Managing Below-Inflation Budgets

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Managing Below-Inflation Budgets

• Dr. John E. Niederhuber
• Director, National Cancer Institute

Board of Scientific Advisors March 5, 2007
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NCIs Congressional Appropriations FY 1998 to FY
2008
PB 4.8
4.9
4.8
4.8
4.8
4.6
?
4.2
3.8
3.3
2.9
2.5
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NCIs Challenge
Funds available
4.8B
4.8B
Adjusted by BRDPI
-12 loss in purchasing power since 2004
4.3B
Biomedical Research and Development Price Index
(http//officeofbudget.od.nih.gov)
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NCI Applications, Awards Success Rates 1998 to
2007 Estimate Competing RPGs
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Examples of What We Have Reduced, Stopped, and
Put on Hold

• Missed Opportunities 2006 RPGs
• RFAs
• SPOREs and Centers
• Support of Clinical Trials Research
• Cancer Control
• Intramural
• Across-the-Board Cuts

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Missed Opportunities 2006 RPGs

• 179 unfunded R01s up to the 20th percentile (58
  million)
• all cancer sites
• carcinogenesis
• gene therapy
• radiation therapy
• therapeutics
• obesity
• screening in high-risk ethnic groups

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RPG Competing RFA Awards
44,568
27,111
41,848
24,355
24,739
(Dollars in thousands)
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RFAs Canceled or Cut Back

• Division of Cancer Treatment and Diagnosis
  (DCTD)
• Cooperative Breast Cancer Tissue Resource
  (CBCTR) 1,013,000 cancellation in 2006
• Division of Cancer Biology (DCB) unable to
  propose
• 3M Tumor Stem Cell Biology RFA
• 5M Systems genetics RFA
• Division of Cancer Prevention (DCP) RFA concepts
  not presented to EC and BSA
• Prevention of Cancer in Former Smokers
• Prevention of Hormonally Non-Responsive Breast
  Cancer
• Division of Cancer Control and Population
  Sciences (DCCPS) RFA disapproval
• Cancer Care Outcomes Research and Surveillance
  Consortium (CanCORS)1st set-aside 6M total 30M

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SPOREs and Cancer Centers

• 8 million (8) reduction in SPORE Program in
  FY06 further cuts may be necessary in FY07.
• 10 reductions to NCI Cancer Centers may be
  necessary in FY07. Non-competing awards have
  been flat for the past 3 years. Two new centers
  to be funded at capped (1.5M) levels.

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Clinical/translational trials

• Have planned for a 10 additional cut for FY07 to
  clinical trials (hopefully much less)
• 16,500,000 reduction to Clinical Cooperative
  Groups from 2003-2006
• 30-35 Phase 3 trials postponed or not initiated
• 60 Phase 2 trials postponed or not initiated
• A reduction of 2,600 patients in accrual to Phase
  3 and Phase 2 studies in the Cooperative Groups
• 12,000,000 reduction to Community Clinical
  Oncology Program from 2005-2007
• A reduction of 1,500 patients in Treatment trials
• A reduction of 1,000 in Cancer Prevention and
  Control trials

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Cancer Control
531.6
531.3
530.0
510.4
505.7
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Cancer Control/DCCPS examples

• 6.5M reduction to Tobacco Control Research
  Branch from FY04 to FY07
• 7.1M reduction to Quality of Cancer Care Program
• 1M reduction to Cancer Survivorship Program
• 760,000 reduction to Risk Factor
  Monitoring/Energy Balance in FY06

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Intramural Research
711.0
708.3
691.7
687.7
686.6
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Intramural-DCEG

• 1.8M reduction to Bladder Cancer Whole-Genome
  Association Study in FY07
• 400K reduction to Translational Genomic Research
  in FY07
• 1.5M reduction to Identifying Genetic
  Determinants of Cancer Risk Factors in FY07
• 1.5M reduction to Kidney Cancer Whole-Genome
  Association Study in FY07
• 900K reduction to NIH-AARP Study in FY07
• 300K reduction in the Chernobyl Research Program
  in FY07
• 225K reduction in second cancers following
  radiotherapy study in FY07
• 400K reduction in LC/MS Technology for Hormone
  Measurements in FY 07

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CCR Patient Accrual
4,210
3,950
3,795
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Across-the-Board Cuts

• 10 cut NCI Office of the Director
• 8M cut (managing a 10 reduction)
  NCI-Frederick
• 2.9M operational and scientific support staff
  (40 positions reduced)
• 2.7M advanced technologies capital equipment
• 2.4M facilities repairs and maintenance

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NCI Director
Office of Media Relations
Deputy Directors

• 10 savings since January from merging OC and
  OESI
• MITRE Corp. review underway
• 750K savings halted a mid-stream contract bid
  and ended the work
• 20 reduction to Cancer Information Service
  regional contracts
• 14 budget reduction to NCI Exhibit Program 
• 20K savings by not sending writers to ASCO 
• 33 reduction to contract supporting the
  Enterprise Vocabulary System
• 400,000 cut NCI Cancer Bulletin
• EC reduced from 48 to 24 issues/year (April 3)
  and stopped printing contract (March 20)

Ethics Office
Institute Review Office
Divisions and Centers
(External Affairs)
Executive Officer
ACD
Office of Advocate Relations
Dep. EO for Strategic Planning Budget
Deputy EO for Mgmt. Personnel Resources
OBFM OSPA OPAR
Office of Grants Admin.
Office of Acquisitions
Office of Communications and Education
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It is relatively easy to count projects, trials,
and patients affected. It is far more difficult
to account for missed opportunities and ideas
lost.