NIH in the Post Doubling Era: Realities and Strategies for the Future Elias A. Zerhouni, M.D. Director National Institutes of Health

Elias A. Zerhouni, M.DElias A. Zerhouni, M.D.. September 2006September 2006

NIH in the Post Doubling Era:Realities and Strategies for the Future

Elias A. Zerhouni, M.D.Director

National Institutes of Health


Competition for funds from the NIH and other sponsors, intensifying year by year, now stands at an unprecedented level, and shows no sign of abating. Never before have so many established investigators faced so much uncertainty about their longevity as active scientists. Never before have so many novices faced so many disincentives to entering or continuing a research career.

Dr. William F. Raub, NIH Associate Director for Research and Training, strategy paper, 1982


The budget of NIH has doubled

- but -

Success rates have dropped by a third

What is happening?

The Apparent Paradox:


What Is Really Happening?

Facilities building and faculty growth throughout U.S. research institutions

100% growth in applications and 75% growth in applicants per year by 2007

Budget appropriations below inflation since 2003

Budget cycling phenomenon


10

8

6

4

2

0

1990-1997 1998-2002 2003-2007

Dol

lars

(in

bill

ions

)

3.2B

5.4B

9.5B

Year

AAMC – Survey of Research Facility Investments (99 of 125 AAMC Member Schools) Data Based on AAMC Faculty Roster*

Investment in Research Facilities at U.S. Medical Schools

Success Rates Applications

Projected

% S

ucce

ss R

ate

of G

rant

s F

unde

d

0%

5%

10%

15%

20%

25%

30%

35%

1998 1999 2000 2001 2002 2003 2004 2005 2006 20070

10

20

30

40

50

60

+8,303

+8,359

31%

22%

Num

ber of Applications/A

pplicants (in thousands)

National Research Capacity and Demand for Grants Surges at End of Doubling Period, Success Rates Fall

19%

43,069

24,154

49,656

boehma

Updated (no applicants)

Success Rates Applications

Projected Num

ber of Applications/A

pplicants (in thousands)

% S

ucce

ss R

ate

of G

rant

s F

unde

d

0%

5%

10%

15%

20%

25%

30%

35%

1998 1999 2000 2001 2002 2003 2004 2005 2006 20070

10

20

30

40

50

60

43,069

Applicants

+5,334

+5,208

19%

31%

36,653

19,744

31,791

National Research Capacity and Demand for Grants Surges at End of Doubling Period, Success Rates Fall

boehma

Updated (no applicants)


NIH’s Challenge: Maintain Research Enterprise Vitality in Light of Reduced

Purchasing Power and Increased Demand

22

23

24

25

26

27

28

29

30

FY 2004 FY 2005 FY2006 FY2007

Bill

ion

s o

f D

olla

rs

Nominal funding

Adjusted by BRDPI

−8.3% loss in purchasingpower since 2004

Note: BRDPI is the Biomedical Research and Development Price Index

$25.7 B

$28.6 B$28 B

boehma

A new line is needed with a new scale on the side. No data provided yet.


The Budget Cycling Phenomenon:What Funds are Available in any One Year?

NIH Appropriations

Committed Funds

Uncommitted Funds

Budget Increase

From ending grants started 4-5 years ago

From current year to previous year

Continuing grants


NIH Congressional Appropriations B

illi

on

s o

f D

oll

ars

DOUBLING

$13.7$15.6

$17.8

$20.5

$23.3

$27.1$28.0 $28.6 $28.6 $28.6

$0

$5

$10

$15

$20

$25

$30

FY1998

FY1999

FY2000

FY2001

FY2002

FY2003

FY2004

FY2005

FY2006

FY2007

?


The Bottom Line: Demand for Grants “Took Off” Just as NIH

Budget Was “Landing”!

Post doubling “boom” in applications has led to a supply/demand imbalance

Success rate drop is due to – Near 100% increased demand for grants– 40% increased costs of grants – Decrease in inflation adjusted budget

Budget cycling effect will slightly improve supply vs. demand of

grants in 2007 and beyond

Applications

Budget


Common Misperceptions


56.6%53.9% 55.2% 56.4%

52.1%

53.0%

55.2% 55.8%55.2%

56.1%

40.5%39.2%

38.4% 38.5%

39.8%

40.8%

43.5%41.0% 41.0% 40.8%

5.0%7.0%

3.7%5.7% 5.5% 5.2% 4.8%

3.6%

3.1% 3.1%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

FY 1998 FY 1999 FY 2000 FY 2001 FY 2002 FY 2003 FY 2004 FY 2005 FY 2006 FY 2007

Basic Research Applied Research Other

Common Misperception 1: NIH is Over-emphasizing Applied Research


Common Misperception 2:NIH is Shifting Towards Solicited Research

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

1994 1996 1998 2000 2002 2004 2006

Fiscal Year

Per

cen

tag

e o

f G

ran

ts

Unsolicited Solicited

91% 93%

9% 8%


Common Misperception 3:NIH Roadmap is Shifting Funds Away from Grant Pool

Roadmap1.2%

Non-Roadmap98.8%

FY2006 Budget = $28.6 B

Developed to increase synergy across NIH

Not a single initiative but over 345 individual awards in FY 2005, 133 institutions, 33 states

