A half century of sustained investment by the United States
Federal Government in biomedical research has dramatically
advanced the health and improved the lives of the American
people. The National Institutes of Health (NIH) specifically
has had a significant impact on the United States’ global
preeminence in research and fostered the development of a
biomedical research enterprise that is unrivaled throughout
the world. As the world’s largest supporter of biomedical
research, the NIH competitively awards extramural grants
and supports in-house research. However, with the continued
decline in real dollars allocated to biomedical research each
year by the federal government, the opportunities to discover
life-changing cures and treatments will drastically decrease.
Federally funded biomedical research is supported through
funding to NIH, National Science Foundation, United
States Department of Agriculture, Department of Energy,
National Aeronautics and Space Administration, Centers
for Disease Control and Prevention, and Department of
Veterans Affairs. However, the NIH is the leading and
sometimes only source of funds for certain types of vitally
important clinical and translational research that is not
performed in the private sector or other government
agencies. Formed in 1887, the NIH comprises 27
institutes and centers and annually invests more than $30
billion in medical research. More than 80% of the NIH’s
funding is awarded through almost 50,000 competitive
grants to more than 300,000 researchers at over 3,000
universities, medical schools, and other research institutions
around the United States and throughout the world.1
In the past, Congress has shown bipartisan support for
biomedical research by consistently increasing the budgets
of the agencies that support such research. From 1998
to 2003, a commitment was made to double the budget
of the NIH from $13.6 billion to $27.3 billion, allowing
the agency to fund a number of important clinical trials
for chronic conditions, develop tests for earlier cancer
detection, and conduct the Diabetes Prevention Program.2
Since the doubling of its budget, the NIH has received
annual funding increases below the rate of biomedical
inflation.3 As a result, the NIH budget is insufficient
to fund all of the research that needs to be done. At
present, less than one in five projects can be supported.
Further analysis of the NIH budget shows that
The NIH budget has not kept pace
with inflation since 2001.
The number of research project grants funded by NIH has declined since 2004, and we do not expect the number of grants to recover in 2018, despite recent increases to the NIH budget.
Grant success rates have fallen more than
15 percentage points in the past decade and
are projected to decline even further.
Not only does the decline in grants affect the number of
scientists who are able to continue their research and
discover new treatments and cures, it also has a significant
impact on the United States economy. In order to fully
understand the importance of maintaining the growth
experienced during the doubling period, policymakers
must first understand the positive impact that research
programs have on the population of the country.
Increased longevity and improved quality of life
Endocrine-related research funded by federal dollars has
resulted in significant advances in the prevention and
treatment of some of the nation’s most prevalent diseases,
at a fraction of the cost of simply managing these conditions.
For instance, the Study of Osteoporotic Fractures found
that for women, one of the best predictors of fracture is
bone mineral density of the hip, resulting in a better method
for identifying those at risk for osteoporosis and preventing
costly and debilitating fractures that cost $18 billion annually
in direct care. Studies conducted by the NIH have found that
with intensive lifestyle intervention, a patient’s risk of getting type 2 diabetes can be reduced by 58%, and that the drug
metformin can reduce the development of diabetes by 31%.4
However, if funding levels for biomedical research do not
even keep pace with inflation, many of the breakthroughs
in medical care that are on the horizon will not be realized.
Impact on the national, regional, and local economy
Biomedical research funds allocated by the federal
government support both basic and translational
research, ensuring that the discoveries made in the
laboratory become realistic treatment options for
patients suffering from debilitating and life-threatening
diseases. In addition to improving quality and length
of life, these advances in treatment also reduce the
health care costs of our nation. As the population of
the United States ages, the incidence of costly, chronic
conditions such as diabetes, obesity, and cancer
will significantly increase, and a large portion of the
projected increase in health care costs will be due to the
prevention and treatment of these diseases. To save the
country billions in healthcare costs, significant investment in
biomedical research will be needed. For instance, treatments
that delay or prevent diabetic retinopathy save the country
$1.6 billion a year,5 and primary prevent programs that
reduce the risk of developing type 2 diabetes can result in
a net savings to Medicare of $2 billion over 10 years.6
In addition to the impact that research has on spending on
health care for the nation’s population, research funding also
has a significant impact on local economies by supporting
the development of new, high-paying jobs. Two examples
from California and Texas follow: for each dollar of taxpayer
investment, UCLA generates almost $15 in economic
activity, resulting in a $9.3 billion impact on the Los Angeles
region, meanwhile, the estimated economic impact of Baylor
University on the surrounding community in Houston is more
than $358 million, generating more than 3,300 jobs.7 Without
federal research funding, the revenue injected into local and
regional economies would be lost, significantly impacting not
only those individuals directly involved in research, but also
affecting industries that depend on the downstream revenue.
