Margaret Anderson's written testimony on FY14 House Appropriations Subcommittee regarding NIH
Chairman Kingston, Ranking Member DeLauro, and members of the subcommittee, thank you for the opportunity to present my testimony on the critical importance of the federal investment in medical research at the National Institutes of Health (NIH).
I am Margaret Anderson, executive director of FasterCures, the Milken Institute’s Center for Accelerating Medical Solutions. FasterCures is a nonprofit and nonpartisan organization focused on improving the medical research and development (R&D) system – so that we can speed up the time it takes to get important new medicines from discovery to patients. We work across diseases, disciplines, and sectors – academic institutions, government agencies, biotechnology and pharmaceutical companies, investors, medical research foundations, and patient advocacy groups – to catalyze transformative action that's focused on improving the medical research system to meet patients' needs.
At a time when scientific and technological advances have yielded and continue to promise remarkable breakthroughs, the ecosystem has yet to refine its ability to translate these advances into therapies that improve patient health.[i] But having an R&D enterprise that’s functioning at peak performance is the only hope for one in three Americans suffering from cancer, Alzheimer’s disease, diabetes, Parkinson’s disease, heart disease, and other illnesses for which there are still no cures—and, in many cases, few meaningful treatment options. Our ability to fully realize science’s potential heavily depends on our national commitment to supporting medical research.
I am submitting this written testimony to urge the subcommittee to reaffirm our nation’s commitment to medical research.
Investing in the NIH yields enormous returns
As you well know, federal investment in NIH-funded medical research over the past few decades has yielded enormous breakthroughs in understanding, preventing, diagnosing, and treating many diseases – advances such as the sequencing of the human genome, which is leading us closer to the age of precision medicine.
Here are just a few tangible examples of how NIH research has vastly improved our lives.
- Americans are living nearly 30 years longer than they did in 1900. Not only have these gains in longevity enriched many lives, they have added an estimated $3.2 trillion annually to the U.S. economy since 1970.[ii]
- An investment of approximately $5 per year for NIH heart disease research from each American has been key to reducing mortality from heart disease and stroke by more than 60 percent since 1970, with an economic return estimated at $2.5 trillion per year.[iii]
- Meanwhile, $7 a year per American supported HIV/AIDS research. A disease which once threatened to overrun our hospital systems is manageable today without hospitalization thanks to breakthroughs enabled by NIH, with total savings of $1.4 trillion to date.[iv] Not only have we developed effective therapies that are increasingly transforming the disease from a death sentence to a chronic condition, but also researchers are now closing in on a vaccine. Had we failed to invest in AIDS studies, millions more would have suffered and died.
- An investment of approximately $9 per year for NIH cancer research from each American over the past 40 years[v] has doubled the survival rates for a number of cancers, and survivors enjoy a better quality of life.
But much remains to be done
At our recent Celebration of Science[vi] event held in September 2012, we witnessed scientific discovery literally unfold on the stage of the National Institutes of Health as scientists and patients told breathtaking stories of research triumph – a glimpse of how scientific discoveries have improved health and saved lives. It was remarkable.
We understand the biology of thousands of diseases, but only 250 have treatments available. So, while we need to celebrate the success stories in medical research that allow us to carry on our lives – be those successes through prevention, diagnostics, devices, or medical intervention – we have more work to do. We must ensure that we continue to have a robust flow of scientific discoveries that we can then translate into better health.
Today, our aging population faces unprecedented health challenges that threaten to send entitlement spending to unsustainable levels. Alzheimer’s disease alone will cost an estimated $1.1 trillion a year in 2012 dollars by 2050 (up from $200 billion today) if we don’t change its course.
Demographers, epidemiologists, and economists project that the rising costs of age-related chronic conditions will surpass our ability to pay for care, leaving us with bleak choices between widespread suffering and financial ruin.
At FasterCures, we’re more optimistic. Research will solve this challenge – and many others. But timing matters.
NIH helps drive economic productivity and global competitiveness
A continued investment in basic science is also key to our economic productivity and global competitiveness. An analysis on NIH’s role in sustaining the economy[vii] found that:
- NIH supports nearly half a million jobs all across the country and remains the largest funder of life sciences research in the U.S.
- More than 80 percent of its budget directly funds “extramural” research performed by 325,000 scientists at more than 3,000 institutions in all 50 states and DC.
- In 2011, NIH research funding led to the creation of more than 400,000 new jobs, $62 billion in new economic activity in the U.S., and 500 patent applications worldwide.
America still leads the world in scientific discovery, but China, India, Japan, the U.K., Singapore, and others are catching up quickly as they increase research budgets as much as 20 percent a year. China has pledged to devote $308.5 billion just to biotechnology between 2012 and 2017, compared with a projected $160 billion for all NIH programs.[viii]
- If present trends continue, China’s financial commitment to biomedical research will be twice that of the US’s in the next five years (and four times greater as a share of GDP);
- Growth in high-wage, high-skill jobs in the life sciences sector is flat-lining in the United States, while employment in other countries, like Germany and France, shows consistent growth;
- The U.S. accumulated a $136.7 billion trade deficit in pharmaceutical products over the last decade, a period when many competitors realized increasing trade surpluses;
- The United States’ share of global biopharmaceutical patents and overall industry output is shrinking, while China’s continues to expand in these areas; and
- China already has more gene sequencing capacity than the entire United States and about one-third of total global capacity.
