National Institutes of Health: Fiscal Year 2013 Research Funding Allocations across Selected Diseases and Conditions

What GAO Found

In fiscal year 2013, the National Institutes of Health (NIH) reported research funding levels that ranged widely for the 40 different Research, Condition, and Disease Categorization system (RCDC) categories GAO examined that corresponded to the most frequent causes of death in the United States, the most frequent causes of death globally, and the most prevalent chronic conditions for adults in the United States. For example, NIH reported funding levels ranging from $11 million for projects in the fibromyalgia category to about $5.3 billion for projects in the cancer category. Similarly, in a GAO report issued in March 2014, which included information about NIH’s fiscal year 2012 research funding related to these same diseases and conditions, GAO found that research funding levels for the same 40 RCDC categories also varied widely. RCDC is used by NIH to categorize research activities across the agency, though NIH officials told GAO that the RCDC was not designed to be able to estimate a total, non-duplicated amount of funding specific to a given disease or condition because RCDC categories are neither mutually exclusive nor exhaustive. Specifically, projects may be reported in multiple RCDC categories—on average, a single project may fall into five or six categories; some categories are inherently related, and therefore an entire RCDC category can also be contained within another category; categories do not exist for all diseases; and, according to NIH officials, 3 to 5 percent of NIH funded research projects do not appear in any RCDC category.

Why GAO Did This Study

NIH is the nation’s leader in sponsoring and conducting biomedical research related to life processes and many diseases and conditions, including those that are among the leading causes of death both in the United States and globally. In fiscal year 2013, NIH, an agency of the Department of Health and Human Services, had a budget of over $29 billion, most of which was used to fund research that supports scientists and research personnel working at universities, medical schools, and other research institutions and research performed by NIH scientists in NIH laboratories. Twenty-four of NIH’s 27 individual institutes and centers (ICs) support extramural research focused on particular diseases, conditions, or research areas. Decisions about which projects are funded are made by these individual ICs. GAO also found in its previous report that the five selected ICs that it reviewed set research priorities considering several similar factors, such as the burden of disease in a population, available appropriations, and gaps in funded research, among others. NIH reported fiscal year 2013 funding for 237 research, condition, and disease categories in RCDC. GAO previously reported information about NIH’s fiscal year 2012 research funding related to diseases and health conditions that are the leading causes of death or the most prevalent chronic conditions (see GAO-14-246). GAO was asked to provide fiscal year 2013 research funding related to these same diseases and conditions, and reviewed NIH funding reported by RCDC for the 40 research, condition, and disease categories that were identified in the prior report.

For more information, contact Linda T. Kohn at (202) 512-7114 or kohnl@gao.gov.