By Meg Tirrell Dec. 31 (Bloomberg) — The U.S. National Institutes of Health has created or saved 50,000 jobs with its $10 billion in federal stimulus funds, boosting medical research and returning $2.25 on the dollar in goods and services, the agency’s director Francis Collins said. Collins , appointed by President Barack Obama in August, said the Bethesda, Maryland-based organization aims to accelerate drug development, promote research on rare, neglected diseases and cut health-care costs. He spoke in a Dec. 30 interview and outlined areas for investment and research in an article released today by the journal Science . The NIH is aiming to prove that science is an important investment in the economy’s recovery as budgeting decisions are being made for the 2011 fiscal year, Collins said. The 50,000 jobs the agency created in the first year with stimulus money “are high-paying, quality jobs that are employing people with considerable skills that we’d hate to see migrating overseas.” “After five years of flat funding between 2003 and 2008, where NIH effectively lost about 15 percent of its buying power, the community has been exhilarated,” Collins said. “We’re going to see acceleration in both the basic and the clinical aspects of biomedical research.” Comparative Effectiveness The agency is investing $400 million of stimulus money in studies comparing the efficacy of treatments for ailments including dementia, gastro-esophageal reflux disease, or GERD, and the staph infection MRSA, according to the agency’s Web site . MRSA, or methicillin-resistant staphylococcus aureas, has become increasingly resistant to standard treatments and affects about 2 million Americans. Germs such as MRSA cost about $20 billion annually to treat, according to the Centers for Disease Control and Prevention. Comparative effectiveness studies can help lower health- care costs and benefit patients by identifying the best treatments with the fewest side effects. Previous such studies have shown that exercise and life- style changes prevent the onset of diabetes better than medication, and that older, less expensive antipsychotics work as well as newer drugs, with fewer side effects, Collins wrote in his article. Economic Incentives The agency also plans to start a grant program encouraging development of new models for health economics, Collins said. Incentives for doctors should be based on patient outcomes rather than the number of tests or procedures performed, he said. “Our health-care system is currently loaded with incentives that may be counter to cost savings,” Collins said. “We would like to perhaps study that more carefully in a research environment.” In a frenzy to access the stimulus funds, researchers submitted thousands of grant applications, with some institutions such as the University of California in Irvine preparing more than 200, according to an April article in Science. Not all applicants concluded the program would help boost the economy. “I am one of the 21,000 applicants for the NIH Challenge Grant, which will fund roughly 200 grants at a success rate of 1 percent,” Sailen Barik, of the University of South Alabama College of Medicine in Mobile, wrote in a July 7 letter to Science. “This unprecedented low rate makes me wonder whether this feeding frenzy is actually stimulating American recovery.” Barik wasn’t immediately available for comment today. Neglected Diseases The U.S. has a responsibility to use its resources to help solve some health problems in developing areas of the world, going beyond the “big three” of AIDS, tuberculosis and malaria, Collins said. Some diseases are rare or affect patients in areas with few resources, making them unappealing to drug companies that need cover the cost of research through revenue, Collins said. The NIH plans to forge more partnerships with drugmakers in which academic investigators perform initial studies. That may help remove some of the risk of drug development so companies can enter in the later stages and take a more mature treatment through human trials. Model Drug Development Collins cited as a candidate for this model a treatment for a disease called schistosomiasis, found primarily in sub-Saharan Africa and the Middle East, that’s carried by water snails and affects about 250 million people. Parasites on the snails can transfer to humans and cause damage to the liver, intestines, lungs and bladder, according to the CDC. “There hasn’t been a new drug for this in 50 years,” Collins said. “Through academic efforts, as a consequence of NIH investing in the front-end of the drug development pipeline, a very promising compound has emerged that cures this disease in the mouse model, and can now be moved toward the clinical trial potential.” Before taking his current role, Collins was director of the National Human Genome Research Institute , an arm of the NIH that sought to understand the genetic makeup of humans. It completed a map of the human genome sequence in April 2003. A physician with a Yale University doctorate in chemistry, Collins helped isolate the gene linked to cystic fibrosis in 1989. In 1993, he helped pinpoint the gene for Huntington’s disease, a brain disorder. That same year, he joined the government’s genome research institute, taking over the Human Genome Project, which had begun in 1990. Affordable Human Genome One goal supported by the NIH’s stimulus funds is the reduction in cost of sequencing an individual human genome to $1,000 from about $20,000 currently, Collins said. “If you just do it really well one time for $1,000, you’re probably going to save money in the long run from a lot of targeted testing,” he said. Researchers may be on track to reach the $1,000 mark within three to five years, he said. “It’s not going to end at that,” Collins said. “Take this out 10 years and the cost of the complete genome sequence will be under $100.” While stimulus money has boosted biomedical research this year, Collins said he worries that progress will be interrupted in 2011 when the two years to spend the funds are up. “Science is not a hundred-yard dash; it’s a marathon, and very few projects get done in two years,” he said. “We will have revved up this remarkable engine of discovery and then we will run the risk that the tank falls empty in 2011, and a great deal of disruption may occur as a result.” To contact the reporter on this story: Meg Tirrell in New York at mtirrell@bloomberg.net .
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