Resumen
Federal agencies including the National Institutes of Health (NIH), the Department of Defense (DoD) Congressionally Directed Medical Research Program (CDMRP) Spinal Cord Injury Research Program (SCIRP), and the Department of Veterans Affairs (VA) provide the majority of funding for spinal cord injury (SCI) research in the United States. However, systematic evaluation of how funding is distributed across research areas, therapeutic approaches, and translational stages has been limited. To understand the distribution of funds, we curated and classified 1, 589 federally funded SCI research awards from the NIH (2008–2023), the CDMRP SCIRP (2009–2023), and the VA (2017–2025). Each award was annotated based on the biological system or problem studied, the therapeutic intervention or approach utilized, and its placement along the translational continuum. Our analysis revealed that the NIH predominantly supports basic and early-stage translational research, especially in areas of SCI pathology, regeneration, and motor functional recovery. In contrast, the CDMRP funding is more concentrated on applied and clinical research, particularly in the areas of pain, bladder function, and neuromodulatory device development. The VA predominantly invests in rehabilitation-focused studies and interventions aimed at improving musculoskeletal and functional health outcomes. While the complementary missions of these agencies collectively support a diverse SCI research ecosystem, we identified critical gaps in funding for high-priority areas such as bowel/gastrointestinal health, cardiovascular function, and mental health. Furthermore, the recent discontinuation of the CDMRP SCIRP and proposed NIH budget reductions are projected to lead to an approximate 50% decline in federal SCI research funding by 2026—posing a substantial risk to the field’s progress and threatening the stability of this ecosystem. These findings underscore the urgent need for coordinated, data-driven funding strategies that align more closely with the needs and priorities of the SCI community. To that end, we propose the development of a publicly accessible “living dashboard” to enhance transparency, foster interdisciplinary collaboration, and guide strategic investment in SCI research moving forward.
| Idioma original | English |
|---|---|
| Publicación | Journal of Neurotrauma |
| DOI | |
| Estado | Accepted/In press - 2025 |
Nota bibliográfica
Publisher Copyright:© 2025 Mary Ann Liebert, Inc., publishers
Financiación
In the United States, the majority of SCI research is funded by federal agencies; the National Institutes of Health (NIH), the Department of Defense (DoD) Congressionally Directed Medical Research Program (CDMRP) Spinal Cord Injury Research Program (SCIRP), and the Department of Veterans Affairs (VA) represent the three principal contributors. Together, these agencies fund a diverse range of research, from basic studies of spinal cord biology to translational studies and clinical trials. Importantly, the missions of these three agencies are distinct: the NIH aims “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” ( https://www.nih.gov/about-nih/what-we-do/mission-goals ); the CDMRP SCIRP portfolio seeks “to fund research and encourage multidisciplinary collaborations for the development and translation of more effective strategies to improve the health and well-being of Service members, Veterans, and other individuals with spinal cord injury” ( https://cdmrp.health.mil/scirp/default ); whereas the VA Office of Research and Development describes its mission “to improve Veterans’ health and well-being via basic, translational, clinical, health services, and rehabilitative research.” These complementary goals establish the three federal agencies as three pillars upholding the SCI research ecosystem in the United States. Another important consideration in SCI funding decisions is the high cost of clinical trials. Depending on study design and participant requirements, the cost of conducting a single clinical trial can range from $3.4 million to $21.4 million, with a median per-participant cost estimated at $41,400. In addition, the overall cost of developing a new therapeutic compound from discovery through clinical approval has been estimated to range from $1.31 billion to $2.3 billion. These figures highlight the substantial financial investment required to advance SCI treatments from bench to bedside and suggest that the current scale of federal funding, while foundational, may be insufficient to fully support late-stage clinical translation and commercialization. Notably, private industry, particularly biopharmaceutical and medical device companies, plays a crucial role in bridging the translational gap between early-stage research (typically supported by NIH and CDMRP) and clinical implementation (supported by the VA). Industry is often responsible for the most expensive phase of the pipeline: late-stage development. For example, a single Phase 3 clinical trial funded by industry can cost upward of $100 million, a figure that approximates the entire annual NIH budget for SCI research. To address this critical knowledge gap, we curated and analyzed 1,589 federally funded SCI research awards spanning 2008–2025 within the NIH, CDMRP, and VA funding portfolios. Data for NIH awards span 2008–2023, data for CDMRP awards span 2009–2023, and data for VA awards span 2017–2025. Each award was categorized using a standardized classification schema developed with input from program officers, researchers, and individuals with lived SCI experience. Awards were categorized according to three axes: (1) the biological system or problem studied, (2) the therapeutic approach or intervention utilized, and (3) the stage of translational readiness. This structured analysis provides new insights into federal funding trends, agency-specific priorities, and gaps in research that may hinder scientific and clinical progress. Our findings also serve as a foundation for the development of a centralized, publicly accessible SCI research funding dashboard designed to inform strategic planning and support a more efficient, collaborative research ecosystem. This work was supported in part by the National Institutes of Health (R01NS116404 to J.N.D., R35GM138098 to H.B., R01NS122961 to D.A.M.), the Craig H. Neilsen Foundation (#546639 to J.N.D.), Mission Connect, a program of TIRR Foundation (#021-101 to J.N.D.), the Paralyzed Veterans of America Research Foundation (#3195 to B.R.K., #3196 to R.N.M.), the National Science Foundation Graduate Research Fellowships Program (DGE2139772 to M.R.P., DGE2140743 to J.B.), Michael Smith Health Research BC (CTTP-2024-04574 to R.N.M.), and the Canadian Training Platform for Trials Leveraging Existing Networks (CANTAP-2023-03855 to R.N.M.).
| Financiadores | Número del financiador |
|---|---|
| Congressionally Directed Medical Research Programs | |
| DOD CDMRP | |
| NIH | |
| SCI research awards spanning 2008–2025 | |
| U.S. Department of Veterans Affairs | |
| U.S. Department of Defense | |
| National Science Foundation Arctic Social Science Program | DGE2139772, DGE2140743 |
| TIRR Foundation | 021-101 |
| National Institutes of Health (NIH) | R01NS116404, R35GM138098, R01NS122961 |
| Craig H. Neilsen Foundation | 546639 |
| Paralyzed Veterans of America Research Foundation | 3196, 3195 |
| Michael Smith Foundation for Health Research | CANTAP-2023-03855, CTTP-2024-04574 |
ODS de las Naciones Unidas
Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible
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Good health and well being
ASJC Scopus subject areas
- Clinical Neurology
Huella
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