At my institute, there is only one metric that matters: dollars you bring in through grants. There are a variety of ways to get to the cash: you can do it with a small number of high-impact papers, a larger number of low-impact papers, by finding a valuable niche, or by chasing fads.

So I would say that fundamentally the problem is with study sections and how they think. They are incredibly conservative, but in all the wrong ways. They highly value institution of origin, preliminary data from pilots, no matter how shitty, and the sort of hypothesis that seems reasonable from prior literature. There are also a lot of political games on study sections.

This means that if you repeat a lie often enough in the literature, and you know people, then voila, you now have support for the same hypothesis in future grants.

Peer review is not working for funding. I would say the NIH (in my case) needs to hire completely independent full-time reviewers, and needs to place a real, high emphasis on reproducibility. It is in the NIH's interest to do so, because as I said, its funding will be cut if this continues.