The Senate followed the House in in an overwhelming  94-5 vote in support of the 21st Century Cures Act.  According to The Hill, it is expected to be signed into law by the President very quickly. Passage of the Act is considered a victory for biomedical researchers, pharmaceutical companies and patients. In addition to mental health and opioid addiction aid and provisions affecting patients, the Act contains several features important to the biomedical research community, including measures intended to advance research and expedite approval for lifesaving cures.

Highlights of the “Cures” Act include an authorization for increased funding for the NIH, acceleration of the FDA drug approval process, and prioritization for the development of innovation projects that support research discovery at the NIH and FDA. It also provides for the review of regulations and policies affecting researchers using animal models, with an emphasis on reducing administrative and regulatory burden.

This has been one of the most heavily lobbied pieces of legislation in the history of Congress and will have a far-reaching impact on our community.  There is a lot to be happy about in this bill but our advocacy work is more important now than ever.  Many of the funding provisions in the legislation are dedicated to specific efforts and it is imperative that we ensure that this funding supplements and does not supplant funding in the regular appropriations process.  

The Act authorizes the following funding for biomedical research:

Key Authorizations

• $4.796 billion of funding for the National Institutes of Health (FY 2017-2026)
• $1.8 billion for cancer research (FY 2017-2023)
• $1.511 billion for BRAIN (FY 2017-2026)
• $1.455 billion for the Precision Medicine Initiative (FY 2017-2026)
• $500 million of funding for the FDA (FY 2018-2026)
• $30 million for regenerative medicine research using adult stem cells (FY 2017-2020)

AWARD OF RESEARCH GRANTS

The Act simplifies the application and approval process for researchers and reduces burdens on recipients. Specifically, the Act provides for the following provisions related to NIH grants:

• Implement measures to reduce burdens on the monitoring of sub-recipients of grants, including an exemption from subrecipient monitoring or the implementation of alternative grant structures which remove the need for such monitoring.
• Establish considerations to modify the timelines for the reporting of financial conflicts of interest and ensure they are appropriate for the award.
• Avoid duplication of procedures and requirements between the agency and the department, requiring the Secretary of Health & Human Services (HHS) and the Director of the NIH to evaluate expenditure reporting to minimize burdens on funding recipients.
• Creates the “Next Generation of Researchers Initiative” to foster a new crop of investigators. The Initiative will promote research independence and increase opportunities for funding and mentorship, and will enhance workforce diversity for young researchers.

DRUG APPROVAL PROCESS

FDA is granted authority by the Emergency Use Authorization (EUA) to strengthen the nation’s response to chemical, biological, radiological, or nuclear (CBRN) threats through the use of unapproved medical products. 21st Century Cures clarifies this authorization by allowing the use of conditionally approved medications. It also expands the use of these unapproved countermeasures to animal drugs and animals.

REDUCTION OF REGULATORY BURDEN

The Act aims to reduce administrative and regulatory burden for biomedical researchers. Two other bills (H.R. 5583 and S. 2742) were previously introduced in the 114th Congress to alleviate regulatory burden in research, but no action was taken. The language of the “Cures” Act states in Sec. 2034, page 69 that not later than 2 years after enactment, “the NIH Director shall collaborate with the Agriculture Secretary and Food and Drugs Commissioner to complete a review of the policies and regulations for the care and use of laboratory animals. As appropriate, they shall revise and reduce burden placed on investigators, while protecting research animals and maintaining the integrity and credibility of research findings.”

The Director of the NIH shall seek input of experts and shall:

• “Identify ways to ensure such regulations and policies are not inconsistent, overlapping, or unnecessarily duplicative, including with respect to inspection and review requirements by Federal agencies and accrediting associations;
• Take steps to eliminate or reduce identified inconsistencies, overlap, or duplication among such regulations and policies; and
• Take other actions, as appropriate, to improve the coordination of regulations and policies with respect to research with laboratory animals.”

The Act also provides for a review by research funding agencies regarding the policies covering the disclosure of financial conflicts of interest and make any revisions necessary to harmonize these policies.

RESEARCH POLICY BOARD

One year after enactment, a research policy board will be established to advise government officials about the effects of regulations on researchers. The board will consist of the Administrator of the Office of Information and Regulatory Affairs of the Office of Management and Budget, the Director of the Office of Science and Technology Policy, the Secretary of HHS, the Director of the National Science Foundation, and other secretaries and directors that support or regulate scientific research, as well as 9 and 12 members from nonprofit scientific organizations. The board will conduct assessments of regulatory policies and offer suggestions for improvement. The board will then submit a report to selected federal offices and Congressional committees containing their formal recommendations.

Text of the legislation, section by section summaries, and fact sheets are available now.

Last updated: December 8, 2016