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Government
Affairs Committee
August, 1995
Senate
Appropriations Action
Wednesday,
August 23, 1995 9:13AM
A.
OVERVIEW
Now
that the House has completed its work and has
proposed a 5.7%, or $642 million, increase for the
NIH, our attention turns to the Senate. The Senate
Labor, Health and Human Services, & Education
(Labor/HHS) Appropriations Subcommittee will begin
to markup its FY'96 Labor/HHS spending bill that
includes funding for the NIH. The markup is
scheduled for September 12-14. Following this, the
full Appropriations Committee will vote on the
spending bill, and than the entire Senate. After
the Senate completes its work, the House and Senate
bills must than be reconciled during the conference
committee. Your response in the past has been
critical to the success that we have achieved to
date. To achieve a funding level in the Senate that
is at least that of the House we need your support
and that of your colleagues.
B.
ACTION PLAN
Our
message to Senators is to support the $642 million
increase proposed by the House.
1. If
your Senator (or if your institution is located in
the state) of a Member of the Senate or House
Appropriations Committee (see contact list below),
write to the Senator to support funding for the NIH
above the House figure. In your letter, note that
as a member of the Appropriations Committee, he/she
has significant influence in protecting the NIH and
entire biomedical research enterprise. (Members of
the Senate Labor/HHS Subcommittee that has direct
funding jurisdiction over the NIH are in
CAPS).
2. If
your Senator does not sit on the Appropriations
Committees listed below, you should also write to
support the NIH. It is especially important that
Members of Congress hear from
scientists-constituents in States that have a
smaller biomedical research enterprise. These
Members of Congress may be indifferent to the NIH
unless they hear directly from you.
3. All
CLC members should continue writing letters and
opinion pieces to support adequate funding for the
NIH to editors of you local newspapers. Some
members have already had success in Oregon, Texas,
and Tennessee. If you wish to see published
articles by scientists as a guide for your local
efforts, please respond to this message (ask for
the oped sample) and it will be e-mailed directly
to you.
C.
SENATE APPROPRIATIONS COMMITTEE CONTACT
LIST
Phone
and fax numbers are listed next to Members name.
All area codes are 202. However, we urge you to
mail your letters since fax numbers are often busy
from high volume or disconnected. We ask that you
do not e-mail letters to Members of Congress. Not
many Members of Congress have valid e-mail
addresses and there is no substitute for an
original hard copy of a letter. Members of the
Senate Labor/HHS Subcommittee are listed in
uppercase.
The
mailing address and salutation for the Senate
is:
The
Honorable______
United
States Senate
Washington
D.C. 20510
Dear
Senator__:
Senate
Appropriations Member Phone Fax
Robert
Bennett (UT) 224-5444 224-6717
Christopher
Bond (MO) 224-5721 224-8149
Dale
Bumpers (AR) 224-4843 224-6435
Conrad
Burns (MT) 224-2644 224-8594
Robert
Byrd (WV) 224-3954 228-0002
Thad
Cochran (MS) 224-5054 n/a
Pete
Domenici (NM) 224-6621 224-7371
Slade
Gorton (WA) 224-3441 224-9393
Phil
Gramm (TX) 224-2934 228-2856
Judd
Gregg (NH) 224-3324 224-4952
Tom
Harkin (IA) 224-3254 224-9369
Mark
Hatfield (OR) 224-3753 224-0276
Ernest
Hollings (SC) 224-6121 224-4293
Daniel
Inouye (HI) 224-3934 224-6747
Jim
Jeffords (VT) 224-5141 n/a
J.
Bennet Johnston (LA) 224-5824
224-2952
Robert
Kerrey (NE) 224-6551 224-7645
Herbert
Kohl (WI) 224-5653 n/a
Frank
Lautenberg (NJ) 224-4744 224-9707
Patrick
Leahy (VT) 224-4242 224-3595
Connie
Mack (FL) n/a n/a
Mitch
McConnell (KY) 224-2541 224-2499
Barbara
Mikulski (MD) 224-4654 224-8858
Patty
Murray (WA) 224-2621 224-02238
Harry
Reid (NV) 224-3542 224-7327
Richard
Shelby (AL) 224-5744 224-3416
Arlen
Specter (PA) 224-4254 224-1893
Ted
Stevens (AK) 224-3004 224-2354
D.
FACTS SUPPORTING INVESTMENT IN THE NIH
The
NIH is the world's leading biomedical research
institution, supporting more than 35,000 scientists
at more than 1,700 research universities and
institutions in the United States. More than 80
percent of the NIH's FY 1995 budget of $11.3
billion will be spent on extramural research
conducted at universities, research institutions
and hospitals throughout the United States.
