zerhouni crossroads

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NIH at the Crossroads: Myths, Realities and Strategies for the Future Elias A. Zerhouni, M.D. Director, National Institutes of Health

NIH Budget Facing a “Perfect Storm” in 2006: 

NIH Budget Facing a “Perfect Storm” in 2006 Federal & Trade Deficits Defense and Homeland Security needs Katrina Pandemic flu Post- Doubling effects Physical Sciences focus Biomedical research inflation- 3 to 5%

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NIH Budget: Myths and Realities…

What is Driving Success Rates?: 

What is Driving Success Rates? Is NIH placing more emphasis on applied as opposed to basic science Is NIH shifting towards solicited research (RFAs and PAs) at the expense of unsolicited, investigator-initiated research? Is it due to the Roadmap?

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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 Basic and Applied Research

What is Driving Success Rates?: 

What is Driving Success Rates? Is NIH placing too much emphasis on translational science at the expense of basic research? Is NIH shifting towards solicited research (RFAs and PAs) at the expense of unsolicited, investigator-initiated research? Is it due to the Roadmap?

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Grants: Unsolicited Far Outnumber Solicited 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%

What is Driving Success Rates?: 

What is Driving Success Rates? Is NIH placing too much emphasis on translational science at the expense of basic research? Is NIH shifting towards solicited research (RFAs and PAs) at the expense of unsolicited, investigator-initiated research? Is it due to the Roadmap?

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NIH Roadmap for Medical Research Roadmap 0.8% ($237 Million) Non-Roadmap 99.2% ($28,520 Million) FY2005 Request = $28,757M Developed to increase synergy across NIH Not a single initiative but over 345 individual awards in FY05: 40% basic 40% translational 20% high risk

What Is Really Happening?3 Fundamental Drivers: 

What Is Really Happening? 3 Fundamental Drivers Large capacity building throughout U.S. research institutions and increase in number of tenure-track faculty Large increase in applicants and applications occurring after 2003 Budgets: Appropriations below inflation after 2003 ( +3 % in ‘04, 2.2% in ‘05 and 0% in 06 ) while BRDPI in 2004 was ~ 5% Budget cycling phenomenon

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New Grant Applications and Success Rates During and After Doubling Period Success Rates Applications Projected Number of Applications % Success Rate of Grants Funded 31% 19% 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 22% 49,656 43,069 24,154

As Many New Applicants in the Last 2 years as during the previous 5 years!: 

As Many New Applicants in the Last 2 years as during the previous 5 years! ≈

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

The Budget Cycling Phenomenon: What Funds are Really 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 : 

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!” : 

The Bottom Line: Demand for Grants “Took Off” Just as NIH Budget Was “Landing!” NIH managed well in 2004 and 2005 by shifting “one time” funds from 2003 to 2004, and obtaining small increases in 2004 (2.9%) and 2005 (2%) Katrina requirements led to a flat 2006 NIH while rest of HHS underwent a 2.5% cut Budget cycling effect will improve demand vs supply of grants in 2007 but we need to educate public about need for sustainability in research

The Question on Everyone’s Mind:“What are MY chances of being funded?”: 

The Question on Everyone’s Mind: “What are MY chances of being funded?” Payline is not the funding cut-off line! Success rate per application understates funding rate per applicant FY 2005- 22.3% success rate for applications, but 27.6% for applicants FY 2006- 19.8% for applications, but ~25% for applicants

Success Rate is Higher than the Percentile Payline: 

Success Rate is Higher than the Percentile Payline 0 10 20 30 40 100 0 - Percentile Score Percent R01s Funded

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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 Rates are always higher for Applicants than for Applications 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

Where Do We Go From Here?Adaptive Strategies A Vision for the Future : 

Where Do We Go From Here? Adaptive Strategies A Vision for the Future

Strategies: 

Strategies First: Know the facts Second: Develop adaptive strategies Protect the essential: Knowledge and Discovery Increase number of competing grants (supply/demand management) Support new investigators New Pathway to Independence Program Institutes and Centers efforts to assist new investigators Third: Convey a unified message Increase communications about positive impact of NIH at local, regional and national levels Fourth: NIH’s exciting vision for the future

CSR—Making Peer Review More Efficient: 

CSR—Making Peer Review More Efficient Electronic Receipt Exploring ways to make peer review more efficient for both applicants and reviewers Pilot study to shorten the review cycle for new investigator RO1 applications

Basic Discovery Today Provides the Foundation for Tomorrow’s Medicine: 

Basic Discovery Today Provides the Foundation for Tomorrow’s Medicine Basic Research and Technology Development Translational Research Clinical Applications

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The Future Paradigm: Transform Medicine from Curative to Preemptive Preemptive Personalized Predictive

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NIH Transforming medicine through discovery