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Executive Summary

NIH SHOULD "MODULATE" NUMBER OF R0-1 GRANTS to forestall runaway budget growth, Institute of Medicine President Samuel Thier maintained in a recent letter to "The Pink Sheet". Thier suggested that National Institutes of Health budget planners ought to pay particular attention to the number of investigator-initiated grants. "Modulation of the number of R0-1 grants is needed," Thier said, to keep investigator-initiated grants "from causing an exponential growth in the NIH budget from the pressure of inflation alone." Thier wrote to "The Pink Sheet" on April 20 to clarify remarks about the NIH budget which he delivered at the Pharmaceutical Manufacturers Association annual meeting in early April ("The Pink Sheet" April 9, p. 15). Stating that the "meaning" of his previous remarks was "seriously misinterpreted" by the previous report in "The Pink Sheet," Thier declared that his primary message was that defenders of the NIH budget should focus on the potential from continued biomedical research instead of complaints about recent funding cuts. "I intended that those wishing to support increases in the NIH budget...stress opportunities and capacity for biomedical research rather than focusing on a sense that the NIH had been dealt with harshly in budgets of the past several years," Thier explained. He pronounced himself an advocate of increases in the NIH budget. During his speech to PMA, Thier noted that NIH has increased the number of grants, their duration and size. In his letter to "The Pink Sheet," he pointed out that "I do not in fact believe that extending the length of grants was a poor decision." He declared that he favors "the longer grant periods and higher per grant dollar awards." The IoM president said his message was cautionary, with its warning aimed primarily at watching the number of grant awards. "What I was stressing was that if the length of grants and their average size were increased, the increase in the number of R0-1 grants would have to be modulated, or there would have to be an NIH budget increase well above inflation, or there would have to be a fall in capacity to fund new grants in the out years." In his PMA address, Thier used more colorful language to emphasize the need for careful review of NIH's grant funding. The IoM president's opinions are presumably derived from figures collected for an upcoming report by the Institute on NIH. Thier's letter to "The Pink Sheet" indicates the sensitivity, and import, of the IoM review of NIH's spending patterns to the biomedical research community. The letter repeats Thier's concern about the increase of grant funding as a proportion of NIH's total budget. To PMA, Thier said: "The message that I am trying to deliver is that we have pursued a strategy in biological research which has said that our product is research and what we are going to do is that we are going to keep producing that product and we are going to spend down all of our long-term capital if we have to." In his letter to "The Pink Sheet," Thier similarly stated: "In general, I was pointing out that budgetary strategies such as an emphasis on R0-1 grants can push them out of proportion and have deleterious effects on such other demands as research training and facilities."

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