NIH and War on Opioid Abuse Fare Well in Spending Bill

May 01, 2017

The National Institutes of Health (NIH) and the war on opioid abuse fare well in a discretionary spending bill that would keep the federal government funded through September 30, which marks the end of fiscal 2017.

Republican and Democratic lawmakers hammered out the plan over the weekend. The Republican-controlled House and Senate need to pass the measure by midnight on May 5 to avoid a government shutdown.

A 6.2% increase for the NIH contrasts with President Donald Trump's much criticized plan to cut the agency's budget by 20% in fiscal 2018, which begins on October 1. Under the spending bill, NIH funding would increase from roughly $32 billion in fiscal 2016 to $34 billion in fiscal 2017, with almost half of those extra dollars going to three institutes in particular:

Table. NIH Spending Increases

FY 2016 Enacted Spending FY 2017 Proposed Spending Year-to-Year Change in Dollars Percentage Change
National Institute on Aging $1,600,191 $2,048,610 $448,419 28%
National Institute of Allergy and Infectious Diseases $4,629,928 $4,906,638 $276,710 6%
National Cancer Institute $5,214,701 $5,389,329 $174,628 3.3%
Total NIH $32,084,000 $34,084,000 $2,000,000 6.2%
FY = fiscal year
Source: House Appropriations Committee

In a deeper drill-down of NIH spending in 2017, the bill provides $400 million more for Alzheimer's disease research, $120 million more for the Precision Medicine Initiative, $110 million more for the Brain Research through Advancing Innovative Neurotechnologies Initiative, and $50 million more for antibiotic resistance research.

The proposed spending bill makes good on lawmakers' promises to battle the nation's epidemic of opioid abuse and overdose deaths. The Substance Abuse and Mental Health Services Administration (SAMHSA) would receive an additional $150 million for programs to prevent and treat opioid and heroin use. That amount is on top of another $500 million in opioid-abuse initiatives authorized by the 21st Century Cures Act, passed in December 2016.

Aside from the spending increase for opioid programs, SAMHSA would experience an overall 0.4% decrease in fiscal 2017, one of several federal agencies that essentially would remain at 2016 levels. Spending would increase by 0.3% for the Centers for Disease Control and Prevention and decrease by 0.5% for the US Food and Drug Administration. The needle moves a little more for the Health Resources and Services Administration (HRSA), which includes programs to bolster the clinical workforce. Its fiscal 2017 spending would increase by 1.2%.

The entire bill provides for $1.07 trillion in discretionary spending to operate the federal government. That amount doesn't include mandatory funding for programs such as Medicare and Social Security. The bill also allots $102 billion for overseas military and antiterrorism operations, border security, and disaster and emergency response.

Oncology Groups Pleased

The bipartisan spending bill quickly garnered good reviews from medical societies, particularly in regard to the $2 billion raise for the NIH.

"This increase reaffirms the United States' longstanding, bipartisan commitment to scientific research, and will reinvigorate the scientific community as it continues to build after a decade of flat funding," said Cliff Hudis, MD, CEO of the American Society of Clinical Oncology, in a news release. Dr Hudis added that his group would continue to push for robust NIH funding in fiscal 2018.

The American Association for Cancer Research (AACR) was just as pleased. In a note to members, AACR President Michael Caligiuri, MD, and CEO Margaret Foti, MD, PhD, said that the increased funding would "significantly accelerate our nation's pace of progress against cancer."

John Meigs Jr, MD, the president of the American Academy of Family Physicians, told Medscape Medical News in an emailed statement that his group appreciates how the legislation keeps the funding level for HRSA. Dr Meigs cited HRSA scholarships for medical students who go into primary care and work in underserved areas, and other programs that support primary care education. He also found good news in a mere 3% cut — and survival — for the Agency for Healthcare Research and Quality (AHRQ), which some Congressional Republicans have proposed abolishing, and which Trump wants to fold into the NIH.

"The continuation of the agency recognizes its importance," said Dr Meigs. He called the AHRQ "fundamental to ensuring that primary care physicians have the most up-to-date evidence on providing safe, effective, and efficient healthcare."

Follow Robert Lowes on Twitter @LowesRobert

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