If we fail to make the investment now, we will not only lose our leadership in the global economy, we will also find young American scientists seeking more promising opportunities in other fields or in countries with a more robust medical research infrastructure.
Just as our nation has always sought to honor the commitments we made to veterans, we should also follow through on the implicit promises we made to the next generation of scientists. America’s leaders told these students there is a great future in pursuing STEM education (science, technology, engineering, and math). Those who did, and then persevered through as much as 15 years of professional training, now find their opportunities are shrinking.
As FasterCures founder Michael Milken noted, “unlike delaying construction of a bridge that can be resumed in a few years, if we lose a generation of scientists, there’s no way to rebuild that human capital quickly.”
NIH research provides the foundation for biotechnology and pharmaceutical companies
Improving and accelerating research and development requires all stakeholders in the medical research ecosystem to work together – including federal agencies, industry, academia, and patient groups. A majority of therapies have come to market because of national investments in science from agencies such as NIH.[ix]
Medical research at the NIH directly impacts the pharmaceutical research and development industry, with 90 percent of PhD scientists relying on NIH to support their research training and 74 percent of pharmaceutical and biotechnology companies having licensed patents from NIH-funded academic research.[x]
To provide additional context, I wanted to share anecdotes from two biopharma executives:
- Earlier this month, at a FasterCures and Friends of Cancer Research briefing on Capitol Hill, N. Anthony Coles, president and CEO of Onyx Pharmaceuticals, stressed that biotechnology and pharmaceutical companies depend solely on research funded by the NIH to understand human biology and disease origins, and that industry then takes this knowledge, advances the research, and moves it toward the delivery of medical products to patients.[xi]
- In November 2012, at our 4th annual Partnering for Cures conference, we heard from Mikael Dolsten, president of worldwide R&D for Pfizer, that, “even as one of the biggest biomedical R&D investors in the world, Pfizer cannot and should not go it alone.”
We face a major paradox – the potential of science is greater than ever but the outlook for funding has never been bleaker
As I wrote in Science Translational Medicine[xii] earlier this month, when it comes to supporting medical research, time is not on our side. The decisions we make today will have implications long into the future.
Committing less to our medical research infrastructure means that we are letting the possibility of a cure sit in a cupboard instead of pursuing its full potential to benefit patients, families, and communities. Allowing the opportunities presented by science to wither on the vine means the potential for transformational advances in health and medicine will remain untapped. Which initiative in science doesn’t matter? Which disease isn’t relevant to study? Which therapy won’t be developed? Which young scientist will not make the discovery we are all counting on in the future?
The cost of inaction is unthinkable. We must act. Our future is at stake.
Increased funding for the NIH must be prioritized, for all of the reasons mentioned. Cuts today will have ripple effects for years to come. Our collective future is at stake.
There are many compelling reasons why FasterCures supports a continued strong investment in NIH. But the most primary and powerful reason we care for this vital agency lies at the core of our mission: It’s about saving lives. There isn’t a single person whose life has not been touched by disease. We all know someone who could use a faster cure.
We are at a critical inflection point in current discussions within the biomedical research enterprise about what actions need to be taken to push the science toward cures where possible. We need to take advantage of this moment and adequately fund our nation’s medical research agency.
Thank you again, distinguished Committee members, for your service to our nation. I appreciate the opportunity to present this written testimony. I would be happy to answer any questions you have or provide additional information.
[i] Drug discovery and development: Understanding the R&D Process. www.innovation.org
[ii]Impact of NIH Research. www.nih.gov/about/impact/health.htm
[iii] Forbes: Legendary Drug Industry Executives Warn U.S. Science Cuts Endanger The Future. March 6, 2013 http://www.forbes.com/sites/matthewherper/2013/03/06/drug-industry-greats-say-the-u-s-must-reverse-the-cuts-to-our-investment-in-science/
[iv] Forbes: Legendary Drug Industry Executives Warn U.S. Science Cuts Endanger The Future. March 6, 2013 http://www.forbes.com/sites/matthewherper/2013/03/06/drug-industry-greats-say-the-u-s-must-reverse-the-cuts-to-our-investment-in-science/
[v] NCI Budget Information. http://www.cancer.gov/aboutnci/servingpeople/nci-budget-information
[vi] Celebration of Science. www.celebrationofscience.org
[vii] United for Medical Research: NIH’s Role in Sustaining the U.S. Economy. http://www.unitedformedicalresearch.com/wp-content/uploads/2012/07/NIHs-Role-in-Sustaining-the-US-Economy-2011.pdf
[viii] United for Medical Research: Leadership in Decline. http://www.unitedformedicalresearch.com/advocacy_reports/leadership-in-decline/
[ix] NIH: NIH… Turning discovery into health. www.nih.gov/about/discovery/viewbook_2011.pdf
[x] Economic Impact of NIH Funded Research, Burnham Institute for Medical Research Congressional Briefing, February 25, 2009.
[xi] FasterCures-Friends of Cancer Research Hill Briefing: Cutting-Edge Science, Collaboration, and Sustained Funding Needed to Get New Medicines from Lab to Patient. February 5, 2013. http://www.fastercures.org/Programs/hill-briefings.php
[xii] M. Anderson, No time to waste. Sci. Transl. Med. 5, 174ed3 (2013).