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On Monday, July 30, I presented, on behalf of NIH Director Dr. Francis Collins, the Fiscal Year 2020 NIH Professional Judgment Budget for Alzheimer’s Disease and Related Dementias at the meeting of the HHS Secretary’s Advisory Council on Alzheimer’s Research, Care, and Services. The estimate—commonly referred to as a Bypass Budget—is based on scientific opportunities that NIH could pursue to achieve the research goal of the National Plan to Address Alzheimer’s Disease—to prevent and effectively treat Alzheimer’s disease by 2025. 

NIH estimates we will need a total of $2.393 billion in FY 2020 to keep us moving toward the 2025 goal. In FY 2018, funding for this research was an estimated (enacted) $1.9 billion. This latest Professional Judgment Budget estimates $876.7 million in additional funds needed relative to the FY 2019 President’s budget proposal—comprising $399 million to compensate for proposed reduced funding in FY 2019 and $477.7 million in additional investment. 

Developing infrastructures and partnerships 

This year, we discuss progress in building a national research infrastructure. We have new tools, technologies, and approaches—from supporting the ideas of individual investigators to the collection and analyses of vast amounts of data from populations worldwide. These advances are largely a result of unprecedented partnerships among government, advocacy groups, foundations, thought leaders, and pharma, biotech, and technology companies. 

This report describes our progress to date, new initiatives underway, and the type and cost of additional research in FY 2020 that will help move us toward the goal of effectively treating or preventing Alzheimer’s and related dementias (AD/ADRD) by 2025. Our efforts are broad and far-reaching. We are:

  • Enabling precision medicine research through advances in genomic sciences and deep molecular phenotyping of existing cohorts and the launch of new diverse cohorts
  • Using the open science research model of the Accelerating Medicines Partnership for Alzheimer’s Disease to hasten the discovery of the next generation of therapeutic targets and biomarkers
  • Creating new translational infrastructure programs to enable rapid sharing of data and research models and enhance research rigor and reproducibility
  • Developing emerging therapeutics in academic centers and in the small business community
  • Making advances in disease monitoring, assessment and care, powered by the revolution in mobile technology, which are helping us bring in people living with AD/ADRD, and their caregivers, as direct partners in research

Several efforts focus on “open science,” a participatory approach to research in which progress is accelerated by making research data, methods, and tools available to all qualified investigators. NIA has been taking a leadership role in promoting the broad availability of research data for quite some time. It’s particularly important that we continue to do so at a time when the rise of big data and new analytical approaches help us to better understand human wellness and disease in a person-specific manner. 

We cannot succeed in these efforts unless we engage the public and secure the commitment of people from all walks of life to participate in clinical research. With facilitation by the Alzheimer’s Association, in collaboration with private, academic and industry stakeholders, the broad strategy is to find ways to step up recruitment to clinical studies as a way to accelerate treatments for this devastating disorder. We are looking forward to launching this multi-pronged strategy by the end of the summer.

Expanding funding opportunities 

We’re also looking forward to supporting more AD/ADRD research projects in the months ahead. In the meantime, remember that you can see our current AD/ADRD funding opportunities now. We are seeking innovative, high-quality proposals in a wide range of areas. I’d also like to remind you that we’re posting information on concepts for new FOAs very soon after they’ve been cleared by our National Advisory Council on Aging. While these concepts are not yet FOAs, they do give you an idea of our research priorities. 

We also expanded our existing supplement program to invite existing grants not focused on Alzheimer’s to add an aim on Alzheimer’s to their awards. This year we invited all NIH Institutes to take part in the program. Nearly all of them did and we have received a very robust response to this effort. We hope it turns into new avenues to solve the challenging problem of Alzheimer’s disease and its related dementias.

Expanding the Alzheimer’s research community

With the recent increases in funding, NIH has been monitoring the capacity of the scientific community to offer even more high-quality research proposals to match. As part of this analysis, NIA has found that in FY 2015-2017, more than one-quarter of NIA’s Alzheimer’s and related dementias awardees were either new or early stage investigators and one-third were established investigators who were new to the field of AD/ADRD.

Together, we make the difference

Alzheimer’s disease and related dementias affect millions of people and their families. Advances in science and technology, along with increased financial support, have helped researchers better understand these diseases and identify potential ways to prevent and delay them. Thanks to the renewed commitment from the American public, the dedication of study volunteers and their families, and the relentless work of researchers and clinicians, NIH-supported researchers, and the AD/ADRD community at large, we have identified promising pathways to effective therapies. Together, we can make the difference.

