Where is the FY18 Bypass Budget?

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Cancer Groups Want to Know

The NCI Bypass Budget was expected to be made public on Oct. 6.

Alas, this didn’t happen; why didn’t it?

America’s top cancer groups would like to know, and theirs is not idle curiosity. The NCI Bypass Budget is an important, unique authority established by the National Cancer Act of 1971.

That law designates the NCI director as the top official of the National Cancer Program, requiring this official to inform the U.S. President about opportunities in the cancer program. At least on paper, the document bypasses NIH and HHS, and goes directly to the White House.

The NCI document was prepared, and its summary was sent out to members of the National Cancer Advisory Board, and was obtained by The Cancer Letter. The document is posted here.

Citing his unique authority and his position as the coordinator of the National Cancer Program, NCI Acting Director Douglas Lowy is asking for $6,484 million for FY18—an increase of $590 million over the President’s FY17 Budget Proposal.

That increase consists of a $165 million inflation adjustment and $425 million in additional funding.

42-38 Table

The House and Senate appropriations bills contain no new funds for the Moonshot program. However, the 21 Century Cures Act, should it become law, does contain budgetary increases. The version of that legislation that was passed by the House proposes an $8.75 billion increase for NIH, which would be given out over five years. These funds are contingent on budgetary offsets.

With Hillary Clinton seeming likely to win the upcoming election, it appears that the moonshot program run by Vice President Joe Biden will continue.

On Oct. 17, a report of the Moonshot Task Force will be released at a White House ceremony. With the moonshot likely to continue into the new administration, observers worry about the prospects of these new funds not making their way to NCI as well as the prospect of erosion of the NCI director’s authorities.

Three major oncology organizations contacted by The Cancer Letter said they are eager to see the Bypass Budget released:

• American Society of Clinical Oncology: “We appreciate that NCI must take into account a wide range of factors in determining the timing of the bypass budget release,” said ASCO President Daniel Hayes. “The bypass budget serves as a critical benchmark in the federal budget process that ASCO and others examine to better understand the funding requirements needed to advance critical cancer research priorities.

“ASCO continues to be encouraged by Vice President Biden’s moonshot initiative and the Blue Ribbon Panel recommendations.

“We will continue to strongly advocate for funding that will supplement, not supplant, current NCI appropriations in order to realize the moonshot’s vision for accelerating progress against cancer.”

• American Association for Cancer Research: “We are very much looking forward to NCI releasing its FY 2018 Bypass Budget, especially since it’s a tool for us to use when talking to policymakers about the extraordinary opportunities that exist today in cancer research,” said Jon Retzlaff, managing director for science policy and government affairs at AACR. “This annual budget document from NCI also specifies the investments that are needed to support the innovative and cutting-edge science that will ultimately make a major difference for cancer patients and their loved ones, as well as highlights the evidence-based ideas and approaches for preventing cancer from ever occurring in the first place.

“As we all know, if Vice President Biden’s Cancer Moonshot Initiative is going to meet its overall objective of achieving a decade’s worth of advances in five years, it’s going to require robust, sustained, and predictable funding increases for NCI. Therefore, in addition to fighting hard during the upcoming lame duck session of Congress to ensure that significant resources are allocated to the NCI in FY 2017 to carry out many of the National Cancer Moonshot programs and initiatives that have been proposed, we also need to begin establishing a foundation to ensure that this momentum for increased resources continues into FY 2018 and beyond.

“Of course, we will be provided with such an opportunity once the NCI releases its FY 2018 Bypass Budget. We are optimistic about NCI’s budget being supplemented in FY 2017 with some significant research dollars that are increasingly likely to be included in the respective 21st Century Cures Bills in the House and Senate when Congress reconvenes after the elections for a lame duck session. The Cures bills are important vehicles for ensuring that the NCI receives the funding that’s necessary for the agency to implement the initiatives and programs that have been proposed as part of the Vice President’s Cancer Moonshot program.”

• American Cancer Society Cancer Action Network: “The Bypass Budget is essential for the National Cancer Program. It enables the NCI director to clearly communicate what resources are necessary to meet cancer researchers’ scientific needs as well as advance the most promising research opportunities, including those recommended by the Blue Ribbon Panel,” said Chris Hansen, president of ACS CAN. “The cancer community relies heavily on the bypass budget for its planning of various types of related work and initiatives.”

The White House and NIH officials deflected The Cancer Letter’s questions to NCI, and NCI officials didn’t respond by deadline.

The Bypass Budget mentions NCI’s primary role in the cancer program.

“As coordinator of the National Cancer Program, NCI seeks and supports new ideas to understand and intervene in the cancer process, from the earliest stages to the most advanced,” Lowy writes in the introduction. “Improvements in prevention, screening, diagnosis, and treatment have resulted in lower death rates for most cancers.”

Lowy mentions the moonshot, too:

“I am privileged to put forward this Annual Plan & Budget Proposal for Fiscal Year 2018 at a unique and exciting moment in time, when two major initiatives—the President’s Precision Medicine Initiative (PMI) in oncology and the Cancer Moonshot, led by Vice President Biden— have the potential to transform cancer research,” he writes. “The Cancer Moonshot aims to accelerate progress against cancer, accomplishing a decade’s worth of advances in just 5 years. As part of this effort, a Blue Ribbon Panel of experts and cancer advocates.”

In another highlight, Lowy mentions the NCI Blue Ribbon Panel and its recommendations.

“As part of this effort, a Blue Ribbon Panel of experts and cancer advocates from around the country identified specific opportunities poised to accelerate research progress and formalized a set of 10 bold, yet feasible, recommendations to the National Cancer Advisory Board,” he writes. “I was gratified to see not only the recommendations themselves but also the spirit of collaboration that was so evident among these leading cancer experts from academia, industry, and the public and private sectors.”

Matthew Bin Han Ong contributed to this story.


President Joe Biden’s proposed Advanced Research Projects Agency-Health would be a welcome partner to NCI—particularly in conducting large, collaborative clinical investigations, NCI Director Ned Sharpless said.“I think having ARPA-H as part of the NIH is good for the NCI,” Sharpless said April 11 in his remarks at the annual meeting of the American Association for Cancer Research. “How this would fit with the ongoing efforts in cancer at the NCI is still something to work out.”
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