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Cited by 509Health and Medical Research ImpactsHealth Systems, Economic Evaluations, Quality of LifeGlobal Health Care Issues

The Relation between Funding by the National Institutes of Health and the Burden of Disease

Gross, Cary P., Anderson, Gerard F., Powe, Neil R.·1999·New England Journal of Medicine
DOI 10.1056/nejm199906173402406
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Abstract

BACKGROUND: The Institute of Medicine has proposed that the amount of disease-specific research funding provided by the National Institutes of Health (NIH) be systematically and consistently compared with the burden of disease for society. METHODS: We performed a cross-sectional study comparing estimates of disease-specific funding in 1996 with data on six measures of the burden of disease. The measures were total mortality, years of life lost, and number of hospital days in 1994 and incidence, prevalence, and disability-adjusted life-years (one disability-adjusted life-year is defined as the loss of one year of healthy life to disease) in 1990. With the use of these measures as explanatory variables in a regression analysis, predicted funding was calculated and compared with actual funding. RESULTS: There was no relation between the amount of NIH funding and the incidence, prevalence, or number of hospital days attributed to each condition or disease (P=0.82, P=0.23, and P=0.21, respectively). The numbers of deaths (r=0.40, P=0.03) and years of life lost (r=0.42, P=0.02) were weakly associated with funding, whereas the number of disability-adjusted life-years was strongly predictive of funding (r=0.62, P<0.001). When the latter three measures were used to predict expected funding, the conclusions about the appropriateness of funding for some diseases varied according to the measure used. However, the acquired immunodeficiency syndrome, breast cancer, diabetes mellitus, and dementia all received relatively generous funding, regardless of which measure was used as the basis for calculating support. Research on chronic obstructive pulmonary disease, perinatal conditions, and peptic ulcer was relatively underfunded. CONCLUSIONS: The amount of NIH funding for research on a disease is associated with the burden of the disease; however, different measures of the burden of disease may yield different conclusions about the appropriateness of disease-specific funding levels.

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Authors
Gross, C. P., Anderson, G. F., & Powe, N. R.
Affiliations
Johns Hopkins University (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1999-06-17
Volume
340
Issue
24
Pages
1881-1887
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199906173402406
OpenAlex
W2330331754
Cited by
509
References
25
Citations by year
2026: 9 · 2025: 16 · 2024: 15 · 2023: 21 · 2022: 14 · 2021: 16 · 2020: 12 · 2019: 29 · 2018: 10 · 2017: 7 · 2016: 19 · 2015: 18 · 2014: 23 · 2013: 18 · 2012: 28
FWCI
32.43
Type
journal article
Language
en
Open access
closed
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health and Medical Research Impacts
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Health Professions › General Health Professions › Global Health Care Issues
Keywords
National Institutes of Health, research funding, disease burden, disability-adjusted life years, years of life lost, incidence and prevalence, length of hospital stay, mortality, health research priorities
MeSH terms
Cross-Sectional Studies, Disease, Hospitalization, Humans, Morbidity, Mortality, National Institutes of Health (U.S.), Research Support as Topic, Social Change, Social Values, United States, Health Care Rationing, Cost of Illness, Sickness Impact Profile, Quality-Adjusted Life Years, Federal Government, Biomedical Research, Resource Allocation

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