BALTIMORE — Advocates of robust funding for biomedical research have a busy week ahead of them in their efforts to restore the budget for the National Institutes of Health.

Sen. Barbara Mikulski (D-Md.), chair of the powerful Senate Appropriations Committee, reiterated her feelings on restoring nearly $1.5 billion in automatic spending cuts the NIH suffered earlier this year as a result of the sequester on federal spending.

“I’m now prepared to stand in front of the sequester budget cuts to make sure we don’t roll over our great institutions in this country that are determined to find the cures and contain diseases for today and the next century,” Mikulski said at a press conference here Monday at Johns Hopkins Hospital with NIH Director Francis Collins, MD, PhD.

The automatic spending cuts — commonly called sequestration or the sequester — were a measure put in place by Congress in 2011 as last-ditch means to hold down federal spending if congressional leaders couldn’t reach a consensus on how to do so. They didn’t, and the sequester went into effect March 1, cutting many nondefense programs by as much as 5% to 8%.

The move has been criticized because its across-the-board nature gives no discretion to traditionally bipartisan work like NIH research. The research agency went from more than $30 billion in annual funding to roughly $28.5 billion. The result: roughly 700 grants lost funding, Collins said Monday.

What was a very competitive application process — just 17% of grants were funded before the sequester’s effects — has become that much worse. “That’s a very unhealthy situation,” Collins said.

Later this week, lawmakers can begin to take steps to correct NIH’s situation.

The Senate subcommittee that handles the Department of Health and Human Services’ portion of the federal budget, which includes the NIH, will meet Tuesday morning to mark up the NIH’s fiscal 2014 budget. The full Appropriations Committee will meet Thursday morning to consider the same spending bill.

Mikulski has pushed for full restoration of the NIH’s budget for next year, but the committee won’t release details on the allocations until the full committee finishes its work Thursday.

“We want to say ‘No’ to the $1.5 billion cut in sequester,” Mikulski said Monday. “We want to say ‘No’ to the slash and crash of reckless cuts in American biomedical research.”

Appropriators in the House have yet to schedule a markup of an HHS spending bill at either the subcommittee or full committee level.

But like many things in Washington, the NIH’s budget may get hung up in ideological conflict between Republicans who control the House and Democrats who control the Senate.

House appropriators are working with an overall proposed fiscal 2014 budget that’s $91 billion less than the budget the Senate is working with — “a huge dollar amount,” said Mary Woolley, president of Research!America, the Alexandria, Va.-based advocacy organization for medical and health research.

“That’s not one of those things where you go to conference, slice it in half, and say you’ve got a deal,” Woolley told MedPage Today in a telephone interview.

The parties also hold opposing views on what role the government should play in biomedical research. “It’s going to be quite challenging this week,” she said.

Increasing NIH research can result in better treatment of cancer, HIV, strokes, and Alzheimer’s disease just to name a few conditions, Mikulski said. And, she noted, funding NIH now can reduce federal spending in other areas. For example, Medicaid spends 80% of its money on treating elderly patients many with cognitive impairments, she said.

“If you want to save money in Medicaid, don’t increase the eligibility requirements. Increase biomedical research and let the talented people in our country be able to do their job,” Mikulski said.

Johns Hopkins, which is in the senator’s home state of Maryland, is losing $70 million this year because of the sequester — $38 million NIH funding cuts plus a 2% cut Medicare payments and a cut in defense contracts.

“As severe [as the dollar cut] is [the cut in] our ability to train our next generation of researchers and physicians,” Paul Rothman, MD, dean of the Johns Hopkins School of Medicine, said Monday.

http://www.medpagetoday.com/PublicHealthPolicy/Washington-Watch/40322