MedPage Today

NIH Funding Needs to Keep Rising, Senators Say

By Joyce Frieden

WASHINGTON -- Federal funding for the National Institutes of Health (NIH) needs to continue going up, Sen. Roy Blunt (R-Mo.), chairman of the Senate committee that reviews the agency's funding, said Thursday.

"Both this administration and the last one proposed cuts in NIH funding," said Blunt, who chairs the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies, at a committee hearing on the NIH's budget for the next fiscal year, which begins in September. "But so far, we've been able to maintain an upward momentum" in funding medical research. The subcommittee has helped increase the agency's funding by $7 billion over the last 3 years -- a 23% increase, he added.

Blunt reminded the audience that the NIH, along with the CDC, "played an important part in responding" to the Ebola outbreak in West Africa that occurred 3 years ago. "Now, the Democratic Republic of Congo faces another Ebola outbreak ... and we need to be well-prepared."

He also noted that a February report from the National Academy of Sciences found that NIH funding contributed to each one of the 210 drugs approved by the FDA from 2010 to 2016. "That is quite a record," he said.

The hearing was not entirely a love-fest, however. Sen. Patty Murray (D-Wash.), the committee's ranking member, said that she supported increased funding, but that "it was particularly troubling that questions have been raised about the impartiality of a study to assess the health benefits of moderate alcohol consumption." According to an article in The New York Times, NIH officials lobbied alcoholic beverage companies to help fund the $100 million study, which they agreed to do. The officials reportedly suggested to industry executives that the study was likely to show a health benefit from consuming alcoholic beverages.

In response, NIH Director Francis Collins, MD, PhD, told the committee that the study was halted last week. "This particular study was set up in such a way that the funding is largely coming from the beverage industry, and there is evidence that NIH employees assisted in recruiting those funds for the study in a way that would violate our usual policies," Collins said.

"We are in the midst of investigating that through the Office of Management Assessment and through a working group I convened. There are sufficient concerns about that study that I would like to tell you that 1 week ago we decided to suspend enrollment in that study of the moderate effects of alcohol on cardiovascular health while we continue the investigation and make a decision about whether the study is in fact still worth pursuing."

"All of those are complicated issues and believe me, have caused considerable pain and stress on the people involved, but for NIH our reputation is so critical, and if we're putting ourselves in a circumstance where that could be called in question, I felt we had to look at that very seriously and come up with another strategy," he added.

Blunt also asked Collins about a partnership that NIH had been developing with opioid manufacturers to come up with new treatments for opioid addiction and non-opioid alternatives for pain management. The $400 million partnership was initially going to be structured with half of the money coming from industry, but that was later changed. Blunt wanted to know "[why] you decided -- frankly, without consultation with the committee ... not to do what you had asked us to put in the budget to allow you to do."

Said Collins: "We had been in deep conversations with industry partners for a year about ways in which we might develop a partnership to come up with better ways to treat addiction, to treat overdose, and come up with non-addictive treatments for chronic pain, which are desperately needed. Working with 33 such companies over the course of many months, we identified a number of areas of opportunity which we could do effectively in a public/private partnership in ways that neither sector could do alone. That includes sharing data, sharing assets ... and running clinical trials together."

"The good news is that the partnership is very much alive and will be going forward," he continued. "The controversy was, whether given the circumstances around the opioid crisis and the fact that there are lawsuits filed against no less than five of these companies claiming they may have played some role in the opioid crisis in the first place by marketing such drugs as Oxycontin (oxycodone), whether it's a good idea or carries a reputation risk to receive funds from the company."

Collins convened a group of outside advisors, and "to my surprise, they made a strong recommendation that we go forward with the partnership but not have actual cash contributions from the companies involved, he said. "Their concern was that it would create at least the impression if not the reality that the project going forward would be in some way a conflict of interest and be driven by something other than best needs of public. I had to accept that strong recommendation." Collins apologized for not consulting with the subcommittee on the matter.

Committee members also queried the NIH officials about issues of particular interest in their states. Sen. Cindy Hyde-Smith (R-Miss.) asked what was being done to help cancer patients living in rural areas get access to clinical trials.

Norman Sharpless, MD, director of the National Cancer Institute, said one program helping with this was the National Community Oncology Research (NCOR) program, whose sites can conduct clinical trials. "Fifty NCOR sites each have several satellite sites, so [there are] 900 NCOR sites across the country," he said. "These sites ... have catchment areas that have patients that are more likely to be rural and more likely to be underserved minorities, so we can enroll a demographic that looks more like the United States in general ... We just decided to expand this program so we can build on that."