Federal budget cuts continue to take a toll on cancer research and, unless a budget agreement is reached within a few weeks, will continue to have far-reaching impact into next year, according to the leaders of several cancer centers.
Since they went into effect March 1, the cuts mandated by the Budget Control Act of 2011 – better known as sequestration – mean that fewer clinical studies have started and fewer patients have been enrolled in existing trials.
Walter J. Curran
The cuts also have led to the submission of less-innovative grant applications in hopes that they will be more easily approved by the budget-hamstrung National Cancer Institute, the directors of three NCI-designated cancer centers said at a press briefing Dec. 3.
Sequestration required the National Institutes of Health to cut 5%, or $1.55 billion of its fiscal year 2013 budget, applied evenly across all programs, projects, and activities. NCI officials estimated in June that they would be able to fund 326 fewer grants in 2013, for a savings of about $200 million.
The final impact on NCI-designated centers during fiscal 2013 – which ended on Sept. 30 – is still being calculated, in part because the government shutdown in October delayed that work, said David Pugach, director of federal relations for the American Cancer Society Cancer Action Network (ACS CAN).
Individual cancer centers, however, have already tallied the effects.
Dr. Walter J. Curran, executive director of the Winship Cancer Institute of Emory University, Atlanta, said that the center will have $5 million less from March 2013 to March 2014. With potentially another 5% cut in the NIH budget due next year, Winship is looking at another $4 million reduction for 2014, he said.
Winship has been growing steadily since its NCI designation in 2008, said Dr. Curran. Because of sequestration, the growth trajectory has slowed dramatically. "We’re working very hard just to keep a stable cadre of faculty and staff," he said.
Sequestration is having a "chilling effect" on investigators, who are pursuing less risky research "in favor of safer bets" and are either giving up on their field or moving overseas, where government-backed research is more plentiful, according to Dr. Chi Van Dang, director of the Abramson Cancer Center at the University of Pennsylvania, Philadelphia. He said that the 12,000 patients Abramson sees daily are "looking for hope every day and I think this cutback is taking away their hope," said Dr. Van Dang.
Thomas Sellers, Ph.D., director of the Moffitt Cancer Center and Research Institute in Tampa, agreed, noting that many cancer patients seek out NCI-designated centers because they can get into NCI-sponsored trials. But at Moffitt, the sequester is wreaking havoc. One major grant was allowing 250 patients a year to enroll in a particular study. Enrollment has now been capped at 100 patients a year – a 60% decrease.
Moffitt has lost $2 million from the NCI cutback and expects to lose $4 million in 2014. Dr. Sellers said that the result will be fewer employees, fewer supplies purchased, fewer animal models created, and less tissue culturing, among other reductions. Like other institutions, Moffitt researchers also are seeking grants for smaller projects and projects that the NCI might be likelier to approve.
"We’re going for marginal science, safe science, just to keep the labs going," he said.
John Seffrin, Ph.D., chief executive officer of ACS CAN, said that the entire cancer community is frustrated. "Sequestration is not a policy. It is actually an abdication of Congress’ obligation," he said.
ACS CAN and other cancer groups have been urging Congress to exempt cancer care and research from sequestration.
A bipartisan, bicameral group of legislators led by House Budget Committee Chairman Paul Ryan (R-Wis.) and Senate Budget Committee Chairman Patty Murray (D-Wash.) have been meeting to come up with a federal spending plan that also replaces the sequester. They aim to present a plan by Dec. 13.
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