Alzheimer's Disease Budget Research Richard HODES

Together we make the difference in Alzheimer's and related dementias research: NIH's FY 2020 bypass budget and progress report

As mentioned in last week’s blog, our current appropriations situation presents us with a conundrum. It is possible that we will see an increase in support for Alzheimer’s disease and Alzheimer’s disease-related dementias (AD/ADRD) research and perhaps some additional funds for our general allocation. Yet, for now, we are working with a continuing resolution (CR) that—if projected over the full year—reduces our budget by a small amount relative to last year. Of course, we want to make as many awards as early as possible. Yet we certainly do not want to create an unbalanced funding line if an increase does not materialize. (“Yes, I know we can’t pay your wonderful 10th percentile application and I know we paid that other 20th percentile application last month… No. we have nothing against you. What makes you think that?”)

To the tea leaves

What can we do? We engage in the fine art of reading tea leaves. Earlier in the year we paid our general allocation applications to the 7th percentile and AD/ADRD applications to the 10th percentile (with adjustments for large applications, early-stage investigators, and new investigators). These numbers were based on projecting future application numbers and future application scores in review. Now, many more of the applications received for fiscal year 2018 have been scored. All of the “regular” (research grant, CSR-reviewed, investigator-initiated, percentiled) applications have been received. That means our models are more informed. We still do not have complete information. The final round of applications (May Council) have yet to be reviewed.

With that additional information, we are now paying AD/ADRD percentiled research grant applications to the 18th percentile (large applications: 15th percentile; early-stage investigators: 23rd percentile; other new investigators: 21st percentile). You may expect an award if your application scored within these percentiles. Please do check with program staff though. We do look closely at the review and if there is a strong indication that the science can be improved, then we will not necessarily pay an application even if it falls within that percentile range.

The same models tell us that we can now pay applications in the general allocation to the 9th percentile (large applications: 6th percentile; early-stage investigators: 14th percentile; new investigators, 12th percentile).

We are paying AD/ADRD career award applications to a score of 25 and general allocation career award applications to a score of 17. Again, check with your program officer. You may expect an award but sometimes we decide that another submission is necessary even for an application within that score range.

Continuing to play a waiting game

Between the gray skies of CRs to the potential blue skies of a substantially increased appropriation, we are making a funding forecast. We know that these numbers will leave too many wondering about the fate of applications now submitted. Again, the message is: Contact your program officer. You can gain the most information about the chances for your own individual application from that source. Please remember that these are not funding lines. They are our best estimates of how far we can pay given present, incomplete information and the current short-term continuing resolution.

Thank you for your continued patience as we do our best to read the tea leaves.

Applications Budget Pay Lines Robin BARR

The art of reading tea leaves

The new fiscal year started on October 1, and we began it with hope in our hearts for continued good news on our budget. Our increased appropriations in FY 2017 allowed us our most generous funding lines in our general allocation in many years, along with a positive windfall for research in Alzheimer’s and related dementias. With a rapidly growing older population in the nation and across the world, this recognition of the worth and potential of aging research to address the problems of aging, and to prevent or delay Alzheimer’s disease, is truly welcome.

Still, we started the year again on a now-familiar continuing resolution, which holds our current funding to the FY 2017 level—at least until December 22. So, what do we do? Maybe we will see another increased appropriation. Or maybe not. At the same time, increasing numbers of applications are arriving in response to the new money we have received. Could they crowd the funding line—with welcome strong science—but in so doing limit how far we can pay down the line? And yet we want to start paying awards as early in the year as we can—to limit the pressure on us (and you) late in the year if we do see an increase in our appropriation. (Not to mention having potentially critical research start as soon as possible!)

Current pay lines

Are you following so far? This is one of these open-ended problems where there is no clear signal to point us in any particular direction. We faced these multiple uncertainties in making the decision to move forward with initial, conservative allocations.

At this time, we’re paying CSR-reviewed applications in our general line to the 7th percentile and applications focused on Alzheimer’s disease and related dementias to the 10th percentile. We are starting career award funding by paying all applications (general and Alzheimer’s) to a score of 16.

Changes in the year ahead

These allocations are a beginning. We hope to extend our funding when we have a full-year budget. And, especially for Alzheimer’s research, we hope to extend that funding a long way.

