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Sequester cuts research budgets ‘to the bone’
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Cuts to health care funding resulting from the US government’s budget sequester may have a devastating effect on medical research and patient care, according to several clinicians.
The current cuts — which total approximately $85.4 billion during fiscal year 2013 — and provisions for similar cuts from 2014 to 2021 were enacted by the Budget Control Act of 2011. They took effect on March 1.
On April 8, thousands of clinicians and researchers attended the Rally for Medical Research in Washington. The event, held in conjunction with the AACR Annual Meeting, was designed to encourage federal lawmakers to make funding for the NIH a priority.
Impact on institutions
The budget cuts are affecting research and patient care in two key ways. One is the reduction in grant funding, and the other is Medicare cuts that will affect patients who receive chemotherapy, Candace Johnson, PhD, deputy director of Roswell Park Cancer Institute, told HemOnc Today.
Roswell Park, a free-standing NCI-designated center, will lose about $8 million the first year of sequestration, Johnson said. About $6 million of that will be NIH budget cuts, and the other $2 million will be from Medicare.
“Most of these institutions can bear the brunt of this for a short period of time, but if this goes on for more than a year or so, it could be very detrimental to cancer research across the country,” Johnson said.
Michael A. Caligiuri
Years of stagnant funding that has not kept pace with the growing cost of medical research forced researchers at many institutions to operate on “extremely lean budgets,” Michael A. Caligiuri, MD, director of The Ohio State University Comprehensive Cancer Center and CEO of the James Cancer Hospital and Solove Research Institute, told HemOnc Today.
“Sequestration cuts to the bone,” Caligiuri said. “Equally disturbing, sequestration will decrease opportunities for scientific advancement, job creation, technology commercialization and the solution of global cancer problems for our university.”
The full impact of the sequester remains to be seen, Johnson said.
“It is unclear how much these cuts will affect us because all we can do is model what this may be,” she said. “The impact will be phased in throughout the year.”
Fewer than 10% of grants that are submitted get funded, Johnson said.
“Sequestration is going to cut this across the board,” she said. “Now this investigator who asks for $100,000 only gets $80,000 or $90,000 to spend. This cuts into the ability to do the research they have proposed and to hire people to do these projects.”
Effects on patient care
Clinical trials are the only viable treatment option for many patients, Caligiuri said.
Reductions in NCI funding have forced Ohio State to cut participation in clinical trials in half, he said.
“Under sequestration, these trials will likely be completely eliminated, affecting patients under treatment for leukemia, lymphoma, breast cancer and a variety of other forms of cancer,” Caligiuri said. “As a result, sequestration is greatly impacting patient care.”
Sandra M. Swain
Federal funding has yielded huge strides in cancer research and therapy in recent years, and the cuts could stall that progress, Sandra M. Swain, MD, president of ASCO, said in an interview.
“The adjuvant trial of Herceptin (trastuzumab, Genentech) involved two federally funded cooperative groups,” she said. “That drug is saving thousands of lives worldwide. These advances need to continue, but they won’t if the funding is not there.”
“Cancer patients don’t have the luxury of waiting for better fiscal times, and the country can’t afford to put medical research on hold until federal funding is again available,” Ca ligiuri added. “Research data will be lost and cutting-edge projects won’t reach their potential if funding for cancer research is not quickly restored.”
Young researchers
The budget cuts could discourage up-and-coming scientists, Swain said.
“Young, excited, passionate researchers who are not able to get funding for their projects may be likely to do something else,” she said. “They may not want to invest years of their lives if it is extremely unlikely that they will get funded. That is my biggest concern — that we are going to lose a hugely talented pool of young investigators.”
Caligiuri agreed.
“The cuts further discourage future generations of would-be researchers from entering the field,” he said, “and seasoned researchers will begin to turn their attention to opportunities outside of the United States.”
Projects that are currently funded can be finished if the investigators can find a way to cut back, Swain said. Still, the cuts will eliminate new projects, decrease jobs and, consequently, slow progress in research.
That is why the Rally for Medical Research was so important, Johnson said.
“The general public has not been made aware of these issues,” she said. “The press and the general public need to know that sequestration is affecting medical research. It is affecting potential cures.” – by Rob Volansky, Stacey L. Adams and Melissa Foster
For more information:
Michael A. Caligiuri, MD, can be reached at Division of Hematology, Starling Loving Hall, 320 W. 10th Ave., Columbus, OH 43210.
Candace Johnson, PhD, can be reached at Roswell Park Cancer Institute, Elm and Carlton streets, Buffalo, NY 14263.
Sandra M. Swain, MD, can be reached at MedStar Washington Hospital Center, 110 Irving St. NW, Washington, DC 20010.
Disclosure: Caligiuri, Johnson and Swain report no relevant financial disclosures.
Perspective
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Peter D. Emanuel, MD
The sequester soon will be long gone, but the effects on medical research will be very profound and will last for a long, long time. We can’t just turn the switch off and on when it comes to medical research. Once that switch is turned off, the momentum we have lost is dramatic. Even more concerning is the fact that young, talented researchers are going to be dissuaded from going into medical research because they don’t view it as a viable career. We’ll lose that entire cadre of young researchers and we won’t be able to gain them back. As the effects of the sequester started to become realized last year, ASH started a Bridge Grant Program. The society committed $9 million to fund 30 researchers a year for the next 3 years as we try to keep our researchers sustained. ASH takes this turndown in NIH funding very seriously, and we hope Congress will see fit to reverse these funding trends.
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