What if NIH had been 40% smaller?
Bhaven Sampat, Pierre Azoulay, Matthew Clancy, Danielle Li
Abstract
The US National Institutes of Health (NIH) has enjoyed unusually consistent support from the US government since its expansion after World War II (1). Continued support is less certain. For much of 2025, new and competitive grants at NIH were more than 40% below the levels that had been disbursed by the same date in the preceding year (2). Meanwhile, the president’s proposed budget for discretionary spending called for a 39.3% cut to NIH for fiscal year (FY) 2026 (3). To help understand the effects of such large cuts to funding, we leveraged new data and measures to consider an alternative history: If the permanent NIH budget had been 40% smaller, how would that have affected the medicines we enjoy today? Results suggest that such large cuts could affect a large share of drug approvals.
Citation
Pierre Azoulay et al. What if NIH had been 40% smaller?.Science 389, 1303-1305(2025).DOI:10.1126/science.aeb1564