In a sense, we’re also finishing our funding from FY 2017. We ended that year with an extremely tight funding line in our general allocation, Small Business Innovation Research (SBIR) line. (That’s the non-Alzheimer’s one.) We promised to fix that line early in FY 2018. We have now done that and are paying the August Council general allocation SBIR applications to a score of 46.

We have begun. It’s a small step while we wait for that other shoe to drop—our full-year budget.

Alzheimer's Disease Budget Funding Policy Pay Lines Small Business Funding Robin BARR

Beginnings: Our first steps in making awards in FY 2018

In recent years, we have scrambled to try to maintain a funding line by finding ways to stretch what seemed to be ever-shrinking resources. Then a trickle of new money arrived—beginning in FY 2014—targeted towards Alzheimer’s disease and related dementias (ADRD). In the following years, that trickle became a stream, and then a river. In FY 2017, it was a $400 million river. Most recently, we have also received increases to our general appropriation, benefiting the broad spectrum of NIA research along with other Institutes at NIH.

The additional appropriations in FY 2017 increased our general funding line substantially, from the scrimped 11th percentile in the previous year to the more comfortable 19th percentile for most regular applications. (The funding policy page has full information on all our pay lines.) For Alzheimer’s research, we even reached the 28th percentile. We hope we have unleashed a wave of research on aging and on Alzheimer’s that will help generate the breakthroughs we so urgently need in our rapidly aging society.

A slightly different approach

In the context of these more generous funding lines, we exercised greater selectivity than previously in what we decided to fund. For example, when we saw a research application that clearly could be improved, we did not necessarily support it, even though its percentile was within these expanded funding lines. Sometimes we awarded a short-term award (R56) to allow the investigators to initiate research, while modifying the proposed research to address particular concerns. Sometimes we decided that an amended application was required.

We supported applications responding to the Alzheimer’s PARs to much the same level as the applications in our ADRD pay line. Again, we showed selectivity when we saw possibilities for improvement and made some short-term awards.

Looking two ways

At the NIH level, our springtime squall was in the form of the “Grant Support Index” that resolved to a renewed commitment to early-stage investigators and a discovered commitment to mid-career investigators (the August 2 blog has the details if you want to relive the experience). Looking forward, the gathering drumroll of implementing NIH’s new clinical trial policies is making itself heard. New instructions were recently posted for applications. Funding Opportunity Announcements are now appearing with odd tags (Clinical trials required, optional, not allowed). A big crash of cymbals occurs on January 25, when the first submissions arrive under the new policy. The finale of this grand opening movement plays out over the reviews next spring.

Much of the angst around this policy change rests on how broadly a clinical trial is defined. NIH does have a very useful policy implementation page that is being updated with expanded case examples as we learn of continuing uncertainties in the community. If your research involves human participants, some of your time would be well spent looking closely at that site and returning to it for possible updates.

A well-deserved tip of the hat

But now is a moment to take stock of the year behind us.

Our staff deserve the final word. We received our budget for the year in early May, with only five months left to decide how to allocate these precious funds and make the awards. That budget was a 28-percent increase on the prior year, all in new, competing dollars. Among the feats achieved by staff across a hectic summer were receipt, review, and funding decisions on 150 administrative supplement applications in one month; review of a legendary flood of initiatives that generated around 700 applications (my thanks both to the Center for Scientific Review and to NIA Review), and award of an unprecedented number of grants compressed into a tiny window of time (truly heroic work from our unassuming grants specialists).

It is a privilege to work with such a dedicated and capable group of people.

Budget Funding Policy Pay Lines Robin BARR

Every year at NIA brings its own challenges. This one was special -- and how!

The wait was long—but the news is good! If you’ve been following events on Capitol Hill, you already know this. NIH has received a $2 billion increase in budget for this fiscal year, reflecting much-appreciated bipartisan support for biomedical research. NIA’s own budget received a monster $400 million boost for Alzheimer’s-related research, and our budget for other research areas increased at the same percentage rate as the NIH budget. It took 30 years (from 1975 to 2005) for the annual NIA budget to reach $1 billion dollars. Now, with the number above $2 billion, the budget has doubled in just 12 years. This alone reflects the substantial public interest in our mission in an era where interest in science generally has lagged.

A continuing focus on Alzheimer’s disease

At NIA, that interest has focused primarily in research on Alzheimer’s disease and related disorders, and that is how our budget has been shaped in recent years. We continue to have unprecedented opportunity to help you to make a difference in our ability to prevent and to treat these devastating disorders, and to provide caregiving relief for the many affected.

