WASHINGTON _ When President Clinton submitted his 1995National Institutes of Health (NIH) budget to Congress earlier this year,he set aside roughly $1.4 billion for AIDS research, a 6 percentincrease over the $1.3 billion appropriated for AIDS in 1994. The 1995AIDS allotment accounts for about 12 percent of the total proposedNIH'S budget of $11.5 billion.But Clinton's proposed AIDS spending didn't make it through a recentHouse Appropriations subcommittee hearing. Last week, thesubcommittee amended Clinton's budget and slashed the 6 percentincrease in half, boosting the AIDS program by $40 million instead of$80 million. William Paul, director of the NIH's Office of AIDSResearch (OAR), reported the bad news at a meeting of the NIH'sAIDS Program Advisory Committee (APAC) in Bethesda, Md. onMonday.The House subcommittee's action is only one step in the 1995 budget'slong legislative journey _ the full House has yet to debate the bill andthe Senate must also process the budget through its various committees.But Paul said that the action demonstrates the new environment oflimited resources facing AIDS research.In addition to hearing a report on the fate of 1995's proposed budget,APAC members reviewed the main areas of focus for AIDS research in1996. The panel unanimously endorsed the five areas of focus forAIDS research spending outlined by OAR section heads: naturalhistory and epidemiology, etiology and pathogenesis, therapeutics,vaccines and behavioral research.Paul said that while many AIDS experts have begun to call for a"rededication to fundamental science," OAR will not abandon researchand development for therapeutics. "We can only rededicate ourselvesin the context of striking a balance," he told APAC members. "Theconcept of a wholesale shift in NIH's focus is not viable."BIO Sees Price Controls In Gibbons' MarkThe draft health care reform bill now pending before the House Waysand Means Committee contains a provision which the BiotechnologyIndustry Organization (BIO) has labeled a new variant of price controlsfor biotechnology drugs. The bill, drafted by acting Ways and Meanschairman Sam Gibbons (D-Fla.), places some biotechnology drugscurrently reimbursed under Medicare Part B under a new, proposedoutpatient drug benefit.That new benefit would cover immunosuppressants, osteoporosisdrugs, erythropoietin, oral cancer drugs, antigens and drugs for bloodclotting. The end result: all Medicare sales of these products wouldinvolve manufacturers paying the standard rebate of 17 percent."This maneuver is a back-door way to institute price controls aimed atbiotech drugs and cutting edge technology," said BIO president CarlFeldbaum. "It sets a very dangerous precedent for long-term biotechdrug research and development. Under this proposal, price controls arehere now."Currently, Medicare Part B pays for drugs administered in hospitals,nursing facilities, hospices, dialysis facilities and physicians. Certainself-administered drugs are also covered, including those used bytransplant patients, home dialysis patients, cancer patients,hemophiliacs and others. Under Gibbons' plan, these drugs would befolded into the outpatient drug benefit plan, making prices subject tothe required rebate.Feldbaum said the proposed change would discourage investment indrugs to treat diseases associated with aging. Ways and Means is one ofthree House committees and two Senate committees which will drafthealth care reform bills and attempt to vote on them. To date, only theSenate Committee on Labor and Human Resources has voted on itsversion of a health care reform bill. Ultimately, the bills will have to bereconciled in intense negotiation sessions by leaders of both chambers.n

-- Lisa Piercey Washington Editor

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