Scientists Decode Secret of Getting NIH Grants - WSJ
Mon, 28 Jun 2004
The Secret of Getting Grants: Marketing Helps University Win $350
Million a Year, by Bernard Wysocki, a front page article in The Wall
Street Journal, provides insight into an iron triangle that controls
medical research. This triumvirate has tainted not only the grant approval
process but the focus and integrity of research, as greed and ambition
have won over scientific merit.
The article focuses in particular on the University of Pittsburgh
(Pitts), and the aggressive, manipulative marketing tactics employed
by a master grant getter, Dr. David Kupfer, head of the department of
psychiatry, who has succeeded in obtaining hundreds of millions in grants
annually from the National Institutes of Health and untold millions
from the pharmaceutical industry.
Inasmuch as psychiatry has made hardly any advances in the treatment
of mental illness--which is ostensibly the focus of psychiatric research--Congress
should be asking what was done with those funds?
That is not to say, that psychiatry has done nothing with the money.
The WSJ reports: "Pitt's strategy, since the university is building
a $205 million biomedical tower scheduled to open in 2005. The tower
will have annual operating costs of about $75 million. More than 80%
of this is expected to come from NIH grants."
High profile academic psychiatrists, such as Dr. Kupfer (the center
piece in the article), have been enormously successful in garnering
both government grants and pharmaceutical company contracts. University-based
psychiatrists, whose influence at the National Institute of Mental Health
is described in the WSJ article, simultaneously collaborate closely
with drug manufacturers. Together they have made psychotropic drugs
blockbuster profit earners: in 2003 antidepressant drug sales rose to
$19.5 billion and antipsychotic drug sales rose to $12.2 billion.
This marketing feat was accomplished by an iron triangle composed
of pharmaceutical company executives, university psychiatrists, and
NIMH psychiatrists who worked in unison to promote the newest, most
expensive psychotropic drugs--antidepressants of the SSRI class and
so-called atypical anti-psychotics--as first line treatment for anyone
complaining about almost any dissatisfaction. The drugs are widely and
indiscriminately prescribed even though they have failed to demonstrate
safety or effectiveness in controlled clinical trials conducted by a
cadre of academic / company investigators. The successful marketing
of the drugs was accomplished by concealing evidence from failed trials
and evidence of severe adverse drug effects--including increased risk
of suicidal behavior which, in children is double the risk.
The Wall Street Journal report concludes:
These days, with NIH funding on a plateau after the five-year doubling,
Drs. Levine and Kupfer are ratcheting up the pressure on scientists
to keep up the frenzy of grant applications. Dr. Kupfer says he wants
the number of psychiatry department proposals to double, from 165 last
year, to take more of the NIH money in a flat market. "We will increase
our market share," he vows.
Contact: Vera Hassner Sharav
Tel: 212-595-8974
~~~~~~~~~~~~~~~
THE WALL STREET JOURNAL
At Pitt, Scientists Decode The Secret of Getting Grants
By BERNARD WYSOCKI JR.
June 28, 2004; Page A1
PITTSBURGH -- For David Kupfer, getting grant money from the National
Institutes of Health isn't only about science. Marketing is also key
to success.
So earlier this month, the head of the University of Pittsburgh's
psychiatry department used an NIH-sponsored conference in Phoenix for
a bit of self-promotion. Allotted five minutes to speak as co-chairman
of a panel on bipolar disorder, he filled the time with a PowerPoint
presentation pitching his own ideas on the subject -- which are central
to a $4 million grant proposal now pending at NIH. In the audience:
prominent psychiatrists who sit on the NIH review panel that will help
decide whether Pitt gets the money.
The maneuver is one of many that Dr. Kupfer, 63 years old, says he
uses to try to score hundreds of millions of dollars for Pitt in grants
from Uncle Sam. A consummate schmoozer, he chats up NIH officials about
hot new areas that might produce funding for his 240 faculty members
and researchers. He requires young Pitt scientists to attend boot camps
on grant writing. And he makes sure the scientists who win NIH money
get onto the agency's review committees to further penetrate the grant-giving
system at NIH, in Bethesda, Md. Researchers can get bonuses of as much
as $50,000 a year based on how much NIH money they bring to Pitt.
"We're called Bethesda North," says Dr. Kupfer.
There's a lot of NIH money to be had. In the past five years, the
budget of NIH has doubled, to $28 billion. Some of that money goes to
researchers in Bethesda who are directly employed by NIH's 27 institutes,
such as the National Cancer Institute. But the lion's share -- about
80% -- gets parceled out to other researchers across the U.S.
NIH isn't the only government agency whose largess is eagerly sought
by universities. In Atlanta, Emory University has used its proximity
to the federal Centers for Disease Control to win contracts for CDC-related
research. The University of Pennsylvania has created an Institute of
Strategic Threat Analysis and Response, a loose alliance of experts
from 12 Penn graduate schools, to go after big federal grants from the
Department of Homeland Security and other sources of funds.
Few institutions, though, have made such a grab for market share in
government funding as the University of Pittsburgh and its affiliated
20-hospital medical center.
A research also-ran 20 years ago, Pitt has successfully gone after
NIH funds in psychiatry, cancer research, genetics, and other fields.
The university has funneled revenue from its organ-transplant program,
a world leader since the 1980s, into recruiting new faculty and expanding
its research. Last year, thanks in part to the newcomers, Pitt pulled
in $350 million of NIH money. That made it the eighth-biggest recipient,
up from No. 12 just five years ago and ahead of such eminent research
universities as Yale, Duke and Columbia.