NIH-supported researchers have made the U.S. the
world leader in biomedical research, creating
thousands of jobs and new business in the process.
The NIH has played a critical role in facilitating
innovations that have led to significant reductions
in health care costs in many areas. In a 1994
report, the NIH estimated that approximately $4.3
billion invested in clinical and applied research
supported by the NIH had the potential to realize
annual savings of between $9.3 billion and $13.6
billion. This translates into a 200 to 300 percent
annual return on the investment in research.
Contingent on adequate federal support, America can
expect continued advances that will change the face
of tomorrow's health care.
I.
Examples of Cost Savings From NIH-Supported
Research
a.
Researchers supported by the National Institute of
Allergy and Infectious Diseases and the National
Institute of Child Health and Human Development
found that the drug AZT can reduce by two-thirds
the rate of HIV transmission from mother to infant.
The use of AZT in HIV-infected pregnant women could
prevent the infection of 1,200 infants each year,
with annual savings to the U.S. health care system
of as much as $170 million.
b.
Previously, 50 percent of people with diabetic
retinopathy with high risk characteristics were
blind within 5 years. Research supported by the
National Eye Institute has demonstrated that laser
treatments are up to 95 percent effective in
preventing blindness. In addition, it is estimated
that these treatments, which are currently used in
only half of the patients with high risk
characteristics, result in annual societal savings
of between $1.2 billion and $1.6 billion. The costs
of blindness include Social Security benefits, lost
income tax revenues, and Medicare expenditures. NEI
clinical research cost the American taxpayer $181
million between 1971 and 1992.
c.
Research supported by the National Institute of
Allergy and Infectious Diseases and the National
Institute of Diabetes and Digestive and Kidney
Diseases has led to the discovery of a connection
between the presence of a specific bacterium --
Heliobacter pylori -- in the upper gastrointestinal
tract and chronic gastritis and duodenal ulcer.
This has led to the development of a revolutionary
new treatment for peptic ulcers that eliminates the
bacterium, cures individual lesions, and prevents
their customary life-long recurrence, saving as
much as $400 million a year in reduced treatment
costs.
d. For
an investment of $5.1 million, the National
Institute of Allergy and Infectious Diseases
developed an antiviral therapy using acyclovir to
treat newborn infants suffering from neonatal
herpes simplex. Research suggests that early
diagnosis and treatment can reduce significantly
the costs of premature mortality and severe
neurological impairment, saving as much as $183
million a year for a one-year group of infected
infants.
e. In
a recent National Institute of Mental Health-funded
study of severely ill patients with
treatment-resistant schizophrenia who were
maintained on Clozapine for over 2 years, total
cost savings averaged $22,937 per patient. Applying
these findings to the 75,000 schizophrenics who
began taking clozapine between 1990 and 1994, it is
conservatively estimated that $1.6 billion has been
saved.
f.
Through research supported by the National
Institute of Arthritis and Musculoskeletal and Skin
Diseases, a drug therapy for kidney disease
resulting from lupus has been found to save $93.1
million in health care costs in the United States
each year. This drug regimen cost a total of only
$9.8 million to develop.
g.
National Cancer Institute research has led to new
technologies to make affordable and effective bone
marrow transplantation a treatment option for
breast cancer. Five-year, disease-free survival
rates increased from 30 percent to 72 percent in
women with breast cancer in 10 or more lymph nodes,
and from 1 percent to 15-20 percent in women with
advanced breast cancer; improved outcomes for bone
marrow transplantation by decreasing death rates
(mortality) associated with the procedure from 21
to 25 percent to 2 to 3 percent; and decreased
health care costs for bone marrow transplantation
from $140,000 to $65,000 per transplant.
h. A
clinical trial co-sponsored by the National Heart,
Lung, and Blood Institute and the National
Institute on Aging showed that an inexpensive,
commonly-used antihypertensive drug reduced stroke
and heart attack in victims of systolic
hypertension (SH), a form of high blood pressure
that afflicts about 3 million older Americans.
Nationwide treatment of SH in the elderly could
save at least $25 million a year in health care
costs.
i.
Research supported by the National Institute on
Diabetes and Digestive and Kidney Diseases on the
prevention of recurrent kidney stones has resulted
in significant reductions in the cost of treatment.
If it is assumed that drug therapies are adopted by
50 percent of eligible patients as opposed to
surgical therapy, this research would result in
estimated realizable one-year savings of
approximately $300 million.
j. A
multicenter clinical trial supported by the
National Institute of Neurological Disorders and
Stroke demonstrated that the risk of stroke could
be reduced by 50 to 80 percent in individuals with
atrial fibrillation, a condition characterized by
an irregular heartbeat and associated with 70,000
strokes each year, by treating them with aspirin or
an anticlotting drug called warfarin. Application
of the findings of this study, which cost
approximately $4.6 million, could prevent an
estimated 20,000 to 30,000 strokes each year, with
potential annual savings of $200
million.
