NIH chief, drug industry leaders educate White House on US biomedical enterprise

Trump administration officials summoned drug industry, academic and government leaders to the White House May 8 to educate staff there about how the U.S. biomedical enterprise works.

Francis Collins, director of the U.S. National Institutes of Health, said he explained to White House staff and administration officials the economics of running the government's side of that enterprise and the benefits it brings to the nation, but did not discuss what he called the elephant in the room: the president's proposed $6 billion funding cut for the agency.

"We didn't spend that much time getting into financial funding models," Collins told reporters after the closed-door White House meeting, whose guests also included executives from Celgene Corp., Regeneron Pharmaceuticals Inc., Vertex Pharmaceuticals and Royalty Pharma as well as leaders from some of the top U.S. academic research institutions, including Stanford University, The Rockefeller University and the Mayo Clinic.

The idea of the meeting was to have an "open" discussion about the significant advances in human health and the economic stimulus that have resulted from public and private investments in biomedical research, "and why this is a particular exciting juncture for seeing acceleration in that pace," he said.

But Collins said that conversation occurred without directly acknowledging that President Donald Trump wants to slice 18% off the NIH's fiscal-year 2018 budget, which lawmakers on both sides of the aisle have said would severely hamper the agency — the world's largest single public funder of biomedical research.

Research grants

Most of the NIH's funds, which totaled about $32 billion for fiscal year 2017, including a $2 billion funding boost, are not spent internally by the agency, but are allotted in grants to academic institutions or biotechnology companies and other small businesses, which not only help to advance their research and development efforts, but also stimulate their local economies.

It is estimated that for every dollar the NIH puts into research over the next eight years, there will be $8.38 in investments and economic growth by the private sector, Collins said during the teleconference with reporters.

About 30% of the grant money the NIH distributes goes toward covering indirect expenses — funds used for facilities and administration costs to keep laboratories operating.

But Collins' boss, Health and Human Services Secretary Tom Price, argued at a March 29 hearing that because those funds are being spent on "something other than research," they could be cut.

Even though Price was at the White House meeting, his suggestion to cut those funds was among the "several elephants in the room" that were ignored, Collins said, adding that rising drug prices was another topic not addressed.

An economic driver

"Overall, the theme of the meeting was the way in which the combination of remarkably advanced university research engines funded by the NIH, together with the private sector picking up those basic science discoveries and moving them forward into clinical products — drugs and devices — has turned out to be a major driver of the American economy," Collins said. "And we are still unquestioned as the lead around the world in that effort."

He said those details were "something the administration might want to know about and to encourage."

"If you're going to have American innovation, it's good to figure out where the opportunities are and this was clearly an intention to look at this space and see what was happening and what could happen with appropriate kinds of support," Collins said.

The drug company executives invited to attend the meeting "all made the case that what NIH does in this space in terms of supporting basic science is not something that companies could do," he said. "Their shareholders would not tolerate the idea that they were putting their investments into the kinds of science that's not directly connected to a downstream product. And yet, they deeply depend on NIH to provide that and that has been the reason in their view why this has been such a successful enterprise."

After two hours in the room, Collins said he hoped the White House staff and administration officials understood that "we have a vigorous engine for discovery that depends on all of these parts and all the parts need to be running in a very effective way in order for this to continue."

"The message in the room was loud and clear: we need the NIH. And we need it now more than ever," Cory Bargmann, president of science at the Chan Zuckerberg Initiative, wrote on Facebook after the meeting.

Trump did not attend the meeting, but the group had a brief encounter with him in the Oval Office, Collins said. He noted that Vice President Mike Pence offered some opening remarks but did not stay for the meeting.