In a cheeky symbol of its emergence into the top tier, Pitt last September
recruited away the entire 20-person biosecurity think tank from Johns
Hopkins University, the No. 1 recipient of NIH funds. Pitt pledged to
spend $12 million getting the team established at spiffy offices in
downtown Baltimore. It hopes the biosecurity researchers will get government
money, especially homeland-security funds, not only for themselves but
also for colleagues in Pittsburgh.
"As long as the federal government is the major funder in the billions
of dollars, we want our colleagues to be in the Baltimore-Washington
area ... [and] quite frankly to be first in line to bring the funds
back to Pittsburgh," said Jeffrey Romoff, president of the University
of Pittsburgh Medical Center and architect of the deal, speaking at
a press conference. In return for all this money, of course, the American
public is supposed to get progress in combating disease. The university's
cutting-edge research includes an effort to reverse the effects of stroke
by surgically implanting nerve cells. It has also developed a substance
called Pittsburgh compound B that enhances images taken of the brains
of Alzheimer's-disease patients.
Still, research universities and NIH itself are under pressure from
Congress to show even greater results. Some legislators want NIH to
devote itself less to fundamental scientific inquiry and more to "translational"
research that can generate drugs, devices and other therapies. Among
scientists, there is fierce debate about how to make research more productive.
Some think NIH allows too much bottom-up research proposed by individual
scientists; others say it creates too many top-down megaprojects with
grand but elusive goals.
Pitt plays both sides of the game, with big teams and individual efforts,
and its success is the envy of other universities. "We're consciously
headed in the same direction," says Fred Sanfilippo, senior vice president
of health sciences at Ohio State University, which is building a $150
million biomedical tower.
The battle for grants is expected to become more bare-knuckled because
the NIH is no longer getting double-digit budget increases each year
-- a result of the federal budget deficit and feelings in Congress that
the institutes now receive enough money.
Already, there is resentment against Pitt, say some scientists. Thomas
Insel, director of the National Institute of Mental Health, says people
from competitor universities who sit on review panels sometimes say,
"God, those people already have so much going on; we need to spread
the wealth." Michael Swift, a genetics specialist formerly at the University
of North Carolina and New York Medical College, is a critic of Pitt.
"They're teaching people how to work the system," he says. "What does
it have to do with science or health? It has a lot to do with money."
Dr. Swift, 69, won more than $10 million in NIH grants during his career
but has had trouble getting NIH funding in recent years. He is now retired
from academia and does research independently.
By far the biggest winner in getting NIH money -- and the template
for the rest of Pitt -- is the university's psychiatry department and
its affiliated 276-bed Western Psychiatric Institute and Clinic, which
last year pulled in nearly $75 million in funds from NIH, mostly from
the National Institute of Mental Health.
Dr. Kupfer, a trim New York native, operates from the institute's
Depression-era brick tower with a salesman's optimism. He frequently
calls branch chiefs at NIH's various institutes and keeps in constant
touch with Pitt researchers who leave to take positions there, inviting
them back for lectures. Of one colleague who left for NIH, he says fondly,
"He left but he never really left."
Within NIH's mental-health institute, Pitt has long occupied a spot
on the 18-person national advisory council, which makes funding recommendations
to the director after an initial review by scientific committees made
up of experts in specific subfields. People now speak of the "Pittsburgh
seat" on the advisory council. Other universities have representatives
on the council, but nobody talks of a "Yale seat" or a "Cornell seat."
The current occupant of the Pittsburgh seat is Charles Reynolds, a
senior Pitt faculty member. "It's extremely self-serving," says Dr.
Reynolds of his position on the advisory council. He has used his seat,
he says, to lobby successfully to reinstate a branch of the mental-health
institute devoted to his specialty, the mental health of the elderly,
although he plays no role in approving his own grant proposals.
To make sure Pittsburgh stays ahead of the pack, Dr. Kupfer runs an
intensive "survival skills" course for young postdoctoral fellows in
psychiatry to train them in the fine points of applying for their first
grants, typically about $600,000 for five years. The biggest trick young
scientists need to learn, he says, is to focus their proposals more
narrowly. To Dr. Kupfer, it's almost like marketing or branding. "You
need a T-shirt," he constantly exhorts his charges, by which he means
a quick phrase that tells the world what the research stands for.
Xxx cut xxx
These days, with NIH funding on a plateau after the five-year doubling,
Drs. Levine and Kupfer are ratcheting up the pressure on scientists
to keep up the frenzy of grant applications. Dr. Kupfer says he wants
the number of psychiatry department proposals to double, from 165 last
year, to take more of the NIH money in a flat market. "We will increase
our market share," he vows.
As added incentive, Dr. Kupfer runs a bonus program that allows scientists
to get a payment equal to 10% of the size of a grant, up to $50,000
a year. The program, once limited to the psychiatry program, has been
expanded by Dr. Levine to all of Pitt's health sciences departments.
Dr. Kupfer also thinks psychiatry can tap sources of funding beyond
NIH's mental-health institute by teaming up with scientists in other
fields. A few weeks ago, he spent an hour brainstorming with Tara O'Toole,
the head of the biosecurity team that Pitt lured from Johns Hopkins,
on ways to join forces. One idea: trying to get grant money, from the
NIH or elsewhere, to study how to avoid mass public hysteria in the
event of a terrorist attack.
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