Research funding. Politics and funding in the U.S. public biomedical R&D system.

1797 POLICYFORUM F ederal funding for biomedical R&D through the National Institutes of Health has grown from $8.3 billion in FY1984 to $28.7 billion in FY2008 (1, 2). The NIH supports half of all federal nondefense R&D and more than 60% of federally funded research in American universities (3). The agency awards funds to research performers based on " peer review " but the decisions are not insulated from political influence. How do congressional appropriations committee members influence the allocation of federal funding for biomedical research? We investigated this question by studying congressional appropriations bills and appropriations committee meeting reports covering the 20 fiscal years between 1984 and 2003. During every year of this period, the director of the NIH negotiated with the Department of Health and Human Services and the Office of Management and Budget within the Executive Office of the President to craft a budget request for the NIH that was consistent with White House priorities. The NIH's budget is considered by the Appropriations Committees of the House and Senate. In the House Appropriations Committee (HAC), the NIH budget request is handled by the Labor, Health and Human Services, and Education and Related Agencies Subcommittee (LHHE). A similarly named subcommittee of the Senate Appropriations Committee (SAC) evaluates the NIH budget request in that chamber. The LHHE subcommittees consider the NIH budget request, amend the funding requests in the presidential budget, and " mark up " the appropriations bills, sometimes specifically for institutes and centers at the NIH, that are ultimately reported to the House and Senate by each chamber's appropriations committee. The subcommittee meeting reports that accompany the appropriations bills to the floor contain additional detail and guidance on the allocation and disbursement of appropriated funds by the NIH. Transfers affecting the level of support may involve (i) reallocation for NIH funding among the agency's institutes and centers , (ii) subcommittee support for specific fields of biomedical research associated with particular diseases, and (iii) project-level transfers that reallocate funding among particular lines of research and/or research projects within a given disease field. (See Supporting Online Material for examples). To test whether these reallocations are affected by representation on the relevant appropriations subcommittees and committees , we analyzed data on the amount of NIH peer-reviewed grants received by 8310 " extramural " bio-medical research institutions for every congressional NIH appropriations bill during the 1984–2003 period (4, 5). The primary …