new medications that could prove equally lifesaving or life-changing.
Pharmaceutical companies are essential to developing new drugs, but the early chapters of many medicines’ origin stories are based in academia, backed by federal funding. A key reason is the 1980 Bayh-Dole Act, which allows research institutions to patent inventions made with federal funding, creating an incentive to turn basic research into drugs. Numerous studies show how critical taxpayer-funded research has become.
One study found that funding from the National Institutes of Health contributed to research associated with 99 percent of drugs approved over a decade.
The story of how any given drug came to be is often a complex and serendipitous tale, pushed forward by a team effort that spans academia and companies over decades. The federal government is now targeting the roots of the system that has helped fill the world’s medicine cabinet with innovative drugs, although some of its efforts have come under court challenge.
The Washington Post examined the history of six important drugs invented over the past few decades. In each case, crucial steps in the development of the medication came from taxpayer-funded research at universities now at risk of losing federal support.
Keytruda
Key research occurred at: Harvard Medical School
The top-selling drug in the world last year was Keytruda, a cancer immunotherapy with $29.5 billion in sales. Initially approved in 2014 for advanced melanoma and now used against a wide array of cancers, it is the best known of a new class of drugs that unleash immune cells against tumors. It works by targeting a protein called PD-1.
James P. Allison at the University of Texas MD Anderson Cancer Center, whose lab began to be supported by NIH in 1979, shared the Nobel Prize for medicine with Tasuku Honjo of Japan for work that led to this new way to treat cancer. At Harvard Medical School, immunologists Arlene Sharpe and Gordon Freeman helped identify a molecular switch in the PD-1 pathway that stops the immune system from attacking cancer cells – and discovered a way to flip it. An analysis by Fred Ledley at Bentley University shows that much of the NIH investment in PD-1 research came from its infectious diseases institute. “It goes to show that you never know where fundamental discoveries can take you,” Sharpe said.
Her grant from NIH was among more than $2 billion in funding to Harvard that was frozen by the Trump administration in April, then ordered to be restored by a federal court. “The uncertainty makes it very challenging,” Sharpe said.
Lyrica
Key research occurred at: Northwestern University
Richard Silverman, a medicinal chemist at Northwestern University, started a NIH-supported line of research to create a treatment for epilepsy in the late 1970s. In 1989, Ryszard Andruszkiewicz, a visiting scholar in his lab, synthesized a molecule that looked promising.
Pharmaceutical company Parke-Davis (through a series of acquisitions, it became Pfizer) licensed 17 compounds from Silverman’s lab, including the most potent anticonvulsant agent the company had ever tested. In 2004, Lyrica was approved in the U.S., initially for treating neuropathic pain and later for epilepsy and fibromyalgia. Sales of Lyrica peaked at just over $5 billion in 2017. The drug is now generic.
One study found that $13.8 million in NIH funding had supported development of Lyrica. At Northwestern, $790 million in federal funding was frozen in April. “There needs to be more funds put into research,” Silverman said. “Fundamental research can lead to important applications and commercialization.”
Viagra
Key research occurred at: University of California at Los Angeles
In the 1980s, Louis Ignarro, a pharmacology professor now at UCLA, became interested in nitric oxide, an air pollutant that could dilate blood vessels. At the time, he was on the fringes of his field. “I pursued that much to the dismay of my colleagues, who thought I was crazy,” Ignarro recalled.
Ignarro’s primary interest was the cardiovascular effects of nitric oxide. But in 1992, he discovered the compound also played a key role in male sexual function. Pfizer had been originally developing a heart drug, but in 1998, Viagra was approved instead for erectile dysfunction. Ignarro shared the Nobel Prize that year for his work on nitric oxide. Viagra, which is now generic, hit $2 billion in sales in 2012.
Ignarro, 84, is still active in science, but retired in 2016 from his academic responsibilities at UCLA. More than half a billion in federal funding to UCLA was frozen, then ordered to be restored by a court while litigation continues. “Without funds, without the money, you cannot bring in the good people to do your work. Without the money, you can’t buy the chemicals, you can’t buy the instrumentation you need to make discoveries,” Ignarro said.
Truvada
Key research occurred at: Emory University
This medication to treat and prevent human immunodeficiency virus is rooted in the work of Emory University researchers Raymond Schinazi, Dennis Liotta and Woo-Baeg Choi. In 1989, they discovered emtricitabine, a key ingredient in Truvada, that combats the enzyme that replicates HIV RNA into new viral DNA. The National Cooperative Drug Discovery Group for the Treatment of AIDS, a program created by NIH in the early days of the epidemic, supported the research.
“So many people were dying at the time,” said Schinazi, who lost a cousin to HIV soon after his lab’s discovery. “We had ideas. We wanted to do something about HIV, and government funding was absolutely crucial.” His work served as the basis for further exploration into HIV preventative therapy, funded by the NIH at other universities including the University of California at San Francisco and the University of Georgia.
A 2023 study published in Health Affairs found 73 federal awards totaling an estimated $143 million to 11 researchers contributed to the development and clinical testing of Truvada, which hit the market in 2004. The drug’s sales peaked at about $2.3 billion in 2019.
Emory is contending with $92.5 million in canceled federal research funding.
Ozempic
Key research occurred at: Harvard Medical School
While working at Massachusetts General Hospital in the 1970s, Harvard Medical School professor Joel Habener laid the foundation for the wildly popular weight-loss drug Ozempic. His team set out to investigate the connection between blood sugar and the hormone glucagon, and discovered a similar hormone that became known as glucagon-like peptide-1, or GLP-1.
Habener said grants from the NIH funded the postdoctoral researchers who worked on the project. “Without postdocs we couldn’t do the work, and without funding we wouldn’t have postdocs,” he said. “The National Institutes of Health was instrumental, and has been a wonderful partner for decades.”
Habener and other scientists, including Svetlana Mojsov at Rockefeller University and Lotte Knudsen at drugmaker Novo Nordisk, continued to build upon his initial research. Their subsequent work showed that GLP-1 could help control blood sugar levels in people with Type 2 diabetes and reduce appetite.
In the first half of this year, sales of Ozempic topped $10 billion worldwide, according to Novo Nordisk. As for Harvard, the Trump administration froze more than $2 billion in research grants to the university. A federal judge ruled last month that the administration could not withhold the funding, and some money has been restored. However, the Department of Health and Human Services last week initiated action to bar Harvard from all federal funding.
Sovaldi
Key research occurred at: Emory University
After more than a decade of increases in acute hepatitis C cases, numbers declined in the United States for the first time in 2022, according to the CDC. Now, the disease is targeted for global elimination as a public health threat by 2030.
The threat level changed because of sofosbuvir. Sold under the name Sovaldi, the antiviral agent was in part created by taxpayer-funded labs at Emory University. From 1993 through 2007, Emory received $7.7 million in today’s dollars in grants that directly led to sofosbuvir, according to data from a journal article on public funding’s role in the drug.
The man awarded nearly half of those grant dollars was Dr. Dennis Liotta.
He and his lab partners found their work on HIV drugs was applicable to hepatitis C, determining sofosbuvir did a remarkable job of stopping the hepatitis virus from replicating. The FDA designated the pill a “breakthrough.”
Liotta said the federal cuts to collegiate medical research projects endanger the nation’s standing as a global biotechnology leader.
“It’s not that I am unique. There’s so much innovation that’s emerged from universities,” he said. “This is insanity.”