W

ASHINGTON — Secretary of Health and Human Services Tom Price on Wednesday defended the Trump administration’s proposed cuts to medical research, saying that the National Institutes of Health budget is plagued by unnecessary expenses.

“Our goal is to fashion a budget that focuses on the things that work, that tries to decrease the areas where there are either duplications or redundancies or waste, and whether indeed we can get a larger return for the American taxpayer,” Price told a House committee.

Price also noted that given across-the-board HHS spending cuts, the NIH next year will continue to receive roughly one-third of total department funding.

advertisement

The remarks came a day after reports that the administration had proposed an additional $1.2 billion cut to the NIH for the current fiscal year, on top of a suggested $5.8 billion cut for 2018. The NIH’s 2016 budget totaled $32.3 billion.

Newsletters

Sign up for our Daily Recap newsletter

Please enter a valid email address.

Republicans and Democrats alike questioned Price on the nature of the cuts at a health appropriations subcommittee hearing on Wednesday. Members of Congress from both parties have expressed either skepticism or flat unwillingness to support President Trump’s initial 2018 budget recommendations.

Price repeatedly suggested reducing the amount the NIH pays universities to cover “overhead” costs, like lab equipment and utilities. That would let the agency direct more of its funds to actual research, even if the overall budget were reduced, he said.

“I was struck by one thing at NIH,” Price said, “and that is that about 30 percent of the grant money that goes out is used for indirect expenses, which as you know means that that money goes for something other than the research that’s being done.”

Representative Tom Cole, the Oklahoma Republican who chairs the subcommittee, replied: “We look forward to working with you to find ways to stretch those dollars further.”

Cole had previously told STAT that the proposed cut to the NIH budget was a nonstarter.

Congresswoman Lucille Roybal-Allard of California, a Democrat, pressed Price on the administration’s plan to consolidate the Agency for Healthcare Research and Quality back into the broader NIH.

“We envision the opportunity for the NIH to assume the important duties of AHRQ, and then to decrease or reduce or eliminate the duplication and redundancies,” Price said. “Clearly, some of the kinds of things that are being done at NIH are also being done at AHRQ, and so we look forward to the opportunity to fold AHRQ into NIH and gain those efficiencies but also make sure we’re continuing to fulfill [AHRQ’s] mission.”

The AHRQ received $428 million in HHS funding in 2016, and has a stated mission “to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable.”

An earlier version of this story incorrectly stated that AHRQ received funding from NIH.

Leave a Comment

Please enter your name.
Please enter a comment.

  • “Cut indirect costs like lab equipment that don’t go to actual research”. What exactly could be more direct a cost than the instrumentation that allows a scientist to actually do science? I don’t think I’ve ever heard a dumber statement uttered in my entire life. This is an all out assault on biomedical research. Whatever doctors in the future treat Trump should have no access to lab equipment. Let’s go back to 19th century medicine.

  • Perhapsody he would like to do his job without computers, phones, pens, paper,pencils, aides, vehicles, mileage, file czbinets, desks, chairs, ……do I need to go on. Idiot

  • Tom Price is 99% wrong, but the 1% right is significant. Indirects, some exceeding 65% at the more ‘prestigious’ institutions, are outrageous and should be brought under control and some kind of rational accountability established. Allowing them to be used to pay off construction debt, add to administrative bloat and all the rest is not causal but certainly a contributing factor in our universities and medical schools turning into self-perpetuating adjuncts to the pharmaceutical/industrial complex. There might be an iota of justification for this if we were leading the world in health indicators, but we’re lagging far behind. In fact, you can look out from the polished windows of some of our better known local institutional monuments to modern academic architecture and stare down into neighborhoods with alarming health disparities.

  • My daughter is a pediatric oncologist at Boston Children’s Hospital. She is currently doing pediatric leukemia research. She has benefited greatly from the NIH. It has been helpful with her medical school loans. If she doesn’t continue to receive the aid, she may be forced to halt her research. She will have to seek employment outside the scientist/research field. We lost her Dad, my husband, to cancer, so this has special meaning to her. All her patients are so precious to her. Please reconsider these cuts. If you don’t the shortage of physicians who can afford to continue in the research field will be further increased.

  • To lower costs and improve outcomes in low back, Dr. Price should endorse the recent nondrug guidelines by the American College of Physicians that recommend spinal manipulation and therapeutic massage as front-line treatments. These ACP guidelines would drastically reduce the amount of opioids, epidurals, and spine fusions that have proven clinically and cost ineffective. But will Dr. Price, an orthopedist, ever recommend such guidelines to his fellow spine surgeons and live to tell about it? I seriously doubt he will ever cut back on the medical spine surgery industry as he did on the NIH budget. It’s not about evidence-based “best practices” but it’s about pride, prejudice and profit.

  • This is an absurd comment. Indirect costs are not waste proof, but by and large they go to research funding. Gotta keep the lights on, pay salaries for people who dont’ have a current grant etc.

    • This is a really naive comment. Indirects have long paid for highly questionable expenses, and PIs curse them all the time.

      “But many worry that the negotiation process allows universities to lavish money on new buildings and bloated administrations. ‘The current system is perverse,” says Richard Vedder, an economist at Ohio University in Athens who studies university financing. “There is a tendency to promote wasteful spending.'”

      http://www.nature.com/news/indirect-costs-keeping-the-lights-on-1.16376

    • DCer – most of the indirects, at least at the last two R1 research institutions I have worked for, go towards paying the debt service and overhead on the buildings where the research is taking place. If you take indirects away, the PIs aren’t going to have anywhere to conduct their research.

    • Total hyperbole. The US medical research infrastructure has already been overbuilt in some leaders’ opinions (see Bruce Alberts circa 2009), and that was before the $1B stimulus funding to NIH for extramural labs.

      Furthermore, I also know multiple PIs that have had R01s renewed that have then been wooed by other academic centers with a $1,000,000 signing bonus and a sweet new lab. The indirects from that R01? They can be used to write that off if once they recruit the PI.

      It’s a system with zero transparency, one that has become wrought with incentives for waste and abuse.

    • Actually, indirect costs do not go to research funding.

      Direct costs = technician wages, researcher salaries, scientific supplies, conference travel, etc.

      Indirect costs = facility maintenance, electricity bills, water bills, administrative support, etc.

      Students already pay massive tuition fees which go towards the “indirect costs”. Also, salaries for labor is considered “direct costs”. Indirect costs intrinsically are not going towards research funding whatsoever.

    • -V

      But without those indirect costs, the research would not be possible. Plus, much of the equipment in my lab or shared departmental equipment that is used every day is purchased using indirect funds.

      And student tuition is just a red herring. Yes, tuition has been going up at an alarming rate, but that’s not really because of wasteful spending. Yes, there are always examples of large administration salaries or high cost student buildings, etc. But if you add all that up and spread it over tens of thousands of students, that really only raises tuition a few hundred dollars per student. The reason tuition is so large is that state/federal education spending has declined.

Sign up for our Morning Rounds newsletter

Your daily dose of news in health and medicine.

X