NEWS

Cancer Research Funding Now Has Many Financial Players

Susan Jenks

More than 3 decades after the initial ramp-up of federal funding for the nation's War on Cancer, the National Cancer Institute is still the largest single provider of funds for cancer research.

But other financial players — in particular, the pharmaceutical industry — have steeply increased their cancer research budgets, necessitating, according to a recent report, a reassessment of NCI's "planning and priority setting . . . to ensure that there is overall balance in the national cancer program."

The report, prepared for the National Cancer Policy Board, which addresses national cancer-related issues, found that although the institute accounted for the lion's share (65%) of cancer research funding from all sources in 1974, it was the source of less than half (46%) of all funding by 1997, the most recent year for which statistics were available. NCI provided $2.4 billion of an estimated $5 billion or more spent on cancer research in the United States that year while the pharmaceutical and biotechnology industries spent $1.6 billion.

This shifting funding picture, suggested the report's authors, Michael McGeary and Michael Burstein, has implications for NCI when considering policy issues and establishing research priorities.

McGeary, a consultant on science and technology policy analysis, and Burstein, a Yale University student interning at NCPB, said that the institute and other agencies at the National Institutes of Health that provide funds for cancer research will "generally want to avoid funding work industry would fund anyway," such as applied research with "relatively shorter time horizons." Also, the authors noted, non-profit agencies play an important role in filling in gaps in federal funding, such as that for new researchers or established researchers who are caught between federal grants.

Broadening Base

The War on Cancer, which was launched with the signing of the National Cancer Act in 1971, greatly increased the priority of cancer research in the federal budget and NCI's budget has increased steadily over the years to $2.9 billion for FY 1999. But over the past 2 decades, the report said, the funding base has broadened to include besides the pharmaceutical industry other arms of the federal government, a growing philanthropic sector, and the states.

"NCI is just one partner — and no longer the majority funder — in the national cancer research enterprise," said McGeary and Burstein. "More and more, NCI's planning and priority setting need to take into account the activities of others."

In the federal arena, for example, although NCI is still the "largest single [funding] institution and has the broadest scope," other departments and agencies have begun to provide substantial dollar amounts. The Department of Defense, for example, has become a major source of funds in recent years for research on breast, prostate, and more recently, ovarian cancers, the report said.

Also, at the NIH, other institutes contributed $372 million or 13.5% of the total NIH cancer research budget in 1997, according to the report. Among the highest contributors in 1997 were the National Heart Lung and Blood Institute, which spent $57.6 million; the National Institute of Environmental Health Sciences, which spent $84.4 million; and the National Institute of Allergy and Infectious Diseases, which spent $43.1 million.

And in the private sector, industry funding for cancer research has mushroomed from 2% in 1974 to 31% in 1997. According to the Pharmaceutical Research and Manufacturers of America, which surveyed its members in 1997, $1.4 billion was spent on cancer in that year including work on some 316 drugs and vaccines in various stages of development and a growing investment in basic research. Members of PhRMA include 8 of the 10 largest biotechnology firms as well as many of the largest U.S. pharmaceutical companies.

"Unique Status"

The report singles out the Howard Hughes Medical Institute as having a "unique status as a medical research institute," which contributes a large amount to the national biomedical research effort, although its exact contribution to cancer-related research is considered difficult to ascertain. The main reason for this, McGeary and Burstein said, is that HHMI sponsors people — not projects. However, estimates by HHMI officials places its 1997 budget for cancer-related research at about $95 million.

Of voluntary health organizations, the American Cancer Society is the largest cancer charity and the largest single non-government funder of cancer research in the United States. In 1997, the ACS received an estimated $427 million in donations and provided $91.1 million in support of cancer research, down from $102 million in 1993.

Other categories of funding sources include foundations such as the Susan G. Komen Breast Cancer Foundation, state governments such as those in Texas and New York that appropriate funds directly to cancer centers, and individual gifts and bequests.

For the purposes of the report, the term research was broadly defined, although the NCPB asked the authors to exclude education and outreach activities and public health service programs, which they did. However, research on better ways to inform and educate the public and on ways to improve public health measures, such as trials of smoking cessation programs, was included.

McGeary and Burstein also noted several caveats: Data were taken from secondary sources and are not complete for all sectors; there might be some instances of "double-counting," although the report's authors believe it is minimal; and a substantial amount of cancer research is "so basic that its actual relevance to cancer is hard to predict."

(The full report is available on the web site of the National Academy of Sciences. Go to www.nationalacademies.org/cancerbd/ and look under "background papers.")



             
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