II.
NIH Research Is An Investment In
Innovation
a.
Basic Research
Improvements
in public health depend on basic research to find
answers to fundamental questions about disease
processes. The development of an evolving, dynamic
base of knowledge through a sustained investment in
fundamental research is central to our ability to
pursue an understanding of disease. Ultimate
success in the war against disease will be
impossible without the commitment of long-range
funding in multiple areas of scientific
investigation and a continuously renewed pool of
talented scientists.
b.
Biotechnology
Research
funded by the NIH provided the tools that created
the biotechnology revolution and established the
United States as the international leader in the
field. The NIH funds over 84 percent of this
nation's spending in biotechnology research, an
investment that continues to fuel and attract
private capital to the biotechnology industry.
Biotechnology is a major commercial enterprise that
will play an increasingly prominent role in the
U.S. economy by the end of the decade. World-wide
sales of biotechnology-derived products have grown
from zero in 1980 to $6 billion today, and are
projected to be $50 billion by the year 2000. If
the United States is to reap the benefits of
advances in health care offered by biotechnology,
support for basic research must
increase.
III.
NIH Research Is An Investment In
Prevention
a.
Improving Nutrition and Fitness
NIH
research programs on nutrition and fitness are
vital to learning how to sustain good health and
prevent disease. This research has resulted in a
greater understanding of the influence of diet and
physical activity on specific diseases such as
cancer, diabetes, osteoporosis, and heart disease.
NIH research also is identifying and examining
methods to maintain and increase involvement in
physical activity, particularly among children and
the elderly.
b.
Linking Biology and Health
The
environment, our genes, and age interact to
determine our predisposition to good health or
disease. Our advancing understanding of genetics,
resulting from NIH-supported basic research,
promises to revolutionize prevention. For example,
an individual's genetic profile may reveal a
predisposition to lung, breast, or prostate cancer,
greatly improving the chances of diagnosing and
treating these disorders earlier. The National
Institute of General Medical Sciences and the
National Center for Human Genome Research supports
research focused on the identification and mapping
of genes that cause common, complex genetic
disorders, such as high blood pressure and certain
cancers.
c.
Fighting Infectious Diseases
The
development and use of vaccines is one of the
safest and most effective measures for preventing
infectious diseases. NIH-supported basic research
in virology, immunology, and molecular biology have
led to exciting new developments. For an investment
of $19.1 million, researchers supported by the
National Institute of Allergy and Infectious
Diseases developed a vaccine against Haemophilus
influenza type B (Hib), which until recently was
the leading cause of pediatric bacterial meningitis
and acquired mental retardation in the United
States. This vaccine saves over $435 million for
each group of infants vaccinated in a one-year
period. A $30 million investment in research led to
the development of a vaccine to prevent some types
of hepatitis, the ninth leading cause of death
worldwide. It is believed that 300,000 Americans
are infected each year, and an estimated one
million in the United States are chronic carriers
of the virus. Widespread use of two genetically
engineered vaccines could result in savings of as
much as $138 million each year.
d.
Combatting Chronic Disease
The
direct and indirect costs of chronic disease in the
United States are staggering. It is estimated that
the costs of heart attack, stroke, and
cardiovascular disease exceed $137 billion
annually. The costs for Alzheimer's disease
approach $80 billion a year. Chronic conditions of
mental illness, addictive disorders, and
neurological diseases are responsible for over $300
billion in costs a year. Costs of arthritis and
bone and muscle disorders (such as osteoporosis)
are over $100 billion annually. A recently
completed National Institute of Neurological
Disorders and Stroke-supported clinical trial
showed that surgery to remove fatty deposits from
the carotid artery, one of the main arteries
supplying blood to the brain, reduced the five-year
risk of stroke by about half in patients with a 60
percent or more narrowing of this artery but no
stroke-like symptoms. Stroke, the third leading
cause of death in the United States, the major
cause of permanent disability, and a major
contributor to dementia in later life, cost this
nation an estimated $25 billion in medical costs
and lost productivity in 1995.
IV.
NIH Is An Investment In Tomorrow's Health
Care
a. The
Hope of Gene Therapy
Investment
in basic research in molecular biology, genetics,
and virology during the past forty years has
created the potential not only to identify the
specific genetic defects that underlie many
diseases but also to correct these deficiencies.
