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GAO Issues Reports on NIH Priority Setting and Funding Allocations

May 2, 2014—The Government Accountability Office (GAO) April 30 issued two reports related to how the National Institutes of Health (NIH) sets research priorities and allocates funding among various diseases and conditions.

In the first report, GAO looked at how the five NIH institutes and centers (ICs) that award the largest amount of research funding set their research priorities. The five were the National Cancer Institute; the National Heart, Lung, and Blood Institute; the National Institute of Allergy and Infectious Diseases; the National Institute of Diabetes and Digestive and Kidney Diseases; and the National Institute of General Medical Sciences.

GAO found that while the five ICs used various priority-setting approaches, they all considered similar factors, including scientific needs and opportunities, gaps in funded research, the burden of disease in a population, and public health need. The ICs' mission and appropriations also informed priority-setting approaches, with some IC officials noting that because the costs of potential research projects generally exceed available funding, the ICs must prioritize among research projects.

GAO also examined NIH reported funding levels for the 40 different Research, Condition, and Disease Categorization (RCDC) system (RCDC) categories that best matched with leading causes of death in the United States, chronic disease prevalence for adults in the United States, and leading causes of death globally.

GAO found NIH reported fiscal year (FY) 2012 funding levels ranging from $13 million for projects in the fibromyalgia category to more than $5.6 billion for projects in the cancer category. NIH officials said that the RCDC system cannot estimate a total, non-duplicated amount of funding that is specific to a given disease or condition, because RCDC categories are neither mutually exclusive nor exhaustive.

Two of the five ICs that GAO reviewed — the National Cancer Institute and the National Institute of Allergy and Infectious Diseases — had their own systems for tracking their funding, which allowed them to provide more detailed information than that available from RCDC.

For the second report, GAO reviewed NIH’s RCDC funding data across the same 40 categories for FY 2013 and found, similar to FY 2012, that funding levels continued to range widely: from $11 million for projects in one RCDC category to about $5.3 billion for another.

Both studies were requested by Rep. Jack Kingston (R-Ga.), chair of the House Labor-HHS Appropriations Subcommittee, who has raised the issue of NIH priority setting in several recent hearings.


Dave Moore
Senior Director, Government Relations
Telephone: 202-828-0559


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