Clarifying NIH’s Priorities in Health Economics

Today, NIH is releasing a Guide Notice on Clarifying NIH’s Priorities in Health Economics, demonstrating the importance NIH places on supporting research that examines “how scarce resources are allocated among alternative uses for the care of sickness and the promotion, maintenance, and improvement of health, including the study of how health care and health-related services, their costs and benefits, and health itself are distributed among individuals and groups in society.”  In other words, how economic models and methods can be used to support NIH’s mission to use fundamental knowledge to enhance health, lengthen life, and reduce illness and disability.

Health economics can provide rigorous tools for answering important questions about how new medical innovations are adopted and deployed; about how patients and doctors can make the best informed choices for treatment and prevention; and about how different ways of delivering health care can affect the health of individuals and populations.   Answering these sorts of questions is vital to our work here at NIH, and as of 2015, NIH funding has supported the work of five Nobel Laureates in Economic Sciences who made great advancements in our understanding of health and society.  In fact, health economics is only one example of the type of behavioral and social science research funded by NIH that is absolutely central to our ability to prevent and treat disability and disease.

Today’s Guide Notice clearly demonstrates the importance that NIH places on supporting health economics research in which health outcomes and health-related behaviors are the primary focus, and the connection between the subject(s) of the study and improved understanding of health are clear and explicit.  Health economics research that makes a strong, explicit tie to health and health-related outcomes is central to the NIH mission, and NIH believes that such studies are a worthy investment of taxpayer funds.  It is also true that an economic analysis is often included as one piece of a larger study and that such analysis is often part of understanding the real-world consequences of health interventions. Studies where the primary focus of the research is not health economics, but include such analyses as a secondary aim, continue to be a valued part of the NIH portfolio.

Some topics and approaches which are not necessarily NIH-wide priorities may still be priorities for the missions of individual Institutes and Centers. Principal Investigators (PIs) and potential PIs for NIH research grants should consult with NIH program officers in Institutes and Centers appropriate to their proposed topic if they have questions about whether their work will fit program priorities.

The Notice also identifies study topics outside the NIH mission, which will not be funded by the agency. These topics, although potentially valuable areas of research, do not connect clearly to NIH’s mission or priorities related to the understanding of health, and therefore may be a better fit at other organizations and agencies. This underscores NIH’s strong commitment to responsible stewardship of the taxpayer dollars and to transparency in setting priorities for the agency.

Biosafety at NIH and Beyond….A Shared Responsibility

Co-Authored by Carrie Wolinetz and Deborah Wilson

Following this week’s release of the Office of Science and Technology Policy’s joint memo on biosafety and biosecurity, coming at the tail end of National Biosafety Stewardship Month, it seems like an excellent time to discuss how NIH helps ensure the research we conduct at our own facilities as well as the research we fund across the globe is done safely.

Here at NIH, the NIH Division of Occupational Health and Safety (DOHS) is responsible for overseeing the day-to-day operations of a large and diverse biosafety program. A committed team of biosafety professionals helps ensure that the vital research being carried out by NIH is being done safely. To manage the unique challenges associated with the NIH intramural program, DOHS must be flexible in order to adapt to the changing research landscape.  Recently, DOHS has instituted changes to NIH policies for working with and storing potentially hazardous biological agents including human, plant, and/or animal infectious agents, poisons and toxins. These are significant changes to the way NIH has been doing business for almost four decades. Although NIH registers, reviews, and approves all active work with human pathogens and research involving non-exempt recombinant nucleic acids, it became clear we also needed to re-evaluate and optimize the methods used for keeping track of all biological agents that might have been stored in laboratories or repositories. In addition to support received from senior NIH management, a plan for interactions and information sharing was developed.  A continuous, open dialogue with NIH’s safety committees, such as the institutional biosafety committee (IBC), was also essential to invoking changes to long-standing programs and processes.

In support of the biosafety programs of the institutions that NIH funds, the NIH Office of Science Policy (OSP) conducts an extensive program of outreach and education on topics related to biosafety.  One of the signature programs in OSP is our extramural site visit program for grantee institutions.   The aim of these educational visits is to enable NIH to have a face to face dialog with institutions and to assist IBCs with their programs of biosafety oversight.  The visit includes a review of the policies and procedures that the institution is implementing to ensure the safe conduct of recombinant or synthetic nucleic acid research.  To date, OSP has visited over 110 institutions, and a write up of the program received the 2015 Richard C. Knudsen Memorial Publication Award from the American Biological Safety Association.

OSP has also used the information we have gathered from our site visits to develop a body of information on best practices, in particular the IBC Self-Assessment tool which institutions can use to evaluate their own IBC program.  We encourage all institutions to use the self-assessment tool, which addresses all of the major requirements of the NIH Guidelines.

These are just of few examples NIH is doing to ensure essential biomedical research is conducted safely.  Biosafety is a shared responsibility for all those involved in the research enterprise.  The close and collaborative relationship between the DOHS and OSP help ensure that NIH is at the top of the class with respect to biosafety oversight.  To learn more about NIH’s intramural biosafety program, please visit http://www.ors.od.nih.gov/sr/dohs/Pages/default.aspx.  More information on how NIH engages our extramural grantee institutions with respect to biosafety can be found at: /office-biotechnology-activities

RADM Deborah Wilson, Dr.P.H., is the Director of the Division of Occupational Health and Safety at NIH