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 As drugmakers shift focus to more lucrative areas, such as oncology
and rare diseases, fewer heart drugs in their pipelines means NIH-funded
research may be more important to cardiology than ever, doctors at
the recent American College of Cardiology meeting said.
Despite major advances that have helped patients live longer,
healthier lives, heart disease remains the world's No. 1 killer.
Top heart doctors and researchers at the ACA meeting used words like
"chilling" and "catastrophe" to describe their reaction to the
proposed $5.8 billion cut to the NIH budget.
They noted that the Nobel Prize-winning scientists whose discovery
led to development of the world's most successful, widely used heart
drugs were funded by the NIH, as were countless studies and research
that has changed medical practice and enhanced the lives of
millions.
"There are trials that we have to do that will never be funded by
drug companies. We rely on NIH," said Dr. Leslie Cho, head of
preventive cardiology at Cleveland Clinic.
A prime example: the government-funded landmark Sprint trial that
found more aggressive treatment with generic blood pressure
medicines dramatically cut heart failure and risk of death in adults
aged 50 and older.
Interviews with about a dozen top cardiologists at the ACC meeting
found unanimous condemnation of the proposed cuts amid fear they
will halt important work and disenfranchise a new generation of
researchers.
"I'm a little concerned that there hasn't been a complete eruption
that the NIH is being targeted for such substantial cuts. This is a
landmine waiting to explode," said Dr. Clyde Yancy, a former
American Heart Association president.
"Laboratories will be shut down; personnel would be released; ideas
would be left incomplete; proposals would go unaddressed. We just
can't afford to have the pace of scientific discovery slowed down
like this," said Yancy, from Northwestern University Feinberg School
of Medicine in Chicago.
Dr. Steven Nissen, chief of cardiology at Cleveland Clinic, pointed
to the work of Michael Brown and Joseph Goldstein that eventually
gave the world statins, such as Pfizer's Lipitor, the cholsterol-lowering
drugs which prevent heart attacks. Early NIH-funded research laid
the groundwork for a wide range of big-selling drugs produced by the
pharmaceutical industry.
"How many millions of heart attacks and lives have been changed by
that. If you don't fund the Browns and Goldsteins of the world,
where do the next discoveries come from?" asked Nissen.
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Dr. Andrew Kates runs the cardiology fellowship training program at
Washington University in St. Louis.
"I know the struggles that our fellows face looking for career
development awards and that's all NIH-funded grants. So the pipeline
that we need for future researchers will be at significant risk,"
Kates said. "We all need to be concerned."
To be sure, the real budgeting power lies with Congress, which could
reject NIH cuts.
"Aside from defense and vets, NIH is one of the most universally
loved programs on Capitol Hill," said Capital Alpha Partners analyst
Rob Smith.
But Congress is controlled by the president's party and there is no
guarantee Republicans will stand against Trump or to what extent.
Dr. Patrick O'Gara, director of clinical cardiology at Brigham and
Women's Hospital in Boston and a former ACC president, said massive
NIH cuts would hurt local economies.
"That will eventually trickle down to the workers who are able to
enjoy access to good jobs that have been driven by this
biotechnology juggernaut, much of which relates to the level of
research that can be accomplished," O'Gara said.
"I'm hopeful that this is just an opening gambit and Congress ...
will look at things differently," he added.
ACC President Dr. Mary Walsh, director of heart failure and
transplantation programs at St. Vincent Heart Center in
Indianapolis, called for fierce opposition to the proposed cuts.
"All of medicine and all of investigation need to make our voices
heard," she said. "This could become a unifying theme. Science
matters!"
(Reporting by Bill Berkrot; Additional reporting by Julie
Steenhuysen in Chicago; Editing by Leslie Adler)
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