Biomedical Research:

Issues Related to Increasing Size of NIH Grant Awards

HRD-88-90BR: Published: May 6, 1988. Publicly Released: Jun 6, 1988.

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In response to a congressional request, GAO reviewed the growth in the National Institutes of Health (NIH) biomedical research grant awards to determine: (1) trend data in the NIH budget for fiscal years (FY) 1983 through 1987; (2) the size of research project grants for those years; (3) factors that could explain the increased size of awards; and (4) the reviewing, monitoring, and reporting practices NIH uses in dealing with grant recipients.

GAO found that: (1) NIH awarded the majority of its grants through its extramural research programs as research project grants (RPG) to institutions to conduct basic and clinical research; (2) between 1983 and 1987, the total NIH budget grew by 54 percent, from $4 billion to $6.2 billion; (3) average RPG awards rose 42.7 percent, from $123,800 to $176,700, with the sharpest rise between 1986 and 1987; and (4) NIH used the Biomedical Research and Development Price Index, rather than the gross national product, to adjust costs for inflation, which made the average grant award rise 17.7 percent between 1983 and 1987. GAO also found that the factors that contributed to the increased size of grant awards included: (1) inflation and the rising costs of biomedical research; (2) the types of grants funded; (3) increased personnel costs; (4) indirect costs, which accounted for about one-third of total grant amounts; and (5) the increasing complexity of research and the increased use of human subjects. In addition, GAO found that: (1) NIH has relied on its grantees to monitor and audit grants; (2) NIH shifted most audit efforts to the institutions and required them to contract with independent firms and send audit reports to NIH for review; and (3) most of the audits were general in nature and did not focus on individual grants.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: NIH budget submissions continue to include the GNP implicit price deflator, but not BRDPI. NIH stated these data will be provided on request to the House Appropriations Subcommittee. The Subcommittee has not asked that BRDPI be routinely included in budget justifications.

    Recommendation: The Department of Health and Human Services (HHS) should use both the GNP implicit price deflator and BRDPI, as supplemental data to accompany NIH budget requests, to compare current and constant dollars of research grants.

    Agency Affected: Department of Health and Human Services

  2. Status: Closed - Implemented

    Comments: As a followup to the report, the House Appropriations Commitee required the HHS Office of Inspector General (OIG) to study this issue. OIG provided a report to the Committee on its review. NIH stated it will continue to monitor increasing costs.

    Recommendation: HHS should report to Congress on the results of its analyses and any measures taken or required to ensure the adequacy of controls over research grant awards.

    Agency Affected: Department of Health and Human Services

  3. Status: Closed - Implemented

    Comments: NIH provided these data to Congress in FY 1989 and will continue to do so, since the subject almost always arises during hearings. With the HHS OIG review being initiated, these issues are to be included.

    Recommendation: HHS should analyze the increasing size of research grants, including the large incremental increases in competing renewal awards and cost-of-living increases in noncompeting continuation budgets unrelated to the actual inflation rate.

    Agency Affected: Department of Health and Human Services


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