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Advisory Council July 2017 Meeting Presentation: FY19 NIH Bypass Budget

Friday, July 28, 2017

Printer Friendly Version in PDF Format (8 PDF pages)


Development of the FY19 NIH Bypass Budget for Alzheimer's Disease and Related Dementias

Richard J. Hodes, M.D.
National Institute on Aging

Growth of AD and ADRD Research Spending at NIH

Research/Disease Areas
(Dollars in millions and rounded)
FY 2015
FY 2016
FY 2017 Estimate
Alzheimer's Disease $589 $929 $1,348
Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD) $631 $986 $1,414
Alzheimer's Disease Related Dementias (ADRD) $120 $175 $234
Frontotemporal Dementia (FTD) $36 $65 $68
Lewy Body Dementia $15 $22 $23
Vascular Cognitive Impairment/ Dementia $72 $89 $93

Bypass Budget Language

SEC. 230. Hereafter, for each fiscal year through fiscal year 2025, the Director of the National Institutes of Health shall prepare and submit directly to the President for review and transmittal to Congress, after reasonable opportunity for comment, but without change, by the Secretary of Health and Human Services and the Advisory Council on Alzheimer's Research, Care, and Services, an annual budget estimate (including an estimate of the number and type of personnel needs for the Institutes) for the initiatives of the National Institutes of Health pursuant to the National Alzheimer's Plan, as required under section 2(d)(2) of Public Law 111-375.

NIH Meetings Provided the Basis for Priorities, Milestones, and Budget Estimates

  • 2012 Alzheimer's Disease Research Summit
  • 2013 meeting on Alzheimer's Disease-Related Dementias: Research Challenges and Opportunities
  • 2013 meeting on Advancing Treatment for Alzheimer's Disease in Individuals with Down Syndrome
  • 2015 Alzheimer's Disease Research Summit
  • 2016 meeting on Alzheimer's Disease-Related Dementias

Recommendations used to create milestones for developing the Alzheimer's Disease (and related dementias) Bypass Budget

Combined External and Internal Input -- FY19 AD Bypass Budget

  • Input at 2012-2017 meetings:
    • Academic research community
      • Industry
      • Non-governmental organizations
    • Other Input:
      • 2017 Request for Information
  • Development of comprehensive milestones (NIH staff) -- based on recommendations and milestones from meetings
  • Trans-NIH (including NINDS) staff discussion; milestones edited to ensure comprehensive inclusion of priorities for FY19
  • NIH staff "price" the milestones
  • Final budget estimate for FY19

Trans-NIH Input for FY19 ADBB

  • Nine Institutes and Centers provided feedback that contributed to the development of this year's professional judgment budget:
    • NIA
    • NINDS
    • NIMH
    • NINR
    • NICHD
    • NIEHS
    • NIDDK
    • NIDCR
    • NHLBI

Using CADRO as a Framework

  • The eight CADRO (Common Alzheimer's Disease Research Ontology) categories provide the overarching framework for the FY19 AD Bypass Budget and narrative.
  • CADRO provides the framework for IADRP (the International Alzheimer's Disease Research Portfolio) and will allow tracking of implementation in the budget areas in future years.

FY19 Professional Judgment Budget

Area of Research Amount
(dollars in thousands)
A. Molecular Pathogenesis and Physiology of Alzheimer's Disease $110,000
B. Diagnosis, Assessment and Disease Monitoring $70,100
C. Translational Research and Clinical Interventions $191,000
D. Epidemiology $58,025
E. Care and Caregiver Support $32,800
F. Research Resources $76,375
H. Alzheimer's Disease-Related Dementias $55,000
Staff Needs, Support, and Misc. $3,800
Total Additional Resources Needed $597,100

Distribution of Additional Budget Funding Request Across Research Areas, FY19(Total: $597,100,000)

Pie Chart: Epidemiology (10%), Care and Caregiver Support (5%), Research Resources (13%), ADRD (9%), Staffing Needs and Administrative Support (0.6%), Molecular Pathogenesis and Pathophysiology of AD (18%), Diagnosis, Assessment, and Disease Monitoring (12%), Translational Research and Clinical Interventions (32%).

FY19 Professional Judgment Budget Baseline

Baseline Estimate, President's Budget, Fiscal Year 2018
(dollars in thousands)
Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD+ADRD)

FY19 Professional Judgment Budget Considerations

Resources needed for new AD/ADRD research
(dollars in thousands)
Difference between FY18 President's Budget Request and the FY17 Omnibus Appropriation
(dollars in thousands)
(dollars in thousands)
(dollars in thousands)

Implementation Tracking

  • IADRP:
    • Will continue to offer detailed tracking of initiatives and awards with respect to our research milestones, under the CADRO categories
  • Web-based tool for tracking funding initiatives and activities:
    • Developed by the NIH and other AD funding organizations
    • Aimed at addressing the research milestones associated with NAPA


Other Federal Updates

ADRD Non-Governmental Organizations (NGO) Roundtable Meeting

June 16, 2017
Hosted by NINDS and NIA

  • To share updates about research activities, funding-related information, and progress on the ADRD Research Milestones
  • To discuss opportunities for NIH and NGOs to work together toward preventing or effectively treating AD/ADRD by 2025
  • Participants: NINDS and NIA Leadership and staff, and 9 NGOs, including
    • Alzheimer's Association
    • American Heart Association & American Stroke Association
    • Association for Frontotemporal Degeneration
    • The Bluefield Project to Cure Frontotemporal Dementia
    • BrightFocus Foundation
    • CurePSP
    • Lewy Body Dementia Association
    • The Michael J. Fox Foundation for Parkinson's Research
    • Rainwater Charitable Foundation

2017 VHA-NIA Collaboration/Partnership Alzheimer's Disease and Related Disorders

  • Goals:
    • Foster new networks between VA- and NIA- investigators.
    • Leverage each Institution's state-of-the-art instrumentation, data information, clinical resources, and Centers of Excellence to synergistically move the field forward.
  • Timelines (in process):
    • Request for Information (RFI)- NOT-AG-16-083 (9-received)
      • Potential AD and ADRD research topics to address.
      • Barriers & challenges that could prevent coordination and collaboration.
      • How to leverage resources
    • Meeting between VA point of contact (Dr. Block) and NIA (Drs. Opanashuk and Liggins) points of contact (2-29-17).
    • Development of Work Groups (April 15, 2017) - ~10 people/group
      • Basic Disease Mechanisms Work Group
      • Genetic and Population Studies Work Group
      • Diagnoses and Disease monitoring Work Group
      • Translation and Clinical Research Work Group
      • Care and Caregiving Research Work Group

July 28, 2017 -- Advisory Council Meeting #25

The meeting was held on Friday, January 26, 2018, in Washington, DC. The Research Subcommittee took charge of this meeting's theme, focusing on the process from targets to treatments. The Council heard speakers on the preclinical pipeline, the clinical trial pipeline, and the industry perspective. The meeting also included discussion of a driver diagram to guide the Council's future work, updates and a report from the October Care Summit, and federal workgroup updates. Material available from this meeting is listed below and is also available at

Comments and questions, or alerts to broken links, should be sent to


General Information


Presentation Slides



  • Welcome thru Clinical Care -- [Video]

  • LTSS Research -- [Video]

  • Public Comments thru Federal Workgroup Updates -- [Video]

  • Recommendations thru Adjourn -- [Video]