RheumPAC is the ACR’s non-partisan political action committee, which promotes the needs of rheumatology providers and patients. Advocacy efforts often focus on legislation to improve the day-to-day clinical care of rheumatology patients, such as establishing clinical exceptions to step therapy requirements and reforming the prior authorization process. In addition, the ACR and RheumPAC recognize the importance of both clinical and basic science research and advocate vigorously to preserve and promote research funding opportunities within the field of rheumatology.
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Explore This IssueSeptember 2019
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In recent years, the ACR was able to help influence Congress to increase medical research funding through the National Institutes of Health by $1.25 billion, despite a proposal by the Trump administration to decrease funding. Similarly, the ACR continues to advocate for the Centers for Disease Control and Prevention’s Arthritis Program. Despite these successes, the ongoing unmet need for arthritis research funding is demonstrated by the fact that arthritis is the leading cause of disability in the U.S. As a rheumatology community, we must continue to advocate for additional, much needed resources.
Advocating for DOD Arthritis Research Funding
The U.S. Department of Defense (DOD) is explicitly charged with funding research on diseases that affect members of the military. The incidence of osteoarthritis is more than twice as high in the military population over the age of 40 compared with the general population, showing a clear need for better prevention and treatment of this condition.1,2 Osteoarthritis affects both the number and readiness of available service members, because it is the most common condition resulting from battle injury that leads to medical discharge from the military.3,4 In addition, arthritis is the leading cause of disability among veterans, with 32% reporting doctor-diagnosed arthritis compared with 22% of non-veterans.5
The physical demands of the military put service members at significantly increased risk of developing post-traumatic osteoarthritis. Despite the call for research to enhance prevention and management of joint injuries, which would minimize the disabling effects of joint degeneration in this young patient population, arthritis does not yet have its own dedicated research program at the DOD.4
Meanwhile, funding increases annually for diseases more weakly correlated with military service. Currently, more than 30 designated disease areas are funded through the DOD’s Congressionally Directed Medical Research Programs (CDMRP), including spinal cord injury ($30 million in fiscal year [FY] 19), Gulf War illness ($22 million in FY19) and breast cancer ($130 million in FY19). We believe arthritis deserves a similar focus.
For the past several years, the ACR and RheumPAC have teamed up with the Arthritis Foundation to advocate for dedicated arthritis research funding as part of the CDMRP, which was created in 1992 to promote biomedical research that benefits both service members and the American public.
Currently, DOD funding for arthritis research can be obtained through broader programs, such as the Peer Review Medical Research Program. Over the past 20 years, an average of $4.25 million per year has been awarded for arthritis-focused projects.6 These awards have yielded important advances, such as the development of new cartilage-penetrating nanocarriers for improved drug delivery to treat osteoarthritis.7 However, these grants are difficult to secure, with researchers across many disciplines competing for the same funding, making the grants unreliable as a consistent source of arthritis research funding. The ACR and RheumPAC are advocating for a dedicated arthritis line item in the CDMRP to allocate $20 million a year for arthritis research. This would provide funding stability to ensure investigators have the longitudinal support they need to improve arthritis prevention and treatment in a meaningful way.