Taking Steps to Address Cancer: Research Funding

Last year, MD Anderson President John Mendelsohn, M.D., proposed 10 steps that can be taken to ensure cancer deaths decrease more rapidly, the ranks of survivors swell, and an even greater number of cancers are prevented in the first place.

This is the seventh in a series of posts on key actions outlined by Mendelsohn:

7. Increase funding for research.

After growing by nearly 100% from 1998 to 2002, the National Cancer Institute (NCI) budget has been in decline the past four years.

Through budget cuts and the effects of inflation, the NCI budget has lost approximately 12% of its purchasing power. Important programs in tobacco control, cancer survivorship and support for interdisciplinary research have had significant cuts. Currently, the NCI is able to fund only 10% of grants submitted and approved by the peer-review process. Lack of adequate funding discourages scientists with outstanding research track records from undertaking innovative, but risky research projects. And this jeopardizes the U.S. leadership in biomedical research.

The issue of how to pay for clinical trials must be addressed. The non-experimental portions of the costs of care in clinical trials currently are borne in part by Medicare, and should be covered fully by all payors. The new health care reform legislation addresses this important issue.

The experimental portion of costs of care should be covered by the owner of the new drug, who stands to benefit from a new indication for therapeutic use.

Another major concern is inadequate funding of clinical trials carried out under NCI sponsorship. According to two recent studies, NCI grants to support cooperative group clinical trials reimburse only one-third of the costs of trials despite their tremendous contributions to patient care.

Clinical research supported by pharmaceutical and biotech companies focuses primarily on gaining FDA approval for new agents. In contrast, NCI-sponsored clinical trials carried out by national cooperative groups and individual cancer centers are more likely to focus on:

• comparative effectiveness of new therapies,
• comparisons of approved drugs,
• combining novel agents from different companies,
• therapies for rare diseases, screening and prevention, and
• multimodality therapies.

In exchange for and as an incentive for improved funding, clinical investigators should continue to improve the quality and speed of launching clinical trials.

Next: 8. Encourage new partnerships for drug and device development.