Very excited to announce a new series of short papers on NIH reform from an event co-organized with and .
With an annual budget of ~$47 billion, the NIH is our most important health R&D funder, but we can make it even better.
Conversation
The NIH plays a fundamental role in nearly every aspect of biomedical research.
In addition to being the largest funder of basic research, ~50% of patents linked to drugs approved by the US Food and Drug Administration directly cite NIH-funded research.
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But the NIH also faces considerable challenges:
- The average age of principal investigators keeps rising
- Researchers report spending ~half their time on grant-related paperwork rather than active research
- The ratio of “disruptive” papers appears to be declining
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While there is a lot of excitement over potential new models – funding people instead of projects, or using “golden tickets” to allow reviewers to champion specific proposals – we don’t really know which approaches are most effective at funding socially valuable science.
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This series of papers brings together scholars to shed light on these issues.
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Bhaven Sampat starts with a foundational piece on the history and debates surrounding the NIH’s design and subsequent reforms.
His insights into the history of the NIH peer review process provide context for current reform efforts.
brookings.edu/wp-content/upl
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Pierre Azoulay () documents a "risk-taking penalty" in NIH grant renewals and proposes an agenda to study this phenomenon by validating metrics of risk and testing potential reforms.
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Paula Stephan and Chiara Franzoni (), likewise, argue that grant review may disadvantage risky research.
They propose alternative ways to evaluate the expected value of research and to reduce biases against high-risk, high-reward work.
brookings.edu/wp-content/upl
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Lisa Larrimore Ouellette () articulates the political and empirical challenges to reforms related to patenting and licensing, and argues that the NIH should pilot and rigorously evaluate reforms to its commercialization policies.
brookings.edu/wp-content/upl
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Kyle Myers () explores the potential for institutionalizing randomized experiments within the NIH to generate robust evidence on key open questions.
This approach could further enhance the NIH's ability to evaluate and fund impactful science.
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Maya Durvasula () discusses the relationship between clinical trial infrastructure and representative medical research.
She argues NIH is uniquely equipped to make targeted infrastructure investments to facilitate representative evidence.
brookings.edu/wp-content/upl
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Robert Cook-Deegan () argues that the largest gap in U.S. health research is relatively sparse support for health services research and social sciences.
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Former Rep. Rush Holt () discusses NIH's challenges in balancing fundamental science and practical health goals.
He calls for a shift in the research paradigm, urging NIH to take a more active role in bridging science and public understanding.
brookings.edu/wp-content/upl
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This series of papers underline the immense social value of the NIH and the need for constant introspection and reform.
Even small improvements in the productivity of NIH’s spending could translate into massive gains in social welfare.
Full series:
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I'm very grateful to our writers, workshop participants, and co-organizers , Richard Frank, and
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