# Presentation: 259903

## NIH in the Post Doubling Era:

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

## NIH Budget Facing a “Perfect Storm” in 2006

- Federal & Trade Deficits
- Defense and Homeland Security needs
- Katrina
- Pandemic flu
- Post Doubling effect
- Physical Sciences focus
- Biomedical research inflation

## 	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

**Notes:**
	BRDPI	FY04 (actual) 3.5%	
			FY05 (est.)     3.3%	
			FY06 (est.)     3.2%	
			FY07 (est.)     3.2%

## *

- 10

- 8

- 6

- 4

- 2

- 0

- 1990-1997

- 1998-2002

- 2003-2007

- Dollars (in billions)

**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**

## New Grant Applications, Applicants and Success Rates During and After Doubling Period

**Success Rates**

**Applications**

**Projected**

- % Success Rate of Grants Funded

**0%**

**5%**

**10%**

**15%**

**20%**

**25%**

**30%**

**35%**

- 1998

- 1999

- 2000

- 2001

- 2002

- 2003

- 2004

- 2005

- 2006

- 2007

**0**

**10,000**

**20,000**

**30,000**

**40,000**

**50,000**

**60,000**

- 49,656

- 43,069

- -

**Applicants**

- Number of Applications/Applicants

- 24,154

- 19,663

- 31,791

- 34,811

## New Grant Applications, Applicants and Success Rates During and After Doubling Period

**Applications**

**Projected**

- Number of Applications/Applicants

- % Success Rate of Grants Funded

**0%**

**5%**

**10%**

**15%**

**20%**

**25%**

**30%**

**35%**

- 1998

- 1999

- 2000

- 2001

- 2002

- 2003

- 2004

- 2005

- 2006

- 2007

**0**

**10,000**

**20,000**

**30,000**

**40,000**

**50,000**

**60,000**

- 49,656

- 43,069

- -

**Applicants**

**New Grant Applications, Applicants and Success Rates**** ***During and After Doubling Period*

- 24,154

- 19,663

- 31,791

- 34,811

## What are My Chances of Being Funded? Success Rate per Application Understates 

- 0%

- 5%

- 10%

- 15%

- 20%

- 25%

- 30%

- 35%

- 40%

- 1995

- 1997

- 1999

- 2001

- 2003

- 2005

- Applicant

- Applications

- Success Rate for R01 Equivalents

- Fiscal Year

- Success Rate files as of May 3, 2006.  Program srf_indiv_060103_rfm
- Individuals are determined using the pi_profile_person_id in IMPAC-II

**What are My Chances of Being Funded?** *Success Rate** *_*per Application*_* **Understates *
*Funding Rate** *_*per Applicant*_

**Percentile Payline does not Equal**
**Success Rate**

**Notes:**
FY 2005- 22.3% success rate for applications, but 27.6% for applicants
FY 2006- 19.8% for applications, but ~25% for applicants

## Inflation Eroded Gains in NIH FundingReal and Nominal NIH Funding Levels Since 2003 

**Nominal funding**

**Adjusted by BRDPI**

- Note:  BRDPI is the Biomedical Research and Development Price Index

**7.3% loss in purchasing power since 2003**

**22**

**23**

**24**

**25**

**26**

**27**

**28**

**29**

**30**

**FY 2003**

**FY 2004**

**FY 2005**

**FY2006**

**FY2007**

**Billions of Dollars**

**Notes:**
7.3% loss does not reflect increased requirements for biodefense and program evaluation (PE) tap.  Biodefense has grown by $530 million since 2003, and is now 6% of NIH budget.  PE tap has grown $100 million from 2003 to 2006.  Purchasing power for NIH non-biodefense net of PE tap has fallen 9.0% since 2003.

## 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 

**Billions of Dollars**

**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**

**FY**

**1998**

**FY**

**1999**

**FY**

**2000**

**FY**

**2001**

**FY**

**2002**

**FY**

**2003**

**FY**

**2004**

**FY**

**2005**

**FY**

**2006**

**FY**

**2007**

**?**

## 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

## Common Misperception 1:

- 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**

** *****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**

**Percentage of Grants **

- Unsolicited

- Solicited

**91%**

**93%**

## Common Misperception 3:

***NIH Roadmap is Shifting Funds Away from Grant Pool***

**Roadmap**
**1.2%**

**Non-Roadmap**
**98.8%**

**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

## FY 2005 Roadmap Awardsto NCI Grantees

|  | Total Number
of Awards | Total Amount
of Awards |
| --- | --- | --- |
| Total 2005 Roadmap | 352 | $240M |
| TOTAL (NCI grantees) | 53 (15%) | $42.1M (18%) |
| Pathways to Discovery | 30 | $28.8M |
| Research Teams | 17 | $8.2M |
| Clinical Research | 6 | $5.1M |

- NCI 2005 Investment in Roadmap = $30.5M (13%)

## Where Do We Go From Here?

***Adaptive Strategies based on key principles***

## Principle 1:Protect core values and mission 

*Discovery and Generation of*
*New Knowledge*

**Principle 1:*****Protect core values and mission***** **

## Balanced National Biomedical Research Portfolio

## Principle 2: Protect the Future

- Launched new “Pathway to Independence Awards;” 150 - 200 per year.
- Each Institute and Center asked to develop policies appropriate to the circumstances for each new investigator.
- New peer-review pilot allows new investigators to re-apply within five months instead of typical nine months.

## Principle 3:Focus on Balancing Supply/Demand

- Actively manage supply/demand imbalance by
- adjusting programs
- Recycle budgets into larger number of competing
- grants (+3% in 2007)
- Prioritize projects to maintain reasonable
- investigator-initiated success rates
- Maximize research and development activities by
- managing costs across all portfolios
- Facilitate peer-review processes to reduce need
- for multiple applications

## Principle 4:Proactive Communication about Investment in NIH

**Survivorship**

- Millions of People

- 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

## Principle 5: 

**Principle 5: **
***Promote NIH’s vision for the future***

- Preemptive

- Personalized

- Predictive

## NIH

**NIH**

*Transforming medicine and health through discovery*

## Congressional Testimony on Behalf of the NIH

- Full Testimony Before the House Subcommittee on Labor – HHS – Education Appropriations, United States House of Representatives, including:

**http://olpa.od.nih.gov/hearings/109/session2/**
**testimonies/overview.asp**

-    NIH Budget request for fiscal year 2007
-    Accomplishments and priorities of the NIH

## 2004 Investment in U.S. Health Research

- Industry

- Federal
- Government

- University

- State and Local
- Government

- Other

- Source: Research!America

## Payline Is Not Funding Cut-off Line

- 0

- 10

- 20

- 30

- 40

- 100

- 0

- -

- Percentile Score

- Percent R01s Funded