These are increases on top of our general budget. It’s important to note that nothing has been taken away from our other scientific fields. And, as noted above, these fields also enjoy an increase for the second consecutive year, even though it’s significantly more modest than the increase for Alzheimer’s-related research.

What does this all mean for you? If this were a normal year—are there any normal years these days?—I would be telling you to hold your horses. After the President signs the budget, the numbers pass through several agencies on their way to us and then to you. That takes time. And that’s a problem this year: We have very little time. The fiscal year ends in under five months. So, we are taking immediate steps.

Immediate changes in some pay lines

We have just announced changes to several different funding lines. The big differences, of course, are for research on Alzheimer’s disease (AD) and Alzheimer’s-related dementias (ADRD). We have increased NIA’s regular pay line for AD/ADRD research from the 18th percentile to the 28th percentile. We are also restoring the administrative cuts that we made to these awards earlier in the year when our budget was uncertain.

I hope you’ll notice a couple of other changes, though. We’ve increased the general allocation training grant line to 22 and the general allocation career development award line to 19. These changes reflect a decision to put more emphasis on early-career development and on bringing investigators into aging research. You’ll be hearing more from us on this point going forward. The actions here are an initial statement.

Some of you may be wondering how we are going to be able to disburse these funds in the most scientifically sound way when we have so much to spend and so little time on the clock. Luckily, we did have some indication that an increase might be coming (see the prior blog on the flurry of Funding Opportunity Announcements over the fall and winter) and, we have a lot of plans in place that we are implementing quickly—including the just-announced changes to our funding lines. You will see future blogs and funding policy changes as we move forward. It is going to be quite a ride—while FY2018 looms in another fog of uncertainty.

Budget Pay Lines Robin BARR

At long last—a budget!

The entire U.S. government, including NIA, is currently operating under an extension of a continuing resolution (CR) that will end on April 28…unless it is extended again, that is. A continuing resolution extends the previous year’s appropriations act, and the appropriations language within it, into the next fiscal year. It is usually minimally altered from the terms in the prior year. In other words, at this point in FY 2017, we’re operating with virtually the same budget we had in FY 2016.

Rather than wait in a state of suspended animation until we know our budget for this fiscal year, we have developed a pay line by projecting over the full year the funding that we now have under the current CR. This projection generates a general pay line that looks very similar to the line that we ended with last year. (In fact, we have managed the 11th percentile line in four of the last five years. I’m not going to say that this is becoming normal, but it’s something close to that.) New and early-stage investigators have 3- and 5-point advantages, respectively, in the pay line, corresponding to the 14th and 16th percentiles. Expensive applications—those requesting $500K and over—have pay lines three points poorer than the general pay line. All of these pay lines could change when we eventually learn what our final appropriation will be for FY17.

NIA-reviewed applications

We do not assign percentiles to applications reviewed by NIA. So, like the lines for training grants, career awards and fellowships, the funding lines for NIA-reviewed research grant applications are expressed as impact ratings (otherwise known as priority scores), rather than percentiles. Assiduous blog readers will know that program project applications, unlike other NIA-reviewed applications, are reviewed in two stages. The scores from the two-stage review are considerably more scattered than those from single-stage reviews. That explains why our general pay line for program projects, now at 28, is higher than our pay line for other NIA-reviewed research grant applications, now at 22.

Alzheimer’s disease research

I’ve written four paragraphs without mentioning Alzheimer’s disease. How remiss of me! You will discover more generous pay lines for research on Alzheimer’s disease (AD) and Alzheimer’s disease related dementias (ADRD) across most of our mechanisms. The lines are not as generous as last year’s lines, and—unlike last year—we are making administrative cuts in Alzheimer’s and related dementias research awards. Why is this necessary? Because we’ve had two years now to expand the Alzheimer’s and related dementias program and we have many more initiatives and applications this year than we did last year. On top of that, applications for many of the initiatives have either not yet been received, or, if received, have not yet been reviewed.

There’s also the matter of our uncertain final budget: There’s some chance that we will receive additional funds for AD and ADRD research this year, and some chance that we will not receive additional funds.

With that fog obscuring our clear view of the future, then, we are showing caution in the Alzheimer’s allocations at this time.

At least we are in double digits even as we wait out the long continuing resolution. I hope this information provides you some reassurance that we continue to have a funding stream, we continue to pay grant awards, and we continue to seek your applications on a wide range of age-related research.

