Little Innovation with Sequestration

“It hangs over us like a dark cloud,” noted National Institutes of Health (NIH) director Francis Collins Tuesday, March 10 at a Senate Committee meeting on “Continuing America’s Leadership in Medical Innovation for Patients,” in reply to a question regarding the impact of sequestration on the NIH. The sequestration was a serious blow to the NIH, which equaled a $1.55 billion cut in the organization’s budget. While the NIH has tried its best to recover lost grants, 750 grants were unable to be funded.

As a result of research at the NIH and other national health efforts, deaths from heart disease have been reduced by more than seventy percent from 1950 to 2008. Cancer death rates have been dropping about one percent annually for the past fifteen years — life expectancy gains that save the nation billions of dollars. The costs of sequestration, thus, are numerous: It slows the development of medical breakthroughs in diseases like cancer, creates difficulties in recruiting and retaining a talented scientific workforce which employs one million U.S. citizens and imposes risks on losing the U.S. competitive edge in the field of biomedical research.

Therefore, consistency and predictability in funding remains a challenge for the NIH as it embarks on life-saving initiatives. China and Japan are substantially increasing their investment in research while the U.S. is imposing huge cuts. Instead of being able to focus on their research, scientists are constantly worried about whether they will have enough funding to continue their line of work and bring medically innovative technologies to the public.

The Administration’s FY 2015 budget request for the NIH is $30.362 billion, $211 million, or 0.7 percent above the FY 2014 level. This budget request reflects the President’s and the Secretary’s commitment to improving the health of the nation and to maintaining our nation’s leadership in the life sciences. The budget request helps investments in innovative research that will advance knowledge and speed up the development of new therapies, diagnostics and preventive measures to improve public health. But it is not enough.

$211 million extra in 2015 is hardly enough to fund over 200 disease areas. For example, arthritis research alone costs $239 million in 2014. To put it into perspective, an estimated 52.5 million adults in the United States reported being told by a doctor that they have some form of arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia. One in five (22.7%) adults in the U.S. report having doctor diagnosed arthritis, and this is for people under the age of 65.

Cancer is another costly disease with costs projected to reach at least $158 billion in 2020.  If one extrapolates the current cancer incidence and survival rates into the future, the number of cancer survivors in 2020 will increase by 31 percent, to about 18.1 million. Because of the aging of the U.S. population, researchers expect that the largest increase in cancer survivors over the next ten years to be among Americans age 65 and older. With the aging of baby boomers, the costs of healthcare will continue to increase unless funding goes towards these plaguing diseases. These are just a couple examples out of many.

As noted earlier, funding has been unreliable. Meanwhile, many Asian countries raised their biomedical research investments with double-digit annual growth rates, topped by China’s hefty 33 percent.  Japan’s total spending expanded by the biggest absolute dollar amount of any country: $9 billion. The U.S. should not lose its competitive advantage. Investments in biomedical research are vital to curb health care costs. Because the government has backed out of funding the NIH, an increase in public-private partnerships is a must.

Collaboration between large pharmaceutical industries, academic teams and biotechnology companies can result in significant advances for the development of innovative drugs. It is apparent that the NIH is starting to do this since it has formed the Accelerating Medicines Partnership (AMP) with the goal of cutting down on the more than 95 percent failure rate for drug candidates. This will allow a better gateway for funding and exchange of data between companies. An increased focus on public-private partnerships will help ameliorate the loss of investment that the NIH has been suffering.