Research Funding in an Era of Austerity Emily Holubowich, MPP Senior Vice President, CRD Associates Executive Director, Coalition for Health

Budget Control Act Changes Game Enacted August 2011 to avoid national default, reduce deficits over decade Cut $900 billion from discretionary spending starting FY 2012 Sequestration triggered March 2013 – Cut additional $1 trillion between FY FY 2021 Social Security, Pell Grants, Medicaid exempt Bipartisan Budget Act enacts short-term changes

Federal Spending, FY 2014

Federal Spending, FY 2022 Source: Center on Budget and Policy Priorities based on CBO data

NDD Lowest Level Since Eisenhower Source: Center on Budget and Policy Priorities based on CBO data

Health in the Crosshairs Federal discretionary health cuts 11% to date – Wide variation across HHS Sequestration in FY 2013 alone… – Cut $2.5 billion from discretionary health Cut $1.5 billion from NIH Most cuts restored in FY 2014 – $1 billion restored at NIH FY 2015 level provides no room for growth

The Lost Decade (?) The levels are too low – Zero sum gain going forward – Levels don’t keep pace with inflation, growth – Conflicting priorities create additional strain Fierce competition for limited resources – Must do vs. nice to do – Cannibalization of health

NAEVR estimates that in 2013, United States spent $2.8 billion on vision research – Federal government: $717 million NEI: $637 million (intramural/extramural) Other NIH: $30 million DoD: $20 million VA: $20 million (intramural) Other (NSF, DoE): $10 million – Foundations: $50 million (est) – Industry: $2 billion (est) Funding Is Out There

Thinking Strategically to Survive Remain vigilant to break the cycle of austerity – Educate about impact of cuts, both real and opportunity costs Visit for examples! Adjust to the “new normal” Explore creative funding models amid declining federal funds – #IceBucketChallenge, walks, rallies aren’t enough Vision Research Funding Partnership: Imagining the Possibilities Sept. 17, 2014

Supplementing Federal Funding Many models for supplementing federal research investments in the private, philanthropic sector – Research (e.g., American Heart Association) – Career development (e.g., universities) – Young investigators (e.g., research societies)

ASH: “Bridging” the Gaps American Society of Hematology established “bridge” program to enhance competitiveness of its members in NIH applications Developed by Board in direct response to declining federal funding (pre-sequestration) Society is principal funder, with additional support from corporate, individual donors Meant to be temporary solution

ASH: “Bridging” the Gaps Goal: Sustain research and contribute to retention in hematology investigation Baseline commitment: $9 million over three years ( ) Awards: 30, one-year awards of $150,000 each year Match: Institution must commit $50K – Ensures institution is vested in investigator success

ASH: “Bridging” the Gaps Eligibility: ASH members who applied for NIH R01 or equivalent but were denied funding – Investigators with $250K in resources ineligible Purpose: To address critiques from NIH application, strengthen for resubmission, and ultimately obtain NIH funding – NOT a new R01

ASH: “Bridging” the Gaps Research: basic, translational, patient- oriented clinical, outcomes-based Process: Synchronized with NIH cycle; study sections review bridge applications Demographics: Wide spectrum of researchers and disciplines (PhD, MD, MD/PhDs)

Success to Date Early wins show program’s promise – Positive feedback from awardees – 11 awardees have received R01s – NIH “loves it!” – ASAE 2013 Summit Award for “excellence in working to create a stronger America and world” Full evaluation planned Continuation to be considered

Lessons from ASH Governance: Who oversees the program? Administration: Who manages the program? Funding: Who funds, at what level? Where does money go? Match or no match? Eligibility: Who’s eligible, for what research? Promotion: How do you get the word out? Evaluation: How do you define “success?” What metrics?

Contact Emily J. Holubowich, MPP Senior Vice President Cavarocchi ∙ Ruscio ∙ Dennis Associates Follow