Notice Number: NOT-OD-16-025

Key Dates
Release Date: November 25, 2015

Issued by
National Institutes of Health (NIH)

Purpose

The purpose of this Guide Notice is to clarify NIH policy related to funding health economics research. This Notice serves to communicate NIH’s priority areas of health economics research as well as research aims that generally fall outside of the NIH mission to seek fundamental knowledge about the nature and behavior of living systems, and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability.

Applicants and potential applicants for NIH research grants are advised to consult with NIH program officers in Institutes and Centers (IC) appropriate to their proposed topic if they have questions about the alignment of their research with IC program priorities.

Background

Health economics is the study of how scarce resources are allocated among alternative uses for the care of sickness and the promotion, maintenance, and improvement of health, including the study of how health care and health-related services, their costs and benefits, and health itself are distributed among individuals and groups in society. Health economics research offers rigorous tools that can help NIH pursue its overall mission to improve health, and is an integral part of the interdisciplinary science that NIH supports. Many NIH-supported studies in disease prevention and intervention, health behavior, and community health incorporate methods and models from the economic sciences. Health economic analyses are often included as part of larger NIH-funded studies on clinical efficacy or effectiveness. NIH values economic contributions to our understanding of the relationship between health and society, and, to date, five Nobel Prizes in Economics have been given to individuals who had received NIH support.

There are several federal agencies funding research for which health economics is relevant. Therefore, it is useful to clarify how research using health economics approaches serves the NIH mission in particular, and what research is lower priority for NIH or likely to be judged as not aligned with the NIH mission.

Impact of Guide Notice

NIH will continue to accept applications involving health economics research in which health outcomes and health-related behaviors are the primary focus, and the connection between the subject(s) of the study and improved understanding of health are clear and explicit. The following areas of economic research are identified as NIH-wide high priorities, Institute- and Center-specific priorities, and areas outside the scope of NIH’s mission.

Highest-priority Areas for NIH
NIH is especially interested in health economics research designed to understand how innovations in treatment, diagnosis, prevention, and implementation strategies can be most effectively deployed to improve health and well-being as well as research aimed at designing better interventions with these insights. Examples include, but are not limited to, studies utilizing economic methodologies designed to:

• Measure or model the actual or potential impact of specific interventions, approaches, or strategies on health-related behaviors, healthcare utilization, and health outcomes.
• Understand behavioral, financial, and other factors that influence the implementation, adherence, dissemination, and adoption of medical discoveries into health care.
• Determine the impact of both financial and non-financial incentives on health-related behaviors, healthcare utilization, and health outcomes.
• Assess how environmental, social, economic, and other factors affect health status, health-related behaviors, healthcare utilization, health outcomes (including health-related quality of life outcomes), health disparities, and responses to interventions.

Institute- and Center-Specific Priorities
NIH may also fund other areas of health economics research, depending on the mission-based priorities of individual NIH Institutes and Centers (ICs) as communicated in, for example, strategic plans and funding opportunity announcements. Such studies may include, but are not limited to, research specific to an IC’s mission utilizing economic methodologies that:

• Analyze organizational influences on the efficiency of the delivery of IC-mission-relevant medical care that are primarily or exclusively focused on healthcare utilization or other health-related outcomes.
• Assess alternative models of delivering IC-mission-relevant care with a focus on outcomes related to health, including health-related behaviors and healthcare utilization.
• Measure the economic value of population health and health care delivery relevant to an IC’s mission. Such studies may focus on determining the effects of health status and/or health interventions on broader societal economic outcomes, such as Gross Domestic Product (GDP).
• Broadly describe and quantify the economic impact on society of disease and disability, as well as the impact of IC-specific research and/or evidence-based changes in health practice or health policy.

Areas Outside of NIH’s Mission
A number of topics covered by health economics research, while still valuable research endeavors, are not sufficiently related to NIH’s mission of improving health and reducing disability, and would be more appropriately sponsored by other organizations and agencies. While NIH acknowledges the importance and informative nature of such studies, applications whose relationship to health is unclear or distantly removed do not fall within the NIH’s mission. Such studies are minimally related to specific health outcomes at the population or individual level. Examples include, but are not limited to, studies designed to:

• Understand individual financial well-being, labor market outcomes, industrial organization, or economic growth without a specific and direct tie to health made within the study aims.
• Examine the financing of healthcare, including the impact of changes in structure or function of the health care marketplace on broad measures of health care cost but not health outcomes.
• Analyze the economics of health professions as they relate to compensation, efficient delivery, or market value, as opposed to health outcomes or access to quality health care.
• Estimate consumer demand for specific interventions, including measures of price elasticity and the effects of healthcare marketing strategies, in which the findings are designed to inform decisions related to profitability, rather than the quality of care or health outcomes.
• Assess the cost and efficiency of healthcare service delivery, in which cost is the primary or major factor by which comparisons are made, without considering clinical outcomes or quality of care.

As stated above, applicants and potential applicants for NIH research grants are advised to consult with NIH program officers in Institutes and Centers appropriate to their proposed topic if they have questions about the alignment of their proposal with IC program priorities.

Inquiries

Please direct all inquiries to:

Carrie Wolinetz, PhD
Associate Director for Science Policy
Office of Science Policy
Telephone: 301-496-9838
Email: [email protected]