Budget Pay Lines Research Robin BARR

NIA funding line policy for 2017: First draft

I visited Cleveland over Thanksgiving. In a moment of peace from family conversations, I picked up the local paper. The first story I encountered was a long report on the Health and Retirement Study findings, funded by NIA, showing a substantial decline in U.S. dementia rates in the last 20 years. The gist of the story is that we have made great progress in reducing dementia rates and shifting them to older ages, but we're not exactly sure why we made that progress! Then, I encountered a story reporting Eli Lilly's clinical trial results on solanezumab. It was yet another failure to affect the progress of Alzheimer's symptoms.

My immediate conclusion was that, no matter where I go, my job follows me! (Well, not really, but I did have some additional conclusions.) First, I concluded that Alzheimer's disease is of huge public interest. Second, we have a mysterious finding of progress that we need to understand. Third, we have no magic bullet yet to treat this disease , and, last, clearly it is more important than ever to think broadly about new targets and treatments for the disease.

A wealth of new opportunities for research

And here we are in the middle of a mighty push to find ways to prevent and treat Alzheimer's disease and related disorders. Through our funding opportunity announcements (FOAs), we are asking you to broaden the targets; to reach for solutions as to why patterns of dementia onset are changing in this country; to understand the disease in the context of aging; to trace the disparities in disease burden and find ways to reduce them. Above all, we're asking you to use your imagination, creativity, and scientific training to wrestle this disease into submission.

Yet, we are still waiting for our budget. The hoped for additional funds in FY2017 for Alzheimer's research remain more promise than reality. The budget remains at this juncture mired in a continuing resolution.

Even so, we remain optimistic. As we announced in October, we have now published 17 new program announcements and requests for applications that anticipate these funds. Their submission deadlines grow nearer with every tick of the clock. What is a poor researcher to do?

Apply now

I worried that my cup of metaphors had run dry, but then I remembered a slide that some of you have probably seen me use from time to time:

  • The chances of funding are uncertain.
  • Not true.
  • They are uncertain only if you apply.
  • If you do not apply, you will certainly not be funded.

I urge you to make your chances of funding uncertain by applying! The full list of published Alzheimer's FOAs is now on our site. We anticipate several new FOAs coming soon, especially for training opportunities and opportunities for small businesses. In FY14, NIA received an increase of $100 million targeted for AD/ADRD research, in FY15 an increase of $25 million, and last year, in FY16, NIA received an increase of $350 million targeted for AD/RD research. These funds allowed us to support outstanding research proposals in those years, and also resulted in an increase in the NIA base budget and funds available for new proposals this year. That means we can still pay some projects from these FOAs without a further increase in budget. Of course, that will happen only if you write these stellar applications! Start writing now!

Please do comment on this post. Perhaps you follow the "show me the money" school of thought and think it's better to wait until the budget appears?  Perhaps you consider this push untimely, given absence of more advanced infrastructure that would truly facilitate progress? Perhaps you believe that a broader initiative around aging would accomplish more public good, and may still yield progress against the disease? Then, again, apply!

Whatever your thoughts, we welcome your comments—and your response to the FOAs for Alzheimer's disease.

Alzheimer's Disease Budget Funding Opportunities Robin BARR

Certainties and uncertainties about Alzheimer's funding

It is April. Spring flowers, trees in bud, warming temperatures, and a funding update from NIA that is as natural as the Spring, and as welcome as the flowers? (OK. Not so much!)

Still, it is good news for some. Within the general allocation we have pushed the pay line for applications under $500K to the 9th percentile. That now rises a little above 2015’s, 8th percentile year of misery. We are continuing to reach out to early-stage and other new investigators, even more than in earlier years, in these tight times, and are supporting R01 applications from early-stage investigators to the 19th percentile, and from other new investigators, to the 17th percentile. If you are seeking more funds from us ($500K and over) then you need to work a little harder, and do a little better in review, as we subtract three points from each line if your application’s costs rise to the $500K threshold and beyond.

The news for Alzheimer’s research is definitely more Spring-like. The substantial increase in our allocation for Alzheimer’s research in fiscal year 2016 is really making an impact on our ability to pay research in this field. The pay line now reaches the 22nd percentile. Early-stage investigator R01 applications will be paid to the 27th percentile and R01 applications from other new investigators will be paid to the 25th percentile. We certainly hope that the funds will lead to many more exciting findings and accelerated progress over the next few years.