Continued dominance in science and the global economy
As the amount of real dollars allocated to federal research
funding declines, so too do the opportunities for researchers. As a result, scientists are often forced to find other careers
or move to other countries to continue their research,
depleting the pool of talent that government agencies and
pharmaceutical companies have to draw from. Without these
scientists in our workforce, many medical breakthroughs
will either never happen or will be realized and drive public
health and economic activity outside of the United States.
A recent Research!America poll found that 64% of
Americans feel that it is very important to maintain our
position as a global leader in scientific research, and
76% believe that it is very important to create more
career opportunities in science and research.8 Cuts to
research will disadvantage our scientific workforce, with
negative downstream consequences for research and
development in the United States. Policymakers must
continue to ensure that funding is available to create
opportunities for new and existing researchers.
The Endocrine Society remains deeply concerned about the
future of biomedical research in the United States without
sustained support from the federal government. The Society
strongly supports increased federal funding for biomedical
research in order to provide the additional resources needed
to enable American scientists to address the burgeoning
scientific opportunities and maintain the country’s status
of the preeminent research enterprise. As such:
For FY 2019, the Endocrine Society recommends
that the agencies that support biomedical research
receive the following appropriations in order to
recoup the losses caused by biomedical inflation,
fund necessary new research programs, and build on
the discoveries made during the doubling period:
National Institutes of Health—at least $39.3 billion, representing a $2 billion increase
over the FY 2018 enacted level
National Science Foundation—$8.45 billion
Department of Energy’s Office of Science—$6.6 billion
Department of Veterans Affairs—$787 million for
VA Medical and Prosthetics Research Program
Revised August 2018
Impact of NIH Research: Our Society. National Institutes of Health.
our-society. Updated May 26, 2016. Accessed May 11, 2017.
Impact of NIH Research: Our Knowledge. National Institutes of Health.
our-knowledge. Updated March 11, 2016. Accessed May 11, 2017.
Diabetes Prevention Program (NIH Publication No. 09-5099).
(2008.) U.S. Department of Health and Human Services, National
Institutes of Health, National Institute of Diabetes and Digestive
and Kidney Diseases. Retrieved from https://www.niddk.nih.
dpp/Documents/DPP_508.pdf. Accessed May 9, 2017.
NIH Research Funding Trends. Federation of American Societies for Experimental
NIH-Research-Funding-Trends.aspx. Accessed May 11, 2017.
Diabetes Prevention Program (NIH Publication No. 09-5099). (2008.) U.S. Department of Health
and Human Services, National Institutes of Health, National Institute of Diabetes and Digestive and
Kidney Diseases. Retrieved from https://www.niddk.nih.gov/about-niddk/research-areas/diabetes/
diabetes-prevention-program-dpp/Documents/DPP_508.pdf. Accessed May 11, 2017.
Medical Research: Saving Lives, Reducing the Cost of Health Care, Powering the
Economy. Research!America. http://www.researchamerica.org/sites/default/files/uploads/
EconomicFactSheet.pdf. Created November 9, 2012. Accessed May 11, 2017.
Thorpe, K. and Z. Yang. Enrolling People with Prediabetes Ages 60-64 in a Proven Weight
Loss Program Could Save Medicare $7 billion or More. Health Affairs. September 2011.
National Institutes of Health State Funding Facts for FY 2016: California. FASEB. http://faseb.org/viewer.aspx?type=statefactsheet&id=32&nocache=63630114938578
0676&Name=Value-of-NIH-Funding-in-California.pdf. Accessed May 11, 2017.
National Institutes of Health State Funding Facts for FY 2016: Texas. FASEB.
588877&Name=Value-of-NIH-Funding-in-Texas.pdf. Accessed May 11, 2017.
America Speaks: Survey Data Reflecting the Views of Americans on Medical, Health,
and Scientific Research. Research!America. http://www.researchamerica.org/
sites/default/files/RA-PDS_Vol16_12_0.pdf. Accessed May 11, 2017.