Estimated in FY 2006:― 51% basic― 36% translational― 13% high risk


Where Do We Go From Here?Adaptive Strategies Based on Key

Principles


Discovery and Generation of

New Knowledge

Principle 1:Protect Core Values and Mission


Balanced National Biomedical Research Portfolio

NIH - $28B

Clinical Research

Basic Research

Translational Research

Private Sector - $59B

Clinical Research

Basic Research

Translational Research


NIH Director’s Pioneer Awards

Support individuals with untested, potentially groundbreaking ideas in many areas of science, from neuroscience to chemistry to behavioral science

Highly competitive 465 applications for 7 funded

awards in 2006 Institutes and Centers

contributed to enable funding more awards, for a total of 13


Principle 2:Protect the Future

Five years of support consisting of two phases

Phase I provides 1-2 years of mentored support for advanced post doctoral fellows- 90k per year

Phase II provides up to 3 years of independent RO1 equivalent research support- 250k per year

NIH aiming for 150-200 awards per year

– Received ~700 applications so far

– First award announcements this Fall

Pathway to Independence Award

http://grants1.nih.gov/grants/new_investigators/index.htm


Principle 3:Focus on Balancing Supply/Demand

Actively manage supply/demand imbalance by

adjusting programsRecycle budgets into larger number of

competing

grants (+3% in 2007)Prioritize projects to maintain reasonable

investigator-initiated success ratesMaximize research and development activities

by

managing costs across all portfoliosFacilitate peer-review processes to reduce need

for multiple applications


Misperceptions in the MediaDeclines in Funding NIH R01 Grants

9%12%

38%

23%

35%

0%

5%

10%

15%

20%

25%

30%

35%

40%

New Unamended applications not from PAs or RFAs

New Unamended applications from PA's and RFA's

Type 1 Amendments

Competing Continuations and Supplements

Total of all Applications

Suc

cess

Rat

es,

FY

200

5


0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

1998 1999 2000 2001 2002 2003 2004 2005

Fiscal Year

Nu

mb

er

R01 Equivalent* Includes R01, R23, R29 and R37

Misperceptions in the MediaNumber of R01 Equivalents Decreased


Fiscal Year

$0

$2

$4

$6

$8

$10

$12

1998 1999 2000 2001 2002 2003 2004 2005

Fu

nd

ing

(in

Bil

lio

ns

)

R01 Equivalent* Includes R01, R23, R29 and R37

Misperceptions in the MediaR01 Funding Decreased


Survivorship

Mill

ions

of P

eopl

e

1971 1986 1990 2003

9

6

3

Principle 4:Proactive Communication about Investment in NIH

For the first time in recorded history, annual cancer deaths in the United States have fallen

10 million cancer survivors

Improved effectiveness of early cancer detection and screening

Thanks to the doubling, new targeted, minimally invasive treatments for cancer multiplied

New drugs developed for cancer prevention

30-year investmentper American:

~$260Total

Average investmentper American

~$8.60per year


NIH Communication Goals

• Increase awareness of the benefits every American receives from public investment in biomedical research

• Convey to all audiences the role research will play in transforming medicine in the 21st century

• Persuade the public and private sectors of the importance of sustaining momentum in advancing knowledge and discovery


• NIH Homepage – More than 40 Fact Sheets– State-by-state Funding Data– Newsletter from NIH Director

http://www.nih.gov/about/researchresultsforthepublic/index.htm


Coming to Your Doctor’s Office: Free, Authoritative, Up-to-Date

Health Information


22 Million Readers, Plus Website Visitors


Mentions “National Institutes of Health” April through August

2006

Average: 4,200 per month

(Not including specific Institute and Center programs)


NIH Beyond the Beltway


2006 Is the Year…

To succeed in communicating the importance of medical research and the role of NIH…


Principle 5: Promote NIH’s Vision for the Future

PreemptivePersonalizedPredictive

Participatory


NIH Transforming medicine and health through discovery

Documents

NIH in the Post Doubling Era: Realities and Strategies for the Future Elias A. Zerhouni, M.D. Director National Institutes of Health