Percentiling confusion for the Alzheimer’s FOAs

I want to take this opportunity to clear up some confusion around the reviews of applications that were the first to respond to the 10 Alzheimer’s-related FOAs that we issued last Fall. We will not use the percentile ranks that appear here for these applications. So, if you responded to one of these FOAs, do not use the 22nd percentile (and related numbers) to find out if your application is being paid. We will rely on the priority scores for these applications and, of course, critical reading of the reviews. The problem with the percentile rank in this case is that different panels used different standards to rank them. The panels went all the way from using the table of all CSR-reviewed applications as a comparison set to percentiling them against themselves in review (and shades in between, too). So, any kind of comparison by percentile across the applications responding to different FOAs makes no sense and we cannot use the percentile ranks to allocate funds to each of the FOAs.

Is this all there is?

Will there be a summer? I do not expect our general allocation funding line to change again this year. It is much more likely that we will again raise the Alzheimer’s allocation funding line. Also, some select pay of Alzheimer’s applications is possible—with senior staff discussing each choice before making a decision. We are also likely to make more short-term high-priority awards (R56) both from the general allocation and from the Alzheimer’s allocation.

And, finally, a little more patience is necessary for news about policies for career award, fellowship, and small business award aspirants. There are reasons why updates for each of these funding lines is delayed, and the reasons are different for each line. I hope to have news on them next month.

I will be glad to answer any questions that you have about these policies as they affect you or your field of aging research.

Budget Pay Lines Robin BARR

April pay line update

Back when the millennium was still new, NIH held high to the lofty principle that a commitment was a commitment. We paid our non-competing awards at their full level. Then came the dark days of sub-inflationary budgets, and even, in the grim year of 2013, a budget reduced from the prior year’s amount.

Lofty principle gave way to cold realism. We at NIA and at NIH started taxing those previously protected commitments. Our grantees suffered cuts to their awards each year. NIA made these cuts even after imposing an average administrative reduction of 18 percent at the outset of the award. The measures were taken in order to allow funding at an acceptable, although severely constrained, pay line for new awards during those years. Sharing the pain among everyone, including currently active awards was the only strategy that made sense in the circumstances. So, we made active grantees endure these cuts.

FY 2016 funding policy now online

As the funding policy statement makes clear, the fiscal year 2016 budget is a historic first for NIA. Yes, we received a very substantial increase for research related to Alzheimer’s disease—$350 million. But, in addition to that, we received a 4.2-percent increase in our general budget. That amount is above the rate of inflation for the first time since 2003, at the end of the era of doubling the budget.

The competition for new and renewing awards remains fierce. Yet, at the same time, active grantees have made clear that the cuts have been hurting their ability to accomplish the aims of the research they are pursuing. This time, then, we at NIA (and across NIH) have decided that honoring our commitment—paying non-competing awards at their full level—is the most appropriate funding strategy this year. With that strategy, given the 4.2-percent increase, we are confident that we can support a similar number of new and competing awards to those made last year to sustain all fields of aging research.

The table on the funding policy page contains a sharp contrast. Our initial allocation allows us to pay most research grants through the 7th percentile. The equivalent allocation for applications focused on Alzheimer’s disease is the 18th percentile. This disparity reveals what we conveyed in earlier blog posts. Now is the time to make major progress on the critical priority of Alzheimer’s disease, and this differential funding line should provide a strong stimulus to that research .

This is only the beginning

These are INITIAL allocations. We cannot post a final pay line at the moment because the May 2016 round of applications remain to be reviewed. Last year, we had also established a 7th percentile line early in 2015. Then, the May round yielded an unexpectedly large number of applications scoring within the 7th percentile. I can testify to my sense of looking in every pocket and under the last desk to find money to make that pay line. In the end, we went beyond the 7th percentile. We anticipate going beyond the 7th percentile this year, too. Our remaining caution comes from that May 2015 surprise.

Oh, and one more thing: The Alzheimer’s pay line is also likely to go beyond the 18th percentile, perhaps considerably beyond it.

No, we are not happy with what will, in all likelihood, be a single digit funding line in the general allocation for the second year in a row. We have begun experimenting with an expanded R56 (short-term, high-priority) award program to find out if it does advance research successfully. We are likely to continue that experiment this year.

I welcome your thoughts on the extraordinary ups, and remaining challenges, of our budget this year.

Budget Funding Policy Pay Lines Robin BARR

NIA funding policy and pay line update