As U.S. lawmakers search for ways to incentivize medical breakthroughs, some appear to have their eyes on the prize. A provision in a new biomedical innovation bill passed last week in the House of Representatives would create a new program to launch prize competitions at the National Institutes of Health (NIH).
Some federal agencies have been offering prizes for years, and the 2010 America COMPETES Act officially authorized them to do so. The Defense Advanced Research Projects Agency (DARPA) has run a series of high-profile competitions in robotics and vehicle design since 2004, the latest of which took place last month in California (see photo). The private sector has also embraced the concept, and the 2004 Ansari XPRIZE competition is widely credited with spurring the U.S. commercial space industry. And prizes were central to the discussion this week during a Senate hearing on promoting cures for deadly diseases.
Challenges are an appealing alternative to traditional research grants because “you’re only paying for success,” Christopher Frangione, XPRIZE’s vice president of prize development, told members of the space, science, and competitiveness subcommittee of the Senate commerce committee on Tuesday. And although grant competitions usually require fully developed proposals written by acknowledged experts, Frangione said, prizes can inspire applicants from outside the academic mainstream. “You’re democratizing innovation,” he said. “As long as you solve the problem, you win.”
Several senators were enthusiastic about the model. “Agencies like DARPA, the Department of Energy (DOE), and NASA already have a solid track record when it comes to challenge prizes,” Senator Tom Udall (D–NM) said, “but I think we could be doing more to encourage other agencies to consider this approach.” In March the House of Representatives passed H.R. 1162 , which sets new guidelines for federal agencies to partner with private companies in creating competitions, and Udall said he plans to introduce a companion bill shortly in the Senate.
A 2007 National Academies report called such prizes “a sound investment” but cautioned that federal agencies face several hurdles in making sure that the money is well spent and the programs properly managed. Frangione told legislators that biomedical research prizes present unique challenges. “There only a few places where prizes really work in health,” he testified. A grand challenge might pay off in research areas that require engineering expertise, that are underfunded due to a small patient pool, or that benefit from interdisciplinary collaboration, he said, but long-term studies that require basic research are poor candidates for a prize.
NIH has tested the benefits and risks of prizes on a relatively small scale. Its largest prize announced to date is the $500,000 Follow that Cell Challenge launched last summer by the National Institute of Mental Health (NIMH), which is seeking new ways to track the behavior of a cell inside the body over time.
Lawmakers may be thinking of future prizes in much bigger terms. In debate last week before House passage of the 21st Century Cures Act, H.R. 6, representatives Todd Young (R–IN) and Andy Harris (R–MD) suggested establishing a new NIH program to award prizes of up to $250 million. The final bill does not contain any figure. But it would create an NIH Innovation Prizes Program, with a nine-member advisory board that would design new biomedical challenges and determine winners. The board would consist of the NIH director, four members appointed by the director, and four other members appointed by the majority and minority leaders of the House and Senate.
One opponent of that proposal, Representative Frank Pallone (D–NJ), worried that the program could reduce funding for other grant mechanisms. He also argued that including politically appointed advisers “threatens to undermine the independent peer-review process that is the bedrock of NIH funding.” But Harris’s suggestion carried the day in a voice vote before the House passed the overall bill by a margin of 344 to 77.
NIMH’s Andrea Beckel-Mitchener, who manages the Follow that Cell Challenge, didn’t comment directly on the process laid out in the bill. Her program relies on a panel of NIH employees to judge the winners, she noted, a process intended to avoid potential conflicts of interest. “I hear about the enthusiasm about [prizes] in other quarters, and I share that enthusiasm,” she says, before adding that “I would hope it doesn’t take over, in the sense that I think NIH operates best with its [existing] grant mechanisms.”
Some lawmakers warned about overselling the impact of biomedical prizes because bringing new medical products to market still requires costly clinical trials and Food and Drug Administration approval. “A $10 million prize is not going to incentivize breakthroughs in something that literally costs hundreds of millions of dollars to develop,” said Senator Ron Johnson (R–WI).
At the same time, putting the weight of the government behind competitions could create powerful incentives, predicts Georgina Campbell Flatter, an innovation policy expert at the Massachusetts Institute of Technology (MIT) in Cambridge who helped direct an MIT clean energy prize sponsored in part by DOE. “When you get endorsement like that … you can then go out and raise money,” she says, “because you’ve been endorsed by one of the most impactful agencies in the country.”