With adequate federal support, we are within reach
of major breakthroughs in understanding and
treating chronic, debilitating diseases that affect
millions of Americans including systemic lupus,
rheumatoid arthritis, scleroderma, and other
autoimmune rheumatic illnesses. NIH-supported
research has led to major advances in our
understanding of the genetic basis of
neurodegenerative disorders of the brain, including
Huntington's disease, amyotrophic lateral sclerosis
(Lou Gehrig's disease) and the most common form of
Alzheimer's disease have been
identified.
b.
Unlocking Cancer's Secrets
Advances
in genetics has ushered in a new era in the
prevention and treatment of some forms of cancer.
Researchers have discovered the genes responsible
for inherited breast cancer and an inherited form
of colon cancer. In addition, recent research has
shown that prostate cancer may be linked to a
defect that hampers the body's defense against
cancer-causing substances in the environment.
Scientists found that a specific genetic defect
blocks production of a protective enzyme, and they
have been able to use drugs to make the problem
gene work again under laboratory conditions.
However, more research is needed to find out
whether this can be done in people.
c.
Understanding the Immune System and Combatting
AIDS
Scientists
have recently begun examining the use of an
established cancer drug as a means to combat the
AIDS virus, by undermining the processes that
control its reproduction in the body. The findings
that the drug hydroxyurea may block the replication
of the human immunodeficiency virus (HIV) and that
a protein from the virus controls the latent
disease in the body following infection suggest
that finding ways to control the disease without
directly attacking it may be the optimal approach.
Although only test-tube results are available now,
scientists are optimistic about the indirect way of
controlling the virus that attacks the body's
immune system.
d.
Enriching the Lives of the Elderly
NIH-funded
researchers have identified a genetic marker for
Alzheimer's disease that may lead to improved
diagnosis and treatment. New genetic discoveries
related to a protein known as apoE4 may lead to an
effective inexpensive means of diagnosing
Alzheimer's diseases.
Half
of all Americans age 65 and older will suffer from
some form of arthritis by the year 2000. In recent
years, investigators have gained significant
knowledge about how enzymes break down cartilage
and bone in osteoarthritis, the most common form of
the disease. Efforts to translate these basic
research findings into clinical applications are
now on the horizon.
As
many as 3 million Americans suffer from congestive
heart failure, the leading cause of hospitalization
in Americans over age 65. An estimated 400,000 new
cases of congestive heart failure occur each year.
National Heart, Lung, and Blood Institute-supported
researchers have discovered that an ACE inhibitor
used in conjunction with standard therapy can treat
symptoms, reduce hospitalization and death rates in
people suffering from overt heart failure, and
delay the onset of congestive heart failure in
asymptomatic patients with poor ventricular
function.
Parkinson's
disease, which afflicts about 1 million Americans,
is caused by the unexplained and gradual loss of
brain cells that produce dopamine, a chemical in
the nervous system (neurotransmitter) responsible
for coordination of muscular activity. Recently,
researchers have discovered a possible potent,
specific nerve growth factor with promising
potential as a treatment for Parkinson's disease.
GDNF may be able to prevent or even reverse
symptoms of the disease.
The
National Institute of Neurological Disorders and
Stroke supports research on stroke prevention,
diagnosis, rehabilitation and treatment to protect
nerve cells and limit brain damage following a
stroke. Researchers are developing strategies to
advance understanding of stroke through new genetic
and novel immunologic technologies that will
contribute to health care cost savings by allowing
early diagnosis of stroke in patients at stroke
risk and developing more effective treatment for
stroke patients.
e.
Enriching the Lives of Children
Recent
advances in National Heart, Lung, and Blood
Institute supported research have begun to clarify
the genetic basis for many of the 35 types of
congenital heart defects. NHLBI research aimed at
identifying mechanisms by which nutrients affect
genes necessary for normal heart development may
lead to the recognition of new genes controlling
heart maturation and ultimately to the prevention
of congenital heart defects. NHLBI-funded centers
of research in pediatric cardiovascular diseases
are focusing on innovative multidisciplinary basic
and clinical research on congenital and acquired
cardiovascular diseases in children that could
produce new prevention and treatment
methods.
Juvenile
diabetes (insulin-dependent) affects over 1 million
Americans and primarily strikes children. Juvenile
diabetes occurs when the body's immune system
attacks itself and destroys insulin-producing cells
in the pancreas. This autoimmune attack is
triggered by a certain agent only in people with a
specific genetic profile. Researchers have found
evidence that the trigger may be the polio-related
coxsackie virus. If this virus is show to be a
primary cause of the disease, vaccines against it
could prevent diabetes. In addition, recent
advances in the identification of the genes
associated with diabetes will allow more accurate
assessments of people at risk of developing the
disease.
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