Senate Approves $2.34 Billion Budget for Alzheimer’s Research
The U.S. Senate has voted to allocate more funds to Alzheimer’s research. In an 85–7 vote on August 23, the lawmakers stipulated a 2019 fiscal year budget that, if signed into law, would include $2.34 billion for AD research, topping 2018’s AD research budget by $425 million. The bill also includes a $2 billion increase for the National Institutes of Health, increasing that agency’s funding to $39.1 billion. The research budget was a small part of a massive, $857 billion appropriations bill, which laid out spending for the departments of Defense, Labor, Health and Human Services, and Education.
- Senate voted to allocate $2.3 billion to AD research.
- Tops last year’s AD research budget by $425 million.
- Total NIH budget boosted by $2 billion.
The $2.34 billion proposal for AD research still pales in comparison to the estimated $277 billion the country spends every year on dementia care, Sen. Roy Blunt told the Senate ahead of the vote. According to the Alzheimer’s Association, this price tag includes $186 billion in Medicare and Medicaid payments. Without a cure, government spending is predicted to rise to $1.1 trillion by 2050, Blunt added.
Bruce Lamb of the University of Indiana School of Medicine in Indianapolis noted that the budget proposal exceeds the $2 billion in annual funding proposed in 2011, when the National Alzheimer’s Project Act was first passed and the National Plan was developed. “Given some of the recent disappointments in the AD clinical trials, we likely will need to further increase investments to help speed the process of identifying new drug targets, to improve the drug-discovery pipeline, to redesign clinical trials that target specific patient populations, and to discover lifestyle interventions that slow or prevent dementia,” Lamb told Alzforum.
Ilya Bezprozvanny of the University of Texas Southwestern Medical Center in Dallas called new budget fantastic news. “Hopefully it will enable testing of multiple new ideas about the causes of AD and help in developing new treatment options in addition to amyloid-targeting drugs, which are currently being tested in clinical trials,” Bezprozvanny said.—Jessica Shugart
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The passage of the Senate budget proposal to include an additional $425 million to the FY19 federal budget is an exciting development and continues the progress toward (and past) the original $2 billion proposed when the National Alzheimer’s Project Act was first passed in 2011 and development of the first National Plan.
The ambitious goal laid out in the National Plan was to have an effective treatment or prevention by the year 2025, which is now a mere six and a half years away! Given some of the recent disappointments in AD clinical trials, we likely will need to further increase investments to help speed the process of identifying new drug targets, to improve the drug-discovery pipeline, to redesign clinical trials that target specific patient populations, and to discover lifestyle interventions that slow or prevent dementia.
Indiana University School of Medicine
The congressional support for AD research in the recent past is extraordinary, and it is reassuring that our elected representatives have come to recognize the magnitude of the impact of the disease and provide new resources for research. The level of funding for AD is approaching a level commensurate with the public health threat it represents, for which we in the research community are very grateful. The challenge is to effectively deploy the new research dollars into endeavors that will provide new therapeutics. Indeed, the new funding has provoked a forceful reexamination of our scientific approaches to the disease. The impact of the new funding will be contingent upon our capacity to better understand the biology of AD and rethink therapeutic approaches to the disease.
Indiana University School of Medicine
The increased funding for Alzheimer’s research is a very welcome and encouraging piece of news. There is little doubt that hard work from activists, researchers, editorials, and public support played their parts. Now it is up to NIH to effectively utilize this funding.
It is important that grant support be provided in a rational and timely manner to boost Alzheimer’s research on multiple fronts. NIH administrators need to decide whether to direct the lion’s share of funds toward the same general paradigms of i) trials with ever-larger sample numbers in an attempt to p-hack out a small effect size or to ii) follow-ups of the “go-early” mantra based on blocking proximal disruptions (accumulations or secretases) rather than root causes.
Instead, bold ideas should be encouraged, not only from young investigators but also from seasoned hands. This requires equally bold steps by NIH, even reconsidering some time-hallowed methods.
For example, NIH follows the priority score from different study sections, which may or may not reflect bold or groundbreaking ideas any more than they reflect the tastes and biases of small evaluation teams. The fate of an application is based on the “initial score,” which is the arithmetic mean from a mere three reviewers. No measure of scale (e.g., standard deviation, range, or dissent) is provided or required to indicate if a poor mean is the consensus of the reviewers or reflects an outlier. Although NIH increasingly emphasizes the use of proper statistics to indicate inter-assay variability and reproducibility of NIH-funded research, it ironically does not do so when presenting its proposal evaluations. If any reviewer gives a bad score, the proposal is inevitably undiscussed/unscored.
Such a system essentially mandates a conservative and incremental approach, for fear of upsetting or going over the head of one reviewer. A large disparity in scores could very well indicate that a proposal is, indeed, truly novel, thus unlikely to sail through any selection of any three potential reviewers, who might be unable to evaluate the novel portions of the proposal and reject it out of hand for being "unthinkable." Thus, new ideas are killed before the benefit of a full-review panel that could be more trusted to have a sufficiently broad understanding to field the remarkable breadth of current-day proposals.
Many unfunded applications were based on ideas that were later found to be fruitful and that saw the light of day in high-impact publications, but at a potentially great cost of time—the only resource that cannot be recouped once squandered. Can we do better now with this increased funding?
Nathan Kline Institute/NYU Langone School of Medicine
Despite the deep political divide within the country, the proposed 2019 fiscal year budget that passed in the Senate $2.3 billion dollars earmarked for Alzheimer’s disease research, effectively surpassing the 2018 fiscal year AD research budget by $425 million. This bipartisan effort provides an impressive boost in federal AD research expenditures. Every person and organization at the local, state, and federal levels who lobbied and advocated for this increase should be commended, as our collective voices have been heard. Importantly, the multiyear upswing in AD research spending indicates the serious level of commitment by the federal government to research aimed at addressing AD, one of the most expensive and devastating public health issues in the U.S. and worldwide. I trust these funds will be used wisely to support basic, translational, and clinical research to understand the underpinnings of AD pathogenesis and foster new treatment avenues. Hopefully, this influx in dedicated funds will create a diversified portfolio infrastructure that supports young investigators, established investigators, and collaborative research programs that expand our current understanding beyond established norms so novel research endeavors can be nurtured that may lead to true discovery science for basic understanding and therapeutic intervention for AD and related dementing illness.
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