New Evidence on the Allocation of NIH Funds Across Diseases

A student uses a microscope in school.

The National Institutes of Health (NIH) is the world’s largest funder of biomedical research.

Where does NIH funding go and is it responsive to disease burden?

Prior research on the topic was constrained by a lack of consistently collected data. To address that, in 2008, the NIH created the Research, Condition, and Disease Categorization (RCDC) system to classify grants by standard category definitions for its 27 institutes and centers.

These researchers used RCDC data to examine the responsiveness of NIH funding to two measures of disease burden—(1) death and (2) hospitalizations. RCDC data covers 215 categories, half of which related to diseases. Its database allows disaggregating funds into different types of grants—requests for application (RFA), clinical trial grants, center grants, and contracts. Another NIH database, RePORTER, allowed the researchers to determine institute-specific funding for diseases and by award type. Additionally, they mapped the 107 disease categories to specific and multiple diseases using codes from the International Classification of Diseases, ninth and tenth editions (ICD-9 and ICD-10).

They found statistically significant associations between NIH funding and deaths and hospitalizations associated with disease. They showed differences across institutes in responsiveness to disease burden, consistent with the different institutes set priorities.